It is with great sadness that we learned of the death of Sir Brian Barratt-Boyes, the pioneering New Zealand heart surgeon on March 7, after redo heart surgery at the Cleveland Clinic.
Sir Brian was educated in New Zealand at Wellington College and studied medicine at Otago’s Medical School, graduating in 1946. He continued his training as a surgeon, initially in New Zealand, and later at the Mayo Clinic (1953–1955) and as a Nuffield Fellow in Bristol (1955–1956). At Mayo, he worked under John Kirklin, the two developing a high mutual regard that endured and grew over the years.
In 1956, he was recruited back to Auckland, New Zealand, by Sir Douglas Robb, and pioneered the development of cardiopulmonary bypass with Sid Yarrow in New Zealand. The first patient to have surgery performed in 1958 was a 9-yearold VSD. Despite New Zealand’s relative remoteness and small population, the Green Lane Hospital surgical team quickly achieved an international reputation for innovative excellence. Indeed, Sir Brian suggested that Auckland’s isolation conferred an advantage comparable to that enjoyed by the Mayo Clinic in small-town Rochester, MN, making it less likely that day-to-day interruptions would interfere with the real purpose of their work. Much of the original equipment had to be fashioned or modified locally. Sid Yarrow provided much of the technical expertise to achieve the successful establishment of cardiopulmonary bypass at Green Lane and in conjunction with Sir Brian pioneered perfusion practice in New Zealand and Australia.
In 1962, Sir Brian introduced, independently but simultaneously with Donald Ross in London, the human cadaveric aortic homograft for aortic valve replacement and for many years he worked to perfect valve preparation, emphasizing its inherent physiologic advantages and simplifying its surgical implant technique. He and his team’s results became the standard for others to match.
In 1969, he brought the technique of profound hypothermia and circulatory arrest into the limelight as a practical method for dealing with major corrective surgery in neonates with congenital heart disease, in so doing further establishing Green Lane Hospital on the international stage.
In recognition of these and other achievements he was knighted in 1971. Sir Brian showcased the Green Lane experience at many international meetings, as well as in workshops he hosted in Auckland. The 1987 Asian Pacific Congress was a particular success for him for the size of the international contingent it drew and the bright spotlight it shone on Green Lane’s history of achievement. In 1985 he and John Kirklin published their authoritative text “Cardiac Surgery,” referred to by his staff as The Book has become the definitive text for cardiac surgery.
Christiaan Barnard wrote of Sir Brian—“I had the privilege of meeting Sir Brian at Green Lane Hospital in Auckland where his surgical unit had achieved an international reputation. What struck me was his single-mindedness—a clear-sighted striving towards a goal and a vision. Little wonder that he refused to suffer bureaucratic limitations on his work and plans. Having gone down that same road, I can identify strongly with his epic fights with bureaucracy for a better deal for his unit and an improved health service for his country. Fame he had, fortune he spurned—turning down lucrative overseas offers and preferring instead to stay with the team he had built up and the country of his birth.”
My personal memories of this outstanding cardiac surgeon stem from my commencement in perfusion at Green Lane in 1972. Sir Brian, BB as he was known to the staff, was a hugely charismatic leader of the cardiac unit. By then, he had cemented an era of surgical innovation and prolific clinical research. His demeanor in the operating room was one of complete control and calm, and while he commanded great respect, he had an engaging friendliness and sense of humor. BB was an outstanding teacher and an inspiration to those of us who worked with him that remains to this day. He had a keen interest in perfusion having been directly involved from its infancy and followed developments throughout his retirement as Patron of the ASCVP. We were swept along in the excitement of breaking new boundaries and innovative research with a wonderful team spirit that comes with outstanding leadership and achievement. His death marks the end of an era for cardiac surgery—he is sadly missed.