New innovative bypass surgery at RWT
Date of release: 29 January 2025
Wolverhampton has become one of the only hospitals in the country to perform less invasive heart bypass surgery, and is aiming to offer this service as regular service to patients.
From left: Luke Pedrosa, Theatre Support Assistant, Jason Guillermo, Scrub Nurse, Mae Galindo, Sister, Daniel Pullar, Theatre Manager, Roejane Rubite, Sister, Dominic Layson, Scrub Nurse, and Jinglord Lim, Theatre Support Assistant. Seated, from left, Chander Sharma, Mr. Giuseppe Rescigno and Mr. Mahmoud Abdelaziz
Four patients have now received Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) in the Heart and Lung Centre at New Cross Hospital.
This procedure can be performed for a single heart artery vessel or as a hybrid for multiple heart artery narrowing.
This combines the best of treating heart artery blockages with coronary stents and coronary artery bypass graft surgery, but keeping the benefits of both, as well as minimal access surgery.
A MIDCAB operation involves a small incision of five to seven centimetres, usually on the left of the patient’s chest, under general anaesthesia.
This operation leaves a much smaller scar and avoids cutting through the breastbone and its associated complications.
MIDCAB is associated with less post-operative pain and faster recovery, and it allows patients to return to their normal routine much sooner.
It is a multi-disciplinary team approach, with Consultant Cardiothoracic Surgeons, Cardiologists, and Anaesthetists involved.
Mr Giuseppe Rescigno and Mr Mahmoud Abdelaziz, Consultant Cardiac Surgeons at The Royal Wolverhampton NHS Trust (RWT), are now performing this procedure, supported by Dr Ranjit Bains, Consultant Anaesthetist, and Dr Lampson Fan, Consultant Interventional Cardiologist.
The Surgeons aim to avoid a sternotomy (cutting of the breastbone), which avoids lengthy recovery time for the patient.
With this approach, recovery and the return to normal life is much faster. This route will also offer a better aesthetic look for patients.
During this procedure, the Surgeon performs a bypass to the most important artery of the heart – which is the gold standard – and the Cardiologist inserts coronary stents in the remaining narrowed vessels.
From left, Ranjit Bains, Consultant Anaesthetist, Dr Lampson Fan, Mr Giuseppe Rescigno, Mr Mahmoud Abdelaziz
Mr Rescigno said: “This is being done occasionally in Stoke but regionally, no other cardiac centre in the West Midlands (Birmingham or Coventry) do this.”
Mr Abdelaziz said: “This is a real collaboration with the Cardiologist – where we perform the surgery on the most important artery for long-term outcomes and survival – Consultant Cardiothoracic Surgeons, and Interventional Cardiology Consultants.
“The latter will put coronary stents in various other arteries as required for the best patient outcomes and complete revascularisation.
“It requires a strong commitment to do this as a regular procedure but our teams are really determined to succeed with this.
“We are very lucky to have the Cardiologists support us with this because many people do stenting, but the long-term results would not be as good as this procedure. This will definitely be the future.”
Mr Fan said: “We find out what the initial coronary diseases are and the options are stents or surgery, but this hybrid approach gives us the best of both worlds.
“Very few cardiac centres in the UK do this regularly, which is understandable as this is a very challenging operation.
“Excellent technical skills from the Surgeons are needed and we’re lucky to have those here. And without the management to support it, you can’t have innovation.”
Chander Sharma, Group Manager, Cardiac Services at RWT, said: “This is an exciting and forward-thinking step for the department.
“It has taken support from several different areas of the Trust, all coming together to make this innovation a reality, and is further evidence of our ongoing commitment towards quality and patient experience at RWT.”
Post-surgery, local or regional anaesthetics are used to reduce the pain significantly.
A fact-finding visit to Italy to see the procedure performed paved the way for RWT.
The first two procedures had the external support of a Proctor from Belgium, then RWT’s Consultants operated two other cases on their own. Two more patients have been lined up.
Patient Paul Hughes, 58, a builder from Cornwall, asked for a MIDCAB as he was keen to return to work as soon as possible.
The procedure was successful and the patient returned to his normal life in a couple of weeks.
“It went really well,” said Paul. “It was a bit sore, but I had the stitches out after eight days and Mr Rescigno did a lovely job – he even saved my tattoo!
“The wound is as clean as a whistle and he talked me through everything thoroughly and answered everything I had to ask.”
ENDS
- For further information, please call Tim Nash on 07714 741097 or email tim.nash2@nhs.net
