Heart Surgery PSP Top 10 Priorities
- 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?
- How can we address frailty and improve the management of frail patients in heart surgery?
- How can we improve the outcomes of heart surgery patients with chronic conditions (obesity, diabetes, hypertension, renal failure, autoimmune diseases etc.)?
- Does prehabilitation (a programme of nutritional, exercise and psychological interventions before surgery) benefit heart surgery patients?
- When should heart valve intervention occur for patients without symptoms?
- How does minimally invasive heart surgery compare to traditional open surgery?
- How do we minimise damage to organs from the heart-lung machine/heart surgery (heart, kidney, lung, brain and gut)?
- Can we use 3D bio printing or stem cell technology to create living tissues (heart valves/heart) and repair failing hearts (myocardial regeneration)?
- What are the most effective ways of preventing and treating post-operative atrial fibrillation?
- 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:
- How can we improve the communication between the medical team and patients/carers regarding the risks and benefits of heart surgery?
- What are the benefits of heart surgery in older patients?
- What are the long-term outcomes, including life expectancy, after heart surgery?
- What are the best ways to prevent, diagnose and treat patients with acute aortic dissection (including long-term management)?
- Does ERAS (Enhanced Recovery After Surgery) improve outcomes in heart surgery?
- Does having access to specialist cardiac nurses or consultants by electronic methods improve outcomes for heart surgery patients?
- What is the best strategy for managing acute heart failure after heart surgery (inotropic drug, mechanical support or intravascular devices)?
- What can patients do (in terms of their lifestyle choices - exercise, diet, smoking, well-being etc.) before and after heart surgery to improve outcomes?
- How do transcutaneous techniques for heart valve surgery compare to traditional open surgery (TAVI vs AVR)?
- What are the best cardiovascular medications for management in heart surgery (e.g. ACE-inhibitors, antiplatelet, anticoagulant)?
- Do outcomes of heart surgery and follow-up time vary by postcode/location and how to reduce the variation?
For full details of all of the questions identified by this PSP, please see the document below.