Providing life-saving surgery during the pandemic: the Cardiac Hub

During the COVID-19 pandemic, Harefield Hospital was designated one of only two hospitals in London to perform emergency cardiac (heart) surgery.

Two of our clinicians, Mr Mario Petrou, consultant cardiac surgeon, and Dr Shelley Rahman Haley, consultant echocardiologist, jointly set up and chaired a ‘Cardiac Hub’ to ensure that priority cardiac procedures could still go ahead.

The Cardiac Hub ran through the first and second COVID-19 waves and involved bringing together an expert team of consultant cardiologists and surgeons from across London who met virtually seven days a week to review and discuss patient cases from across the capital and the South East – to decide if urgent surgical intervention was needed.

Dr Rahman Haley explained: “When COVID-19 hit, we had to come up with a new way of working to ensure cardiac patients still received the best treatment, despite the strain the pandemic was having on the NHS.

“People didn't stop having heart attacks and people were still living with serious heart conditions that required urgent attention to prevent permanent damage. Time is an important currency for patients with critical conditions, and the Cardiac Hub process helped to clarify who needed treatment and when.”

Mr Petrou said: “With the Cardiac Hub, patients were not just getting a second opinion from one doctor, but maybe 20-plus doctors, which is incredible.”

Dr Rahman Haley added: “Heart surgery during a pandemic is risky, but sometimes the risk to patients of doing nothing is worse, and we must make difficult choices. This way of working, where surgeons work with and take on work from other surgeons in a real collegiate manner, showcased the best of the NHS.”


Care for transplant patients 

Teams at Harefield’s transplant unit continued surgery throughout the pandemic. Normally 40 to 50 lung transplants are carried out each year, and between 25 and 30 heart transplants. Over the past year, focusing on patients with the very greatest need, the teams still transplanted 25 lungs and 13 hearts.

Like many other teams across the Trust, the lung transplant team had to adapt how it delivered services. Many patients who were shielding benefited from having their appointments virtually (see Changing working practices).

The move to ‘virtual’ appointments – by phone or video – is one of the positives to have emerged from the pandemic.

Vanessa Tedbury, who had a lung transplant nine years ago, needs regular check-ups. Now instead of them taking place in person at Harefield, they are virtual appointments, but she says: “I prefer it. I used to have to write off a day.”

Vanessa also benefited from new regular online webinars organised by the transplant team to keep patients informed about the latest COVID-19 developments and how these might impact them. The first webinar was hosted by respiratory and transplant medicine consultants Dr Martin Carby, Dr Anna Reed and Dr Vicky Gerovasili, consultant pharmacist Haifa Lyster and psychologist Dr Melissa Sanchez, and attended by 117 participants.

It included a comprehensive question and answer session covering topics such as face masks, vaccination and socialising.

Explaining the rationale for the webinar, the team said: "The media has concentrated on the obvious negative aspects of the pandemic but we wanted to provide our patients with some balanced information for reassurance, along with education and a message of hope as government advice about emerging from lockdown changes."

The session was very well received with positive feedback from patients including:

“Thank you very much! I am sure I speak for all of us when I say I miss seeing you guys! This has been really useful. Stay safe and well at Harefield.”

“Brilliant, really informative and reassuring.”


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Aircrew flew in to help staff on the frontline >