Yesterday,
the Advanced Placement Biology class went on the tenth annual field trip to the
Inova Fairfax Heart and Vascular Institute to observe open heart surgery of a patient who was having a Coronary Artery Bypass Graft (CABG) (quadruple). The first thing the students heard was an introductory briefing on the
patient’s status by a registered nurse. She explained the kind of
symptoms the patient experienced that brought them to the hospital. She then talked about the patient’s genetic history for heart disease and
any risk factors they had with a particular focus on things that people
can control like smoking, alcohol use and diet. The nurse went on to talk about the
byapss the patient was about to undergo.
Before the students
entered the dome, they took a quiz about general heart health. Once in the dome, the
nurse talked extensively to the students about what was going on below. She talked about each person in the room and their role. She also
shared the kind of education and training a person needs to undergo to do
that job. In the room were the cardiothoracic surgeon, the scrub nurse,
the perfusionist, the certified nurse anesthetist, the registered surgical
nurse, and circulating nurses and anesthesiologist.
While the procedure
progressed, the nurse explained every step from the location and removal of the
saphenous vein in the leg using a narrow scope to the opening and preparation
of the chest cavity. The students learned about the removal of the vein
and the tests it must undergo to ensure the integrity of it as well as the
redirecting of blood flow that occurs as a result of the removal. While
that was going on, the surgeon prepared the heart by opening the ribs,
entering the pericardium and stitching catheters in place to redirect blood
flow to the heart/lung machine which circulated the patient's blood and
oxygen while the bypass took place.
One of the most amazing
moments occurred when the doctors stopped the heart using a high potassium solution. The Holton students have learned about osmosis and maintaining an isotonic state as well
as the importance of ion exchanges across cell membranes. Both concepts
proved useful during the observation. While the heart was stopped, the
surgeon took sections of saphenous vein and created new pathways for blood
flow that successfully fed the heart muscle valuable nutrients and
oxygen.
The girls were highly
engaged yesterday, asking a lot of great questions and making connections
between concepts learned in class and the applications to open heart surgery.
