My Very First Time At An Open Heart Surgery

That day, that special day, happened at the end of 3rd year during summer practice.

I was part of a general surgery team for a month. That day we had three short operations. 

All of them were in the field of surgical endocrinology, which means the surgery of the hormone secreting glands in our body. 

Two of the operations were thyroidectomy, which means removal of the thyroid gland located in your neck. You can try to palpate it, but you probably can’t, well, if you could feel it maybe it’s a good time to go to the doctor. 

Anyway, do you know that notch of bone at the bottom neck (the upper most part of the sternal bone)? two fingers up from there is your line of first cut and right below the skin, fat and muscles you can find the butterfly shaped gland, the thyroid. The 3rd operation was hemithyroidectomy in which you remove only one lobe (either left or right). We perform this type of operations in some special cases of tumors or disease in order to preserve some of the functioning gland in the body where it keeps producing hormones, keeping the patient out of hormonal replacement therapy. 

At the end of the last surgery, I was heading out to the changing room when two guys, surgeons, were leaving the operation theater across the hall. When they enter the changing room I heard them talking about their recent surgery, an aortic valve replacement. One of them had to go back to the theater and left the room, then I introduced myself to the other surgeon asking if I can join the next cardiac surgery, since I’m free for today. He agreed. 

One hour later we met again in the locker room when he explained about the surgery I’m about to watch, CABG (pronounced as “cabbage”). CABG is the acronym for Coronary Artery Bypass Grafting, which in simple words means taking different blood vessel, either from the chest (the mammary artery) or leg (saphenous vein) or sometimes even from the hand and pass the “blocked” coronary artery to restore the heart muscle’s adequate blood supply. 

He explained the procedure briefly, and said it will be without “arresting the heart” due to a new device called tissue stable, that as the name suggest; stables a small part of the heart tissue where the blocked coronary is found so that the surgeon can work without stopping the heart.

It’s time, after waiting around 20 minutes for the anesthesiologist to arrive from another operation, the patient is finally sedated and ready. The first cut, from that notch again and all the way down to the end of sternum, then the electric saw, coagulation of leaking blood vessels of skin and muscles, opening of the pericardium (the sac that wrap the heart) and here it is; the heart. 

I must say, it was beautiful. The rhythm of beating, the powerful strokes, absolutely amazing. 

The procedure took an a bit more than one hour. One surgeon open the chest while the other one harvested the saphenous vein from the leg. Eventually, this patient had two new blood supplies from the left mammary artery and that vein from the leg. When the hard part ended, the senior surgeon thanked the crew and went out, leaving the closure of the chest (the easy part) to the young surgeon in the room. 

That was my first experience out of many. Even though it was a simple procedure, you never forget that very first time.

P.S - i tried to keep it simple, if you have any questions please comment and I will try to answer.