It's amazing how far we've come.
I've been on my cardiac anesthesia rotation for the last month and a half. It has been my most interesting anesthesia rotation to date (not that it's saying much since all I did before was basic anesthesia). I'll admit that I did not think I would like it nearly as much as I did. Most days we do on pump (using the cardiopulmonary bypass machine) CABG (coronary artery bypass grafting). Every once in a while we do a MAZE procedure (freezing part of the heart to stop an irregular rhythm called atrial fibrillation) or a valve replacement/repair.
Today we did something completely different, a pericardectomy. The pericardium is the layer of tissue that surrounds the heart. There is a small amount of fluid between the heart and the pericardium that allows for free movement of the heart. Sometimes, the pericardium can become stiff and less flexible, preventing the heart from beating freely. It makes it harder for the heart to fill with blood and pump it out. To fix this, the surgeon removes the pericardium from around the heart, removing the restriction.
The patient today also had an implanted defibrillator. The wikipedia article can be found here . In it there's a pretty good description of why a person might need one and the types of devices that are used. Now, to get a defibrillator placed, everything is done through the large veins in the upper chest/neck. We don't even put the patient to sleep, most times they just get a little sedation and some local at the incision site. But as recently as 14 years ago, it was a much more complicated process. They used to open up the heart and apply a patch directly to the heart's surface. Since the original one was placed in this patient, another more modern device was implanted to replace it. So the surgeon actually took out the patch.
Today was one of those days where I realized how far we've come in medicine. Especially in the last few years. Things that were once major surgical procedures that took days of in hospital recovery can be done as same day surgeries due to new surgical and anesthetic techniques. I can't wait to see what the future holds.
Today we did something completely different, a pericardectomy. The pericardium is the layer of tissue that surrounds the heart. There is a small amount of fluid between the heart and the pericardium that allows for free movement of the heart. Sometimes, the pericardium can become stiff and less flexible, preventing the heart from beating freely. It makes it harder for the heart to fill with blood and pump it out. To fix this, the surgeon removes the pericardium from around the heart, removing the restriction.
The patient today also had an implanted defibrillator. The wikipedia article can be found here . In it there's a pretty good description of why a person might need one and the types of devices that are used. Now, to get a defibrillator placed, everything is done through the large veins in the upper chest/neck. We don't even put the patient to sleep, most times they just get a little sedation and some local at the incision site. But as recently as 14 years ago, it was a much more complicated process. They used to open up the heart and apply a patch directly to the heart's surface. Since the original one was placed in this patient, another more modern device was implanted to replace it. So the surgeon actually took out the patch.
Today was one of those days where I realized how far we've come in medicine. Especially in the last few years. Things that were once major surgical procedures that took days of in hospital recovery can be done as same day surgeries due to new surgical and anesthetic techniques. I can't wait to see what the future holds.
posted by dr. nic | 9:21 PM
3 Comments:
I was on the pump! And they froze my heart while they worked on it. :) Wheee.
Whatever anesthesia they gave me made me so nauseous for the next couple of days, between that and the pain medication. It was not fun.
Totally unrelated: OW should check the Apple battery recall information published today. (I can't get to the website right now, it's probably being swamped since it hit the news around 2:30pm or so.)
Already checked; Macworld's article on the subject shows that affected are certain models of the 12" G4 iBook, the 12" G4 PowerBook, and 15" G4 PowerBook. Dr. Nic uses a 14" iBook G4, and I'm on a MacBook Pro which has already gone through a battery recall.
I was amazed how smoothly that recall went. They just sent me a new one and told me to send back the old in the same box (using an included label).
Thanks for the heads up, though!
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