Cardio-thoracic surgery

Waikato Cardiothoracic Unit stands as one of the most active in Australasia, committed to providing top-tier care and advancing the field through rigorous research and training.

Our mission is to establish the leading research and training center for cardio-thoracic surgery in Australasia, in partnership with the University of Waikato. This effort is built on strong and broad collaboration between our surgeon clinician scientists and basic science collaborators. Our unit is deeply engaged in a variety of research initiatives.

Academic lead – Dr. Nishith Patel, a Consultant Cardiothoracic Surgeon, has recently been awarded the prestigious 2023 Foundation 100 Fellowship by the Heart Foundation of New Zealand to pursue research into aortic dissection. His groundbreaking work has been recognised in the national media through the Waikato Herald, Heart Foundation, and NZHerald.

Professor David McCormack bridges the clinical department and the University of Waikato, ensuring seamless integration between clinical practice, education, and academic research.

Our research efforts are coordinated by our skilled and dedicated research nurse, Kelly Henderson. Together, we strive to lead and innovate in the field of cardio-thoracic surgery.

• Temporary pacing following cardiac surgery - a reference guide for surgical teams. Waqanivavalagi SWFR. J Cardiothorac Surg. 2024 Mar 11;19(1):115. DOI: 10.1186/s13019-024-02619-9. PMID: 38468357.
• Outcomes of Valvular Heart Disease-How Can We Close the Gap for Indigenous Patients? El-Gamel A, Raman J. Heart Lung Circ. 2024 Jan;33(1):7-8. DOI: 10.1016/j.hlc.2024.01.006. PMID: 38342562.
• Hybrid surgical-catheter epicardial ablation of recurrent ventricular tachycardia in an arrhythmogenic cardiomyopathy patient with pericardial adhesions following COVID-19 infection. Ho CY, Al Sinan A, DeBoard Z, Swampillai J, Timmins K, Stiles MK. HeartRhythm Case Rep. 2023 Oct 18;10(1):15-20. DOI: 10.1016/j.hrcr.2023.10.011. eCollection 2024 Jan. PMID: 38264109.
• Ablation and Reduction: Adjuncts in Mitral Valve Surgery in Patients With Large Atria.
  Raman J, Saxena P, El-Gamel A.
  Heart Lung Circ. 2023 Dec;32(12):1411-1412. DOI: 10.1016/j.hlc.2023.12.001.
  PMID: 38105082.
• The Australasian ANZSCTS/ANZICS guidelines on cardiothoracic advanced life support (CALS-ANZ).
  Karcher C, Jurisevic C, Southwood T, McCormack D, Rogers A, Levine A, Dunning J. Crit Care
  Resusc. 2023 Oct 18;24(3):218-223. DOI: 10.51893/2022.3.SA3. eCollection 2022 Sep 5.
  PMID: 38046213.
• Low and intermediate risk aortic dissection detection risk score and negative D-dimer: a word of caution.
  Waqanivavalagi SW. 
  N Z Med J. 2023 Sep 15;136(1582):87-90. DOI: 10.26635/6965.6153
  PMID: 37708488.
• How I do it: repair of sternal fracture with bone graft and plating.
  Stevens N, Patel S, Kejriwal N.
  ANZ J Surg. 2023 Oct;93(10):2502-2504. DOI: 10.1111/ans.18549. Epub 2023 Jun 9.
  PMID: 37296523.
• Aortic-Size Paradox: Reducing the Threshold for Intervention Will Help to Save Some Lives But We Still Need Noah to Predict the Flood.
  El Gamel A.
  Heart Lung Circ. 2023 Mar;32(3):279-283. DOI: 10.1016/j.hlc.2023.02.001.
  PMID: 36958870.
• Patients Requiring Triple Valve Replacement Will (Only) Escape Valve-Related Deaths and Late Myocardial Dysfunction With Further Research.
  El Gamel A.
  Heart Lung Circ. 2023 Feb;32(2):133-135. DOI: 10.1016/j.hlc.2023.01.005.
  PMID: 36863787.
• Bilateral costal cartilage fractures sustained in the gym during repeated bench press exercises.
  Thanalingam Y, Krim AOA, Kejriwal N.
  Trauma Case Rep. 2022 Oct 17;42:100720. DOI: 10.1016/j.tcr.2022.100720. eCollection 2022 Dec.
  PMID: 36311281.
• Early diagnosis of surgically curable lung cancer is commonly serendipitous.
  Gimpel D, Pan A, Manikavasagar V, Lao C, Brown L, McCormack DJ, Lin Z, Meikle F, Conaglen P, Stephenson D, Lawrenson R, El-Gamel A.
  N Z Med J. 2022 Jun 10;135(1556):44-52.
  PMID: 35728247.
• Challenges of emergency thoracotomy in a regional New Zealand setting.
  Kang M, Sharma VJ, Omundsen M, McCormack D, Kejriwal N. 
  Emerg Med Australas. 2022 Aug;34(4):655-656. DOI: 10.1111/1742-6723.14029. Epub 2022 Jun 5.
  PMID: 35661407.
• Can We Better Differentiate Type A Dissections: Evaluating the Role of Aortic Ratios.
  Sharma VJ, Kang M, Ganesh JS, McCormack DJ, Prakash M, Moore R, Patel NN, El-Gamel A.
  Heart Lung Circ. 2022 Aug;31(8):1126-1133. DOI: 10.1016/j.hlc.2022.03.011. Epub 2022 May 19.
  PMID: 35597706.
• Evaluation of the effects of three designs of oxygenators with integrated filters on clinical and haematological outcomes at an Australasian cardiothoracic unit.
  Prakash M, Sharma V, Oh T, Lo C, Parkinson G, McCormack D, Conaglen P, Lin Z, Kejriwal N, Meikle F, Peplow E, Bhana J, El Gamel A.
  Perfusion. 2023 Jul;38(5):983-992. DOI: 10.1177/02676591221090751. Epub 2022 May 5.
  PMID: 35514051.
• Novel use of the Perceval sutureless bioprosthesis for pulmonary valve replacement in high-risk endocarditis patients: A case series. Singh N, Peek KN, Nand P.
  J Card Surg. 2022 Jul;37(7):2159-2161. DOI: 10.1111/jocs.16389. Epub 2022 Mar 2.
  PMID: 35238071.
• No-Touch Harvest: The Solution to Laboring in Vein?
  Byrne K, Wotherspoon S, Patel NN. 
  J Cardiothorac Vasc Anesth. 2022 May;36(5):1231-1233. DOI: 10.1053/j.jvca.2021.11.029. Epub 2021 Nov 24.
  PMID: 34952783.
• Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation: Challenging Pathology Awaiting Specialized Devices.
  El-Gamel A.
  Aorta (Stamford). 2021 Apr;9(2):56-59. DOI: 10.1055/s-0041-1725122. Epub 2021 Oct 7.
  PMID: 34619802.
• How to do hyperthermic intrathoracic chemotherapy for thoracic pseudomyxoma peritonei.
  Sharma V, Bhana J, Lolohea S, Meikle F.
  ANZ J Surg. 2022 Apr;92(4):868-869. DOI: 10.1111/ans.17134. Epub 2021 Aug 16.
  PMID: 34396656.
• Cardiac surgery simulation: a low-cost feasible option in an Australasian setting.
  Sharma VJ, Barton C, Page S, Ganesh JS, Patel N, Pirone F, Lin Z, Kejriwal NK, El Gamel A, McCormack DJ, Meikle F. 
  ANZ J Surg. 2021 Oct;91(10):2042-2046. DOI: 10.1111/ans.17077. Epub 2021 Jul 21. PMID: 34291538.
• Airway compromise from subcutaneous emphysema.
  Prakash M, Sharma V, Kang R, Meikle F. 
  ANZ J Surg. 2021 Jun;91(6):E421-E422. DOI: 10.1111/ans.16477. Epub 2020 Dec 9. PMID: 33300213.
• What are the endovascular options and outcomes for repair of ascending aortic or aortic arch pathology?
  Sharma VJ, Prakash M, Lin Z, Lo C.
  Interact Cardiovasc Thorac Surg. 2021 Jan 1;32(1):106-110. DOI: 10.1093/icvts/ivaa215.
  PMID: 33257950.
• How to create negative pressure wound dressing with wall suction: novel treatment of subcutaneous emphysema with PICO dressing.
  Prakash M, Meikle F. 
  ANZ J Surg. 2020 Oct 8. DOI: 10.1111/ans.16365. Online ahead of print.
  PMID: 33090677.
• Performance of the AusSCORE II and STS Score for Coronary Artery Bypass Grafting in a New Zealand Population.
  Singh N, Gimpel D, Manikavasagar V, Watson N, Roberts J, Conaglen P, Meikle F, Lin Z, Kejriwal N, Odom N, McCormack DJ, El-Gamel A. 
  Heart Lung Circ. 2021 Apr;30(4):600-604. DOI: 10.1016/j.hlc.2020.08.021. Epub 2020 Oct 6.
  PMID: 33032891.
• Right ventricle laceration at laparoscopic foramen of Morgagni hernia repair.
  Macemon JB, Gimpel DJ, Kejriwal NK. 
  ANZ J Surg. 2020 May;90(5):924-925. DOI: 10.1111/ans.15748. Epub 2020 Apr 21.
  PMID: 32314867.
• Preoperative Neutrophil and Lymphocyte Ratio as a Predictor of Mortality and Morbidity After Cardiac Surgery.
  Haran C, Gimpel D, Clark H, McCormack DJ. 
  Heart Lung Circ. 2021 Mar;30(3):414-418. DOI: 10.1016/j.hlc.2020.05.115. Epub 2020 Jul 6.
  PMID: 32665173.
• Full Metal Jacket Endarterectomy of Left Anterior Descending Coronary Artery is Safe With Good Midterm Outcomes.
  El-Gamel A, Chan B.
  Heart Lung Circ. 2021 Apr;30(4):605-611. DOI: 10.1016/j.hlc.2020.08.007. Epub 2020 Sep 18.
  PMID: 32952038.
• Management of patients with early stage lung cancer – why do some patients not receive treatment with curative intent?
  Lawrenson R, Lao C, Brown L, Moosa L, Chepulis L, Keenan R, Kidd J, Middleton K, Conaglen P, de Groot C, Aitken D, Wong J. 
  BMC Cancer. 2020 Feb 10;20(1):109. DOI: 10.1186/s12885-020-6580-6.
  PMID: 32041572.
• Rib Cage Stabilisation With 3D-Printed Polyethylene Sternal Prosthesis Post-Sternotomy Mediastinitis.
  Prakash M, Ong Q, Lo C, Macemon JB, El Gamel A. 
  Heart Lung Circ. 2020 Oct;29(10):1561-1565. DOI: 10.1016/j.hlc.2020.01.005. Epub 2020 Feb 13.
  PMID: 32094079.
• A prospective five-year cohort study of undiagnosed sleep apnea in patients undergoing coronary artery bypass graft surgery.
  Hogan AM, Ibrahim S, Moylan MJ, Mccormack DJ, Openshaw AM, Cormack F, Shipolini A. 
  J Cardiovasc Surg (Torino). 2020 Oct;61(5):648-656. DOI: 10.23736/S0021-9509.20.11200-X. Epub 2020 Mar 17.
  PMID: 32186169.
• Type A aortic dissections: challenges of atypical presentation in remote New Zealand.
  Sharma VJ, Prakash M, Pirone F, Chan B, Lin Z.
  N Z Med J. 2020 Apr 3;133(1512):99-101.
  PMID: 32242186.
• Ascending Aortic Aneurysm Wrapping: The Renaissance of an Old Technique.
  Gamel AE.
  Heart Lung Circ. 2019 Dec;28(12):1770-1772. DOI: 10.1016/j.hlc.2019.10.003.
  PMID: 31813480.
• Minimal Access Aortic Root Surgery: An "Elite Sport" or Is it for Everyone?
  El Gamel A. 
  Heart Lung Circ. 2019 Dec;28(12):1767-1769. DOI: 10.1016/j.hlc.2019.10.002.
  PMID: 31813479.
• Medical 3D Printing. Is This Just The Beginning?
  El Gamel A. Heart Lung Circ. 2019 Oct;28(10):1457-1458. DOI: 10.1016/j.hlc.2019.08.004.
  PMID: 31495503.
• Acute shortness of breath due to reoccurrence of an intrapericardial bronchogenic cyst.
  Gimpel D, Conway J, Meikle F, Lin Z, McCormack DJ, El-Gamel A. 
  Respirol Case Rep. 2019 May 17;7(5):e00431. DOI: 10.1002/rcr2.431. eCollection 2019 Jul.
  PMID: 31131108.
• Inadvertent puncture of right ventricle during chest tube insertion.
  Gimpel D, Magoye T, McCormack DJ, El-Gamel A, Kejriwal N. 
  ANZ J Surg. 2020 Mar;90(3):376-378. DOI: 10.1111/ans.15132. Epub 2019 Apr 15.
  PMID: 30983139.
• Primary care management of chest pain after coronary artery bypass surgery.
  Gimpel D, Fisher R, Khan Z, McCormack DJ. 
  BMJ. 2019 Apr 12;365:l1303. DOI: 10.1136/bmj.l1303.
  PMID: 30979696.
• External stabilisation with vacuum assisted contrivance (ES-VAC) for chest wall injuries sustained from cardiopulmonary resuscitation.
  Gimpel D, Ni Leathlobhair N, Conway J, Magoye T, Macemon J, Macleod M, Nixey K, Odom N, McCormack DJ, Kejriwal N, Meikle F, El-Gamel A, Lin Z. 
  Resuscitation. 2019 Apr;137:49-51. DOI: 10.1016/j.resuscitation.2019.01.028. Epub 2019 Feb 5.
  PMID: 30735741.
• Early Discharge From Intensive Care After Cardiac Surgery is Feasible With an Adequate Fast Track, Stepdown Unit: Waikato Experience.
  Gimpel D, Shanbhag S, Srivastava T, MacLeod M, Conaglen P, Kejriwal N, Odom N, Lin Z, McCormack DJ, El-Gamel A. 
  Heart Lung Circ. 2019 Dec;28(12):1888-1895. DOI: 10.1016/j.hlc.2018.11.002. Epub 2018 Nov 17.
  PMID: 30528814.
• Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial.
  Myles PS, Smith JA, Kasza J, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussières JS, McGuinness S, Byrne K, Chan MTV, Landoni G, Wallace S, Forbes A; ATACAS investigators and the ANZCA Clinical Trials Network. 
  J Thorac Cardiovasc Surg. 2019 Feb;157(2):644-652.e9. DOI: 10.1016/j.jtcvs.2018.09.113. Epub 2018 Oct 19.
  PMID: 30459103.
• A novel treatment option in the management of traumatic hemothorax.
  Singh N, Gimpel D, Zaman Z, French R, Conaglen P.
  J Trauma Acute Care Surg. 2019 Feb;86(2):374-375. DOI: 10.1097/TA.0000000000002122.
  PMID: 30399130.
• Time to Get a @Handle on Twitter and Cardiovascular Medicine.
  Gimpel D, Ray M. 
  Circulation. 2018 Sep 25;138(13):1285-1286. DOI: 10.1161/CIRCULATIONAHA.118.035226.
  PMID: 30354417.
• Assessment of the EuroSCORE II in a New Zealand Tertiary Centre.
  Singh N, Gimpel D, Parkinson G, Conaglen P, Meikle F, Lin Z, Kejriwal N, Odom N, McCormack DJ, El-Gamel A. 
  Heart Lung Circ. 2019 Nov;28(11):1670-1676. DOI: 10.1016/j.hlc.2018.09.004. Epub 2018 Sep 27.
  PMID: 30318389.
• Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery.
  Mazer CD, Whitlock RP, Fergusson DA, Belley-Cote E, Connolly K, Khanykin B, Gregory AJ, de Médicis É, Carrier FM, McGuinness S, Young PJ, Byrne K, Villar JC, Roy A, Grocott HP, Seeberger MD, Mehta C, Lellouche F, Hare GMT, Painter TW, Fremes S, Syed S, Bagshaw SM, Hwang NC, Royse C, Hall J, Dai D, Mistry N, Thorpe K, Verma S, Jüni P, Shehata N; TRICS Investigators and Perioperative Anesthesia Clinical Trials Group. 
  N Engl J Med. 2018 Sep 27;379(13):1224-1233. DOI: 10.1056/NEJMoa1808561. Epub 2018 Aug 26.
  PMID: 30146969.
• Does the use of an in situ or Y-configuration for bilateral internal thoracic arteries influence long-term survival, patency or repeat evascularization in coronary bypass surgery?
  Kelleher R, Gimpel D, McCormack DJ, El-Gamel A.
  Interact Cardiovasc Thorac Surg. 2019 Feb 1;28(2):222-226. DOI: 10.1093/icvts/ivy195.
  PMID: 30052998.
• Complex coarctation of the aorta requiring a third redo operation.
  Gimpel D, McCormack DJ, El-Gamel A.
  Interact Cardiovasc Thorac Surg. 2018 Oct 1;27(4):611-612. DOI: 10.1093/icvts/ivy130.
  PMID: 29688517.
• Desmoid fibromatosis of the chest wall.
  Ong Q, Wong J, Sinha S, Kejriwal N.
  Respirol Case Rep. 2018 Feb 28;6(4):e00310. DOI: 10.1002/rcr2.310. eCollection 2018 May.
  PMID: 29507725.
• Transfusion Requirements in Cardiac Surgery III (TRICS III): Study Design of a Randomized Controlled Trial.
  Shehata N, Whitlock R, Fergusson DA, Thorpe KE, MacAdams C, Grocott HP, Rubens F, Fremes S, Lellouche F, Bagshaw S, Royse A, Rosseel PM, Hare G, Medicis E, Hudson C, Belley-Cote E, Bainbridge D, Kent B, Shaw A, Byrne K, Syed S, Royse CF, McGuiness S, Hall J, Mazer CD. 
  J Cardiothorac Vasc Anesth. 2018 Feb;32(1):121-129. DOI: 10.1053/j.jvca.2017.10.036. Epub 2017 Nov 3.
  PMID: 29273477.
• Does diathermy smoke contaminate processed salvaged blood in cardiac surgery?
  Hulme KR, van den Burg J. 
  Perfusion. 2017 Nov;32(8):656-660. DOI: 10.1177/0267659117715705. Epub 2017 Jun 13.
  PMID: 28610543.