WATCH Triple Bypass Open Heart Surgery
WATCH Triple Bypass Open Heart Surgery
UnityPoint Health - St. Luke’s Hospital in Cedar Rapids, Iowa takes you inside the operating room for a triple bypass open heart surgery. Dr. Garry Weide, a cardiothoracic surgeon operates on Scott Frederick of Cedar Rapids.
Thank you Scott, for allowing us to record your operation so others may see how the surgery is performed and what your recovery has been like.
Learn more about our hospital at unitypoint.org/cedarrapids
Content
8.39 -> [Music]
12.24 -> unity point health st luke's hospital
14 -> takes you inside the heart for a triple
16.08 -> bypass open heart surgery in cedar
18.32 -> rapids iowa our patient is scott
20.8 -> frederick he's a 54 year old cedar
23.519 -> rapids man who had progressively
25.279 -> struggled to catch his breath
27.279 -> initially he thought his asthma was
29.359 -> gradually getting worse and went to an
31.599 -> urgent care to get checked
33.68 -> once there the doctor looked at his
35.6 -> chest x-ray and noticed his swollen legs
38.559 -> and told him to go to the er as he
41.2 -> suspected frederick may have congestive
43.52 -> heart failure
44.879 -> it was confirmed at st luke's er and
47.12 -> frederick received unexpected news he
50 -> would need triple bypass surgery i
52.64 -> couldn't even go for flight of steps
55.039 -> because just being so short of breath i
57.28 -> thought what we both thought was asthma
61.12 -> i was taking a couple different inhalers
63.12 -> and wasn't getting any relief
65.76 -> so yeah so this was
67.36 -> quite a
68.24 -> deviation off the highway going from
69.84 -> asthma to
71.36 -> open heart surgery
73.68 -> that's kind of what led up to it is the
75.04 -> fact that i
76.159 -> did shortness of breath and you know
79.04 -> had the sleep sitting up in my recliner
82.4 -> i couldn't eat much because i just feel
83.759 -> like i bloated the whole time you didn't
84.96 -> retain so much fluid
87.6 -> in the operating room is dr gary whitey
89.92 -> a cardiothoracic surgeon from physicians
92.159 -> clinic of iowa an anesthesiologist a
95.52 -> profusionist who operates the heart and
97.6 -> lung machine a physician assistant and
100.079 -> st luke's highly skilled open heart team
102.56 -> of nurses and surgical techs
104.799 -> you know most people with with coronary
106.479 -> disease or blocked arteries typically
108 -> present with chest pain and he
109.759 -> surprisingly never had any chest pain
112.159 -> but for him what ultimately happened
114.56 -> this was a slow progressive thing where
116.24 -> the blood flow to the heart was reduced
117.92 -> and the heart muscle just progressively
119.36 -> got weaker and weaker and weaker because
120.96 -> it wasn't nourished with the blood that
123.04 -> it needed so as the heart pump started
125.28 -> to
126.159 -> fatigue and fail he started to build up
128.08 -> a lot of fluid on his lungs and his legs
130 -> and so that's how he developed
131.44 -> congestive heart failure so for him it
133.68 -> was more of a progressive slow blockage
136.16 -> thing as opposed to an acute immediate
137.92 -> thing which we can see from time to time
140.4 -> congestive heart failure is a
141.84 -> progressive condition which affects the
143.84 -> functioning of the heart it can be
145.84 -> life-threatening if left untreated so
148.48 -> for him you know he's got what seems to
150.4 -> be a reversible cause in the fact he's
151.76 -> got coronary artery disease and blocked
153.36 -> arteries some people their heart failure
154.72 -> is related to valvular disease if you
157.04 -> correct the valvular problem or replace
158.72 -> the valve you know the heart muscle
160.48 -> typically if it's no longer subjected to
162.959 -> the stress of either a faulty valve or
165.92 -> abnormal or lack of blood flow in time
168.4 -> the heart muscle will ultimately recover
170.48 -> now some people the heart failure is
172.48 -> irreversible and it's damaged to the
174.48 -> point you can't fix it during open heart
176.879 -> surgery the heart is stopped and a heart
178.879 -> and lung machine is used while the
180.56 -> surgeon works on the stopped heart for
182.64 -> us to be able to operate on a motionless
185.36 -> you know virtually bloodless field we
187.04 -> put them on
188.48 -> to bypass our heart lung machine so that
190.159 -> requires us putting in big tubes of big
192.239 -> cannulism of the heart that both drain
193.84 -> blood and give blood back to the heart
195.28 -> and then ultimately what we do is we use
197.2 -> a high potassium solution to cause the
199.599 -> heart to stop so the heart now is no
201.599 -> longer beating which allows us to work
203.28 -> without the heart moving as we're trying
204.799 -> to do things during that time we cool
207.04 -> the patient so the heart's protected the
209.44 -> brain is protected the rest of the
210.72 -> organs are protected and then that gives
212.799 -> us a chance to work for several minutes
214.64 -> to
215.519 -> try to accomplish what we need
217.04 -> ultimately
218.159 -> as the surgery gets underway the
220 -> patient's sternum or breast bone is cut
222.48 -> to allow access to the heart the surgeon
225.2 -> typically works on harvesting what's
226.64 -> called the internal mammary artery off
228.159 -> the front side of the chest plate so it
229.84 -> allows us to work kind of simultaneously
232.4 -> so we can be productive and we can be
234.319 -> efficient through the operations biggest
236.48 -> part of coronary surgery or bypass
238.239 -> surgery is you got to have conduit
239.439 -> whether it's arteries or veins and so
241.28 -> for us today it was an artery that's
242.799 -> just plain two veins from the leg
244.879 -> the surgeon works in tandem with the
246.72 -> physician assistant to harvest healthy
248.56 -> blood vessels which will be used to
250.4 -> bypass the blocked area
252.48 -> the harvesting of the vein left leg uh
254.319 -> historically or many many years ago the
256.4 -> way that was going through a large open
258.239 -> incision down the inside part of the leg
260.88 -> and you would take this the greater
262.56 -> saphenous vein out over the last though
264.8 -> i would say 20 25 years or so techniques
267.6 -> and equipment has been developed to
269.12 -> basically make a small incision by the
270.88 -> knee and you have a camera with a little
272.96 -> dissector on the end of it you can kind
274.56 -> of tunnel it up and down the leg to
277.199 -> basically clear the vein and free the
279.04 -> vein up of the surrounding tissue so
280.84 -> ultimately you can just pull the vein
282.4 -> out with only a small incision by the
285.04 -> knee and that's greatly improved i think
287.199 -> patient comfort patient satisfaction
289.12 -> after surgery once the surgery is
291.44 -> complete the heartbeat is restored and
293.68 -> the patient is disconnected from the
295.44 -> bypass machine we're ready to start the
297.919 -> heart again as i mentioned the heart's
299.84 -> been cooled for a period of time the
301.52 -> heart's got a lot of potassium in it so
304.16 -> we give basically warm blood we call it
306.72 -> a hot shot it's basically warm blood
308.72 -> that's delivered directly to the heart
310.479 -> it does two things one is it washes out
312.479 -> any remaining potassium that's
313.919 -> potentially circulating around the heart
315.52 -> muscle itself and the other thing it
317.12 -> does is it warms the heart up you know
318.639 -> the heart doesn't like to be cold if the
320.32 -> heart's cold it doesn't leak very well
322.24 -> so it does the ability to warm the heart
324.24 -> up wash the potassium and oxygen take
325.84 -> the clamp off ideally you want the heart
328.08 -> to start beating occasionally the heart
331.36 -> isn't quite ready to start beating again
333.039 -> in parts that you know are sicker than
335.52 -> normal in scott's case using a sick
337.6 -> heart the heart defibrillate and so when
339.36 -> the heart begins to fibrillate you gotta
340.56 -> use these paddles to defibrillate or
342 -> shock hard to get it back into it
344.24 -> during the final step in today's
345.759 -> procedure wire is used to close the
348 -> chest when we're done you just check
350.32 -> everything make sure things you know
351.6 -> hemostatic nothing's bleeding
353.039 -> unfortunately for scott everything
354.16 -> seemed to be pretty secure nothing was
355.52 -> bleeding and then closing the chest
357.759 -> there's multiple ways to close the chest
359.44 -> the most common way to close it is with
361.36 -> surgical stainless steel wires and so
363.68 -> for scott you've got a combination of
365.6 -> seven wires in total a combination of
367.52 -> single and double wires the double wires
369.68 -> are just added for protective strength
371.84 -> so the bone can heal back together it
373.84 -> takes typically about eight weeks for
375.039 -> the bone to heal so those wires are
376.479 -> designed to hold the edges of the chest
378.319 -> bone together to allow the bone or the
380.16 -> body's ability to heal it for its own
382.4 -> strength
383.6 -> following surgery frederick spent two
385.6 -> days in the intensive care unit and
387.44 -> another four days at st luke's he
389.919 -> immediately felt a difference in his
391.84 -> breathing frederick is participating in
394.08 -> cardiac rehab and likes that it helps
396.16 -> him know his limits as he works exercise
398.72 -> back into his routine
400.8 -> just me trying to be overly aggressive
403.039 -> but you know i'm
404.24 -> thinking i can handle more maybe a
405.68 -> couple more minutes going on the
407.199 -> machines or maybe a little more weight
408.72 -> when i'm lifting it because i don't feel
410.639 -> taxed but then the nurse is telling me
413.199 -> well you may not feel taxed but that's
415.039 -> not the muscles that you're working that
416.88 -> may be taxed so
418.56 -> a lot has been education basically just
421.28 -> kind of relearning what i need to do
423.039 -> plus there's also this accountability
424.96 -> factor too frederick is already looking
427.44 -> beyond his recovery to spending time
429.44 -> outdoors traveling to see his adult
431.52 -> children and catching a game at wrigley
433.84 -> he's grateful for his carrot saint
435.44 -> luke's from the er to the operating room
437.84 -> to the nursing care oh i think it was
440 -> exemplary everybody was always asking
441.84 -> about what do you need what could you
442.88 -> use that was down from the first year
445.52 -> students that came from co to the ones
447.12 -> that have been here probably 30 years so
448.96 -> everybody was going above and beyond
450.88 -> especially during this time of being so
452.88 -> short staffed unity point health st
454.88 -> luke's hospital is cedar rapids heart
456.8 -> hospital as the area's leader in open
459.12 -> heart surgery since 1978
461.759 -> we invite you to learn more about our
463.599 -> program and st luke's heart care
465.36 -> services today
467.039 -> unitypoint health know how much you
469.52 -> matter to this world
Source: https://www.youtube.com/watch?v=lHVE4MbfZ6I