4/15/16

Today, I went to a case w/ Dr. Nguyen. Valve clinic wasn't a lot of fun to blog about, so I wanted to spice things up for a while with a new procedure in each post. Lectures- like the one I covered a few months ago about vena cava filters- are great, but don't crop up often enough for me to consistently post about them. Feedback on what I'm covering is totally welcome, and I could probably even take requests about certain topics.

The case this morning was a sternotomy-CABG, which is a procedure that I've been looking forward to seeing for a while- the mini-repairs and replacements I've talked about in the past few weeks offer much less visibility, and aren't as interesting to watch. CABG is an acronym for coronary artery bypass graft. In this procedure, the doctors remove a faulty segment of a coronary artery in the myocardium (walls) of the heart, and replace it by grafting on an artery from elsewhere. The graft usually comes from the right or left interior mammary arteries, which run under the breast. This operation is performed if there's a blockage in the coronary arteries that can't be solved by PCI/stenting; the heart needs adequate amounts of blood to pump, so if one of its arteries is blocked by plaque (atherosclerosis), that needs to be taken care of. A lack of blood to the heart's muscles can lead to myocardial infarction, better known as a heart attack. Although I've seen this surgery before, I was really looking forward to seeing it in its entirety today. Complications getting the left mammary artery for the graft led to it taking longer than expected, but there was one good thing: the anesthesiologists let me hang out in their corner of the room. They sit adjacent to the patient, amongst a labyrinth of tubes, wires and equipment. They have a direct view into the chest cavity- and it's the best view in the house. It's an entirely different experience to see the patient's chest, spread open with a still-beating heart inside, and be able to look down to see his head. You realize that it's a person who's being operated on. I've had the same view before, but now that I have more experience and actually know what the doctors are doing, I guess it just gave me new perspective. I made it up to bypass before I had to head out, which is a bummer, but the new outlook I gained made it better than all of the past cases I've seen. 

Also, we've decided to call the project The Educated Patient Series. We also picked a name for the doctor/mascot who will be walking viewers through all of the animations: Dr. Heartwell (clever, right?). We're still working with the animator to make revisions and fine-tune the video, but all of the right things are there. More to come about both my neat OR visits and The Educated Patient Series over the next few weeks.