Putting heads together helps hearts

A multi-disciplinary approach to problems faced by heart surgeons is producing significant progress in the treatment of coronary disease, according to Gianni Angelini, professor of cardiothoracic surgery at Bristol University.

He is encouraging collaboration between clinical staff and scientists from a variety of disciplines on research into the causes of angina and heart attacks, and surgical techniques to combat them. The latest development may help prevent heart disease sufferers from having to have a second artery bypass operation about ten years after their first, as most do now.

Researchers have discovered that veins grafted from the patient's leg to bypass clogged arteries quickly begin to narrow themselves in response to higher blood pressure, and the infiltration of blood components into the vein lining. The process of thickening the vein walls carries on until, usually after about ten years, a new operation becomes necessary.

Professor Angelini believes the problem could be solved by placing a synthetic jacket around the grafted vein, to prevent the triggering of the wall-thickening process. The vein could also be treated with drugs before it is re-introduced to the body, in an effort to inhibit cell-division without releasing toxins into the bloodstream. A new kind of man-made heart valve - the first to be built in Britain - is also being developed.

Professor Angelini, who originally trained as an engineer, says the multi-disciplinary approach, launched by the creation of his chair by the British Heart Foundation two years ago, has paid dividends. The BHF is providing a Pounds 395,000 grant for his work in collaboration with scientists and Andrew Newby in the department of cardiology at the University of Wales.