(Part 2 of a series: My Open Heart Surgery)
As I faced the reality that I needed open heart surgery to repair a leaking mitral valve, I did what I always do: I researched as much as I possibly could about my condition and about open heart surgery itself.
The first question I had was, what is open heart surgery, and what's going to be involved? Turns out there is some disagreement in defining what does and doesn't constitute "open heart surgery." Many of us go by the traditional coronary artery bypass graft model, which has been the star of so many medical dramas like Grey's Anatomy. A lifesaving procedure for many who are threatened with heart attack from artery blockages, this surgery usually includes a long incision down the center of the chest, called a sternotomy, and literal sawing through the breastplate to expose the heart.
Despite opening the chest, CABG surgery does not actually involve operating on the heart muscle itself. Rather, it's something of a plumbing maneuver, taking healthy veins usually from the legs and creating alternative pathways for blood to circulate to and from the heart.
The open heart surgery I was to face involved actual opening of the heart muscle itself.
Either way open heart surgery is defined, most of the time it involves putting the patient on the bypass machine, fondly referred to be those of us in the business (doctor or patient) as "the pump."
As my surgeons explained, I would have a sternotomy (possibly a shorter version of it in a less invasive incision) and my heart would be stopped. (That didn't sound so good to me.) Once my heart stopped beating, the bypass machine would cool down my blood to about 60 degrees and keep it moving around my body the way my heart normally would, if it weren't otherwise occupied. And that is when the surgeon could hopefully repair (not replace) my mitral valve.
All of this sounded overwhelming, of course, but the most difficult part for me to wrap my head around was the sternotomy. I just didn't want to have that "zipper" in the middle of my chest. I didn't care too much about a scar. I was more worried about the discomfort and immobility of the healing process. Certainly, a sternotomy was about as invasive an incision as I could imagine. So I began researching something else: how to avoid one.
And that's how I learned about the Da Vinci Robot, an amazing medical miracle of sorts. The robot allows your surgeon to operate on you using the tiniest instruments imaginable, which are inserted to the site of the surgery through a tube called a cannulus. While one surgeon is at your side inserting the instruments, the surgeon operating on you is across the room, sitting at a large 3-D screen that enables him to see the part of your heart he is operating on with amazing clarity and direct the instruments. Surgery with robotic assistance takes longer because of the longer preparation period. For about an hour and a half before my surgery began, I was in the operating room while various tubes and cannula.
The idea of using a robot for heart surgery may conjure up R2D2 with a scalpel in his hand, but the robot does not operate on you - your surgeon does that. The robot allows for a much smaller incision and not through my chest, but through my right side, under the right breast. The surgery is safer because it is less invasive, which means less chance of infection. The healing time is shorter. There is less pain. And now, three years after my surgery, I literally have no scar at all to indicate that I indeed had open heart surgery.
(Next time, what this surgery is like, before, during and after, and what "pumphead" really means.)
Published On: April 26, 2011