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25 years of Aortic Surgery in Liverpool

This year, our amazing Aortic Team are celebrating 25 years of excellent aortic care at LHCH.  During this time the team have completed over 3,200 major complex aortic operations.  This includes operations on the root and ascending aorta, thoracoabdominal aorta and emergency Type A aortic dissections.

On 20th-21st June, LHCH hosted the tenth biennial International Aortic Surgery Symposium (pictured above).  This was an ideal opportunity to celebrate 25 years of aortic surgery here in Liverpool with international colleagues. 

We met with Miss Deborah Harrington, Consultant Aortic Surgeon and Aortic Lead to find out more about the International Aortic Symposium, the history of the Aortic Service here at LHCH and her thoughts for the future of the service.

What can you tell us about the two-day biennial International Aortic Symposium?

We are delighted to have been able to welcome like-minded professionals, experts in the field, from across the world for this year’s symposium.  Really eminent speakers joined us from the USA, Europe, China, UK and elsewhere to share key learning and developments on all aspects of aortic disease.  The first international symposium took place in the city in 2008.  There have been significant advancements, improvements, and innovations for the benefit of patients and their families since then.  It was fantastic to share these and mark this milestone.

This year we are celebrating 25 years of aortic surgery in Liverpool.  How has the service changed?

In 2007, the Aortic team was formally separated from the general cardiac surgery rota.  This meant that general Cardiac Surgeons no longer performed aortic surgery and the specialist Aortic Surgeon role was introduced. 

Since then, the cases have got more and more complex.  People are generally living longer and as we become more experienced, technically more adept, and highly skilled we can offer surgery for patients that may not have been previously considered.  We have developed more complex technology such as endovascular and hybrid procedures, some of which are minimally invasive, and are able to tackle cases that we never could have before.

The team have developed robust protocols and procedures for all the different components of the service.  The thoracoabdominal aortic service which includes the most extensive and complex surgery offered here, is one of the largest in the country.  The aortic team consists of dedicated surgeons, anaesthetists, perfusionists, Advanced Nurse Practitioners, MEP technicians, surgical care practitioners, specialist nurses and theatre teams to name but a few.

Valve sparing aortic root surgery and the aortic valve repair programme have developed exponentially over the past few years. More and more patients can have their valve repaired instead of replaced, especially important for younger patients. 

In 2021, the Ross Programme was introduced for some young patients with aortic stenosis.  This involves implanting the pulmonary valve into the aortic position and offers several benefits for eligible patients.

Over the last few years we are proud to have developed the Liverpool Cardiovascular Service with the vascular team at Liverpool University Hospital to perform combined open and endovascular cases. The vascular surgeons have their own regular lists here at LHCH meaning that we are able to perform all aspects of surgery on the aorta here at LHCH. 

What impact has it made?

There has been a dramatic improvement in patient outcomes since the service become more formally organised by the specialisation of surgeons.  In particular, the survival rate is now much higher for acute aortic dissection operations.

The aortic valve repair and thoracoabdominal programmes have gone from strength to strength too.  LHCH sees patients from the whole of the north from the UK and sometimes further afield for our highly skilled, specialist aortic services.

We are proud to have two aortic fellowships which are industry sponsored and accredited by both the Royal College of Surgeons of Edinburgh and the Society for Cardiothoracic Surgery.  It is a huge accolade for LHCH and thanks to the hard work of the whole team over the last decade.  They are highly competitive and always receive a high number of applications.

Can you tell us a little about other roles you have had outside of LHCH?

I run annual Aortic masterclasses, funded by Heart Research UK, which provide aortic surgeons from across the UK with a unique opportunity to gain hands on experience of aortic surgery with one-to-one supervision from an expert faculty.

I’m also the current Education Secretary for the Society of Cardiothoracic Surgery responsible for the SCTS Education portfolio of courses and Fellowships. I am on the Women in Cardiothoracic Surgery Committee which aims to support equality and diversity in our specialty. A more diverse workforce is known to improve outcomes, behaviours and team working. 

Future of the service?

The future of the service is extremely bright.  We have expanded the team and now have seven dedicated aortic surgeons.  There is increasing complexity in the conditions we deal with, but, we are highly skilled and still able to deliver excellent outcomes.  Our aim is to continue to expand and become established as the premier centre for Aortic Surgery in the North of the UK.

Thank you to Miss Harrington and the rest of the LHCH Aortic team for their impressive contribution to patient care over the years.  Undoubtedly, the team have made a huge difference, saved many lives and impacted many more as a result.