Heart-stopping moments

A kiwi surgeon and his team, helped advance groundbreaking surgical techniques through the adoption of new technology.

Heart-stopping moments
New Zealand cardiac surgeon Brian Barratt-Boyes, achieved a number of firsts in treating heart patients. © Fairfax Media.

Pioneering patients, surgeons and healthcare teams here in Aotearoa, rode the crest of a great wave of new medical knowledge in the middle of the 20th Century. Together they contributed to a number of important breakthroughs in cardiology. One such pioneer was New Zealand's Sir Brian Barratt-Boyes.

Sir Brian was one of a number of innovative individuals who worked at Auckland’s Green Lane Hospital and it was here that he helped develop cutting-edge solutions to problems affecting the heart. The team at Auckland's Green Lane Hospital were 'early adopters' globally, successfully using and improving emerging technologies and surgical techniques. Barratt-Boyes was among the first surgeons in the world to successfully transplant a human heart valve – a technique known as a homograph. He was also instrumental in importing New Zealand's first heart-lung bypass machine, a piece of technology that allowed the human heart to be stopped so surgeons could undertake repairs.

Bypassing the heart and lungs | The human heart can only be stopped for three or four minutes before a lack of oxygen causes damage to the brain. In order to mend holes in the heart, faulty valves and many other heart problems, surgeons need to be able to stop the heart, take over its essential oxygenating and pumping action, fix the problem and get the patient’s heart working again. Heart-lung machines make this possible by doing the job of the heart and lungs while the patient’s heart is stopped. Prior to 1950, no such bypass technology existed, making most heart surgeries impossible.

When an early heart-lung bypass machine arrived in New Zealand with missing pieces, clever engineers in Auckland helped rebuild and improve on the original design.
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A diagram of a heart lung bypass machine, 1950s.

In 1957, Brian Barratt-Boyes persuaded the Auckland Hospital Board to buy an early British version of a heart-lung machine known as the Melrose Machine. 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.

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The Melrose Machine in operation, 1950s. Photo ADHB.

The first open heart surgery using the Melrose Machine was performed in 1958 on 10-year-old Helen Arnold. Helen’s heart was stopped for 25 minutes so a hole in the septum (the partition wall between the two chambers of the heart) could be sewn closed. At this time, Green Lane Hospital was one of only a handful of hospitals in the world that could offer open heart surgery, all because of the heart-lung bypass machine that enabled Sir Barratt-Boyes to operate on Helen Arnold, and Barratt-Boyes' promotion of new technology.

Today’s heart-lung machines continue to do the same job as the Green Lane Melrose Machine, making possible further advances in cardiac surgery.