cardiac surgery

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Aortic valve replacement! 

WARNING: Graphic Surgical Content!

Bogowie

This photo is of Polish surgeon, Dr. Zbigniew Religa. 

He performed the first successful heart transplant in Poland. 

This picture was taken in 1987. The man on the operating table, Tadeusz Żytkiewicz is still alive. He’s now 88 years old. He outlived Dr. Religa who sadly died in 2009 due to lung cancer. 

I’m posting this because I just got done watching an amazing movie about the topic. The film is called Bogowie (and yes to answer dxmedstudent’s question it does translate to Gods. It’s about a surgeon would you expect any less?).  

Anyway, because it’s not in English I’m sure it hasn’t gotten the press it deserves. But, if you get the chance check it out (subtitles aren’t that bad). It really is a great film and I promise you won’t be disappointed!

It never ceases to amaze me how far medicine has come and how much we still have to learn. This was only 28 years ago. What will we achieve in another 28 years? 

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The dawn of heart surgery.

Clarence Walton Lillehei was known as the “father of open heart surgery”. Indeed, hardly any other cardiac surgeon has introduced a greater number of innovative techniques and concepts.

During his career, Dr Lillehei focused his efforts on cardiac surgery, particularly the development of open heart operations. The difficulty of operating on a beating heart and the hypoperfusion of the vital organs were serious and frequent complications of heart surgery. In 1953, Dr John Gibbon of Philadelphia successfully closed an atrial septal defect using a complex screen oxygenator and roller pumps. However, the mortality of open heart surgery remained high, mainly because of oxygenator-related problems, and many surgeons despaired of ever being able to correct complex intracardiac defects. 

This situation was changed in March 1954 when Dr Lillehei and his associates—Morley Cohen, Herb Warden, and Richard Varco— used controlled cross-circulation to correct a ventricular septal defect in an 11-year-old boy. The boy’s anesthetized father served as the oxygenator. Blood flow was routed from the patient’s caval system to the father’s femoral vein and lungs, where it was oxygenated and then returned to the patient’s carotid artery. The cardiac defect was repaired with a total pump time of 19 minutes. Over the ensuing 15 months, Lillehei operated on 45 patients with otherwise irreparable complex interventricular defects; most of these patients were less than 2 years old. Although cross-circulation was a major advance, it was not adopted for widespread use because it posed a serious risk to the “donor”. Nevertheless, this method paved the way for the open heart surgery era.

That same year, Dr Richard A. DeWall and Dr Lillehei introduced the first clinically successful bubble oxygenator, which remained the standard for extracorporeal circulation until the late 1970s. Dr Lillehei also helped pioneer hemodilution and moderate hypothermia techniques for open heart surgery. 

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Myocardial revascularization is an alternative procedure for patients with ischemic heart disease who are unable to get percutaneous coronary intervention or coronary artery bypass graft procedures because of procedure failure, diffuse coronary artery disease, small coronary arteries, or stenosis.

Would you like to be awake while having open-heart surgery?

This is the astonishing picture of Swaroup Anand, a 23-year-old patient that went under the knife in Bangalore at Wockhardt Hospital while he was still very much awake. Doctors chose to numb his body with an epidural to the neck rather than send him to sleep with general anaesthesia. 

Lead surgeon Dr Vivek Jawali, said they had performed more than 600 operations this way since 1999. Speaking from his hospital in India, he said: “There has been a huge effort in recent times to make heart surgery less invasive. This can be done in two ways. Firstly smaller cuts can be made and this is helped with modern technology and robotics. Secondly we are trying to interfere as little as possible with the body’s natural functions.”

“The patients are given a mild sedative rather than being knocked out - this drops their heart rate but means they can respond to commands. The patients are drowsy so they can be aroused but are also able to drift into sleep,” Dr Jawali said. “If we need them to cough or breathe more deeply to clear air from their heart they can respond. This makes the procedure a lot easier to perform.”

(Read more).

This picture says it all for me.

All my life people tell how can I not believe in god, it’s thanks to him I’m here and I should be thankful and praise him.
That, however, is a false statement if there is a god then he is a sick fuck who wanted me dead at birth. People say “thank god you lived”, NO don’t,  instead try thanking the doctors and surgeons at Johns Hopkins Hospital who gave their time and effort to learning and practicing the skills and knowledge that were used to allow me to live this long. I will soon see myself complete 22 years of living and that is not thanks to any god but to a man who wanted me to have a chance to experience this glorious world. So thank you from the bottom of my heart to all surgeons and doctors who allow people like myself to live full lives, even when people constantly bash you, never give thanks, and threaten your livelihood on a regular basis just to make a quick buck or make them feel better.

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It’s difficult to put a heart transplant surgery in a 15 seconds video! #tbt 

I got in a fight with someone today about doing heart surgery on IV drug users. They didn’t think it was right to take the spot that someone who wasn’t an IV drug user could have had. They thought the people should have to be clean for x amount of time first.

My thought is that usually they are doing these people because they will die without it, and definitely wouldn’t live for 6 months so they could be clean. Although I do believe they should have committed to completing rehab and should only get the tissue valves.

I’m curious about what other people think since it’s obviously a very difficult topic.

ok, lets kick this thing off with something pretty shall we?

this lovely photo was taken during an aneurysmectomy on a patient with Marfan syndrome

what is so cool about that procedure is that patiens own aortic valve is preserved

heres is the link to the original photo: http://www.revespcardiol.org/imatges/255/255v60n05/grande/255v60n05-13106389fig02.jpg

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Removing thrombus!

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Aortic Valve Replacement surgery…

Wanna be a cardiac surgeon ?

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A ventricular assist device (VAD) is a mechanical pump that’s used to support heart function and blood flow in people who have weakened hearts. The device takes blood from a lower chamber of the heart and helps pump it to the body and vital organs, just as a healthy heart would. A VAD has several basic parts. A small tube carries blood out of your heart into a pump. Another tube carries blood from the pump to your blood vessels, which deliver the blood to your body.
Although individual surgeons and centers employ different methods to insert a left ventricular assist device (LVAD), the fundamental concepts remain true for all. That is, most devices use the apex of the left ventricle (LV) as the inflow site to the pump, which subsequently gives off an outflow graft to the aorta, thus bypassing the ailing LV. Currently available devices do not differ significantly with regard to general implantation technique.