Friday, 30 September 2011

Complete coverage of open heart surgery

The most valuable thing a man can have - is the heart and soul. And if the healing of the soul can help a lot: from religion to books, for the correct operation of the heart surgeons meet. In this feature we look to you in AlmatySemaHospital and walk with the patient all the difficult stage of heart surgery.

Zhamaldin Bolushov in search of the best surgeons come from Kyrgyzstan: "At home, I was looking for good doctors, but my cardiologist advised to be treated in this clinic." Excerpt from the case Zhamaldina: "Coronary heart disease. Exertional angina. Trehsosudistoe coronary artery disease. Comorbid diagnoses: diabetes mellitus type II, severe course. Decompensation. Xronicheskaya obstructive pulmonary disease"

Heart problems, I started because of the long smoking (I have 30 years experience). In 2008 appeared the first pains of the heart, in the same year the first time I had a heart attack, the second was this summer. In Bishkek, revealed lesions of 3 major coronary vessels, operated on urgently recommended. Besides, I have four years of suffering from diabetes ...
On the day of surgery preparation process begins with 8 am
His wife helps Zhamaldinu to change into a special form
Prayer before a little excitement takes the patient and relatives
Tansel Turkoglu - an experienced cardiovascular surgeon, behind which 15 years in the prestigious Turkish hospitals. Working in Turkey, he spent up to 800 similar operations in the year. In the spring of this year, Tansel works in Almaty
A few minutes before Zhamaldina taken away for surgery, he was quiet about what is talking with his wife
Zamir: "All in the hands of Allah. In his only hope ...

The doctor in charge of a hospital department, explains the patient's relatives to send it around and when they will be able to see him again
Heart surgery requires the preparation of anesthesiologists vysokoprofessionnalnoy

When applying anesthetic drugs are introduced, relaxing all muscles, including those responsible for the respiratory activity
After installing the snorkel connects ventilator. Anesthesiologist Feruz Babashov pressed to the face mask for better saturation of the pulmonary oxygen
After connecting the system of artificial respiration Feruz inspects the work of the lungs of the patient
For the introduction of drugs used during surgery large blood vessels
There is a puncture the jugular vein for subsequent injection of
Operating nurse anesthetists work waits to begin processing the operative field and the patient. Around her are all sterile, touch to the table, the nurse and the instruments are strictly prohibited. If this rule had been violated, it would have to postpone the operation for a new sterilization
The instruments used in cardiac surgery
A nurse holding a tray with iodine solution
Operative field should be sterile to prevent festering of wounds after surgery
Legs are processed for the subsequent capture of vessels
After the surgical field is handled, go for a boundary but the surgeon and nurses operating strictly prohibited
The first operation begins to nurse Yasemin Selcuk. It should take subcutaneous veins from the feet to replace the vessels in the heart. In Yasemin behind 12 years of experience in cardiac surgery, because surgeons have extensive experience trust her senior operational stages
At this time, a heart surgeon Tansel Turkoglu in the other room watching coronary angiography to clarify the sites of transplantation of vessels
When everything is ready, he goes into the operating room. Washes his hands with a special solution and then treats the liquid with a high alcohol content
He puts on sterile gown and sterile gloves. Operation can begin!
At first retractor expose the rib cage and sternum
During the operation, in blood vessels of the heart flows with a solution, suspending the heart's
Heart-assist device in operation. It receives blood from the vena cava, oxygenated and fed into the aorta for circulation throughout the body
The device plays the role of the patient's heart and lungs during surger
Perfusionist monitors the indicators of hemodynamics during cardiopulmonary bypass, he is responsible for maintaining the level of gases and metabolic products in blood
Registration complete cardiac arrest on the ECG
Apparatus for reducing the temperature of blood, as blood oxygen enrichment takes place at low temperatures
Yasemin has almost finished its work
Veins in the legs lie superficially under the skin and deep into the muscle. During the operation, surface vessels. In the future flow of blood through the deep vessels
The surgeon prepares the site for podshivaniya vessels to the heart
Measured length of the vessel. It is important that it was the right size, so the motion of the heart was no damage or stretching of vessels
The vessel is filed in place of a coronary artery narrowing
When working on the vessels used microsurgical instruments and materials. Thread subsequently absorbed, when the vessel is fully accustomed to a new location
Anesthesiologists watched for the operation. It is important to introduce the drug in certain stages
Patient is sleeping soundly. Stable condition. During the operation the eyes are closed, so as not to dry corneas (which later can cause such diseases as keratitis), since in some patients during anesthesia, the eyelids are opened a little
The clinic has a special air cleaning system: getting into the operating room, the air passes through a filter and comes already clean. In the future, before the air supply to the street, he again is purified to prevent the spread of possible infection
Work on the vessels requires microsurgical accuracy, every millimeter counts, and glasses with surgical loupes - need during the operation
Work surgery is completed, it is removed, trusting last stage of the operation Yasemin
Today we had a classical surgery with cardiac arrest and connecting heart-lung machine - says the surgeon, during his stay. - We also make the operation on a beating heart. Such operations have adopted recently. Usually we use them in one vessel bypass, but in July, for example, we had a bypass 4 vessels on a beating heart. After these operations, the rehabilitation period is reduced, the risk of complications. The Internet is a video with minimally invasive access to the heart in the intercostal spaces
After each operation, a young surgeon Nurali asks questions that have arisen in the operation. In Turkey, the assistant after a 6-year study at the university for 5 years specialize in a narrow area. To gain access to the operating room, an intern for a year just watching over the conduct of the patient in the ICU, and then take him to assist operations
The operating are counting napkins. This might sound a joke, if not for the sad cases where a patient's body tissue and leave the tools
Making sure everything is in place, Yasemin begin stitching the sternum
Stitched leather cosmetic suture thread in the future resolve
The total blood loss during surgery an average of 400 ml
Duration of operation 1 hour and 54 minutes
Taking off clothing, Tansel sent to the patient's relatives to inform on the successful operation produced

While the surgeon speaks with family members, operating in the area continue to operate. A nurse hands over the tools used in operations on the processing and sterilization. At this time, the clinic is capable of producing up to 3 heart surgeries during the day
The patient is prepared for transfer to the intensive care unit
Blaming the patient from the operating table. It is important to do this carefully, because all the muscles of the patient relaxed. Are counted: "one-two-three" ..
and gently move the patient on a special moving bed

Resuscitation room is located next to the operating room, it has everything you need for emergency first aid. The main clinic personnel working in hospitals in Turkey. Their main task - to provide quality care and training of Kazakhstani specialists, for onward transmission to the clinic in good hands
Drainage pipes installed in the pleural cavity and the cavity of the pericardium to drain fluid accumulating in the first postoperative day
Switching the monitor surveillance
The physician controls the principal vital signs
After surgery, the patient is sleeping 6-8 hours before it transferred to spontaneous breathing without the machine

Waiting for the result of a complex operation exhausted all. In those few hours with relatives have time to rest
At six o'clock the relatives already in a special form of dress for visiting the intensive care unit
The patient is ready to receive visitors

My wife could barely holding back tears

The patient should be within days in the intensive care unit for monitoring the status in the early postoperative period. Today he had a bad day ...
Exactly a week later. Zhamaldin is already in the normal ward and will soon be ready to be discharged
Measurement of pressure in the chamber takes place every half hour
The main problem after surgery - long the restoration of full functioning of the lungs. If the patient has smoked for many years, the restore process is extended
After the operation was all right, all right ...- broken voice repeats Zhamaldin. - Changes being felt at once, before the operation, even the most simple movement caused my rapid heartbeat, I felt tired, heart work erratically, and now do not worry, sleep quietly, walking normally. There are a pain, but it's just healing. All doctors who work here, thank you very much!

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