Award-wining system could be used to inform future surgeons about procedural details

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David and Ben Wald
Credit: (London) Evening Standard

David Wald (Barts Heart Centre, St Bartholomew’s Hospital, London, UK) and his 16-year-old son Ben have designed a system that will enable surgeons, via a coded message, to leave details about a patient’s procedure inside the patient themselves to provide details about the procedure to any surgeons performing later interventions.

According to a report in the London Evening Standard, Ben came up with the idea of surgeons writing a patient’s medical history in code inside their chest after observing open-heart surgery at Barts Heart Centre (London, UK) where he was doing work experience. He told the paper that he had noticed how “in one case where the medical records were not available, there was confusion and a bit of uncertainty”, commenting: “I could see that perhaps you could use these wires and sculpt them into something that could tell the cardiologist 10 years down the line what had happened at the original operation. I asked a question about whether the wires could be sculpted into letters and was mocked a bit. It was slightly implausible. But, my father realised it could be developed into a code.”

David Wald told Cardiovascular News that the system uses the wire loops that are routinely used at the end of a bypass, commenting “the code requires no new technology or technique. It takes advantage of surgical wires that are used routinely in bypass surgery”. He adds that it is based on whether the twisted end of each wire loop points up, down, left or right—providing a permanent record of the number and origin of the bypass grafts used.

Furthermore, noting that one in 10 patients undergoing coronary angiogram will have previously undergone coronary artery bypass grafting, Wald says that “knowing how many bypass grafts have been used and knowing where they have been implanted is essential information prior to an angiogram”. “Without this information, procedures take longer and use more contrast—which may damage the kidney or cause pulmonary oedema. There is also a risk of missing a narrowing in a bypass graft that needs treatment,” he explains.

According to Wald, the feedback on the system has “been extremely positive”. He said: “Cardiac surgeons are willing to use the code and, if they do, cardiologists performing future procedures will avoid the frustration of not knowing the details of previous surgery.”

The idea, Wald commented, has already won the Patrick Magee prize for Innovation at the 2017 annual meeting of the Society for Cardiothoracic Surgery in Great Britain and Ireland (12–14 March, Belfast, Northern Ireland). It also due to be presented at the annual meeting of the British Cardiovascular Society (5–7 June, Manchester, UK).