NEW METHOD OF RE-STARTING THE HEART AFTER OPEN HEART SURGERY

Michael Burgio*

ABSTRACT

I developed this surgical procedure during the time I had the privilege of working with Dr. Michael DeBakey. My concern in using paddles to restart the heart had the potential of significant problems postop. As an example, when the panels are placed into the chest cavity one lies directly over the left descending artery. Which supplies one-third of the blood to the heart. Any inflammation of the artery has the potential of creating an additional cardiac event. In developing this procedure, I made every effort to simplify the procedure. There only three parts, a catheter coated with silicone, a standard surgical needle, and a cardiac pacemaker analyzer. In addition to the potential inflammation, when the panels are inserted in the chest cavity the heart is stimulated to a rate of something close to 72 bpm. The difficulty is in most cases the chambers have a minimal amount of blood. Creating a distinct possibility of damaging the internal walls. Using this procedure, we are able to start the heart beating at a rate as low as 5 bpm. and increase the rate in direct proportion to the blood flow from the heart-lung machine. As the blood is filling the chambers the rate is increased proportionately. Reducing the possibility of damage to the internal walls of all four chambers. In addition, this method can independently control, the amplitude, the pulse width, the AV' delay, and the rate. Prior to this surgical procedure many patients were denied open-heart surgery. They were too sick, and a successful outcome was in question. Open-heart surgeries is now available to the sickest of the sick, the elderly, and the patients with so many complications due to years of a lack of quality healthcare. Once the surgical procedure is completed and the chest cavity is closed the catheters are left in myocardial tissue, to be utilized when the patient arrives in ICU, Surgical ICU. In the critical care unit, the catheters are connected to an external pacemaker attached to the patient. Because the catheters are within the myocardium there can be no loss of capture or stimulation. This allows a number of options if the patient goes into distress. Some of the variables within the external pacemaker, the AV-RV pathway through the bundle of His can be extended or shortened to control Wolff Parkinson's White Syndrome, Ventricular Tachycardia, Atrial Tachycardia, Supraventricular Tachycardia, a Cardiac Pause, an Internal EKG, an Internal Defibrillator. If the patient codes the external pacemaker and the catheters could be program as a Dual Chamber (AV) Fixed Rate Pacemaker, providing total control and reducing the possibility of losing the patient. If the patient once again goes into a cardiac arrest, the external pacemaker parameters can be adjusted to increase the Amplitude, Rate, and Pulse Width and returning to a normal sinus rhythm. Additional cardiac events, Heart Failure, Irregular Rhythm, Premature Ventricular Contractions (PVC's) Atrioventricular Block, Bundle Branch Block. This is a small sample of the benefits.

Keywords: Open Heart Surgery, Atrioventricular.