Professor Daniel Keenan

Danny Keenan practiced the full range of cardiothoracic surgery at the Manchester Royal Infirmary and the Alexandra Hospital throughout his career. He trained, initially in surgery, in Belfast learning, at the “coal face” during the “troubles’, the principles of trauma surgery, completing his training in the UK and the USA.  He is a highly successful Consultant Cardiothoracic Surgeon practicing for 40 years, now retired from active practice.  He remained “on-call” to this busy unit all his career. He practiced the full range of adult cardiac surgery and has been heavily involved in thoracic trauma, both open and closed, experienced virtually all presentations particularly in relation to penetrating chest injuries and rib fractures. He has seen all complications and has actively led in their management.

Cardiac Surgery: Professor Keenan has practiced all aspects of adult cardiac surgery, including coronary artery bypass grafting, valve replacement and repair, and surgery of the aorta, particularly in cases of aortic dissection. He has been an innovator in the development of minimally invasive techniques, leading to the advancement of the “off-pump” approach to bypass grafting. In addition to his surgical innovations, he and his team pioneered the “open approach” to surgical results, advocating for transparency by publishing outcomes openly and engaging with both the public and the media. This initiative paved the way for a national approach to result publication. As a result of these contributions, he was appointed Chair of the first Clinical Reference Group in Cardiac Surgery for NHS England.

Thoracic Surgery: Professor Keenan has been actively involved in all aspects of thoracic surgery, with a particular focus on thoracic trauma. His early work contributed to the development of videoscopic approaches to thoracic surgery, particularly as a method for managing pneumothorax. His research interests have included pain relief strategies following thoracic surgery and trauma, initially focusing on cryoablation of the intercostal nerves and later progressing to intrathoracic infusions of analgesic agents. In his later career, he transitioned the unit’s lung cancer surgery responsibilities to colleagues who could dedicate the necessary time to multidisciplinary meetings in this field. More recently, he has played a key role in developing an aggressive approach to managing severely injured patients requiring “clamshell” incisions for bilateral thoracic injuries, including those involving the heart. He is also a member of the Chest Wall Injury Society (CWIS), an international group dedicated to advancing the management of chest injuries.

The training of junior staff in the Cardiothoracic Department has been particularly strong and well evaluated. Prof Keenan has provided significant contributions by ensuring that junior staff receive well-supported training, encouraging them to seek help early. They have been exposed to a wide range of unusual and complex cases, including adult congenital heart disease (ACHD), mitral repair, revisionary coronary surgery, and aortic surgery. Additionally, junior staff have gained experience in "off-pump" coronary cases, with specific training tailored to their level of experience. Their development has been further supported through a structured skills escalator process. Prof Keenan has actively taught and promoted the use of audit to improve outcomes, not only in terms of mortality but also morbidity and overall quality. Under this guidance, junior staff have conducted research on various topics, presented their findings at multidisciplinary audit meetings, and contributed to published work. As a practicing cardiothoracic surgeon, Prof. Keenan’s work has led to important research projects at the University, fostering collaboration with the cardiovascular research group at the University of Manchester. In recognition of these contributions, Prof Keenan was awarded a personal Chair in Cardiothoracic Surgery by the University in 2009.

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Professor Keenan served as Clinical Director of Cardiothoracic Surgery at the Manchester Royal Infirmary from 1998 to 2002. During this time, he played a pivotal role in integrating cardiology into a single directorate and collaborated with the University of Manchester to secure funding for two Professors of Cardiology. Following the healthcare reforms introduced by the Blair government, he led the development of the Greater Manchester Cardiac Network as the Clinical Governance Lead. His leadership transformed the approach to service delivery, ensuring that cardiac care was brought closer to the population by establishing strong connections with all District General Hospitals. In 2011, Professor Keenan was appointed as Associate Medical Director at Manchester University NHS Foundation Trust. In this capacity, he was responsible for the appraisal and revalidation of medical colleagues and was actively involved in managing “doctors in difficulty.” For a decade from 2011, he chaired the Indicator Advisory Committee for NICE, where he oversaw the translation of NICE standards into practical metrics that would assist healthcare services in assuring and improving their quality. Between 2013 and 2016, he chaired the first National Clinical Reference Group (CRG) for Adult Cardiac Surgery. Under his leadership, the group developed standards and metrics for adult heart surgery and contributed to the NHS Outcomes Framework, particularly in defining outcome-related metrics. Additionally, the group established guidelines for mitral valve repair and aortic surgery, helping to shape the current standards in adult cardiac surgery.

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