Special Interview with The Heart Surgery Forum Editorial Board Member Dr. Shahzad Gull Raja: Insights into Coronary Surgery Advancements and Journal’s Development

Dr. Shahzad Gull Raja is an internationally recognized cardiac surgeon at Harefield Hospital, London, UK, and a member of the Editorial Board of The Heart Surgery Forum (HSF). He has been listed among the top 2% of scientists globally for five consecutive years, reflecting the sustained international impact of his academic work.

 

	Dr. Shahzad Gull Raja, MD, MRCS, FRCS
	Department of Cardiac Surgery, Harefield Hospital, London, UK
	Interests: coronary artery bypass surgery; minimal access aortic valve surgery; arterial revascularisation; endoscopic vein harvesting; keyhole heart surgery; TAVI
	Special issue: "Updates and Challenges in Coronary Surgery"

 

Building on this academic standing, Dr. Raja is not only an Editorial Board Member but also serves as the Guest Editor of the HSF. This interview aims to explore his academic journey, perspectives on current frontiers in coronary surgery, and, as guest editor, his insights into the planning of this special issue, “Updates and Challenges in Coronary Surgery”, while also sharing his experience serving in multiple editorial roles for the journal.

Part 1: Academic Journey and Research Focus

1. Could you briefly introduce your academic background and current main research interests? And what specific research area have you been focusing on recently, along with any breakthroughs or progress achieved in this area?

My academic journey has been shaped by a longstanding commitment to advancing coronary surgery through both clinical innovation and rigorous scientific inquiry. I completed my formal surgical training with a focus on coronary revascularization, and over the years, I have been privileged to work in environments that encouraged both high-volume clinical practice and meaningful academic contribution. This dual exposure has allowed me to develop a research portfolio that is closely aligned with real-world clinical challenges.

My primary research interests center on coronary artery bypass grafting (CABG), particularly off-pump coronary artery bypass (OPCAB), graft patency, and long-term outcomes following different revascularization strategies. In recent years, I have focused intensively on the evolution of OPCAB techniques, the nuances of patient selection, and the long-term comparative effectiveness of surgical versus percutaneous revascularization. This has included work on understanding the mechanistic reasons behind graft failure, the role of anaortic techniques in stroke prevention, and the integration of OPCAB into hybrid revascularization strategies.

A key area of progress has been synthesizing the rapidly expanding evidence base into clinically meaningful insights—clarifying where OPCAB offers clear advantages, where its limitations lie, and how surgical techniques can be optimized to improve long-term outcomes. Through systematic reviews, meta-analyses, and collaborative research efforts, I have contributed to a more nuanced understanding of how surgical strategy influences survival, stroke risk, and the durability of revascularization. This work has helped inform contemporary practice patterns and has supported a more evidence-based approach to selecting the optimal revascularization modality for individual patients.

2. You have been selected for the global Top 2% Scientists list for five consecutive years, which reflects the sustained international impact of your research in the field. In your view, what would you attribute this consistent academic influence to in terms of the characteristics or commitments in your research work? For instance, is it due to a long-term, in-depth focus on specific clinical issues, or a distinctive methodological approach?

Being included in the global Top 2% Scientists list for five consecutive years is an honor, and I view it as a reflection not only of productivity but of consistency, focus, and relevance. If I were to identify the key factors behind this sustained academic influence, I would highlight three elements.

First, I have maintained a long-term, in-depth focus on a clearly defined set of clinical questions. Coronary revascularization—particularly OPCAB—has been an area of both passion and persistence for me. By concentrating on a specific domain over many years, I have been able to contribute work that builds on itself, deepens understanding, and remains clinically meaningful.

Second, I have always aimed to align my research with real clinical problems. Much of my work comes directly from the operating room and the bedside—questions about graft durability, stroke prevention, or technique refinement are not abstract academic exercises but issues that affect patient outcomes every day. This clinical grounding ensures that the research remains relevant and impactful.

Third, I place strong emphasis on methodological rigor and transparency. Whether conducting meta-analyses, synthesizing evidence, or evaluating long-term outcomes, I strive to ensure that the work is robust, reproducible, and clearly communicated. This commitment to quality has helped the research resonate internationally and remain influential over time.

Ultimately, I believe that sustained academic impact comes from a combination of focus, curiosity, and a genuine desire to improve patient care. The recognition is gratifying, but the real motivation continues to be advancing the field in ways that meaningfully benefit patients.

Part 2: Frontiers and Hot Topics in the Field

1. You have participated in multiple important research projects, such as the UK TAVI trial and AMBITION trial. Combining your research experience, what do you think are the current hotspots and key research directions in the field of cardiac surgery? How can The Heart Surgery Forum (HSF) better capture and reflect these cutting-edge trends?

Cardiac surgery is undergoing one of the most dynamic periods of transformation in its history. My involvement in major trials such as the UK TAVI trial and the AMBITION trial has reinforced how rapidly the boundaries between surgical and transcatheter therapies are evolving. Several key research directions stand out.

First, structural heart disease interventions continue to expand, with TAVI, transcatheter mitral repair/replacement, and emerging tricuspid technologies reshaping traditional surgical indications. Understanding long-term durability, patient selection, and the optimal integration of surgical and transcatheter approaches remains a central research priority.

Second, coronary surgery is entering a new era, driven by anaortic techniques, advanced conduit strategies, and the maturation of hybrid revascularization. There is growing interest in how surgical precision—whether through OPCAB, minimally invasive access, or robotic platforms—can be combined with PCI to create more individualized treatment pathways.

Third, perioperative optimization and enhanced recovery are becoming increasingly evidence-based. Research on frailty, myocardial protection, neurological outcomes, and organ-preservation strategies is reshaping how we define “success” beyond survival alone.

Finally, data science and artificial intelligence are emerging as powerful tools for risk prediction, imaging interpretation, and intraoperative decision-making. Their integration into cardiac surgery is still in its early stages but represents a major frontier.

For The Heart Surgery Forum, the opportunity lies in being a platform that not only reports these developments but contextualizes them. HSF can amplify its impact by prioritizing rapid publication of emerging techniques, inviting expert perspectives on evolving technologies, and fostering dialogues between surgeons, interventionalists, and imaging specialists. By doing so, the journal can remain at the forefront of the field’s most important conversations.

2. As the guest editor of HSF's special issue "Updates and Challenges in Coronary Surgery", this issue covers 16 key topics ranging from graft selection to reoperative CABG and surgical training. How did you determine these topics during the planning process? Were they derived from unresolved dilemmas you observed in clinical practice or trends in frontier research?

The 16 topics included in the special issue were chosen through a deliberate process that combined clinical relevance, scientific momentum, and the practical challenges faced by surgeons worldwide. Many of these themes—such as graft selection, anaortic OPCAB, reoperative CABG, and training—reflect persistent dilemmas that clinicians encounter daily. Others, such as hybrid revascularization and minimally invasive techniques, represent areas where innovation is outpacing widespread adoption, creating a gap between what is possible and what is routinely practiced.

In planning the issue, I aimed to strike a balance between long-standing controversies and emerging frontiers. The goal was to create a resource that not only summarizes current evidence but also highlights where further research is urgently needed. The topics were therefore derived from both clinical observation and the trajectory of contemporary research—areas where new data are rapidly accumulating, yet consensus remains elusive.

Ultimately, the special issue was designed to serve as a roadmap for the future of coronary surgery, identifying the questions that matter most and the areas where progress will have the greatest clinical impact.

3. This special issue focuses on hot topics such as "minimally invasive and robotic CABG" and "hybrid coronary revascularization". In your opinion, what are the main bottlenecks restricting the clinical popularization of these innovative technologies? What breakthroughs are expected in the next 5–10 years to promote their development?

Minimally invasive and robotic CABG, along with hybrid coronary revascularization, represent some of the most promising innovations in the field. However, several bottlenecks continue to limit their widespread adoption.

The first challenge is technical complexity and the steep learning curve. Robotic and minimally invasive CABG require specialized training, dedicated teams, and consistent case volumes—conditions that are not universally available. This creates variability in outcomes and slows broader uptake.

Second, infrastructure and cost barriers remain significant. Robotic platforms and hybrid operating suites require substantial investment, and many institutions struggle to justify these costs without clear reimbursement pathways or high procedural volumes.

Third, evidence gaps persist, particularly regarding long-term outcomes and comparative effectiveness. While early results are promising, large-scale randomized data remain limited, and this affects guideline recommendations and institutional decision-making.

Looking ahead, several breakthroughs are likely to accelerate adoption over the next 5–10 years. Advances in robotic instrumentation, imaging integration, and automation will make procedures more reproducible and accessible. The expansion of structured training programs and simulation-based learning will help flatten the learning curve. Additionally, as hybrid revascularization becomes more standardized and supported by stronger evidence, it is likely to be embraced as a mainstream strategy rather than a niche approach.

In combination, these developments will help shift innovative coronary techniques from specialized centers to broader clinical practice, ultimately improving patient choice and outcomes.

Part 3: Collaboration with the Journal and Suggestions

1. How did you first become acquainted with HSF, and what motivated you to join the journal’s Editorial Board?

My initial exposure to The Heart Surgery Forum (HSF) came through its consistent presence in the cardiothoracic literature, particularly its emphasis on clinically grounded research and its openness to emerging surgical technologies. Over time, I frequently recommended HSF articles to colleagues and trainees, which naturally deepened my engagement with the journal.

What ultimately motivated me to join the Editorial Board was the journal’s clear commitment to scientific rigor, rapid dissemination, and global accessibility. The open-access model aligns strongly with my belief that high-quality cardiovascular research should be available to clinicians and investigators regardless of institutional resources. Additionally, HSF’s willingness to explore innovative and sometimes underrepresented topics in cardiac surgery resonated with my own academic interests. Serving on the Editorial Board offered an opportunity to contribute to shaping the journal’s scientific direction and to support authors in presenting impactful, methodologically sound work.

2. HSF is an international peer-reviewed open-access journal that encourages the submission of original research and clinical practice-related content. Combining the characteristics of this special issue, what suggestions do you have for young researchers who intend to submit manuscripts to this special issue? For example, how can they highlight the innovation and clinical relevance of their research?

For young researchers, this special issue provides an excellent platform to showcase work that bridges scientific novelty with tangible clinical value. To maximize the impact of their submissions, I would emphasize several key points:

• Articulate the innovation clearly and early. Reviewers and readers should immediately understand what is new—whether it is a methodological refinement, a novel biomarker, a surgical technique, or a translational insight. A concise statement of innovation in the introduction is essential.
• Demonstrate clinical relevance with evidence. It is not enough to claim that a finding is clinically meaningful; authors should explicitly link their results to current clinical challenges, unmet needs, or controversies in practice. Comparative data, risk–benefit considerations, and potential implications for decision-making strengthen this connection.
• Ensure methodological transparency. Young researchers sometimes underestimate how much clarity in study design, statistical methods, and reproducibility contributes to perceived rigor. Transparent reporting enhances credibility and facilitates constructive peer review.
• Contextualize findings within the broader literature. Innovation is best appreciated when situated within existing knowledge. A well-structured discussion that acknowledges limitations and outlines realistic next steps demonstrates maturity and scientific integrity.
• Highlight multidisciplinary relevance. Cardiac surgery increasingly intersects with imaging, engineering, computational modeling, and perioperative medicine. Manuscripts that reflect this interdisciplinary landscape often resonate strongly with HSF’s readership.

By focusing on these elements, young investigators can present work that is both scientifically compelling and clinically meaningful.

3. Based on your experience as a guest editor of this special issue and your long-term service as an editorial board member of multiple journals, what constructive suggestions do you have for HSF in terms of planning future special issues (such as topic selection, guest editor collaboration, etc.)?

HSF is well positioned to continue expanding its influence through strategically curated special issues. Based on my experience, several approaches could further strengthen future initiatives:

• Prioritize forward-looking and cross-disciplinary themes. Topics such as artificial intelligence in cardiac surgery, minimally invasive and hybrid procedures, perioperative optimization, and long-term survivorship are areas where rapid developments are occurring. Special issues that anticipate emerging trends can attract high-impact submissions.
• Engage diverse guest editors. Inviting guest editors from different regions, subspecialties, and methodological backgrounds enriches the scientific scope and broadens the journal’s international reach. Collaborative guest editorship—pairing clinical and basic science experts, for example—can also enhance thematic coherence.
• Promote structured calls for high-quality submissions. Early dissemination of the special issue theme, along with clear expectations regarding methodological rigor and novelty, helps attract strong manuscripts and encourages early-career researchers to participate.
• Integrate invited reviews and expert perspectives. Including state-of-the-art reviews or consensus statements can anchor the special issue and provide readers with a comprehensive overview of the field.
• Leverage digital engagement. Webinars, social media highlights, and author interviews can amplify the visibility of special issues and foster community engagement around the selected topic.

These strategies can help HSF continue to curate special issues that are timely, influential, and widely cited.

4. As a Guest Editor, how has your experience been working with the HSF editorial team, particularly in terms of academic communication, efficiency, and editorial support?

My experience working with the HSF editorial team has been consistently positive and highly professional. Communication has been clear, timely, and academically focused, which greatly facilitates the coordination of peer review and manuscript decisions. The editorial staff demonstrates a strong understanding of the scientific and ethical standards required for high-quality publishing, and they provide thoughtful guidance when complex editorial questions arise.

In terms of efficiency, the editorial process is well-managed and responsive, allowing manuscripts to progress through review without unnecessary delays. This is particularly important for authors who value rapid yet rigorous evaluation. I have also appreciated the team’s effective execution in managing the special issue, particularly in maintaining efficient reviewer correspondence and a smooth manuscript handling process.

Overall, the editorial support has been exemplary, and the collaborative environment has made the guest editor role both productive and rewarding.

This insightful conversation with Dr. Shahzad Gull Raja has illuminated the evolving landscape of coronary surgery, from the refinements in OPCAB and arterial grafting to the frontiers of robotics and hybrid procedures. His dedication to rigorous, clinically relevant research, coupled with his strategic vision for HSF's Special Issue, underscores a deep commitment to advancing the field for the benefit of patients worldwide. We extend our sincere gratitude to Dr. Raja for sharing his expertise and perspectives.

The Heart Surgery Forum remains committed to publishing high-quality research and fostering dialogue on the most pressing issues in cardiac surgery. We invite researchers and clinicians to contribute to our ongoing discourse and explore our latest publications, including the Special Issue "Updates and Challenges in Coronary Surgery".

 

Welcome to learn more about The Heart Surgery Forum and submit your work:

Journal Homepage: The Heart Surgery Forum

Special Issue "Updates and Challenges in Coronary Surgery"