2019 Clarence Crafoord memorial lecturer
Professor Dr Med Dr h c Axel Haverich, Hannover, Germany
Born 1953, Axel Haverich studied medicine in Hannover, graduated in 1978 and pursued a career in thoracic and cardiovascular surgery, becoming senior surgeon (Oberartz) in 1985 in the Medizinische Hochschule Hannover (MHH). Axel Haverich is the Director of MHH Heart- Thoracic- Transplantation- and Vascular Surgery since 1996, after a period (1993-1996) as Director of Cardiovascular surgery at the Christian-Alberts-Universität, Kiel. As oberartz, Haverich served under Professor Dr Med Hans Borst, the inventor of the elephant trunk concept (first performed in Hannover in 1982). The elephant trunk has been championed by Haverich and coworkers and further developed into the frozen elephant trunk (FET), introduced in 2001 . Initially, the Chavan-Haverich custom-made endograft was used for the purpose, with the same outstanding outcomes as later developed commercially available devices . Currently in Hannover, acute type A (DeBakey type I) aortic dissection is routinely managed with FET with excellent outcomes  and as demonstrated by the International Aortic Arch Study Group, the strategy is proliferating, with good outcomes, offering the promise of reduced risk of late reintervention on the downstream aorta .
In 1996, Haverich was bestowed the prestigious Leibniz prize and founded LEBAO, Leibniz Research Laboratories for Biotechnology and Artificial Organs. At LEBAO, clinical applications and development of stem cell research, tissue engineering, and bioartifical organs are in focus. Decellularization of human valve tissue has been explored in detail resulting in the Espoir and Arise pulmonary and aortic valves, respectively [5-6]. Another intriguing concept is the vascularized myocardial patch. While direct stem cell injection in infarcted myocardial areas has been difficult to prove beneficial, replacing an infarcted area with bioengineered tissue including cardiomyocytes as well as vasculature may improve outcomes. LEBAO is currently part of the larger Hannover REBIRTH cluster of excellence.
Haverich is co-author of well above 600 scientific articles. Along with aortic surgery and tissue engineering, he has made substantial contributions in several fields of cardiothoracic research, clinical and experimental: coronary artery disease and treatment, heart failure, ventricular assist devices and transplantation, to mention a few. In a recent personal account, Haverich describes how a medical student, by asking out-of-the-box questions during a coronary artery bypass grafting procedure, inspired a new take on coronary artery atherosclerosis and potential treatment .
A distinguished and internationally recognized surgeon, Haverich is reviewer and editorial member in several scientific journals; member of numerous national and international surgical societies and receiver of considerable research funding from external sources.
1. Shrestha M, et al. The elephant trunk is freezing: The Hannover experience. J Thorac Cardiovasc Surg 2015;49(5):1286-93.
2. Chavan A, et al. Hybrid endograft for one-step treatment of multisegment disease of the aorta. J Vasc Interv Radiol 2005;16(6):823-9.
3. Shrestha M, et al. Total aortic arch replacement with the frozen elephant trunk procedure in acute DeBakey type I aortic dissections. Eur J Cardiothorac Surg 2017;51(suppl 1):i29-34.
4. Poon SS. Frozen elephant trunk does not increase incidence of paraplegia in patients with acute type A aortic dissection. J Thorac Cardiovasc Surg 2019 In press (doi:10.1016/j.ctvs.2019.03.097)
5. Tudorache I, et al. Decellularized aortic homografts for aortic valve and aorta ascendens replacement. Eur J Cardiothorac Surg 206;50(1):89-97.
6. Boethig D, et al. A European study on decellularized homografts for pulmonary valve replacement: initial results from the prospective ESPOIR trial and ESPOIR registry data. Eur J Cardiothorac Surg 2019, In press (doi:10.1093/ejcts/ezz054).
7. Haverich A. A surgeon’s view on the pathogenesis of atherosclerosis. Circulation 2017;135(3):205-7.