A Pioneering Heart Surgeon
A kiwi surgeon, who with his team helped advance groundbreaking surgical techniques through the adoption of new technologies.
In 1958, Brian Barratt-Boyes, one of Aotearoa New Zealand’s pre-eminent cardiothoracic surgeons, garnered national attention when he performed the country’s first cardiopulmonary bypass.
Open-heart surgery | A cardiopulmonary bypass, or open-heart surgery, is undertaken when a patient’s heart is temporarily stopped, and a machine is used to take over the function of the heart and lungs. Barratt-Boyes had worked with this technology — a heart-lung bypass machine — while in training overseas at the prestigious Mayo Clinic.
After his return to Aotearoa New Zealand, and recruitment as surgeon in charge of development of the cardiac surgical programme at Auckland’s Green Lane Hospital in 1957, Barratt-Boyes arranged the importation of the country’s own Melrose Heart-Lung machine. A team of experts was assembled, and the historic, first open-heart surgery was performed on ten-year-old Helen Arnold, on 3 September 1958.
The operation on Arnold was ground-breaking. Barratt-Boyes and his team received national acclaim and the creation of a world-leading cardiac training, research, and operational unit at Green Lane Hospital was underway.
Melrose Machine | Brian Barratt-Boyes persuaded the Auckland Hospital Board to buy an early British version of a heart-lung machine known as the Melrose Machine in 1957. Having worked with prototype bypass machines overseas, Barratt-Boyes was convinced the new technology would allow previously inoperable conditions to be treated in Aotearoa.
But when the Melrose Machine arrived, it was missing vital parts and an instruction manual. The situation called for ingenuity, and two talented engineers from Green Lane Hospital, Sid Yarrow and Alfred Melville, worked with Barratt-Boyes and his team to redesign, rebuild and test the new and improved Melrose Machine.
Further ingenuity | There were more ingenious procedures to follow, including the development of an external pacemaker, allowing the heart to be re-started after bypass surgery. The country’s first permanent pacemaker was implanted in 1961.
Then in 1962, another breakthrough. Barratt-Boyes pioneered (simultaneously and independently of London surgeon Donald Ross) replacement of diseased aortic valves with human cadaveric aortic allografts. Damaged aortic valves had previously been replaced by artificial valves, which although more durable, were subject to clotting, necessitating long term use of anticoagulant drugs with attendant side effects. Barratt-Boyes homograft insertion technique proved superior to that of Ross, and attracted widespread international interest.
Other innovative procedures were developed. Prior to 1969 the heart-lung machines then in use damaged the red cells in the blood, and could not be used safely for neonates and infants. Barratt-Boyes and the Green Lane team modified and publicised a previously obscure Japanese technique using cooling to low body temperatures to allow the heart to be arrested for up to 40 minutes without brain damage; sufficient time to repair even complex defects. This method was quickly adopted worldwide.
An international leader in cardiac treatment | In recognition of these advancements, Green Lane Hospital’s status as an international leader in cardiac treatment was even further established. From 1970, Green Lane Hospital became a hub not only for innovative surgery, but as an important destination for trainees in cardiac surgery. In fact, Barratt-Boyes’s teaching skills were so well-regarded that surgeons from all over the world came to Aotearoa New Zealand to learn under his expert eye.
By now, Brian Barratt-Boyes’s position as an outstanding trailblazer had also been cemented. Charismatic and engaging, not only was Barratt-Boyes an admired and daring surgeon and prolific clinical researcher, but an inspirational leader of his time.
He was also an important advocate. Throughout his career, Barratt-Boyes was an outspoken supporter for improvements and changes in the healthcare sector and facilities in Aotearoa New Zealand public hospitals, including championing one of the first two intensive care departments in the country (the other was the critical care department at Auckland Hospital).
Barratt-Boyes went on to receive numerous awards and honorary titles, including a knighthood in 1971. He was awarded an honorary professorship of the University of Auckland, and in 1968 he received the Lions International Special Humanitarian Award.
His textbook Cardiac Surgery (1986), co-written with John Kirklin, was for many years the definitive text on the subject. Brian Barratt-Boyes retired in 1989, leaving what can only be described as an outstanding legacy.