Harefield Hospital

From general hospital to cardiac specialist 

When drugs were introduced to treat tuberculosis in the mid-1940s and the NHS was  formed, Harefield became a general hospital.   

It later developed an expertise in the treatment of chest disease and became famous around the world for pioneering surgical techniques, treating diseases of the oesophagus and lung and, with the advent of heart surgery in 1947, a specialisation in cardiac work.  

On 4 December 1947, Sir Thomas Holmes Sellors - the first thoracic surgeon at Harefield - carried out the world’s first direct pulmonary valvotomy (surgical incision of a heart valve).  

In more recent times, the work of Professor Sir Magdi Yacoub and his team established Harefield as an international centre of cardiac excellence. The paediatric cardiac service at Harefield began with his appointment as a cardiothoracic surgeon in 1969.   

Professor Yacoub and his team pioneered the use of human heart valves in the late 1960s, as opposed to artificial valves, with amazing success.  

The number of cardiac operations at Harefield trebled and the hospital quickly became the second largest centre in the country. On 8 September 1973, the team carried out its first heart transplant – an operation for which the hospital was later to become famous.  

In the early 1970s, as the regional centre, Harefield provided care to a third of those in need of cardiothoracic treatment in the London area.   

In 1976, a two-stage operation for anatomical correction for children of a complex condition known as ‘transposition of the great vessels’ - in which the aorta and pulmonary artery leave the wrong side of the heart - was pioneered at Harefield. Harefield surgeons started doing the operation in the first few weeks of the child’s life and were probably the first in the world to perform one successfully.  

The world’s first heart/lung transplant 

In 1983, Professor Yacoub carried out the first heart/lung transplant worldwide and the following year he performed a heart transplant on a baby less than a month old.  

In May 1987, the first ‘Domino Procedure’ was performed. It was believed that transplanting both the heart and lungs together was more successful than transplanting lungs alone. But in cystic fibrosis patients whose lungs needed transplanting but whose hearts were healthy, this meant a healthy heart was removed - making it available for transplant. The Domino Procedure is the process whereby a patient in need of a heart transplant was lined up to receive this healthy heart.  

Other areas of expertise 

Less well known is that since 1940 Harefield also treated disease and injury to the lungs and oesophagus. The oesophageal cancer service, which started in the late 1940s, is now nationally recognised for its ground-breaking work.  

Leadership and technology 

The cardiology department at Harefield has developed a national reputation for its innovative work. The department developed a high volume angioplasty service and pioneered mobile cathetorisation services to local hospitals. 

In 1995, Harefield and the National Heart and Lung Institute of Imperial College London, pioneered the development of artificial left ventricular assist devices (devices that assist the heart to pump). Initially the devices were used as a bridge to transplant, for people with severe heart failure. In recent years ‘implantable LVADs’ have been used as a treatment for life. 

Merger with Royal Brompton Hospital 

In 1998 Harefield merged with Royal Brompton Hospital to form the Royal Brompton and Harefield NHS Trust. The merger led to many advances in treatment by successful cross-site working, such as transplantation for patients with cystic fibrosis. 

Harefield Research Foundation 

The Harefield Research Foundation was formed in 2000 to carry on the work of Professor Yacoub and his team of clinicians and scientists. Located in the Heart Science Centre, the Foundation became known as the Magdi Yacoub Institute in February 2004. 

The ANZAC centre 

In 2003, the ANZAC centre was opened, accommodating outpatients, phlebotomy and respiratory physiology (lung function), the transplant clinic, echocardiology and nuclear medicine. Taking over three years to plan and build and costing £4 million, the centre replaced older facilities.