Professor of Cardiac Surgery and Translational Research
Consultant Adult Cardiac Surgeon, University Hospitals NHS Foundation Trust, Bristol, UK.1 Aug 2002 → …
Professor Ascione is Chief Investigator of clinical trials and experimental work aimed at protecting adult high-risk patients from complications during cardiac surgery. Some examples include:
Cardiac Regeneration and Stem Cell: Professor Ascione is leading two ongoing world-first trials using autologous bone-marrow derived stem cells for myocardial repair in patients with acute or chronic MI undergoing either coronary or dilated left ventricular ischemic surgery (TransACT 1 &2 trials; >60% completed). His group had recently identified a novel methodological sequence to expand and transdifferentiate in vitro human cord blood derived CD133+ cells into cells with a cardiomyogenic phenotype. These cells are now undergoing functional assessment with a view to a first-in-man trial.
Cardio-pulmonary protection during cardiac surgery: He has led the validation and translational process of the novel technique of beating heart coronary surgery (OPCAB surgery) via a sequence of >10 randomised trials and >10 large cohort analyses. In addition, he has led research in the areas of myocardial protection in patients with valvular conditions leading to a disease specific cardioplegic arrest approach. An example of work ongoing in this area is the SCAT trial in 160 patients (almost completed) assessing the impact on clinical outcome of shortening cardioplegic arrest time with the beating heart approach in patients undergoing combined coronary and valvular surgery.
Pulmonary protection during cardiac surgery: Professor Ascione is Chief Investigator of clinical and experimental research testing novel interventions of lung protection. Examples include 1. the ongoing PROTECTION pilot trial in 60 patients (almost completed) testing low frequency ventilation during cardiopulmonary bypass and 2. the ongoing LUNG-PERFUSE experimental trial (60% completed) testing the efficacy of the novel intervention of retrograde pulmonary perfusion during cardiopulmonary bypass.
Diabetes Mellitus: He is leading clinical research in cardiac surgery on diabetes mellitus to minimise its impact of postoperative complications. He is Theme Lead of the related research area of the Biomedical Research Unit in Cardiovascuolar Disease awarded by the NIHR. Examples include 1. ascertaining the impact of deranged postoperative blood glucose levels on postoperative mortality and morbidity in a large observational study; 2. evaluating in a pilot trial (CONTROL-DM; starting) strict vs lenient blood glucose control on postoperative health outcome and inflammatory indices; and 3. the ongoing VERDICT trial in 180 patients (>60% completed) aimed at reducing the incidence of postoperative renal failure using preoperative fluid replacement therapy in diabetic patients undergoing coronary surgery.