Then Erik is given a mask with Oxygen and breathes it in, medicine goes into one of his IV's and soon he's asleep. A breathing tube is skillfully passed between his vocal cords and then secured in the proper postion. His body is quickly, but carefully cleaned with an iodine solution.

 

When ready, an incision is made through the middle of Erik's rib cage to the bone and then a saw cuts his sternum in half bleeding is controlled and work is done to expose his still bleeding heart and aorta. The TEE probe is used to take an ultrasound picture of his heart and Aorta/aortic valve to assess the damage. Erik's aortic valve annulus is destroyed and his valve will need to be replaced as well as his proximal aorta.

Preparations are made for placing Erik on a heart lung bypass machine including a cannula to collect all the blood returning from his body to his heart and another one in the aorta to send blood back to his body.

The whole team also prepares to do what is essentially putting Erik in a state of death.

 

Question. How much does one of these fun procedures cost?

 

They cost me nothing, in fact I get paid for them.

 

Where did you get your MD license? A cracker jacks box you say?


How much for the patient you nitwit

 

When the heart lung machine in in place and started it takes over the distribution of blood to the body. The lungs stop being ventilated as the machine is oxygenating the blood. The surgeon says, "Cool to 18 degrees." The patient is put into a barbiturate coma to try to keep his brain safe by turning off its electrical activity, ice is packed around his head to slow down metabolism in his head. The fluid in his veins is chilled, his body temperature cools. When it reaches 18 degrees and the surgeon is ready he instructs the perfusionist to stop the blood flow.

Erik has no blood flowing in his body anywhere, his brain is silenced, it is a state not unlike death.

 

Very interesting Raj.

 

The team works frantically. Time is of an essence here. The longer the circulatory arrest the higher risk for Erik. Preparations are made for the eventual warmup and reaction to the shock the body has endured thus far. Blood in his body will most likely not coagulate. This is a major danger. His heart rhythm may be off, his brain may have been damaged, his electrolytes may be out of whack etc.

As much as necessary, but no more is done under circ arrest and circulation with the heart lung machine is started as soon as humanly possible.
Once circulation is resumed the temperature is raised up from 18 degrees, labs are drawn and monitored. Adjustments are made.

Erik has recieved a new prosthetic aortic valve and gortex portion of his aorta.

 

Good story, Raj.

 

The first tricky portion of this is over, the second is yet to follow.

UPDATES later. I have work to do. Thanks for reading thus far