Mr. Sid Yarrow: Perfusion Pioneer

Perfusion Profiles

Mr. Sid Yarrow:  New Zealander :  Perfusion Pioneer

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A Pioneer Passes…

Editors Note:  The first part of this story was posted by Tim Willcox, CCP (Australia) on Perflist.

I felt it such an inspiring story, that I tried to dig up a little bit more on Sid.  I added just a little about the “whole lot more” that he has accomplished.

Thank you Tim, for sharing the  difficult news, and including such an  inspiring story for the rest of us who follow the course of Perfusion.

“It is with a mixture of sadness and nostalgic pride to report the death of one of the pioneers of perfusion, New Zealander Sid Yarrow on Monday May 23 2011.”  (Tim Wilcox, CCP)

Sid was recruited to Green Lane Hospital in 1954, to what was then the national cardiac surgical unit, by cardiologist James Lowe to work in the cath lab. Around 1957 following the advent of CPB in the US, Sid was to play a pivotal role with Barratt-Boyes, David Cole and others in a series of experimental procedures trying to perfect a model of heat lung bypass.

In the US in Minnesota Dr DeWall had invented his simple bubble oxygenator. Sid built one of these himself and it was used in early animal experiments in the run-up to the first bypass operation. It was never used cliniclly as barrat-Boyes arranged the import of a Melrose Heart Lung machine from the UK. This duly arrived with no instructions for use,  working diagrams and missing essential parts and Sid was charged with getting it functional.

Sid designed a whole raft of parts from scratch for the heart lung machine – some of which remained in use for many years – notably the renowned venous reservoir. This allowed blood to be drained from the heart to this small height adjustable reservoir before being pumped into the oxygenator and it allowed excellent venous drainage. In those days and even when I started – pretty much every part of the heart lung machine circuit was reused. Sid describes how he set about solving problems including how to safely sterilize and reuse this equipment. This included salvaging an old steam sterilizer from the dump and a pump from a milking shed to provide vacuum – begging some ETO gas from his contacts in Australia and running a bunch of experiments with some spectacular failures but ending up building the first working ETO gas sterilizer in NZ.

His innovation was boundless and he went on to build the first pacemaker to be used in NZ Quoting Sir Brian Sid recounts
“BB said one day – now look Sid I want to see you. When we start doing VSDs we’ll get heart block and we’ll need a pacemaker so you’d better make one – just go and do it.   So in my spare time, which actually didn’t exist hardly, I built the 1st pacemaker in a large metal box and we used that and that was our only pacemaker – that also was the first pacemaker ever used in NZ.” This was in 1959.

There actually is a photo of a situation where a patient on the ward had this large apparatus in use and a second patient urgently needed pacing so Sid went to the ward and rigged the second patient to the same pacing device and they are side by side like Siamese twins.

New Zealand’s 1st Open heart Operation

All of this work came together to eventuate in the first open heart operation in New Zealand in 1958 and Sid was of course part of that historic team – the sole remaining survivor as far as I know is Jack Watt the anaesthetist.

(Of that Era…  Not the one used in New Zealand)

Those early days of heart surgery, as surgeon David Haydock remarked the other day, must have been a daily adventure – so much was unknown, no safety devices and as I point out in the photo of that 1st operation the only monitor in sight is Sid’s watch.

The use of donor blood in large amounts was routine  – 6 to 8 pints to fill the heart lung machine  – today in adults most often we use none.

Sid recalls “BB said we must use whole blood to put in the machine, it should be fresh and collected under heparin. And so we had a donor panel, the blood was drained by gravity into a bottle. The donors would come along and give their blood and it would be transported to the theatre. I was on the panel actually and very often I had the experience of putting my own blood into the machine. In those days they were glass bottles of blood which were labelled with the donor’s name and the recipient’s name. So one day the anaesthetist  – Jack Watt – saw my name on the bottle. He said “Here give me that” and held it up and said to BB “what do you think of that”. BB read my name and said “Oh – keep that to the end and use the good stuff first”  – that was the only time I think I heard him crack a joke.”

An Award in His Name

Sid went on to head the technical department of physiology which included the pacemaker clinic, cardiac investigation lab, the respiratory lab, the electronics lab and of course the then bypass unit later known as clinical perfusion.

Sid’s interest in perfusion extended beyond NZ and he played a major role in the establishment of the Australasian Society of Cardiovascular Perfusionists (now the Australia and New Zealand College of Perfusionists) and the Board of Perfusion responsible for educating and credentialing perfusionists in Australia and NZ.

He was made a Life Member of the College and has an award in his name which states: Founded in 1993, this award was named to recognise the outstanding contribution of Sid Yarrow to the perfusion profession over his long career. It is awarded to a student member of the Society who has made the best presentation at its Annual Scientific Meeting.

I have received messages of condolence from across New Zealand Australia and the USA recognising Sid’s outstanding contribution to the field of perfusion.

In His Honor…

“Sid, we the perfusion community salute your great contribution to the field of cardiac surgery and bid you farewell.
I count it an honour and a privilege to have been a colleague and friend.”

(Tim Willcox, CCP)

Sid is survived by his wife Joan, three daughters and grandchildren.

Tim Willcox CCP(Aust)
Chief Clinical Perfusionist, Green Lane Perfusion
Auckland City Hospital
Hon Senior Lecturer, Department of Anaesthesiology
Faculty of Medical and Health Sciences
University of Auckland
[email protected]

“I Felt On Top Of The World…”

Source:  The Times Online: New Zealand

INVENTOR Sid Yarrow is to pacemakers what Sir Brian Barrett-Boyes is to open heart surgery.

Times photo Wayne Martin.

They’re both pioneers and were on the same team of top medical and technical experts to first conduct heart surgery in New Zealand almost 50 years ago.

Howick’s Mr Yarrow, under determined instruction from Sir Brian, invented the first pacemaker for heart operations in the 1950s at Greenlane Hospital.

Of the experience Mr Yarrow says: “I felt on top of the world. I’d never had such a ball of a time in all my life. Throughout the 30-odd years I worked there, I always felt that way. I was the luckiest guy in the world to get that job.”

The 82-year-old has just received an honour for his work accomplishments and is very pleased to now be a life member of the Australiasian Society of Cardio-Vascular Perfusionists.

The society has also created a Sid Yarrow Award, which it says encourages high standards of professional activity from students on a clinical perfusion structured course provided by the Australasian Board of Cardiovascular Perfusion.

Mr Yarrow is originally a Londoner and came to New Zealand after the Second World War.

During the conflict Mr Yarrow used his technical aptitude in servicing and maintaining Range Direction Finding (RDF) equipment, the name the British used for what was later termed radar by United States military personnel.

“I was always interested in electronics. I did radar in the radar branch of the air force.”

He joined the Auckland Hospital Board’s National Cardio Surgical Unit in 1954.

“The head of the surgical unit was Sir Douglas Robb, a remarkable man and very likeable, who was very kind to me,” says Mr Yarrow.

“I proceeded to learn as much as I could about cardiac surgery and cardiology which was quite easy because I had access to the medical libraries and I asked countless questions of the senior medical people.”

When Sir Douglas stood back from leadership duties, Sir Brian was appointed in 1956 to head Greenlane Hospital’s now world-famous surgical unit.

Mr Yarrow says work in developing new operating techniques and equipment sped into top gear. Sir Brian had returned from years studying and working in the United States and his knowledge of the workings of the heart were far more advanced than for anyone else in New Zealand.

“That’s typical of BB [Sir Brian]. I was working all hours of the day and night,” says Mr Yarrow.

“He said, ‘we need a pacemaker, go ahead then, make one’. You couldn’t buy one so I built and designed it myself. It was just expected of me. It was ready by September 3, 1958, when we did our first case.

“I was too busy working to feel much at the time, except there was a great deal of excitement. We knew we were on top of the world and poised to do something that had never been done in this country before.

“Other countries in the world were neck-and-neck with us. But before we could move into the human thing, there was a lot of preparation. I spent hours checking electrical connections. And when it happened, it all went pretty routinely.”

Mr Yarrow says his heart’s in good shape and it’s somewhat ironic that when Sir Brian needed heart surgery of his own, he was only going to have his old Greenlane Hospital colleague on perfusion duties.