Sir Brian Barratt-Boyes
Sir Brian Barratt-Boyes was a New Zealand surgeon who played a crucial role in the development of open-heart surgery. His talent and use of ingenuity saw him overcome numerous challenges in the field and led to the development of techniques that have set the standard for others to follow. His work has saved countless lives and cemented him as one of New Zealand’s most inspiring pioneers.
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He became only the second heart surgeon in the world to replace a heart valve, and his results earned him international recognition and acclaim.
Born in Wellington in 1924, Brian studied medicine at the University of Otago in Dunedin and trained as a surgeon, graduating in 1946. It was here he met his wife Norma, a physiotherapist, and they would go on to have five sons. In 1953, he and his family travelled to the United States, spending two years at the prestigious Mayo Clinic in Minnesota, where he completed a fellowship in cardiothoracic surgery under his mentor, Dr John Kirklin.
Sir Douglas Robb, then surgeon-in-charge at Auckland’s Greenlane Hospital, lured Brian back to Aotearoa New Zealand in 1957 as senior cardiothoracic surgeon. Here, at Brian’s recommendation, a £3000 Melrose heart-lung machine – essential technology for open-heart surgery – was imported from Britain by the Auckland Hospital Board.
However, the machine arrived without any instructions, and with parts missing, so the hospital’s laboratory technician, Sid Yarrow, and Alfred Melville from Auckland Industrial Development Laboratory created the missing parts. Between Brian, Sid, and Alfred, they spent the next year pooling their ideas and developing the machine further, including the addition of a gas flow meter to control the flow of oxygen.
Brian performed his first ‘hole-in-the-heart’ surgery in 1958, on 10-year-old Helen Arnold. This surgery enabled children born with congenital heart problems the chance to live normal, healthy lives. In 1961, he became one of the first surgeons in the world to implant pacemakers before they were commercially available. The pacemakers he used were created by Sid Yarrow, and enabled the heart to be restarted after surgery.
In 1962, Brian made further progress in open-heart surgery through his innovation in human donor heart-valve replacements, driven, in part, by the knowledge that many of his patients from across the South Pacific couldn’t take anticoagulants when they returned home. Artificial valves were prone to problems, and Brian was convinced that human donor valves were a viable option in surgeries. His persistent experimentation in an animal laboratory, and assessment of clinical outcomes, saw Brian develop techniques that set the standard for how homographic heart valves would be used. He became only the second heart surgeon in the world to replace a heart valve, and his results earned him international recognition and acclaim.
In 1965, Brian continued to advance Greenlane Hospital’s position as a global leader by hosting international conferences that featured distinguished and up-and-coming heart surgeons, including John Kirklin as guest of honour, and the then-unknown Christiaan Barnard, who would go on to perform the world’s first heart transplant in 1967.
Brian’s work to improve the deep hypothermia technique, first introduced in Japan, enabled open-heart surgery to be performed on neonates and infants, and demonstrated that many complex conditions could be safely corrected in infancy. He was a superb teacher, and his work training paediatric surgeons was instrumental in developing cardiothoracic units in Thailand, India, and Japan, which gave him immense satisfaction. He received many honours for his pioneering work both in New Zealand and overseas, including a CBE in 1966 and a knighthood in 1971. He was the first person to be awarded an honorary professorship from the University of Auckland, with additional honorary fellowships including the American College of Surgeons, the Royal College of Surgeons, and the American College of Cardiology. He was awarded the René Leriche Prize and Medal from the Société International de Chirurgie in 1987, and the Royal Australasian College of Surgeons Award for Excellence in Surgery in 1994. In 1995, his face appeared on one of New Zealand’s postage stamps, making him one of the few living New Zealanders to have been given this honour.
Alongside his teaching, Brian considered his greatest legacy to be the two-volume textbook Cardiac Surgery, co-authored with John Kirklin, and first published in 1986. Subsequently reprinted and revised several times, the book runs to almost 1,800 pages, and is, to this day, considered to be the authority on every aspect of adult and paediatric cardiac surgery.
Brian remained at Greenlane Hospital until his retirement in 1989, despite being offered many highly paid positions at the world’s top hospitals. He regularly travelled internationally to give guest lectures, contribute to cardiothoracic literature in academic journals, and teach.
A staunch advocate for improvements in the public health system, he was a formidable opponent to bureaucrats and politicians alike, using his reputation and mana to seek increased funding and staffing to enable speedier assessment and treatment.
“People say Greenlane gets more money than it should because of my influence – and there is truth in that, because you never get anything unless you go after it and shout for it,” he said.
A heavy smoker early in his career, Brian himself suffered from heart disease, and underwent his first heart operation – a double bypass – at Greenlane Hospital in 1974, using the same surgery that he had contributed so much to. That, and a subsequent surgery in 1984, would give him thirty more years of life, and he used them well. Sir Brian Barratt-Boyes died in 2006 in Ohio following complications from his final cardiac operation. He was 82. In his obituary, his biographer, Donna Chisholm, wrote: two things struck you when you watched Sir Brian Barratt-Boyes operate. The first was the intensity of his eyes above the mask as he approached the table and gazed at his patient – often a baby – below him.
The second was the sheer physical beauty of his hands in action. Technically, he was flawless. Graceful, precise, and unerring.
Sir Brian Barratt-Boyes saved and improved countless lives through his dedication, surgical innovations, and his willingness to teach others. He was a true pioneer.
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