Science Reporter; 19; The Heart-lung Chain

And I'm John Fitch MIT science reporter. This is the Veterans Administration Hospital in West Roxbury Massachusetts. It's one of the veterans hospitals in the country in which open heart surgery is performed open heart surgery is a job for experts. These men trained for at least 15 years for years of medical school one year of internship five years of residency two years in chest surgery and additional time in cardiac surgery with many examinations along the way. So it's not surprising that there are only about a ha. Great open heart surgeons in the country. One of these is Dr. Ernest virus Amy and he completed his training over seven years ago. He now performs an average of two open heart operations the week until he has a four month waiting list. Dr. Barsamian is chief of thoracic surgery here. He's on the faculty of Harvard Medical School and on the third baffle Boston City Hospital. We met with Dr. Barsamian in one of the operating theaters here at veterans hospital and asked him about heart diseases require open heart surgery.

Do you do that replied open. OK. They are usually the ones that go with it or the divisors of the heart or. In the wall that separates the canvas of the heart. This is a have more than a fifth of the heart has been all of them besides if and I say it has to receive in Hamburg and full pumping. Now these are visas that required open heart surgery maybe he didn't quite get it. I think that born with them on that quiet an example of it can do anything that required open heart surgery and they hone in the wall that separates the neck from that I often came back and into that morning and this is where we may have been falling. Now this was before I don't often hot and the opening. Of. The hole. An example of when I lived in one that affect me are often that this is the valve that communicate with Lindy left pumping Tamba and viola this is the big but that takes you a

lot with it all but you and you can even start the bride right here to the horse to feed it and the diseases that may cause the order that it may be that Natalie applauded. Oh it may call it and eat it again. We need open heart surgery to either correct or not away by widening it or productivity is usually a lot of thinking about how do you know whether a patient has. One of these heart disease where the fish aren't there has a contact in the hot seat today. Child baby is born it will be revealed that it will buy the ticket on it at the price that fitted with here and not in. The memory. Normally when the bus passes for the 5. 1 lead. Time. When that is there for me and if that's not good. And if it does it annoy that with oil. And

gas that I cut the temp then maybe get 5 today in. The Fray. Having to fainting again to hot and dry all the guff that. I'm not the one to complete if it had the complete physical damage then weekday ect. Ok ok and the high that it has all of these are what are we doing. That day and found it will which is the congressman with a double the rate. Of the part that by the way that it bit that bit with that at that. Time. They have a patient column to put on the table. Africa order. Them to fight. Back. Again into the heart and half of the blood from the various members of the house. They can record I've made it up because if they did I don't it is injected and taken better that they show the movement of the

shooting won't be that this would affect do it get at the data. Thank you and I want to have her determine that a patient has but heart disease and how do you decide whether or not to operate what it's going to be sometimes a very difficult decision but what we do is good what with all that conflict between the medical the other and I are going to want to feel that that money back that that's behind us and that the water might then how we decide whether the risk of the surgery. When I gave it up a vision of the patient what we learn. Out. Again I'm working with it I. Read it from the old way and the judgement is made whether. To the effect that they are not and as I say sometimes it isn't. Once you have decided to go ahead with an operation you actually cut right into the heart. We did over exactly what we have to got right into the heart and leave it open and that is why we need

our lung machine that they have over the function of the life of the heart that gave us a drive without blood it was a quiet where we get. To. That but how do you go about it. Way probably easier. The fear is that we have to move with the. Way the technique. Moving. Like this thing was prepared by the act of goodness can and very well have been that the Massachusetts General with that involves the seeing a patient under operating table and the operation of his death has been using his name in the midline cutting of the pheromone which is the big brown in front of a pair this time being caught in the chair is now open. You're seeing the heat of the hot fully covered in with or without a paddle. This will next be cut if he had been lying on both sides of the house coming into view. Now this is a conversation I think our operation and the next there

take a minute and it better come again which is the covering of the heart has been open I was being attacked there would be I did have the benefit in doing the exploiter with the heart with the camera out of the way. That's right now you're looking at the heart the hand was on the hot seat the heart beating. And some of these movements could be you come by that had been going to get radical to actually be more than oh and calculated that it believes that it is. You know the vision to be prepared to put on the right back we're going to see this because I thought that that was the one of the deceiving canvas which brought the bride and the witches today and I'm glad to have him for the heart lung machine with gratitude is

now the latest in what the clothes that I am and it will be connected with the genetic code other than hard line and that's where the bride would normally be coming into the heart but it was the blood where the blood would be coming from a lot of ways into the hive. We thought it good because I don't think it was in line to be up to this interview a lovely I have to do with this because one of the most common problems of how you can make that you would call it because of the way. For the blood comes from that tube that we saw that was inserted in the vein and now it's going to reassure you that what you're seeing here is like fingers moving. Very very near the family. This is referred to as a thing my mother found and it's like trying to bang on a can of compressed thing that building in between a bump in the blood. Forward in that manner. By their predecessor compression of the finger again instead of feet in the heart of being Dr. As you were eventually pumping blood for the heart that they had lung

machine and without fanfare. As I've been a bit and found the oxygen there that are facing the function of the land in the early carbon dioxide and getting up again and to found. An interface in the function of the heart of these beer they're adding the oxygen to the heart. It may be overgrown. With and at will of blood at the bottom of the oxygen with it except that I did it through air and after three and a half again and therefore of the commission of that company in that manner. We're back with a hot. Now this 50 is going in and out of his affection with his you who. Had a fast life this is an outgrowth that this is the big love that that credit is the oxygen at the blood from the next company chain but

it happens not and right in the middle of the screen you're looking at the Outlook to grab your face here that does not have that that I do in the meeting with you do that by a well you know all this is done by calling it when the temperature of the hot 15 degrees centigrade. It's what about people that have been bypassed the if they are already like that and this is why you are able to open this big blood vessels without letting the operating room or not. What they're doing now is very careful there as Jim which was involving the bride and that very thing most of this issue of the bride causing the bride to be. Picture and this is one of the one of the main lesion is not always and trying to leave out the excess and get out there that I had a visual to open the ride now the ride I bet it would get when you remove the crowd

then they become private and you can see that they have removed what I do and the thought that was that it would be how the morning when they went from a place of that there's not going to get to the mall or that there's no way this and the blood but the glow that we're not implying that as a form of blood pressure to the brain and make all of that what we call it for you know it's important that we move on though and if we and the operation has just been concluded the opening Indigo being told now we're doing this for siege and the patient is given a drug which is called this route prevent the collecting of the blood this is important because although we're not we don't need something to prevent letting of blood when we are hurting the blood that the bloody It would carry the clout on the drug so that the patient has the. Right not when the operation finished. Back to the more from the ad to another facet better with what connecting the fan

without fear of this one worked out in the world a kind of drug would be using which is probably what they mean. Louis for all of the normal clotting mechanism the blood but was a little bit that I just saw in the picture which was put up against the heart would better get it started again you know the heart of being cool when it is being real. It would go into fibrillation which is which is like if you were on many a long day in the muscle of the heart at. Least I had. My sizing the hot. Privately in full. It does not apply and that this was the new girl what a defibrillator because this is an electric car that was packed with it was a little more work to figure the nation and I think when I went into that I grew to be so is going into the game again. Sometimes it has to be a few times when you're fortunate to first time will do it and it will be.

There's a fear that when the hot crowd will be. With you will be before they will let you know there's a good draw on the the face when they. Take an. Hour and. Five packs a. Day. And that in the face and. The face down. Have been. Put there. Hard to deny that is you. And before we do the computer nearly put the patient on earth and bypass that the some of the blood fashion to the patient. Will be gone. But none of the factors for the depletion of lovemaking. When we see that everything is that fact a day then we put the patient on that which means all of the blood work for the occupation to end with a question. Of the OP did you know that in the film. Now you want a good beat and leaves out the fact that there would have been put in there but then the van and the black and

white I don't know that we put there. Visualize the difference between the US and there's a lot that was inserted into the face and the NQ of that color. But on account of that in the film but. Now you're going. To feed them. Over and back to things that I'd say not only led me about with a 50 minute going over that long break in bed why there was a food bank a guy feel that it was easy to put your finger if that was enough to make a way out of the way that occurred to me and. One thing I know is. This is a heart lung machine that if you're only operating on the heart working for you the patient on the line. Already the heart has cooled. Prompting him to be that one found blood around to be oxygenated and the blood that comes back at the pump again for the death of the body. If we are near by passed the heart we have for you is. Armed

with that we are connected by bypassing the heart and lungs together. We would love farm and want that and wanted to connect with it without a. Heart lung machine but we've seen the film eat all of your expectation or as I think it does a fairly I declare you are in elective surgery but it doesn't mean we follow it that it has never been rolled back. One of them is that it needs a fight the flood the time now that means you have to have a wand of death before they get drugged you prefer to use their fresh blood. Now what the blood being that Dumond there has a matching that has a you don't have to factor that on out or compound in addition the problem is who. Has been. Offended and better life and death than that for the rest of the fact that they could infect them for you know I think one machine is a great thing to be in the now what would you like to see in

an ideal heart lung machine. I think an idea of how long it. Would be one that would be cool. Oxygen a point that there's a lug and I don't like when the blood get through this without exiting but I think it was the one that was given that contact that would be better lived in that kind of form that is. Of the moment not that I think it would be one that is the face and one of the operators you put in it will be in fact you know me and that it wouldn't have been like the vision at the time of the war it had been face to face and neck and not of the surgeon who works or realized what an ideal machine would be right about getting one developed and built from third have gone to the trouble of designing building and operating one of them said. I think this that cause for some of the thoughts coming from the president outline that I was

fortunate and you think that family Collins of MIT and during our conversation the fact that some of my thoughts on hotline with him and they were kind enough for them to Google. This is Dr. Daniel Collins professor of mechanical engineering at MIT. But designing and building of a new heart lung machine has been one of his personal project for several years and through that project has brought of Yankee ingenuity and considerable pay to this machine is the model Dr. Collins has built could be corrected by a doctor by Fabian working with dogs between them they have simplified the design and every view the number of parts it will soon be ready for you in an open heart. Operate for the purpose of this demonstration. Let's imagine the model of a man his chest and an open heart surgery and we connected to a large main entering the high and did community care system. Rod closed by gravity

through the tube into their training Theo tank. The oxygen nadir which replaces alone during the operation. And from the oxygenate or through the float chamber down into the home which is located here and the drag. From that pond into 15 women. The debugger and from the bottom of the bubbling we whip back into the. Patient. But right across the foot but it's just a trickle in the on the bottom of the trough isn't there a danger of getting air bubble mixed in with it but that would be prayed over the patient would hear it would only take infectious precaution to make sure that doesn't happen we have a sloth here which has a valve on the bottom and there's power down into a circular hole and the flow of blood on the level get below a pre-determined

level of about here. Whenever that fall for that level no more blood can go through. So it is always the old the pump is always field again. Yeah by that vote. I suppose also that means that if you can shut it off you don't have to have a great deal of blood in the reservoir here that drive the. If it makes it possible to get along with very much less blood within the heat. It does not require close supervision. Therefore you can get along with a very minimum of blood and then there are what we go through the boat out down the hall I believe it's in and out of that work. Well if you fear from the field filling the hearing within it is a very heavy world. Rubber tube closed at the bottom. We have here a connection for our. Gas. When the pressure in your in the low there every human living in there getting it filled with blood. When pressure is coming down here the rather cute collapse that.

We have here earlier this year we do the internal volume for million of blood they can contain. Poured out into there. I devote their life in the here now why didn't you go right back up into that chamber. Because the valve located one here. From the lead to flow. Into the phone and one valve here but from the little I. Thought that it was probably very like a five minute complete with about everything we had. For them. And then we come to the problem. Where that do. This is really the foreign very funky one being the bubbler ferries that trailer there containing a great amount of blood and you have. And literally in the machine come through here. It connects at the top and then drawing off using the Brad thing for the bottom and flows out of the bottom where in operation there would be no bubble but in case one could turn out it

will. Come to the top and going that way. Robin I have some other functions I believe that meant three altogether. Where. Are the trainer in here. I made a finding that thing that we'll agree on that front. Another thing of course is when the. Foreign matter that may and I couldn't get into the blood me for at the moment hero might be from the scene of the operation by Brad which had leaked out or got into it with him and sometimes her through three sometimes Brad got to make enough without being there. Robert. Then a day on a part of our first day of the third one who would often be hauled. Out of the home to get it plain loaded so that when they had gone and got it wrong call it with coffee from one of their radical liking in the in the. One thing that I found that

and that is McCain later. For getting back to this larger crowd here how do you actually get oxygen into the blot it out. We have a rotating member of the victim. And I did the oxygenated that is the thing that you fill in there and covered with nylon tool we have two varieties of material one and then you know I gathered that and make it fluffy and. Arranged these are wound on these are about one foot wide and about 12 feet long. They are wound on down there and then there's been they've provided a lot of character. Now they're locating filling their check to the bottom of the trough when they didn't rotate if broke a plenty. I think. And. There it is the nylon material

touches the bottom and that little. Trickle of blood coming down the trough is picked up by their carrot over and over again and their material become like a very thin layer of Bud. We have an oxygen atmosphere inside here and there is the next thing you can do that for it if you couldn't get oxygen to go into the blood that was in the form of very thin veil like your lungs itself. Yet here we are trying to make it much like the longest possible the amount of the rate at which time taken up by the blood is a function of the area the greater the area and more rapidly than the earth of blood and therefore simply means of providing a very very they're there for the lungs. Provide them in the. Area. You know exactly how much area would they have. There are about 50 players here and there throughout this rotate then the tour with nylon material picks up a trickle of blood in the bottom

brings it up into the oxygen atmosphere at the top here and then deposit it back in to go on to the pump and back with a hard drive all of this. I mean you have. To rotate fish and you've got a pump down there and I believe you said that was another problem. What do you drive it. We have a little. Teenager here we carry. Them around. Yet. For all intents and purposes it is 15 and although we do not use seem to drive it we have been under pressure here. We need more oxygen is capable of doing a lot of work. And we make you. A little bit of your work will be covered under pressure if you make it run the machine first and then use it to oxygenate the blood at Fratton could we see the machine in operation during a period. Where. We will be able to see the. Market interrupting. Crank up the engine. Right could be an. Anomaly. Or area in the.

Case but that. Can only be. Glad. That your. Right gravity. Guy. With an AI perio. Right. On the. Upcoming. Really. Oxygenated here on Earth a large. Through the power of the heart let me back up that they are very open very regularly. Paul thank you very right I forgot. About the birthday mean you but the machine what do you think of it at your face methadone and may I think you have. Been on the decline in effect for it. I live here and the day. Before. Play at that music. Going on I think and often. When Earlier you mentioned a few. Emergency workers you have in mind. One of the coming of the day after and you can hear what's going on with that and wonder if you think they're going into me with a thin line and open with me. We have a hard time with that with the

pain of the footnote. With the war and the move the plot from the basement and both of you for fear you would think other types of operations other than over there. Yes this week when I did think of that the both of them that had a path that would make what we did we did on the way out there and then into that led them to the machine but in a rough time for there with the path that yes preventing death coming from the connecting brought the death of what we hope will then move the machine. What record profit for you for having an. Inexpensive readily available machine will that make it possible for more people to have open heart surgery. The machine is going to one of many other factors you have the fact that a thank goodness went thank went back to the had the time. To do a lot. Congresswoman that I did that with the other simplifying the machine I think we can put that. Oh thank you very much.

We've been talking with Dr. Ernest birthday Mian and Dr. Daniel Collins with the Veterans Administration Hospital in West Roxbury. I'm gonna fit MIT Ryan for for. You. This is the National Educational Television.