A TEAM of highly skilled clinical staff at the Essex Cardiothoracic Centre (CTC) are helping to improve safety and recovery times for patients who undergo coronary artery by-pass graft (CABG) surgery. These operations are performed by heart surgeons who reroute blood to and from the heart through one or more new blood vessels.
The replacement blood vessels are obtained in a procedure known as vein harvesting, carried out at the CTC by surgical care practitioners (SCPs) who work alongside the consultant cardiothoracic surgeons. In the early days of CABG operations, vein harvesting was carried out by junior doctors, who were taught the technique by surgeons.
Colin Woodard, lead SCP, explains: “When the patient is in theatre we harvest the conduit blood vessels from their arm or leg, to be used in the
of vein we harvest depends on the number of coronary arteries in the heart that are blocked. After harvesting we then assist with the main part of the operation, before closing all the wounds.”
The harvesting technique requires a high level of skill because it is essential that no damaged or diseased blood vessels are used for the CABG surgery. It also requires incisions to be made on the patient’s leg or arm. These will be long if a lot of vein is needed and are a possible infection risk. At the CTC excellent results are achieved in this area, with wound infections after CABG operations occurring at less than half the national rate.
SCPs receive specialist training at Masters level, on courses which require accreditation by the Royal College of Surgeons. Before training, they must have worked for several years as either a registered operating department practitioner or nurse, trained to degree level. The team at the CTC have worked with Anglia Ruskin University to develop their own accredited SCP course – the only one in the south east of England.
Colin says: “Having SCPs allows surgeons to concentrate on providing the specialist skills for the main part of surgery, and they don’t need to spend valuable time training us either. And because SCPs are repeatedly performing vein harvesting we are constantly building on our specialist skills to provide safe treatment for patients.”
SCPs are now also working alongside orthopaedic and general surgeons at Basildon University Hospital. As well as carrying out minor surgery, they provide care to patients before and after their operation, examining them on daily ward rounds and assisting with management of surgical wounds, seeing them in follow-up clinics on behalf of the surgeons to ensure that they are recovering from their surgery and educating them about how healthy lifestyles to boost the success of their surgery.
Colin adds: “SCP training is demanding but the rewards of greater responsibility are well worth it. We all enjoy being involved with patient care and treatment before and after surgery.”
Bill Readman is looking forward to enjoying the festive season at home with his family in Epping. Last year, the retired solicitor spent Christmas and Boxing Day in the Essex Cardiothoracic Centre, following a successful quadruple CABG, carried out by Mr Nikolaos Charokopos, consultant cardiothoracic surgeon.
Mr Readman, a lean and fit man who regularly played tennis, was 79 years old at the time of his operation. He made an excellent recovery, returning home five days after surgery, and a year on is enjoying an active lifestyle again, walking, travelling and working on his forehand.
The vein harvesting for Mr Readman’s operation was carried out by Natasha Blissett, SCP, who made a 31cm long incision to remove a length of vein from his right leg.
Mr Readman said: “Of course it will be much nicer being home this Christmas, but I can’t praise the surgeon and all the team at the CTC highly enough for the care they gave me last December. I was amazed how quickly I recovered after my operation – it is hard to believe it was only a year ago.
“The scars on my leg and chest have healed very well and I received excellent care and very good information about my treatment from Mr Charokopos, Natasha and all the staff.”