Staff Profile

My research focuses on the role of keyhole techniques to improve the clinical effectiveness of cardiac surgery. I published the NIHR funded MAVRIC trial, the largest ever RCT in minimally invasive aortic valve surgery, in the high impact Journal of The American College of Cardiology. It established for the first time, the safety of the technique and has driven clinical uptake. It was cited in the draft National Institute for Health and Care Excellence (NICE) guideline for Heart valve Disease Presenting in Adults, published March 2021, as one of the key articles supporting a new recommendation that all patients should be offered minimally invasive valve surgery if suitable.

 

I continue to lead the £1.6M multicentre NIHR funded UK mini mitral trial, the largest ever trial comparing keyhole and open techniques for mitral valve surgery. The trial has completed recruitment and will be published in 2022. The findings will immediately impact international guidelines and practice

 

My research also seeks to improve patient’s outcomes by increasing patients' input in their care. I lead the £250,000 PREPs trial funded by Heart Research UK investigating the efficacy and safety of exercise in patients due to undergo heart surgery (pre-habilitation). Prehabilitation was 4^th of 10 research priorities identified by nearly 700 patients and carers who took part in the James Lind Alliance Priority Setting Partnership for adult cardiac surgery. I designed this research trial to meet this expressed need, and patients and clinicians eagerly await the findings.

Along with colleagues, in August 2021, I was awarded a £140,000 Program Development Grant by the NIHR to undertake further feasibility research on factors which will facilitate wider adoption of prehabilitation in cardiac surgery patients. Together, these two projects will enable application for funding for a large multi-centre clinical trial to assess the efficacy and cost-effectiveness of prehabilitation.

 

I co-led the £250K NIHR funded FARSTER study which investigated the role of early exercise after heart surgery. This feasibility trial (delivered across the North East and Humberside) established that the clinical pathway after surgery could be significantly shortened whilst achieving significant cost saving for the NHS. A large UK multicentre clinical and cost effectiveness RCT is planned.

 

2021

National Institute of Healthcare Research Programme Development Grant-£143,000

Prehabilitation before cardiac surgery in the UK (CARDIAC PREHAB-UK)

Co-applicant

 

2019

Heart Research UK - £250,000

Pre operative rehabilitation to improve clinical outcomes and cost effectiveness in elderly patients undergoing cardiac surgery -PREPs Trial

Chief Investigator

 

2018

 

National Institute of Healthcare Research (NIHR- EME) – £1.2 Million

Carbon Dioxide Insufflation and Brain Protection During Open Heart Surgery. A Randomized Controlled Trial

Co-applicant

 

The British Heart Foundation -£2.7 Million

The Early surgery in severe ASYmptomatic Aortic Stenosis trial- EASY-AS -

Co-applicant

 

Madela AG-£10,000

Enhanced recovery after cardiac surgery

Chief Investigator

 

Research Capability funding (NIHR/South TEES)- £25,000

Prevalence of iron restriction in patients undergoing aortic valve replacement and coronary artery bypass surgery

Chief Investigator

 

National Institute of Healthcare Research (RfPB grant) - £280,000

Feasibility Study of Early Outpatient Review and Early Cardiac Rehabilitation After Cardiac Surgery

Co-applicant

 

2017

 

Research Capability funding (NIHR/South TEES)- £25,000

Blood transfusion after aortic valve replacement; does transfusion have a negative effect on mortality and morbidity outcomes ?

Chief Investigator

 

2016

 

Research Capability funding (NIHR/South TEES)- £25000

Impact of minimally invasive surgery on markers of inflammation and platelet activation

Chief Investigator

 

2015

 

National Institute of Healthcare Research (HTA program) - £1.6 Million

Minimally invasive thoracoscopically-guided right minithoracotomy versus conventional sternotomy for mitral valve repair: a multicentre randomised controlled trial

Chief Investigator

 

2013

National Institute of Healthcare Research (RfPB grant) - £360,000

Manubrium-limited ministernotomy versus conventional sternotomy for aortic valve replacement: a randomised controlled trial (MAVRIC).

Chief Investigator

• Bayliss CD, Maier RH, Kasim A, Hancock H, Akowuah E. Does Blood Transfusion Have an Effect on Outcomes After Aortic Valve Replacement Surgery?. Heart, Lung and Circulation 2021, 30(6), 909-916.
• Wagnild JM, Akowuah E, Maier RH, Hancock HC, Kasim A. Impact of prehabilitation on objectively measured physical activity levels in elective surgery patients: A systematic review. BMJ Open 2021, 11(9), e049202.
• Maier RH, Kasim AS, Zacharias J, Vale L, Graham R, Walker A, Laskawski G, Deshpande R, Goodwin A, Kendall S, Murphy GJ, Zamvar V, Pessotto R, Lloyd C, Dalrymple-Hay M, Casula R, Vohra HA, Ciulli F, Caputo M, Stoica S, Baghai M, Niranjan G, Punjabi PP, Wendler O, Marsay L, Fernandez-Garcia C, Modi P, Kirmani BH, Pullan MD, Muir AD, Pousios D, Hancock HC, Akowuah E. Minimally invasive versus conventional sternotomy for Mitral valve repair: Protocol for a multicentre randomised controlled trial (UK Mini Mitral). BMJ Open 2021, 11(4), e047676.
• Hancock HC, Maier RH, Kasim A, Mason J, Murphy G, Goodwin A, Owens WA, Akowuah E. Mini-sternotomy versus conventional sternotomy for aortic valve replacement: a randomised controlled trial. BMJ Open 2021, 11(1), e041398.
• Hancock HC, Maier R, Kasim AS, Mason JM, Murphy GJ, Goodwin A, Owens WA, Kirmani B, Akowuah EF. Mini-sternotomy versus conventional sternotomy for aortic valve replacement: results from the MAVRIC randomised controlled trial. Journal of the American College of Cardiology (JACC) 2019, 73(19), 2487-2492.