NHS 75: Inside the Teesside operating theatre as the heart team gets to work

To mark the 75th anniversary of the NHS, we take an in-depth look at the impact of health services in the North East. Here, we examine the work of the heart unit at The James Cook University Hospital in Middlesbrough.

When I meet patient Alister Little early one morning, he is preparing for a crucial medical procedure: one that should make everyday tasks more manageable and potentially, extend his life.

What is more, the whole process should take no more than a few hours, meaning he will hopefully be back home the same evening.

Mr Little has a heart condition which means he can only walk 10 or 15 yards without experiencing shortness of breath and pain in his chest.

That is because his aortic valve - which controls the flow of blood - is not working as it should.

The procedure, carried out by a specialist team at The James Cook University Hospital, will see an artificial valve embedded in his heart which will take over the work of the failing valve.

It will take place under local anaesthetic, with the new valve passed through a tube inserted in the groin, and up to the heart.

For Mr Little, who has previously undergone open heart surgery, the contrast could not be greater.

He told me: "I find it absolutely amazing actually.

"When you consider the alternative, the one that I had the last time, it's a marvellous step forward."

The process is known as TAVI, an abbreviation which stands for transcatheter aortic valve implantation procedure.

It was first introduced to the James Cook heart unit in 2009, though the team has been constantly refining their approach since then.

So much so, the unit's methods when it comes to TAVI are regarded as a model for others around the world to follow.

Consultant cardiologist Dr Paul Williams explained how things have changed since the early days.

He said: "It was done under general anaesthetic and typically we could only perform two cases in a day.

"Jumping forward fourteen years we are now able to offer this procedure to nearly all patients as a local anaesthetic procedure and we now routinely list five cases in a day because we're just so much slicker and better at doing these procedures."

The TAVI procedure is just one aspect of the work which takes place at the James Cook heart unit.

• The centre opened in 1993 to provide patients on Teesside and the surrounding area with greater access to heart treatments.

• The unit serves a catchment of around 1.5 million people.

• The first TAVI procedure was carried out in 2009 as an alternative, for some patients, to open heart surgery.

A driving force behind the establishment of Middlesbrough's heart unit was Professor Sir Liam Donaldson.

He is best known as a former Chief Medical Officer for England but his interest in improving the region's heart health goes back much further.

Working in the region in the 1980s, Professor Sir Liam was keen to address the high levels of heat disease and deaths - and believed that opening a dedicated unit on Teesside was the only way to ensure that patients in this part of the region had greater and quicker access to treatments.

Looking back over the past three decades, he described the changes as a "miraculous transformation."

He told me: "Fathers, grandfathers, particularly men but some women as well who would have died and left their families far, far too early are now surviving at an unprecedented level as a result of the treatments that are provided here."

Professor Sir Liam, who now chairs the NHS's North East and North Cumbria Integrated Care System believes the impact of the unit - in the space of just thirty years - has been remarkable.

Another man who has welcomed those developments is heart patient Basil Eddershaw.

His treatments, stretching over many years, have taken place side-by-side with the unit's evolution.

When I asked what the unit had brought him, Mr Eddershaw had a simple answer.

"Life", he told me, "An extension of life that I didn't really expect."

Mr Eddershaw, who is 94, continued: "It's remarkable when I was diagnosed that the unit was in existence and there was expectation that it would get better and I was able to sort of ride along in that success as it's developed to now."

Later on the day of my visit, I caught up with Alister Little, who was now recovering after receiving his new heart valve.

Happily, the procedure had gone well and, as hoped, he was preparing to leave hospital.

Recovery would still lie ahead, but as he waved goodbye to the nursing team, that could be done in the familiar surroundings of his home.

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