Arterial coronary artery bypass surgery
- Research Opportunity
- Number of Honour Places Available
- Royal Melbourne Hospital
|Colin Royse||Colin.Royse@unimelb.edu.au||+61408567548||Personal web page|
|Alistair Royse||Alistair.Royse@unimelb.edu.au||+61418554135||Personal web page|
95% of coronary bypass surgery is performed using at least one saphenous vein graft (SVG) from the leg. Yet this conduit is a vein and not an artery, and is subject to progressive failure over time due to the development of progressive and accelerated atherosclerosis. This leads to recurrence of angina, myocardial infarction and heart failure; each of which may contribute to higher mortality.
At the Royal Melbourne Hospital (RMH), "total arterial revascularisation" has been practice in at least 85% of patients since 1996 with individual surgeons as high as 99.7%. Recent large scale analyses from the Australian dataset of more than 51,000 patients, demonstrate a survival disadvantage to the use of SVG. Indeed, in sub-analyses, even one single SVG leads to worse survival over time.
The alternative arterial conduit, radial artery (RA) was pioneered at RMH, and has one of the largest experiences in the world. This contributes reliably, to the achievement of total arterial revascularisation. There remains a considerable dataset that may be analysed and is most suitable for a PhD. It is expected that publications arising from this body of work will continue to be published in the highest impact journals.
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