Special Interests: Adult Cardiac Surgery
Chris qualified in Sheffield and obtained FRCS on the Sheffield rotation. He then came to London for specialist training working at Barts, St Thomas’ and Great Ormond St Hospitals. His final year of training was spent in Birmingham where his love of aneurysm surgery blossomed.
Chris came to St Thomas’ Hospital as a consultant in 1992. He specialised in several areas of cardiac surgery but his love was in management of patients with aneurysms within the chest and treatment of aortic valve disease.
The unit has matured over the years and now has 4 surgeons specialising in aneurysm surgery. GSTT has a combined emergency rota (combined with KCH) for the management of rupturing anuerysms; with only dedicated specialist aneurysm surgeons involved. Chris rolled this across London in 2011 and since then the mortality for this high risk surgery has dropped by over 50%.
Chris has undertaken mini aortic valve replacement (AVR) since 2000 so now has 19 years worth of experience. Since 2011 he has used mini techniques in all patients undergoing isolated AVR needing to convert to a full incision in a minority of cases. He currently undertakes about 75 AVR cases/year. Chris has led a course on minimal access AVR for 4 years now with up to 4 courses/year. Over 400 clinicians have been trained as a result. Chris also is a proctor and mentor for mini AVR nationally and internationally. Finally, Chris has been involved in the percutaneous heart valve programme (TAVI) at GSTT since it began at St Thomas’ in 2008.
In all, Chris has now undertaken over 8000 cardiac surgical procedures.
Risk-adjusted in-hospital survival rate
This graph shows the “in hospital” survival rate of patients who are operated on by the individual surgeon/unit you have selected. “In hospital” means time the patient is in the hospital where they have had their operation. It does not include any time that patients may have spent in other hospitals, either before or after their heart operation.
The data has been through a complex methodology, including the variations in patient risk factors in order to give you a comparative base from which to work from. This means that the survival rates take into account the type and risk of patients being operated on for each surgeon/unit. This is known as risk adjusted survival.
The vertical axis shows the GMC number of the surgeon or the Hospital identifier. In brackets is the total number of patients operated on by the surgeon/unit and the percentage of patients for whom the survival is known. The horizontal axis is the percentage survival. The dashed vertical line shows the risk adjusted survival rate for the UK as a whole. The solid black horizontal line represents the surgeon/unit. What is important here is that the horizontal line crosses the vertical dashed line. If this occurs, it means that the surgeon/unit are within the expected outcomes given the case-mix and risk factors of the patients they operate on.
The icons that sit on the horizontal line should give you more information about your surgeon/team.
The open square is the survival rate with no risk adjustments:
The X is the predicted survival with adjustments
The solid dot is the survival probability after the methodology has been applied.
- If the solid dot is red it means survival is worse than expected
- If the solid dot is black it means that it is within limits
- If the solid dot is green it means that there is significantly higher survival than expected
There is a lot of information on these plots, but the takeaway message is that if the solid black line crosses the dashed vertical line then the survival rate for the surgeon/unit is within expectations and that there is no reason for any concern.
A more detailed explanation about these graphs and methodology can be found here: Graph Explanations