Saturday, August 01, 2015

Heart Breaker

During our last week in Bonn we were able to go to the University Hospital and watch surgeries, and I was lucky enough to stand in on an open heart surgery of a 26 year old woman. She was born with a birth defect and had been through three heart surgeries already and needed a fourth to repair more problems as she'd gotten older. As a biomedical science major this was one of the most interesting and exciting days I've ever had, and was a privilege to watch. It was the first surgery I've ever watched so I didn't know what to do with myself in the operating room, my main goal was just to stay out of the way and not touch anything. Fortunately, I was given a stool to stand on right behind her head, so I had a front row seat to this woman's heart being cut open. 

It was a really complex surgery that overall took almost 4 hours and started by cauterizing through her old scar tissue. It's basically a really hot scalpel used to reduce bleeding and was one of the worst and weirdest smells I've experienced. It was literally burning flesh and the thought that I was in Germany, which was once filled with that scent, did not escape me. Once this was completed they had to saw through her sternum, so out came the power saw. This was probably the most gruesome part of the surgery to watch because the sound of the running blade cutting through her bone was just really odd. Once this was finished though and her ribs pushed apart there was her heart, beating and seemingly strong and completely exposed for everyone to see. That was a great moment and I probably looked like an idiot with my eyes as wide as saucers, but to see a beating heart that gave this woman life was a very surreal thing. 

It was everything you'd think an open heart surgery would be. When they started to hook her up to the heart and lung machine they had to poke holes in her heart for the tubes and blood started squirting out everywhere (which is normal). Since I just took anatomy this was really interesting because I could see the Trabeculae Carne which are ridges in the ventricles, and was able to understand most of what they were saying because I learned it really well last semester. Up until then her heart was literally a moving target, so once she was fully connected to the machine they were able to stop her heart and turn off the respirator that kept her breathing since the machine exchanges gas in the blood artificially. It was really weird to see her heart stop but know she was still alive, modern medicine is really an amazing thing. Once this happened the real work began. She needed a pulmonary valve replacement because blood was spilling back through the valve and not going to the lungs because her's was too small. So they had an artificial tricuspid valve made from bovine material that looked like a circular door with 3 panels that opened and closed like you would see in Startrek or something. So they cut open her pulmonary artery and started to sew in this new valve with 20 different tiny sutures. They eventually got everything sewed in and back together and started to ease her off the heart and lung machine when her heart started to fill with air. This caused the doctors to curse in German (I've heard a few while I've been here) and charge the shocking paddles. They said "clear" and everything and shocked her heart just once and it started beating normally again so everything was fine. They finally totally took her off the machine and started to close her up. This was also a brutal process because it took really thick wire and a scary looking needle to sew between the cartilage of her ribs while they were physically pushing them together. I left once this was done because I'd been standing in the same place for 4 hours with nothing to eat, so my time in the OR was over.

During the surgery it really was like an episode of Grey's Anatomy, the doctors were chatting and laughing and making jokes, the anesthesiologist was on his phone when there was nothing to do, and when things went wrong it got really serious really fast. It was one of the most amazing things I've witnessed and even though I never got sick or nauseous I don't think I would ever want to be in their shoes. Surgery just doesn't seem to suit me, so at least I know that about myself. Next up... Berlin

Annie 

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