There are few things more disturbing than the helplessness of being at the mercy of medical professionals.
I spent 9 days in the hospital after my recent open-heart surgery, largely because the addition of 12 pounds of fluid during my surgery led to a pleural effusion (fluid leaking around the lungs) so I had partial lung collapse (atalectasis) and extreme difficulty breathing. Was this a mistake or a necessary part of the surgery? I’ll never know.
The linked article doesn’t mention the recent incident where a surgeon mistakenly (fatally) removed the patient’s liver instead of his spleen. Or the fatal gastric bypass where the surgeon mistakenly attached the intestine to itself in a closed loop instead of connecting it to the stomach.
Thanks but no thanks. Dealing with lawyers is more painful than being on oxygen for 9 days. Also Medicare paid for everything so I didn’t suffer any financial damage.
Wendy
Between 40% and 85% of patients develop a pleural effusion within the immediate postoperative period, with most occurring within the first 7 days after surgery. Pleural effusion is a common complication of heart surgery, is associated with other postoperative complications, and is more frequent in women
Atelectasis is a common cause of hypoxemia and impaired gas exchange after cardiac surgery. Atelectasis is seen in 30–72% of postoperative cardiac surgery…
This is the reason that TAVR has become the preferred choice with Aortic Valve Replacement. Open heart surgery and long pump runs (extracorporeal circulation) are a traumatic intervention on the patient. Furthermore mechanical forces during pump runs can cause complete destruction of the red blood cells. The oxygen carrying capacity is significantly reduced post op due to the extracorporeal circulation transfer through the machine. This along with even a slight amount of atelectasis will cause respiratory labor, i.e., shortness of breath and labored breathing. You feel like you’re suffocating.
This is the risk of the benefits for cardiac surgery, compared to the reduced risk of benefit with TAVR.
Like I always told my patients, some risks are literally one in a million. It just sucks when you happen to be that one. Was it a “necessary” part of the procedure? No. Was it a potential complication? Yes. Toss a coin enough times and you will eventually get 10 heads in a row.
I’ve seen fatal and near fatal mistakes happen in the OR from both good and bad surgeons. Looking at a live body is nothing like what the textbook pictures show. Humans are error prone.
When my ultrasounds and CT scan showed severe aortic valve stenosis and calcificaion of a bicuspid valve I assumed that I would be getting TAVR. My cardiologist convinced me that I needed open-heart surgery for two reasons.
I also had an ascending aorta aneurysm which could only be repaired by open-heart surgery.
Based on my high level of physical fitness, my cardiologist said that I could live another 15 years or more. (He actually asked me, “How do you stay so young?” since I could still stand on my hands at age 70.) Given the constriction and shape of my aortic valve, TAVR would have required a small diameter prosthetic valve (e.g. 19 mm). If I outlived it, which he felt will be likely, it would be impossible to slip a replacement valve into it by TAVR later. On the other hand, the open-heart surgery allowed the surgeon to cut out the calcification and defective valve. He then inserted the largest available valve (25 mm) that is designed to accept a replacement valve later. I approved of this strategy.
I have had major surgeries before but none on a heart-lung machine. I never had such terrible weakness before. I don’t know how older people who aren’t physically fit can survive it. I knew it would be tough but not that tough. Fortunately, my husband and sister helped me.
The surgery was 11/19/2024. I’m still not feeling 100% but I’m exercising 5 days a week. Cardiac stress test tomorrow. If I’m cleared I will go back to doing HIIT. That’s the only way I will really get my strength back.
Courage Wendy. Sis had a stint put in that was a more significant surgery than the tests indicated. She had a minor heart attack on the table and felt crushed in the first few months post surgery. A year later, she is doing very well and back to super active. Give it time and don’t give up working on it, even if you are not moving forward as fast as you hope.
After Tucson’s excellent description of the challenges of this type of surgery, the answer is most likely “neither”. A topic on my mind at the moment as it’s just over 6 years since I was at dh’s bedside as he was having the breathing tube removed…and I was anxiously awaiting the opportunity to test for one of the more frequent consequences of an extended period on cardiopulmonary bypass had occured…cognitive dysfunction/“Pump Head”.
Spoiler alert…it had not, nor any other post op complications. The profound weakness and disability is a different matter (I tried to drop really broad hints to give you a heads-up @WendyBG…without disheartening or worrying you too much)
I think it’s safe to say that the more complex the surgery, the greater the chances of complications…so the greater the impact of detecting problems before they reach this stage.
No prizes for guessing where I’m going with this one in the context of medical errors. Forget about why Good Custodianship hasn’t protected you (and me) from maladies/procedures commonly associated with craptaculous lifestyle choices…but why the late detection when just a bit more thought and effort could’ve harnessed fairly standard, not-so-cutting-edge technology?
After a couple of visits with my intervention cardiologist, and he presumably fathomed that my miffedness over my late diagnosis wasn’t a result of cholesterol denialism/statin phobia…or me looking for ammo for a malpractice lawsuit…he did agree that “someone should’ve said something”.
