Curiosity 11: Heart surgery

We got the good news today from Patty, David's sister, that a second surgery on her tricuspid valve, plugging a hole that was made two-plus months ago while attempting to replace a lead on her pacemaker (if I have that correct), went perfectly! We are all smiling!

Injury incurred unintentionally by a physician or surgeon, or by medical treatment or diagnostic procedures, is termed "iatrogenic." Patty used that term in her IM to us telling of the successful repair. It's new to me. I guess I'm glad to know it, but I'm not especially glad to know that it's a thing...

In any case, her experience got me wondering about heart surgery generally. The American Association of Anesthesiologists tells me that there are various types of heart surgery:

Coronary artery bypass grafting (CABG) is the most common kind. It's when "the surgeon takes a healthy artery or vein from elsewhere in your body and connects it to supply blood past the blocked coronary artery" or (not so uncommonly) multiple arteries. Otherwise known as "heart bypass surgery."

Heart valve repair or replacement—that's what went down this morning. "Surgeons either repair the valve or replace it with an artificial valve or with a biological valve made from pig, cow, or human heart tissue. One repair option is to insert a catheter through a large blood vessel, guide it to the heart, and inflate and deflate a small balloon at the tip of the catheter to widen a narrow valve."

Insertion of a pacemaker or an implantable cardioverter defibrillator (ICD). This, Patty already had done years ago, when it turned out her heart just wasn't keeping a steady beat. And pacemakers don't last forever: the leads need replacing. Which is what landed her with a hole in that valve, iatrogenically (surgeon error). Medicine is the first treatment option for arrhythmia, but if that doesn't do the trick, a device is implanted under the skin. It "uses electrical pulses to control the heart rhythm when a sensor detects that it is abnormal. An ICD works similarly, but it sends an electric shock to restore a normal rhythm when it detects a dangerous arrhythmia."

Maze surgery. "The surgeon creates a pattern of scar tissue within the upper chambers of the heart to redirect electrical signals along a controlled path to the lower heart chambers. The surgery blocks the stray electrical signals that cause atrial fibrillation—the most common type of serious arrhythmia."

Aneurysm repair. "A weak section of the artery or heart wall is replaced with a patch or graft to repair a balloon-like bulge in the artery or wall of the heart muscle."

Insertion of a ventricular assist device (VAD) or total artificial heart (TAH). "A VAD is a mechanical pump that supports heart function and blood flow. A TAH replaces the two lower chambers of the heart."

Heart transplant. 

In transcatheter structural heart surgery, a long flexible tube (catheter) is guided through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. Once the heart is reached, aortic or mitral valves can be repaired or replaced (with animal tissue).

I remember the first human heart transplant, in South Africa in 1967, and the doctor's name: Christiaan Barnard. He was a sort of hero. Certainly a pioneer. And the science has progressed by leaps and bounds since then, without much fanfare. 

It's almost like magic. Or maybe it is magic.

And...I'm super happy that Patty is fixed. Here's a picture of her matching our cat, from her recent visit down our way for David's 70th birthday. She's the best!