The Lancet Student

New heart

This blog was submitted by MauricioAv on 24th February 2012.
Tagged with Heart, surgery, Transplantation


Mauricio Jose Avila Guerra“The heart is a hollow muscular organ of a somewhat conical form; it lies between the lungs in the middle mediastinum and is enclosed in the pericardium.” Anatomy of the human body, Henry Gray.

As you could figure out in my last post ( I love the brain. But having said that, I have to confess that one of the most beautiful and amazing surgical procedures I have ever seen was a heart transplantation.

I was just getting out of an appendicectomy in OR #2 when I asked “What are they operating in OR #9?” a friend of mine said “a heart transplantation”; his face told me that he was not interested at all. I almost ran to the OR; I entered very quietly, but the chief of the cardiothoracic surgery department saw me and asked “what are you doing here?”. He was not very happy, I was a third year medical student entering the land of giant and untouchable surgeons; my answer was simple “I would like to watch the surgery if there’s no problem”. A simple and concrete answer gave me the privilege to be standing in the OR.

The surgery was unbelievable. Open the chest, put  the sternum to one side, open the pericardium, see the patient's beating heart ( I tried to remember the basic  physiology from my first year; diastole, systole, open the valves, ejection, cardiac output; just in case they asked me something), turn on the “artificial heart” ( heart-lung machine). Until that time in the surgery I was amazed, my fascination grew bigger when the donor heart arrived. A beautiful 26 year old healthy heart arrived in a little red box full of ice . The main surgeon stepped off the surgery table, approached the donor heart and said to me “come closer”. He dissected the pulmonary veins, cuts little pieces of the aorta, and one hour later the new heart was replacing the old dilated heart in the patient’s chest. But the healthy heart was not beating, the heart-lung machine was still running. At this point, it was time for the most critical minutes in all the long hours of surgery, defibrillation.

Two long lollipop-shaped sticks, one in each hand, surrounded the new heart, “charge” said the surgeon, and “boom” first charge, nothing happened; “go up” said the surgeon, second charge and the new heart started beating, thirty four beats per minute, fifty five beats, reaching a reassuring eighty beats per minute.

That day still amazes me. It was one of a kind opportunity to be in the OR watching “magic” happen.

What is the most amazing surgery you have ever seen? Do you still remember all that happened that day?

Mauricio Avila-Guerra is a fifth year medical student in the Pontificia Universidad Javeriana in Bogotá Colombia. He is interested in neurosurgery, neurology (neurosciences in general) and education. Mauricio is part of the neurosciences group of the Hospital Universitario San Ignacio, and the Hippocampus group, a student-based neurosciences research group.