Open heart (cardiac) surgery from the anesthesiologist’s side of the drapes
ฝัง
- เผยแพร่เมื่อ 17 พ.ค. 2024
- What goes into providing anesthesia for cardiac surgery where a patient's heart is completely arrested? In this video, I take you into the operating room during a surgery and talk with Dr. Benji Salter, program director for Mt. Sinai Hospital's cardiothoracic anesthesiology fellowship program.
While no patient information is shown in this video, the patient did provide written consent for filming to occur during surgery. Permission was also obtained from Mount Sinai Hospital's Department of Anesthesiology as well as the hospital's Press Office.
Chapters
0:00 Start
0:44 Surgery background
1:40 Case preparation
2:45 Anesthesia equipment
6:21 Echocardiography
7:16 Preparing for bypass
8:34 Stopping the heart
9:06 Fellowship
10:46 Why cardiac anesthesia?
11:52 Coming off of bypass
13:06 Post-op recovery
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool - วิทยาศาสตร์และเทคโนโลยี
I had open heart bypass surgery 5 years ago. The anesthesiologist hit the nail on the head when he mentioned patients can become very nervous when we see all the doctors and equipment in the OR. As soon as they got me on the table I told the anesthesiologist she better put me out or I was going to walk out. My surgery started at noon and I woke up in cardiac intensive care around 10 pm. The absolute worse thing for me was waking with a breathing tube. My widow maker was 100% blocked and my surgeon later mentioned I should have been a statistic. Very fortunate and blessed to still be alive today.
its stories like this that fuel my drive to become a cardiac surgeon.. just hearing the miracles they perform. still got 10-11 years before im in scrubs but it will go by so quickly .
I hope you read this, I'm going to have double bypass surgery in a few days I'm so scared I want to puke, I don't want to know what they are doing in the OR, also I'm freaking terrified of the ventilator please tell me how you made it through.
@Illegalsnotwelome are you ok Larry?
Update operation was a success, didn't do bypass did full metal jacket all the arteries are stented and wide open I'm sore but feel better, thanks God.
cardiothoracic anesthesiologists and cardiothoracic surgeons always have my highest respect, by far the most finely tuned specialties that require the highest level of skills and attention to details
Doctors/nurses/cleaning staff are the bomb. Thank you for going threw a million years of school to save us and keep us alive.
As someone whose been under the knife and induced many times with Propofol and gas for Congenital Heart Disease (VSD/ASD @ Children's Medical Center Dallas)/numerous IAA repairs (both Children's Dallas/Cleveland Clinic), with removal of Gortex graft & Direct Anastomosis of Ascending/Descending Aorta in 2004 @19 yrs old through the years; this is truly remarkable and quite awesome to see from a different perspective. Watching a Heart-Lung Machine work is a true marvel! Keeping the pt alive, while the surgeons work their magic.
After open heart surgery, you wake up, feeling like an elephant is sitting on your chest, and you cough or laugh it brings a jolt of pain like no other. You do feel night-day difference better after most major Cardiac procedures; the recovery isn't always easy though, though most definitely worth it!
I've been subbed for many years now, and your cases and work always fascinate me. I guess you could say, I'm used to that all too familiar burn of Propofol entering my veins 😴😴
Respectfully,
Randy
Dallas, TX
Born with 3 holes in my ticker, 6 open heart surgeries. 39 on August 9th.
Great vid. I've had three careers---my last was an RN--Staff RN, Nursing supervisor, and nurse manager. I have had several major surgeries, and I know the drill, but my personal apprehension was maxed out on each occasion. The support staff and surgeons were great. I have often wanted to ask some surgeons if they appreciate the fact that what they do is "magic". With some it was a "calling" not simply a job or a profession. One doc, who was a close friend, worked fourteen hours a day, six and a half days a week, and if one of his patients hiccuped and the resident or fellow didn't call him---there would be hell to pay. He came from Pennsylvania and his father had been a coal miner and he never forgot where he came from. I don't impress easily, but many folks that I met when I entered the world of healthcare dazzled the hell out of me. 99% of the public has no idea of the education, training, and sacrifice that specialized physicians go through. My deepest thanks and appreciation.
Thanks for this explanation!! It was excellent!! From an old retired RN whose husband had a triple CABG at age 42 in the facility I worked at. I knew everyone involved. We were blessed to have such excellent care!!
Seeing as I survived an emergency Aortic Dissection surgery, I wish I could have had my surgery recorded! 15 years surviving, so far.
Thank you for everything you do.
I was so scared when I had my first and hopefully only major surgery. Everyone was so kind and gentle, respectful of my needs and truly I couldn't say anything negative about them at all.
Then the anesthesiologist came in and he started cracking little jokes and lightened up the mood. He seemed to know I needed a little giggle before telling me he'd be right there the whole time, that I was in great hands.
I never saw him after the surgery, but I'll never forget him. They saved my life that day and changed it forever for the better.
Thank you for everything you do.
Thanks for this informative video.
I was a triple CABG patient November 2009.
I didn't realize how intensive anesthesiologist's role is in the procedure.
Bless you for your dedication
I echo your comment.
Ditto
As a doc with 30+ years experience, I find it refreshing to see many of these younger doctors really working and caring to keep the personal rapport with their patients at a high level. Too often young doctors today get lumped in with the few knuckleheads that come out of med school treating patients like numbered cadavers because of their own mental insecurities. Congrats to Dr. Salter and his team for not only remembering that there is a human life, beyond the body, on his hands, but teaching and passing on that compassion to those he mentors.
I had several occupations behind me before I became an RN (male) at age 48. I went up the ladder fairly quickly--- as a nursing supervisor, I would remind "everyone" that our patients are people with all the attendant aspirations and fears and it is a useful reminder to think of them as a family member. Your observations r/t medical professionals that have less than a stellar track record r/t interactions with patients is unfortunately accurate. I found myself periodically having a private chat with a few folks reminding them that exhibiting a little additional compassion would go a long way and to "set the good example."
With the very greatest of respect! Thank you!!! You have kept me alive through 3 Cancer Surgeries, one heart ablation, and three weeks ago, a second more complicated one.
Bless you and the highly specialized work you do!!! It takes you and the surgeon to get us through. I’m sorry you don’t get the thanks you deserve. As a nervous patient I truly appreciate the pre meds you have given! ❤️❤️❤️😫😫❤️❤️❤️😫
It's nice to have your teachers and mentors take the time to educate us in TH-cam land.
Thank you for this video. I am a retired 25 year ER PA and am scheduled for ohs for a fibroelastoma resection at Duke September 14 2023 and found this very informative. God bless you all.
I had a heart attack on January 1st of this year and had a quadruple bypass on pump 3 days later. Thank you so much for this video and a big shout out to those who have given people a second chance at life. So grateful to still be here as I know so many others who feel the same. ❤❤❤❤❤❤
I had a double bypass in March of 2023 and fortunately I was not scared I was quite comfortable because the entire staff had talked to me and made me feel like a family member! SIU saved my life! Southern Illinois University was great and my operation went great and no issues
Good job getting all the sign offs and stating as such. So many med videos don’t or either don’t say it. You are a professional and the video demonstrates that.
Such a robust program with so many levels that they do a fantastic job of not going too deep into the weeds and making it a user friendly video. They kept a lot of the medical terminology at a layman's level and then had either an explanation at the bottom or explained it. Basically a great educational tool for anyone who's interested.
Congratulations on becoming a full fledged anesthesiologist. I would 100% trust you to keep me comfortably numb during surgery.
Is this the first video without "I'm an anesthesiology resident" at the start? 🎉
Second 🎉
Massive flex 🔥🔥😆
@@FaizCaliph Right!? COONGRATS MAX!!!
Second video now Max is a certified anestisialogist
He finally made it!!! 🎉🥳🎉
When you talk about the fear the patient experiences on entering the OR I can understand, from experience, as you are immediately set upon by numerous people to prepare you for your surgery. I was blessed with an incredible surgeon that visited me pre-op and I honestly had no fear going into surgery. It’s been 5 years since my triple CABG but I remember much vividly. Thank you for this vid as it covered so much of what happened, I was put put right after entering the OR so I just dealt with all the tubes afterwards. This is a fantastic video.
This video shows so much. It is great!! Thank you for going the extra mile on your videos!
About 14 years ago I had a leaky mitral valve(33% back flow) repairedl, 10 years ago a pacemaker, and tomorrow my battery is being replaced. If I would have had these health problems 20 years ago I don't think I would still be here and active. We are blessed that we have so many great medicine and medical staff. I also am sure that if i had not had good insurance I would not had this extensive procedures.
As one that is facing possible mitral valve in the near future this has been very helpful in putting some of my worries at ease. Than You for taking the time to explain this.
I've had a quadruple bypass 2014. Facinating to see what goes into it just from a sleep point of view. I'd wager this is the most important part of an operation.
Max, as an ECMO Specialist, Respiratory Therapist, and medical student hopeful this video was awesome to see! I'm familiar with many of the concepts discussed here, but hearing it presented directly from the perspective of the anesthesiologists in the OR is tremendously insightful. Fantastic stuff as always!!!
A respiratory therapist too… let’s kindly keep intouch max
Great video Dr. Finestein! ❤❤A lay person knows there is a lot involved in anesthesiology, for any surgery, but wow...cardiology is a whole different ballgame. I had my aortic valve replaced with a pig valve 5 1/2 years ago. My hats off to anyone in this field. I'm so incredibly grateful for another chance for a normal life. ❤
As an aspiring anesthesiologist I love your videos that show what being one will be like.
I have really enjoyed watching this video. My husband underwent CABG x6 in June, 2004. Subsequently, he has had 4 cardiac stents placed (1 in an original graft) as well as 2 peripherally. We were originally told he had a 10 year life expectancy, he is now 2 months short of 20 years. What you folks do is beyond miraculous & so appreciated. Dr Robert Feldman, Dr Peter Chung and Dr Siva Gummadi are among the best of the best & we are beyond grateful for their expertise & care.
Thank you guys. My 4 vessel CABG happened 20 years ago. Your kind of expertise is magical.
I did my internship in the OR and got to see a handful of CABGs so this was really nice to get to see another aspect of the surgery!
I used to do cardiac anesthesia but now I just do regular stuff. It really is a whole different ball game. I did them at a private community hospital so I had to do everything myself (there was no resident or fellow). It was fun for a while but these cases can be stressful. Now I do anesthesia for more “routine” cases like gall bladders, knee replacements, hernias, gastric sleeves, shoulder scopes, c-sections, cystos, colonoscopies, etc. Great video by the way. Brings back some memories.
Recovering from double bypass 2 weeks post surgery here in New Zealand. Thank you so much for this fantastic explanatory video I wish I had seen this beforehand. Both of you explain this so well. Being on my own I was scared sh*&^%# but the anesthesiologists were fantastic and once I moved myself onto the operating table into the right position knocked me out pretty much straight away. I remember it being very cold. Next thing was waking up in ICU . You are all amazing bless you all for this second chance what a team, I will not let you down!!!
The ventilator?? I'm so afraid I want to throw up
Fascinating! I'm working very hard too never need these services but glad to know they are there. I'm a stroke surviver and that focused my attention on health issues. Love the channel!
Can't imagine what it took for you to pull off this channel. How can someone get through all the red tape to be able to do this. From the interviews in the spaces in the hospital to all the seemingly isolated areas you get at times... The effort and amount of stuff going on behind the scenes must be absolutely insane
one of the most responsible specialties, you are professional
CABGx4 after a silent heart attack. So thankful for the skilled team that saved me. I am just glad it happened immediately because knowing all of this ahead of time would have induced such anxiety. Thank you for sharing!
Hi Max, This is your best video yet! Great job!
Thanks for this. As a veteran of 5 cardiac surgeries i found it fascinating!
I dont know much about your area but want to say thank you for everything you have done in this life time for all ❤
Hi Max, congrats on I assuming finishing your residency in Anesthesia. I always found you and your videos very professional and educational.
Incredible job showcasing the complexity of cardiac OR! This is awesome!
Really appreciate that, especially coming from one of the medical TH-cam greats!
Oh this was so exciting to watch. It does require a great team. With all the machines,instruments, so many IVs its a wonder theirs room for all of u to work. That Doctor was awesome and so cool .thank u so much for this. You are so awesome as well! 😊😊❤❤❤
My career has nothing to do with the medical field ,but ever since I found your channel. I love each and every one of them. Always informative and straight to the point. I appreciate what you do. The only medical channel I subscribe too as well. Your attitude in every video is also on point. Happy and uplifting. Take care out there!
Fascinating!! Thanks you so much!
I had to pause the video towards the end of the initial interview when the lead said that patients experience fear when wheeled into the operating room. I had multiple surgeries several decades ago due to a nasty accident. My experiences went from an engineer's fascination with all the operating room equipment during the first few procedures to anxiety attacks after I had experienced some major league pain in pre-op. Now I get an overwhelming emotional reaction just watching a video. Pain creates very powerful conditioning!
Another fantastic video. Very insightful. Thanks so much for this very informative recording.
Thank you for giving insights into the scope of cardio-thoracic anesthesiologist and perfusionist
I had cardiac surgery in Australia and the procedure there was essentially the same as you've described here👍 Brought back so memories 🙂 It's excellent to see this stuff standardised.
I had an aortic valve replaced. What an amazing thing to have done! Its a ton of seriously complicated ❤ 14:41 work for anesthesiologists, perfusionists, surgeons, nurses, techs and housekeeping. Soooo complicated, deep and I'm sure exhausting. I am grateful for every single brain cell it took to train for this deeply complex life saving ballet. 3 yrs out and i am doing so very well. ❤🎉
As an IV tech, I absolutely love these looks into the active OR. I'm far more familiar with cardioplegia than I would ever like to be after making it hundreds of times, but it's cool to actually see it in action like this and what goes through the minds of anesthesiologists and cardiovascular surgeons during its use.
Thanks Max! Nice to get an early morning OR fix.
That bypass machine made me gasp just looking at it. When you think about what it does and how that giant piece of equipment replaces, essentially, your little fist sized heart. It's truly amazing.
Yay!!! Thanks for mentioning the bypass machine!! Cheers from a current perfusion student
My Open Heart Surgery went horribly wrong and I ended up having three surgeries instead one that night. The whole thing was bad and recovery was really hard. I say that, but, life afterwards has been so much better.
Congratulations Dr. Feinstein! I noticed on the Mount Sinai website that you have completed your residency and beginning a fellowship in Pediatric Anesthesia.
I had hoped you'd one day have a patient who wanted their surgery to be featured!! If I ever needed surgery at Mount Sinai for whatever reason, I'd absolutely volunteer to have you make a video about it.
The medical science now is amazing. I couldn't handle it, but for those that can/do, thank you!
Im a student nurse anesthetist who worked in a cardiothoracic ICU and recovered many of these patients after surgery. Massive respect to cardiac anesthesiologists and cardiothoracic surgeons and perfusionists. Definitely some of the most intelligent and skilled professionals you will meet in the hospital
I'm a nurse,aspiring to be a Nurse anesthetist in future,God willing. Are nurse anesthetist allowed to study further and gain expertise in cardiothoracic anaesthesia or any other anesthesia subspecialty?
Thank you for using your proper title and not "nurse anesthesiologist resident". Respect
@@mcbaggins12 what difference would it create?
@@brianmwirigi200 misrepresenting yourself to patients and acting like you're a doctor when you're not
@@mcbaggins12 nurse anesthetist do 100% percent of what MD anesthesiologist do.
Very informative video Max, thank you.
My brother had a quadruple bypass three months ago. He went into hospital to check out minor chest pains and they wouldn't let him go home! They were very surprised that he hadn't already had a heart attack. He had the surgery a couple of weeks later.
Total cost of the surgery? Zero, we're in the UK with our marvellous NHS which the government is trying to sell off to the highest bidder.
The only cost was for car parking at the hospital!
"Im an anesthesiologist"... Congrats on graduating. Wishing you many successes in the future!
I was operated at 13 for a whole in my heart. Never told me if they had to stop my heart. Well I guess I had a bypass machine. Thank u so much 4 being there 4 us. Without ur studies we would be dead. I
I'm loving this one thank you
That great attitude AND medical excellence is why you hire from Michigan. Go Blue!
Being under is by far the best sleep I've ever had. At times I wish they offered that as a service lol, would prob be too expensive tho. Really cool watching how all this happens from the anesthesiologist’s side.
very very interesting . Good to see you Max!
well done and many thanks for sharing the experience. i am due for aortic valve replacement soon .
Thank you for your videos. 3X CABG, it helps me so much to understand the skill and dedication of the Doctors and Nurses involved in my surgery, and to help process the events. Scary from my point of view, yet everyone involved knew what they were doing and brought me comfort during my stay.
I had quadruple heart bypass surgery 15 years ago and I’m doing great.
Loving your scrub cap, Max! 👌
I had an aortic valve replacement and an ascending aorta aneurysm repair, nearly 3 years ago at the Papworth hospital in the Uk. I was nervous going into the operating theatre. The anaesthetic was very reassuring and I don't even remember my breathing tube coming out. I'm only thankful I didn't have to pay for it !
Thanks Max. Fascinating
I got to be in on a cardiac bypass. It was 10 hours and I’ll say it was a pretty amazing experience. I’m glad I wasn’t the one on the table of course but being able to shadow and ask questions on the side just made it more interesting.
This is insane!!!! Crazy the patients let you film these but no matter. Awesome videos!
Very interesting and informative.. Thank you.
Your videos are awesome Dr Feinstein
Dr. Salter sounds utterly confident and competent with every single sentence. I'd want him to be my doctor if I ever needed heart surgery.
Plus he’s a great guy.
My son is internation student in m pesa academy, and he wants to passue in cardialogoly
Brings back memories of some years back, got new aortic valve and they threw in a bypass.
This was dope max good job
When my husband had double bypass surgery the heart surgeon, after careful evaluation, decided he was a candidate for bypass without stopping the heart. His body temp was dropped and his heart was slowed down to a minimum. It all went very well. Apparently, many factors go into not arresting the heart, and the surgeon told us that he opts for it when he can because it has less overall side effects, both physical and cognitive/mental. His temperature was gradually and slowly raised when in the ICU. It's amazing what they've been able to do the past several years. It would be a great idea if you could address this in another video, heart surgery without the heart being stopped and how that's handled different with anesthesia.
The irony is they have been doing this in Russia for many years, mainly due to lack of effective anesthesia drugs.
He is so lucky he had that choice. My father had an emergency triple bypass and was never the same cognitively. Many years later during an Alzheimer’s evaluation I told the doctor that his real decline stated after his bypass, he said that it was well known among doctors as pumphead syndrome. I still wonder if it would have been kinder had he just passed and not gone through all of that.
@@mhastings510 I think in most cases, you guys made the right choice for going through the surgery especially if the person who wanted this surgery to happen willingly rather than was forced by you. There are always complications and side effects to doing anything medically. So, I cheer you on that despite you hating your parents' condition afterward, you never know how they felt since. I'd rather live longer with Alzheimer's and loss of some cognitive function to build more memories with my grandkids and kids if I was old, and I believe if the grandfather was well taken care off than most people in his position would say the same.
Always exceptionally presented🏆 Wish you could pop in for my next surgery in Mobile, Alabama.
I have had two open heart surgeries within nine months of each other twenty years ago and am very thankful for doctors saving my life. I needed these surgeries because a virus damaged the lining of my heart and also my cardiac vessels necessitating these surgeries. I did not have either heart surgery at Mount Sinai Hospital in New York City, but I was born there.
The ventilator I'm so scared I want to puke. I don't know if I can do it 😢😢
I work in a Peds CICU, so my jaw DROPPED when you said 9 French catheter - then reminded myself thesis an adult.
On my last surgery I said that’s crazy on how much it was for anesthesia now I understand with all that knowledge they need
Oh SWEET Dr. F is letting us see the good stuff let me go get my Operation game so I can follow Along ❤
Currently I'm a trauma RN but I've been getting really interested in cardiac stuff lately. Might have to try the CVICU soon.
I grew up in this hospital as my mother was in heart failure since 1960 they produce the best cardiac thoracic surgeons in the world. Dr. Robert Litwack operated on my mother three times RIP Dr. Tristen was her lung specialist. Dr. figure was her hematologist who saved my life. Dr. Mattis was her cardiologist and now I have Dr. Sharma like mother like daughter I only trust Mount Si with my heart❤
Hay doc Max saw ur channel on the heart ❤️. surgery very interesting 🤔 how the heart gets stopped for surgery like that .I give doctors credit who work in that field. Good luck with your channel thumbs up to all doctors no matter the field there in
Good day. Thank you very much for your nice topic.you are extubating in couple of hours..do you use reversals. Like neostigmine or something like that..or without??
WoW! Just thank you, thank you so much! This is helpful to demystify all the boogy man thoughts my mind comes up with. Of course it's the fear of the unknown that gets you. As I age, I am hoping I can stay healthy enough to avoid any surgery, major OR minor. To date, I'm thankful to report I've only had a couple of dental procedures on laughing gas which I have to say was quite enjoyable, but I was still concious! Thanks again, very fascinating. 😊
Hello Dr. Feinstein, I'm actually very interested in becoming a cardiologist. Heart problems run through my family, so I find myself interested in the topic to help them, help myself, and help others who suffer the same problems. Do you have any advice on how I can contact a cardiologist to shadow them?
Amazing work!!!!
Interesting why do you use a miller 2/3? blade for intubation? Miller 00, 0 & 1 we use frequently in paeds but generally we see the mac 3/4 in the adult population used. Interested to know if that’s the standard practice, what’s your rationale?
Wow. Excellent video. My neighbor is a profusionist at VCU Medical Center in Richmond. She primarily works with organ transplant surgeries - liver, kidney, lungs, along with coronary surgeries. She once told me about a patient having a triple organ transplant. I cannot even imagine this. Unfortunately, the individual did not survive for long after the procedures. The other thing that amazed me is how many transplant surgeries are performed there on an annual basis. It is almost like a routine procedure. She said the most difficult are the lung transplants because the donor organs are not as "clean" as the others since the lungs are exposed to more surface bacteria than the others. Makes sense to me. Also, the degree of mechanization in the OR is amazing. Now I understand why so many new surgeons come from undergraduate programs in biometric engineering. Thanks so much for this video along with the Mt. Sinai team.
❤
im just now starting my medical school journey and i hope i can have experiences like this in the future
Your best video ever.
Would you say Cardiothoracic anaesthesia is the most complex and rewarding subspecialty of anaesthesia?
that was epic!
hey im a med student interested into going into cardiothoracic anesthesiology and this video was helpful for me thanks
This was helpful as I face possible surgery!
Hello Dr Feinstein , have heard of the term "pump head" in regards to post coronary bypass surgery ? Thanks !