Wednesday, 8 February 2012

Cardiac Surgery: Triple bypass

Last Friday i had one of those moments where i honestly felt truly privileged to be a medical student, as i was given the opportunity to stoop over the operating table and watch a triple bypass being performed.

I've clerked so many patients with CABGs (Coronary artery bypass grafts) and valve replacements before, but i never really thought about the process of having it done, and seeing the sternum cut down the middle with a saw, the ribs retracted backwards, and the heart pumping in the surgeons hands... I'm definitely going to appreciate what goes into a CABG!!

Whilst Mr S. (the consultant) and his registrars were dealing with isolating the LIMA and the heart itself, others were at the legs isolating the veins. This was one of those "team work moments", and what was 5 hours standing at the head of the patient, felt more like 2 hours. I was just so fascinated by how resilient the body was.

I'm not sure when i started thinking this, but i always thought the heart and the lungs were quite delicate, but this was obviously not so true, as the doctor brushed things aside, and rotated the heart in his hands, sticking bits of "towels" (i have no clue what the technical name would be) around the heart to get it into the right position and to clear up whatever blood spilled over.

The surgery had no complications and as fresh i was coming into the theatre in the morning, i left that afternoon with a new appreciation for CABGs. The next time i come across a patient with a CABG, i will definitely think about the pain the patient must have gone through post-surgery.

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Only 1.5 weeks left on my Cardiology firm! - and i feel like i havn't learnt enough cardiology yet!!

Viva, SBAs and some pharmacology end of firm exam next thursday...
and i have no idea how to revise for it.. i don't even think i can... meh.

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Random fact.. but i've heard on the rumour mill, that dissection is now going to be made a core component of the medical course at Barts! I'm JEALOUS! Why are they only implementing this the year after i finish my pre-clinical medicine :(

5 comments:

Anonymous said...

Imperial GEP here. We had an "intro to surgery" day in the 1st week of 3rd year (1st year clinical), and because the undergrad office never communicates with the actual hospital, there were no general surgeries on that day... so we got sent into theatre halfway during a CABG (despite arriving at 8am). Also, we have 1 week of cardiology firms in the whole course, in final year. I took a day off from urology to go to cath lab.

Tofu said...

It's interesting how the clincal year experience varies so much from uni to uni, and from generation to generation.

At Barts currently, it's:

4/5 weeks renal
4/5 weeks endocrine
4/5 weeks cardiology
4/5 weeks respiratory
4/5 weeks vascular surgery
4/5 weeks gi surgery

i think i've been quite lucky, as i've met a lot of 5th years currently who have never done a cardio rotation, or renal as it wasnt part of the old course.. where they use to do 9 weeks of surgery (any), 9 weeks of something random and 9 weeks of something else. Whilst 4-5 weeks isn't a very long time, it really helps home in on the different examination techniques relevant in each firm. ^^

Tofu said...

Oh... and don't you agree... CABGs are pretty impressive work!

Grumpy Biomed said...

Wow, sounds like an amazing operation to have observed. Cardio sounds really interesting too!

And yeah, I've heard that rumour too.

You need to update more often :P

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