Intended for healthcare professionals

Feature Healthcare innovation

When patients innovate

BMJ 2019; 364 doi: (Published 29 March 2019) Cite this as: BMJ 2019;364:l1474
  1. Jacqui Thornton, freelance journalist
  1. London, UK
  1. jacqui{at}

Patients have unique insights to invent tools that improve outcomes and make life easier, but Jacqui Thornton finds that it can be a long slog getting an invention used widely

This March, in Australia, a landmark passed quietly for Tal Golesworthy, a chartered engineer from Cheltenham in the UK.

He was in Melbourne with the cardiothoracic surgeon Conal Austin to speak at the Australasian Thoracic Aortic Symposium about personalised external aortic root support (PEARS), an operation in which an implant supports the patient’s own aorta and aortic valve, and is designed to prevent enlargement and rupture.

While in Australia, Austin, based at Guy’s and St Thomas’ NHS Foundation Trust, carried out six of these life changing operations as a visiting surgeon.

Golesworthy knew exactly what those patients were going through, because he experienced the first operation of this kind, nearly 15 years ago, for aortic dilatation relating to his Marfan syndrome.

What was the difference between him and these latest patients? Golesworthy had used his engineering skills to invent the implant used in PEARS surgery after he had been told the only clinical option for him was total aortic root replacement, which offers patients the drawback of a lifetime of anticoagulant therapy. He refused and set about developing an alternative, which was successfully implanted in him in 2004.

The benefits of PEARS include a shorter operation with no need for cardiopulmonary bypass, shorter stays in intensive care, and a very low reoperation rate.

Golesworthy has been dubbed “the man who fixed his aorta.” He admits, when pressed, that he’s the “ultimate patient innovator.”

The “ultimate patient innovator”

With the six recent Australian operations, 200 people have had the PEARS surgery in 23 specialist centres around the world, including Australia, Belgium, the Czech Republic, Ireland, Malaysia, the Netherlands, New Zealand, and the UK.

But it’s …

View Full Text

Log in

Log in through your institution


* For online subscription