Little Hearts, Big Data, Improving Outcomes

Internationally renowned Aussie heart surgeon David Winlaw, MBBS, MD, FRACS, was recently recruited to serve as Division Head of Cardiovascular Surgery, as well as a Co-Executive Director of the Heart Center at Lurie Children's. In an exclusive Q & A for our closest supporters, find out what this surgical innovator and thought leader in the field of pediatric congenital heart disease sees as the most exciting trends ahead, plus one group of patients he remembers fondly and why Chicago feels a little like Sydney. 

What drew you to medicine and to CV surgery in particular?

I am fascinated by the circulation and the interface between the blood and the body and by how the heart does its work so reliably and predictably. And how, unfortunately, sometimes that goes wrong during development. Despite that, circulation still exists, and that’s an amazing area of interest for me and sustains me in my work.

What’s changed in the field over the course of your career?

One of the big changes in our field over the last decade is how much outcomes have improved. The expectation now is that most children who come into care and have big operations, even as babies, will make it through the surgeries and go home. That just wasn't the case ten years ago. We, as a society, a profession, as a group of interested people, have all worked together to make this much better. This happens through continually assessing outcomes, through research and through teaching, so that new concepts and ideas are brought up the academic pathway in a way that benefits practitioners and patients.

What do you see as the most exciting or promising developments in your field? What will be different in CV surgery 10 years from now?

What we've demonstrated so far is that you get better outcomes by making better decisions, so the information that we derive from our pre-operative investigations is super important. And when we develop algorithms that can tell us which particular procedure we should be doing, when we should be doing it and how we should be doing it, we will get better results. We really need big data and data scientists to tell us what the outcomes are and predict the outcome for the specific child that we have in front of us. That is a collaborative exercise because you probably need upwards of 50,000 children with similar characteristics to be able to inform the algorithm of what the likely result will be. I think data science is going to have an enormous impact in the next ten years, and that's really exciting. 

Can you share an anecdote about a patient or patients who had an impact on you or your career?

When I introduced the Norwood procedure in Sydney, there was a rush of families who had babies affected by hypoplastic left heart syndrome and seven or eight babies had this surgery in a space of six weeks. It was just an unbelievable run of this particular problem. The families had all shared that experience and formed a small society that still stays in touch. I'm fortunate to receive lots of updates from families whose kids are now doing really well. But the ones from these families are extra special for me. 

Let’s end with an easy question: Do you see any similarities between Sydney and Chicago?

Sydney and Chicago are both bold and interesting places to live with very diverse populations. We're both on big bodies of water, the Pacific Ocean for Sydney and of course the lake here, and the impact of water on the weather and also your sense of well-being is important. I always want to live close to the water. And the food is extraordinary in both cities!