Wednesday, June 8, 2016

6/8/16

After a great weekend at Free Press Summerfest, a music festival here in Houston, I return with the memorable events of last week- pertaining to the HVI and Heartwell, of course. Last Wednesday, I entered some previously uncharted territory by staying for an entire case. It was a double coronary artery bypass (CABG) via sternotomy, and a great surgery to watch. I've mentioned in earlier blog posts that the more invasive the procedure, the easier it is to see what's going on; here, I could see everything, especially when the anesthesiologist wasn't tending to the patient's anticoagulant needs. From that angle, I could peer down at the chest cavity, able to see the performing doctors' precise techniques as they worked to graft the new arteries to the patient's heart. Reflections aside, I'll explain the procedure in brief (brief, only because I have some other things to discuss in this post). Coronary artery bypasses allow the coronary arteries to receive proper blood flow if their normal vessels are blocked by plaque, which is usually a result of high cholesterol. Rather than doing something like an angioplasty to repair existing vessels, a CABG uses grafts from other vessels in the body. For this double bypass, a saphenous vein segment was taken from the patient's left leg, and one end of the left interior mammary artery. One might ask, "why one end?" That is because the other is already connected to the subclavian artery, which receives a healthy blood flow from the aorta. Detaching it completely would be super unnecessary, as another hole would have to be created for the other end of the mammary artery. So, the saphenous vein graft connects from the aorta to some part of the right coronary artery, and the interior mammary artery connects from the subclavian artery to some part of the left coronary artery. It was very difficult to tell which of the tiny coronary vessels the new artery and vein were being sutured onto, in this specific case, so that's about as precise as I can be. I will link a picture at the bottom, though those vessel connections might not have been the same as the ones in this case. It all depends on what coronary segments are blocked.

What I really wanted to discuss in this post was my first presentation of the Understanding Aortic Stenosis video. I went to the Amelia Parc senior community, where my grandmother lives, to present the video and do a short Q&A about it. The elderly people there were really receptive of the video, and some had a lot to say about it- ranging from questions to personal accounts of dealing with heart disease. It was good to get the video out to our target audience, as they're the ones who we want to be getting across to. They're the ones meeting with doctors about disease treatment and trying to decipher things. The secret to a good senior community presentation, I've learned, is to stay far away from bingo time; as soon as that started, a good part of the group I had gathered rushed out. I'd never seen people that old move so quickly.

By the way, I might do more local senior community visits- in fact, I already have two set up for this month. If you guys have any suggestions for places to visit and present this information, feel free to contact me or comment on the post. Thanks!

Double CABG (general overview):




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