Professor Angelini and his team highlight problems encountered in surgery, research them in the laboratory, and apply solutions back into the operating theatre for the benefit of patients.
Beating heart surgery
Most forms of heart surgery require the patient’s chest to be opened and an artificial pump to take over the work of their heart during the operation. This is a traumatic event that takes a considerable time to recover from. Surgeons are constantly seeking alternative, less invasive approaches to repair damaged hearts.
Professor Angelini has pioneered a technique to keep the heart beating during heart bypass surgery, avoiding the need for the artificial pump. Short-term, this ‘beating-heart surgery’ showed fewer post-surgery complications for bypass patients, and the team continue to assess the benefits longer term for heart patients.
Improving surgery for babies
Professor Angelini’s team is investigating how they can improve operations to patch up the hole in the heart seen in one in 500 newborns. These babies often have low blood oxygen because of the heart defect, and the sudden increase in oxygen level during surgery can cause injury to the organs. The team are developing ways to regulate oxygen levels during the procedure to give babies the best chance of a quick and complete recovery after the operation.
Find out more about heart disease that can develop in the womb.
Long term success of heart bypass
When your arteries narrow due to fatty deposits, surgery must be completed to get around, or bypass, the narrowed sections of your coronary arteries. People often don't know they need this surgery until they have a heart attack. Leo had a triple bypass, where three sections of his arteries needed surgery, after a heart attack in his 40s.
In collaboration with Bristol colleague BHF Professor Andrew Newby, Professor Angelini has been developing tools and techniques to prevent heart bypass grafts from narrowing. One of these – a collar that surrounds the graft – is currently in early clinical tests.
Stabilising diseased arteries
Healthy cells in the wall of blood vessels are essential for stabilising the fatty plaques that can build up in arteries, leading to 'furred arteries' or atherosclerosis. Professor Angelini’s team is studying how the meshwork of proteins – and their breakdown – around and between cells is important in preventing rupture of the fatty plaques.
Professor Angelini's team, led by surgeon and BHF Professor Gavin Murphy, have investigated the effect of blood transfusions given to patients during or shortly after heart surgery. Surprisingly they have found that in many cases transfusions can cause more harm than good. They are now hoping to improve surgeons' guidelines by undertaking a clinical trial to find out which patients do benefit from transfusions.
Professor Angelini's research could help people like Leo, who needed a triple bypass after a heart attack, or Claire's newborn baby who will require open heart surgery just days after being born.
Read more about how our achievements in heart surgery research are benefiting people.