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. ...

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...

WEBINAR | Research Alumni Series 2020

WEBINAR | Research Alumni Series 2020

WEBINAR | Research Alumni Series 2020

The Heart Foundation is delivering a research webinar series for Heart Foundation research alumni....

Research Alumni

Research Alumni

Research Alumni

The Heart Foundation Alumni Program brings together current and previously funded researchers to create a community of the best and brightest in heart-related research....

Our research stories

Our research stories

Our research stories

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

Thrombus-targeted theranostic microbubbles

Thrombus-targeted theranostic microbubbles

Thrombus-targeted theranostic microbubbles

Breaking down blood clots...

Life changing research currently underway

Life changing research currently underway

Life changing research currently underway

Search our current researcher's and the ground breaking research being undertaken....

A simple test may lead to better treatment

A simple test may lead to better treatment

A simple test may lead to better treatment

Dr Jay Ramchand discusses his latest research project....

More Australians die of Heart Disease than any other cause.

More Australians die of Heart Disease than any other cause.

More Australians die of Heart Disease than any other cause.

And the heartache lasts a lifetime. But you can help the Heart Foundation fund life-saving research to keep more families together....

Heart Health Check Toolkit

Heart Health Check Toolkit

Matilda signs up for Jump Rope just one month after open-heart surgery

Matilda signs up for Jump Rope just one month after open-heart surgery

Matilda signs up for Jump Rope just one month after open-heart surgery

Media Release - 26 June 2020...

Heart Foundation recipes

Heart Foundation recipes

Heart Foundation recipes

Check out our recipe categories to find your next heart healthy meal....

WEBINAR | CVD & COVID-19

WEBINAR | CVD & COVID-19

WEBINAR | CVD & COVID-19

Ask the experts: caring for people with CVD during COVID-19...

What is FoodTrack?

What is FoodTrack?

What is FoodTrack?

FoodTrack supports the collection and monitoring of nutrition and product data for foods and beverages in Australian supermarkets. ...

Workplace giving for employees

Workplace giving for employees

Workplace giving for employees

Your employer’s workplace giving program makes it easy to setup regular, tax-deductible donations from your pre-tax income. ...

Pregnancy and heart disease

Pregnancy and heart disease

Information and resources for health professionals....

Women and heart disease

Women and heart disease

Women and heart disease

Information and resources for health professionals....

Q&A with Dr Lewan Parker

Q&A with Dr Lewan Parker

Q&A with Dr Lewan Parker

Identifying microvascular dysfunction as a novel mechanism of poor health in heart failure patients....

What's your BMI?

What's your BMI?

What's your BMI?

Are you within a healthy weight range for your height?...

What is a heart attack?

What is a heart attack?

What is a heart attack?

The most common cause of a heart attack is coronary heart disease....

Aboriginal and Torres Strait Islander Training Centre

Aboriginal and Torres Strait Islander Training Centre

Training to support identification of Aboriginal and Torres Strait Islander patients, in line with standard practice....

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. ...

What is cardiac rehab?

What is cardiac rehab?

What is cardiac rehab?

Cardiac rehab is proven to keep you out of hospital and reduce your risk of death from heart conditions....

Queensland Cardiovascular Research Network

Queensland Cardiovascular Research Network

Queensland Cardiovascular Research Network

QCVRN provides a framework to strengthen cardiovascular research in Queensland...

Relationships and sex after a heart attack

Relationships and sex after a heart attack

Relationships and sex after a heart attack

Explore some useful things to know about intimacy after a heart attack....

Absolute CVD risk clinical guidelines

Absolute CVD risk clinical guidelines

The Absolute Cardiovascular Disease Risk (CVD) Guidelines helps healthcare professionals identify, prevent and manage a person's risk of developing CVD. ...

Celebrate the life of someone you love by giving to the Heart Foundation in their memory

Celebrate the life of someone you love by giving to the Heart Foundation in their memory

Celebrate the life of someone you love by giving to the Heart Foundation in their memory

Workplace giving program

Workplace giving program

Workplace giving program

Workplace giving is a simple and tax effective way for employees to make regular donations to a cause they care about. ...

Supporting Your Emotional Wellbeing: An Online Forum for Young Heart Patients

Supporting Your Emotional Wellbeing: An Online Forum for Young Heart Patients

Supporting Your Emotional Wellbeing: An Online Forum for Young Heart Patients

Jaxson skips through a bucket list of Sydney landmarks

Jaxson skips through a bucket list of Sydney landmarks

Jaxson skips through a bucket list of Sydney landmarks

Media Release - 15 September 2020...

Apricot & pecan muffin bars

Apricot & pecan muffin bars

Apricot & pecan muffin bars

30 minutes
Serves 8

Lessons learned: recovering from open heart surgery

Lessons learned: recovering from open heart surgery

Lessons learned: recovering from open heart surgery

After having five open heart surgeries between the ages of 13 and 41, Peter knows a thing or two about recovery....

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....

Nutrition Evidence Summaries and Reviews

Nutrition Evidence Summaries and Reviews

Nutrition Evidence Summaries and Reviews

Key Statistics: Risk Factors For Cardiovascular Disease

Key Statistics: Risk Factors For Cardiovascular Disease

Baking recipes

Baking recipes

Baking recipes

Find heart healthy baking recipes ...

Healthy chicken fajitas

Healthy chicken fajitas

20 minutes
Serves 4

Our programs and initiatives

Our programs and initiatives

Our programs and initiatives

The Heart Foundation delivers innovative, evidence-based programs and initiatives to support and prevent heart disease in Australia...