Heart Surgery PSP Top 10 Priorities

  1. How does a patient’s quality of life (QOL) change (e.g. disability-free survival) following heart surgery and what factors are associated with this?
  2. How can we address frailty and improve the management of frail patients in heart surgery?
  3. How can we improve the outcomes of heart surgery patients with chronic conditions (obesity, diabetes, hypertension, renal failure, autoimmune diseases etc.)?
  4. Does prehabilitation (a programme of nutritional, exercise and psychological interventions before surgery) benefit heart surgery patients?
  5. When should heart valve intervention occur for patients without symptoms?
  6. How does minimally invasive heart surgery compare to traditional open surgery?
  7. How do we minimise damage to organs from the heart-lung machine/heart surgery (heart, kidney, lung, brain and gut)?
  8. Can we use 3D bio printing or stem cell technology to create living tissues (heart valves/heart) and repair failing hearts (myocardial regeneration)?
  9. What are the most effective ways of preventing and treating post-operative atrial fibrillation?
  10. How do we reduce and manage infections after heart surgery including surgical site/sternal wound infection and pneumonia?

The following questions were also discussed and put in order of priority at the workshop:

  1. How can we improve the communication between the medical team and patients/carers regarding the risks and benefits of heart surgery?
  2. What are the benefits of heart surgery in older patients?
  3. What are the long-term outcomes, including life expectancy, after heart surgery?
  4. What are the best ways to prevent, diagnose and treat patients with acute aortic dissection (including long-term management)?
  5. Does ERAS (Enhanced Recovery After Surgery) improve outcomes in heart surgery?
  6. Does having access to specialist cardiac nurses or consultants by electronic methods improve outcomes for heart surgery patients?
  7. What is the best strategy for managing acute heart failure after heart surgery (inotropic drug, mechanical support or intravascular devices)?
  8. What can patients do (in terms of their lifestyle choices - exercise, diet, smoking, well-being etc.) before and after heart surgery to improve outcomes?
  9. How do transcutaneous techniques for heart valve surgery compare to traditional open surgery (TAVI vs AVR)?
  10. What are the best cardiovascular medications for management in heart surgery (e.g. ACE-inhibitors, antiplatelet, anticoagulant)?
  11. Do outcomes of heart surgery and follow-up time vary by postcode/location and how to reduce the variation?