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The Lancet A Surgeon and a Scientist

05 February, 2000

Magdi Yacoub: a surgeon and a scientist.

In retrospect, it seems that Sir Magdi Yacoub was destined from an early age to become a cardio- thoracic surgeon. Now one of the world’s leading heart transplantation surgeons, his choice of career was influenced both by his father’s work as a general surgeon in Egypt and by the early death of his aunt from uncorrected mitral stenosis. But his choice was also affected by his strong interest in science, including “a fascination with the biological and mechanical aspects of heart function”. Transplantation, Yacoub suggests, relies “possibly more than any other branch of medicine on basic science”.

Yacoub, who was knighted in 1991 for his contribution to cardiothoracic surgery, is British Heart Foundation professor of cardiothoracic surgery at Imperial College School of Medicine (London, UK). He divides his time spent doing clinical work between the Royal Brompton and Harefield Hospitals, and his eagerness to explore new ideas is perhaps the key to his success in building up one of the UK’s largest multidisciplinary groups of basic scientists dedicated to research in cardiac diseases.

“Yacoub is one of those polymaths and philosophers who has succeeded in establishing connections between conventionally unrelated scientific disciplines, and between basic and clinical research”, explains cardio- thoracic surgeon Marc DeLeval (Great Ormond Street Hospital for Children, London, UK). In this way, Yacoub “has contributed to the vital role of integration in an era of ever- increasing specialisation and scien­tific tunnel-vision”, says DeLeval. And, adds O H (Bud) Frazier (Texas Heart Institute, Houston, TX, USA), Yacoub’s “energy and achievements in heart transplantation and heart failure have been invaluable to all of us who have had the benefit of his inquiring mind”.

Transplantation accounts for 15-20% of Yacoub’s surgical work­load, with coronary revascularisation, valve surgery, and surgery for com­plex congenital heart disease making up the rest. In addition to his heavy clinical workload, Yacoub still makes time for basic research, which recently has included investigations into the role of growth factors in the development of coronary intimal hyperplasia and of the antiprolifera­tive activity of endogenous nitric oxide. He is also investigating the use
of cell transplantation in treating heart disease. And he is studying the molecular, cellular, and functional characteristics of human heart valves, with a view to tissue engineering of such valves.