Beyond the Surgeon – Meet Your Anaesthetist & ICU Team
Who looks after you during aortic surgery, and what happens afterwards in intensive care? Dr Martin Lees from Barts Heart Centre introduces the anaesthetists, perfusionists and ICU specialists who work alongside surgeons to keep patients safe and support their recovery.
The team behind your aortic surgery
When patients are told they need major aortic surgery, it's natural to focus on the surgeon who will perform the operation. But there is another team of specialists whose work is just as important to the patient's care.
At our 2026 Annual Patient Event in Birmingham, Dr Martin Lees, Consultant Cardiac Anaesthetist and Clinical Director of Cardiac Anaesthesia and Cardiac ICU at Barts Heart Centre, St Bartholomew's Hospital, London, introduced the people and procedures involved in keeping patients safe before, during and after surgery.
His presentation, “Meet your anaesthetist, don't forget the perfusionist! ICU and beyond”, offers an insight into a part of the surgical journey that patients and families may know relatively little about.
In this talk
- What a cardiac anaesthetist does and how patients are prepared for surgery.
- Why anaesthetists, surgeons, perfusionists and theatre staff must work closely together.
- How the heart-lung bypass machine supports patients during complex aortic operations.
- How cooling, specialist monitoring and controlled circulatory arrest help protect the brain.
- What happens in intensive care following surgery.
- How ICU teams manage complications and support recovery.
- Why follow-up care matters, including the management of ICU delirium and its effects on patients.
Preparing for surgery
Martin compares the surgical team to a Formula 1 pit crew, with every member playing a particular role and working together towards the same goal.
Before an operation, anaesthetists assess a patient's medical history, medications, allergies and organ function. This helps them understand individual risks, plan the anaesthetic and explain what patients can expect.
During surgery, the anaesthetic team is responsible for far more than putting someone to sleep. They monitor and manage breathing, blood pressure, heart function and other vital systems, using specialised equipment to identify potential problems and respond to them.
The vital role of the perfusionist
One of the less familiar members of the surgical team is the perfusionist, a specialist clinical scientist responsible for operating the heart-lung bypass machine.
During certain types of aortic surgery, surgeons need to temporarily interrupt blood flow or stop the heart so that they can work safely. The heart-lung machine takes over essential functions, circulating and oxygenating the blood while the operation takes place.
Martin explains how some complex procedures also require a carefully planned period of circulatory arrest, during which blood circulation is temporarily interrupted.
To reduce the risks, patients may be cooled and oxygenated blood can be supplied directly to the brain. Specialist monitoring helps the team assess brain oxygen levels and electrical activity, allowing them to identify and respond to potential problems.
He also describes how advances in perfusion technology and ongoing research at Barts Heart Centre are helping teams refine these techniques and improve the information available for clinical review.
What happens in intensive care?
The anaesthetist's involvement doesn't necessarily end when the operation finishes.
Martin also works as an intensive care specialist and explains that the ICU is where patients receive the support they need while their bodies recover from major surgery.
Some patients will initially require assistance with breathing, kidney function or other organ systems. Intensive care teams monitor these needs closely and gradually reduce support as patients improve.
Care involves a much wider group of professionals, including specialist nurses, physiotherapists, pharmacists, microbiologists, radiographers and surgeons.
Martin explains how these teams actively look for signs of complications, rather than simply waiting for problems to develop.
As patients recover, the focus moves towards breathing independently, eating, getting out of bed and preparing to leave intensive care.
Recovery doesn't end when you leave ICU
For some patients, the effects of major surgery and intensive care can continue long after discharge.
Martin describes the importance of post-ICU follow-up clinics, where patients and families can discuss their experiences, ongoing symptoms and any concerns about recovery.
During the audience questions, he also addresses ICU delirium, which can involve confusion, agitation or vivid hallucinations.
He explains that the causes are not fully understood, but that intensive care teams are working to improve how they recognise and manage the condition, including reviewing medications, investigating possible underlying problems and refining sedation practices.
For patients who have experienced delirium, the opportunity to discuss what happened afterwards can be an important part of recovery.
Looking beyond the surgeon
Martin's presentation is a reminder of how many highly trained professionals contribute to a successful surgical journey.
From the initial assessment and anaesthetic plan to heart-lung bypass, intensive care and follow-up, each stage depends on specialist expertise and teamwork.
For patients and families facing aortic surgery, understanding who these professionals are and what they do can help make an unfamiliar and sometimes daunting experience easier to navigate.
Watch Dr Martin Lees's full presentation above.
