BBC Two’s ‘Surgeons: At the Edge of Life’ returns to Cambridge’s two world-famous hospitals at 21:00 on Thursday 18 November for another insight into life-saving work within their busy theatres.
The second episode features consultant cardiothoracic surgeon, Mr Narain Moorjani and his team, who are operating at the edge of what is possible. His patient, Gertrude, is an active and vibrant 80-year-old who needs surgery on three of the four valves in her heart.
An irregular heartbeat has caused two of the four valves in her heart - the mitral valve and tricuspid valve - to stretch and become defective, and need repairing. The third - the aortic valve - has become so hardened and blocked that it needs to be replaced. The valves are restricting blood flow and without the operation, Gertrude’s heart will fail.
To operate on the valves, Narain will need to put Gertrude on heart bypass, cool her body to just 28 celsius and stop her heart. The bypass machine – operated by a perfusionist - will take over the job of circulating and oxygenating Gertrude’s blood.
But with an elderly patient like Gertrude, being on bypass is a great strain on the body, so Narain and his team will need to work swiftly as well as with precision.
Mr Moorjani said: “In the episode we are operating on three of Gertrude’s four valves, and the fourth valve is rarely touched in adults, so this is as complex as it gets for heart valve surgery.
“I am lucky to be working alongside a skilled and talented team in theatre who work together every step of the way, and we hope that comes across in the programme. We are very grateful to Gertrude and her family for being part of this series.”
Gertrude added: “I am very grateful to Mr Moorjani and the whole team at Royal Papworth Hospital for looking after me before, during and after my operation earlier this year. It was an honour to be asked to be filmed and I hope everyone enjoys the episode.”
Perfusionist Terri-Louise Smith will be a master interviewee alongside Mr Moorjani
Mr Rod Laing and Mr Jibin Francis will feature in the the other half of the episode at Addenbrooke’s.
Rod and Jibin have a major challenge on their hands. Patient, 65-year-old therapist, Colin, has a slipped disc in the thoracic spine. This disc has turned into bone and is pressing into the spinal cord, and is threatening Colin with paralysis.
Most surgeons refused to do the operation to remove the disc because of the high risk of paralysis during the procedure. To Colin’s relief, consultant neurosurgeons Rod and Jibin – who have special interests in spinal neurosurgery - were prepared to take on the case.
To reach the disc, they must enter through the side of the chest and work deep into the body, avoiding important nerves and blood vessels. The instruments are just long enough. And when Rod reaches the disc, the risks are at their highest as it is pressing against the spinal cord. He must remove it, millimetre by millimetre, without disturbing the cord or else he risks paralysing Colin.
Mr James Wheeler, divisional director for surgery and consultant colorectal surgeon at Addenbrooke’s, concluded: “This episode highlights how our surgical teams are able to take on challenges that bring new hope and the prospect of a brighter future to our patients. This can only be done with great skill and considerable experience.”
Aortic Valve Replacement - NHS
Mitral valve problems - NHS
Surgeons: At the Edge of Life - BBC iPlayer