Experience during my Cardiac Surgery Rotation
I stare at the monitor while also glancing down at the open chest in front of me. The heart quivers as it becomes cold. Slowly but surely the heart slows and becomes frozen in place.
The monitor flattens to a single horizontal green line. I am so used to seeing it bounce up and down, not as a single flat line. Everything is now zero, except for the oxygen which is at 100%.
I looked down again at the heart and I see the tubes poking out of it flushing out bright red blood into canisters behind the surgeon. The canisters are the bypass machine that keeps the blood oxygenated and prevents clotting. Another tube returns to the body where the aorta is clamped, but on the other side to return to the rest of the body.
The surgeon delicately cuts open the aorta as squirts of blood spray up. I duck to not get splattered. They irrigate the heart until there is no blood running through the heart. It is now just clear fluid which allows us to take a look at the valve we are about to replace.
The aortic valve is covered in calcifications, and it takes around 30 minutes for the surgeon to pull out all the rocks which have accumulated over this individuals lifetime and have now prevented blood from adequately leaving the heart to the rest of the body.
I had the opportunity to touch some of these irregular white calcifications. I can't believe that the body can create them and concurrently block up the arteries. I have seen them before on other surgeries where we have to take hours scrubbing each vessel so an individual can get oxygen back to their their limbs. It is really no joke when a doctor says a patient has atherosclerosis.
After we are done scrubbing the valve clean, we irrigate the heart to make sure there are not any small calcifications that can free flow to the rest of the body. That is another risk of this disease, a plaque can break off and occlude a vessel in the heart or brain - preventing that section of the brain from getting oxygen, causing a stroke.
A new valve is taken out from a box and the surgeon with two other physicians sew up over 30 stitches effectively connecting the new valve to the old heart.
When they are done, it is time for the heart to return so blood is pushed back through the heart and the warmed fresh blood encourages the heart to start beating again.
The attending physician asks me why is the heart is able to just restart? I look at him and say “I was about to ask you that, I have no idea. Maybe because the anesthesiologist restarted it with medications?”
He tells me that the heart is like magic! But in all reality, it is the warmed blood and the decreased amount of potassium, which we originally gave it to originally stop, has been removed. I watch the heart slowly develop a rhythm...up down, up down...It truly is like magic!
I wonder where the patient’s consciousness/soul is at this moment? Are they looking down at us or are they still in the body? I have read books of individuals on the cardiac bypass when their heart stops and they see them selves, looking down and hear the other voices in the room.
The heart doesn’t return to a normal rhythm so the doctor uses the paddles that I have seen on TV to shock the heart a couple times until the patient’s heart can return to a normal sinus rhythm.
How in the world is this real life? How have we uncovered the math and science that allows us to easily stop a persons’ heart then bring it back like nothing happened? I am in awe at the science, but also terrified at the thought of what the worst could happen if the heart decides to not work with us and the patient does not wake up from this procedure.
We return the patient to the ICU. Thankfully the next day they are de-intubated and they awaken. Their heart is beating strong and they now have the ability to live on many more years to come.
Dear heart, you are not allowed to stop again anytime soon...