I am
Keeping a close watch on brain and kidney health during heart surgery.
heartfoundation.org.au|Helpline 13 11 12

Keeping a close watch on brain and kidney health during heart surgery.

More than 1,100 people are admitted to hospital for treatment of heart disease every day in Australia. That’s the equivalent of one person every 1.3 minutes.

Many of these people will need heart surgery to either save their life or improve their quality of life.

These surgical procedures can include:
  • coronary artery bypass graft (where a healthy blood vessel is used to bypass the blocked blood vessel)
  • valve replacement or valve repair  to treat heart valve disease
  • coronary angioplasty (a procedure used to open a narrowing in your heart’s artery).
For heart surgeries, including coronary artery bypass graft and valve repair or replacement procedures, a technique known as cardiopulmonary bypass is needed. This involves a machine, commonly known as a heart-lung machine, which temporarily takes over the job of a person’s own heart and lungs. A heart-lung machine helps to maintain blood flow and oxygen delivery around the body during surgery. Surgeons use this technique to reduce heart movements and keep blood away from the area they are operating in which makes it easier to complete the surgery. While this technique is vital to some types of heart surgery, there are significant risks, including possible acute damage to the brain or kidney.

Dr Yugeesh Lankadeva, Head of the Translational Cardiovascular and Renal Research Laboratory at The Florey Institute of Neuroscience and Mental Health in Melbourne and a Heart Foundation Future Leader Research Fellow, has maintained an interest in brain and kidney health throughout his research career.

His Heart Foundation-funded research focuses on identifying new ways to prevent damage to vital organs during heart surgeries that require the use of a heart-lung machine. This includes new research techniques aimed to improve how kidney and brain health is monitored and preserved during the surgery.

“The research funded by the Heart Foundation revolves around us trying to understand why some people that undergo heart surgery develop acute kidney and brain injury,” Dr Lankadeva explains.

“The development of acute kidney or brain injury is a major complication and puts people at an increased risk of dying in hospital and experiencing prolonged hospital stays.

What’s concerning is that people who survive even mild or short episodes of acute kidney injury are at greater risk of developing chronic kidney disease and end-stage kidney disease in later life. Similarly, survivors of acute brain injury arising from heart surgery are at an increased risk of developing persisting cognitive disabilities, which can reduce their quality of life,” says Dr Lankadeva

After receiving a Heart Foundation-Future Leader Fellowship in 2018, Dr Lankadeva has been working to advance life-changing techniques across multiple research areas of critical illness. In addition to being part of a team that is currently trialing a world-leading treatment option for severe infections (sepsis), Dr Lankadeva is pioneering new ways to better monitor and preserve kidney health during heart surgery.

Throughout surgery, a person is closely monitored using the heart-lung machine to ensure their blood pressure is stable, in addition to many other measures including, blood oxygen levels and body temperature. However, there is no existing method to monitor kidney health during surgery. “We have  found through our research that current practices for delivering oxygen to the kidneys during heart surgery are suboptimal ” says Dr Lankadeva.

Recently, Dr Lankadeva and his team discovered that a way to indirectly monitor kidney health is by monitoring urine oxygen levels in the patient’s bladder. This is also a relatively easy thing to do, given many patients undergoing heart surgery will need to have a catheter inserted into the bladder to drain urine. They found that this new technique provides a reliable indication of how well the kidneys receive oxygen during heart surgery, on a minute-to-minute basis.

“The benefit of using bladder urine oxygen levels as a marker of kidney health is that it’s non-invasive and we obtain this valuable information in real-time. And what’s really exciting is that this technique has now shown promise in multiple clinical trials at Austin Health, Monash Health and Royal Melbourne Hospital,” says Dr Lankadeva.

Dr Lankadeva and colleagues have also now found a way to restore kidney oxygen levels during heart surgery.
"We found that if heart surgery was performed by simultaneously targeting a higher blood pressure and a higher target pump flow using the heart-lung machine, we can essentially restore kidney oxygen delivery to healthy levels” says Dr Lankadeva.

This new intervention is currently being tested in a clinical trial in 400 patients undergoing heart surgery at Monash Health to improve kidney health outcomes (Australian Clinical Trials Registry No: ACTRN12619000128190p) 

Thanks to a 2020 Vanguard Grant from the Heart Foundation, Dr Lankadeva’s focus has been able to shift onto understanding the causes and then finding new ways to prevent brain injury arising from heart surgery.

“We are now developing a new clinical intervention to prevent brain injury in patients undergoing heart surgery. Preliminary findings from research studies suggest that repurposing an already existing medicine, might be a possible treatment,” explains Dr Lankadeva.

“I strongly believe that medical research holds the key to developing new, effective therapies like this that can have a real, positive impact on improving people’s lives.”


You might also be interested in

The Heart Foundation Alumni Program

The Heart Foundation Alumni Program

The Heart Foundation Alumni Program

Stay connected with your research alumni community. ...

Research Directory

Research Directory

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

FACILITATING INTERNATIONAL CLINICAL TRIALS ...

2020 Strategic Grant Recipients

2020 Strategic Grant Recipients

Heart Foundation Research Award Recipients

Heart Foundation Research Award Recipients

Explore our research award recipients and projects...

Research funding programs

Research funding programs

Research funding programs

Understand the application process and requirements of our various funding programs....

2022 Collaboration and Exchange Award

2022 Collaboration and Exchange Award

Our research stories

Our research stories

Our research stories

We fund amazing researchers who have important stories to tell...

Managing your funding

Managing your funding

Managing your funding

Resources to help manage your grant, scholarship or fellowship....

2022 Future Leader Fellowship

2022 Future Leader Fellowship

Future Leader Fellows are emerging leaders – the best and brightest in cardiovascular research....

Environment, climate change and heart health

Environment, climate change and heart health

Environment, climate change and heart health

Information on how air pollution, heatwaves and bushfires can impact heart health, and what you can do to look after yourself. ...

Heart Age Calculator

Heart Age Calculator

Heart Age Calculator

Could you be at risk of heart disease? Get your estimated heart age now....

Heart Health Check Toolkit

Heart Health Check Toolkit

Moroccan spiced fish with couscous and raisin salad

Moroccan spiced fish with couscous and raisin salad

10 minutes
Serves 4

Australian Heart Maps

Australian Heart Maps

Australian Heart Maps

Our Heart Maps allow you to take a closer look at heart disease indicators across Australia....

Heart Week

Heart Week

What is a cardiac arrest?

What is a cardiac arrest?

What is a cardiac arrest?

With immediate help a cardiac arrest can be survived. Learn how to save a life....

Heart failure resources for patients

Heart failure resources for patients

Educate your patients on everything they need to know about heart failure and managing their condition ...

For professionals: Online education and training

For professionals: Online education and training

Online courses for health professionals focused on improving cardiovascular care. ...

Blood cholesterol

Blood cholesterol

Blood cholesterol

Keeping your blood cholesterol at a healthy level can help you reduce your risk of heart disease and other serious conditions. ...

For professionals: Heart failure tools and resources

For professionals: Heart failure tools and resources

Resources for healthcare professionals on the management of patients with heart failure ...

For professionals: Heart Health Checks

For professionals: Heart Health Checks

Heart Health Checks have been supported by Medicare since April 2019....

Your heart medicines

Your heart medicines

Your heart medicines

Information about commonly prescribed heart medicines. ...

Keeping your heart healthy

Keeping your heart healthy

Keeping your heart healthy

Keeping your heart healthy is something you can work on every day. ...

Philanthropic investments

Philanthropic investments

Philanthropic investments

Making philanthropic investments through the Heart Foundation can transform Australians’ health. ...

Heart attack recovery – your first month

Heart attack recovery – your first month

Heart attack recovery – your first month

Explore the Heart Foundation’s guide on what to expect in the first month after your heart attack. ...

Is salt bad for your heart?

Is salt bad for your heart?

Is salt bad for your heart?

Most Australians are eating more than the recommended amounts and this can cause health problems....

Italian recipes

Italian recipes

Italian recipes

Find heart healthy Italian recipes....

Cardiovascular disease (CVD) risk assessment and management

Cardiovascular disease (CVD) risk assessment and management

Absolute CVD risk assessment is an integrated approach that estimates the cumulative risk of multiple risk factors to predict a heart attack or stroke event in the next five years....

Chicken recipes

Chicken recipes

Chicken recipes

Find heart healthy chicken recipes....

Breakfast recipes

Breakfast recipes

Breakfast recipes

Heart healthy breakfasts to start your day right...

Guidelines for the assessment and management of Absolute Cardiovascular Disease Risk

Guidelines for the assessment and management of Absolute Cardiovascular Disease Risk

Guidelines for the assessment and management of Absolute Cardiovascular Disease Risk

Position Description: Consumer Representative for the update of the Guidelines for the assessment and management of Absolute Cardiovascular Disease Risk ...

Lamb recipes

Lamb recipes

Lamb recipes

Find heart healthy lamb recipes....

Become a corporate partner

Become a corporate partner

Become a corporate partner

Partner with us to help us fight for Australian hearts....

Apricot & pecan muffin bars

Apricot & pecan muffin bars

Apricot & pecan muffin bars

30 minutes
Serves 8

Staying active for better heart health

Staying active for better heart health

Staying active for better heart health

Moving more every day is one of the best habits you can have....

Acute coronary syndromes (ACS) clinical resources

Acute coronary syndromes (ACS) clinical resources

Resources and clinical information for health professionals...

Fundraise to save Australian hearts

Fundraise to save Australian hearts

Fundraise to save Australian hearts

Join our community of fundraisers who are committed to taking action to fight heart disease....

The Heart Foundation Research Program

The Heart Foundation Research Program

The Heart Foundation Research Program

We are Australia’s biggest non-government funder of world-class research into heart health. Learn more about our high impact research. ...

Key healthy eating messages for heart attack recovery 

Key healthy eating messages for heart attack recovery 

Key healthy eating messages for heart attack recovery 

Eating healthy foods can help you recover and reduce your risk of more heart problems. ...