The last thing I remember was the cold room with a stainless-steel ceiling. I was about to undergo open-heart surgery--an experience shared by 450,000 people in the U.S. every year. After the anesthesia took affect, surgeons made an incision in my groin to expose my femoral vein and artery. Through the vein they threaded a tube called a cannula up into the right atrium of my heart. This tube, and another attached to the artery, was connected to a cardiopulmonary-bypass pump, or heart-lung machine. A dose of heparin kept my blood from clotting as it traversed the machine's innards. As the venous blood passed through the oxygenator it was cooled; my body temperature lowered to 25 degrees C-deep hypothermia. With all systems go, surgeons inserted an inflatable clamp into my aorta to seal it off. Two liters of cold blood potassium solution stopped my heart, and for the next two hours the machine took over. An eight-inch incision below my right breast allowed the doctors to pass cameras and instruments between my ribs, and then to repair my congenitally defective heart valve.
I left the hospital a week later. The incision healed quickly and painlessly. In a couple of weeks, I was out and about on slow, but successively longer, walks. Within a month I was back in the gym. However, mentally I felt a bit hazy, a little disconnected, sometimes even lost. I soon learned that the surgeon's warning that "You may be a little depressed for a time afterward" would not do justice to what came to be a long, dumbfounding struggle against what seemed to be the sudden onset of attention disorder or incipient senility. Adrift in a clueless no-man's land, I felt my moods range from querulous to despondent. I couldn't muster the concentration to deal with the problem. I just wanted to be able to think. Think anything.
|
I didn't know it at the time, but I was suffering from what surgeons off-the-record call "pumphead," an all-too-apt appellative that refers to the dim-witted existential state in which patients seem to linger after a bypass.[[Does this occur with other procedures that require use of heart-lung? Is angioplasty, for example, risky too? How about when artificial hearts or heart-assist devices are transplanted--does anyone know about those yet?]] Pumphead was long suspected from anecdotal reports, but only recently did a long-term, five-year study of bypass patients prove the existence of the persistence of the condition. Could the familiar heart-lung machine--which provides life-giving oxygen to blood during 900,000 coronary-bypass operations annually worldwide--be the cause?
Making of the Machine
Fifty years ago, John Heysham Gibbon Jr. of Jefferson Medical College in Philadelphia performed the first successful human surgery using a heart-lung machine. He'd begun working on the device in the 1930s, as a research fellow in surgery at Harvard Medical School. After years of animal trials, and working with engineering advice and financing from IBM's Thomas Watson, Gibbon solved what was then the major impediment to heart surgery-giving surgeons enough time to operate.
next >>
|