Kenny Nguyen/Dr. Jonathan Weinsaft - Week 6

 Week 6: 07/10/23 – 07/14/23

I spent my sixth week observing cardiac surgeries ranging from valve repairs to coronary artery bypasses. It was amazing to different cardiac surgeons, despite following the same procedures, operate with their own unique habits and approaches. These experiences enlightened me in the diverse artistry present in the field of cardiovascular surgery, highlighting the amalgamation of technical innovations and tools that are designed to support the “style” of each surgeon. Additionally, the cardiac surgeons were able to seamlessly coordinate with other professionals such as the anesthesiologists and perfusionists to monitor vitals and ensure that the patient was receiving sufficient resources to be stable. 

One case that stood out to me was a planned robotic mitral valve surgery and septal defect repair. The patient suffered from a shunt in the septum that caused blood to flow from the left atrium to the right atrium and a mild-to-moderate mitral regurgitation. After consulting with the patient and their family, the doctors believed an open-heart surgery was the best option to resolve the defects. A traditional approach requires a sternotomy which involves cutting through the breastbone and opening the rib cage to reach the heart. However, a robotic approach allows for small incisions between the ribs to reach the heart where the surgeon uses precise robotic arms to treat the heart. Robotic heart surgery usually results in smaller scarring and faster recovery times. Robotic mitral valve surgery entails peripheral cannulation for cardiopulmonary bypass, usually through the femoral artery. The team soon realized that the patient’s femoral artery was too small to safely fit all of the tubing needed for the heart-lung machine. As a result, the team quickly adapted and resorted to the traditional approach to treating the patient. In the end, the cardiac surgeons were able to close the septal defect with sutures and reconnect the valve leaflets.

My experience observing cardiac surgeries has been a profound lesson in the technical proficiency and capacity for innovation in structured field. I think it is a privilege that we are in a time and age where open heart surgery can be conducted with high confidence, thanks to multidisciplinary collaboration technological advancements, and refined techniques.

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