BMJ PUBLICATION

When patients innovate

This March, in Australia, a landmark passed quietly for Tal Golesworthy, a chartered engineer from Cheltenham in the UK.

He was in Melbourne with the cardiothoracic surgeon Conal Austin to speak at the Australasian Thoracic Aortic Symposium about personalised external aortic root support (PEARS), an operation in which an implant supports the patient’s own aorta and aortic valve, and is designed to prevent enlargement and rupture.

While in Australia, Austin, based at Guy’s and St Thomas’ NHS Foundation Trust, carried out six of these life changing operations as a visiting surgeon.

Golesworthy knew exactly what those patients were going through, because he experienced the first operation of this kind, nearly 15 years ago, for aortic dilatation relating to his Marfan syndrome.

What was the difference between him and these latest patients? Golesworthy had used his engineering skills to invent the implant used in PEARS surgery after he had been told the only clinical option for him was total aortic root replacement, which offers patients the drawback of a lifetime of anticoagulant therapy. He refused and set about developing an alternative, which was successfully implanted in him in 2004.