Week Six and Its Over

Its amazing to see how fast six weeks in NYC can fly by…it seems that it was only a few days ago that we had arrived at the medical school and were trying to figure out way about the hospital and now we’re all packing up and getting ready to head back home to Ithaca with the research that awaits our return.

This week began in the OR where Julius and I were able to observe a double bypass open heart surgery, otherwise known as a CABG (coronary artery bypass graft). The patient was a 72 year male that needed this surgery to regain circulation in other parts of his heart due to occlusions in the main arteries that supplied blood. The patient was put under anesthesia and was prepped for the operation with a cardiothoracic fellow working on opening up the chest cavity and another surgeon that was harvesting two vessels from the patient’s legs. The surgeon performing the vessel harvest made two incisions on the leg and arthroscopically inserted a tool that had a fiber optic camera, a pair of cauterizing scissors, and hook that allowed the surgeon to capture and isolate the vessel of interest. It was amazing to see the speed and accuracy that the surgeon worked at and in a matter of minutes had isolated the vessel, cut off all the branching arteries from it, and had it outside of the patient and was cleaning the vessel up. During the clean up process, the surgeon attaches little staples to where the cauterized branching vessels were (for this reason during an angiogram the staples appear on the x-ray) and then attaches the vessel to a syringe filled with saline and pressurizes the vessel to determine if there are any leaks. Once the vessel is cleaned up, its placed in a holding container with saline and then the surgeon proceeds to work on the other leg and to retrieve another vessel.

During this same time, the cardiothoracic fellow has been working on the patient’s chest cavity and has cracked the rib cage (actually sawed through the sternum with a power saw and then opened it up with a chest cavity spreader). He then proceeded to cauterize all the blood vessels that he had cut through and began to remove the pericardium that covers the heart. As soon as he had the heart uncovered, he then proceeded to get ready for the bypass which involved inserting hoses into the chest cavity and hooking the heart up to a heart and lung machine. This was an amazing sight to see the amount of blood and saline that is used during the recirculation process and the color and thickness that blood takes on when it is flowing in such volumes. After the patient was hooked up to the machine, the heart was chilled to 10C and the chief surgeon Dr. Krieger came into the OR. Even at 10C, the patients heart was strong enough to keep beating and the surgeons then set on with the second part of the procedure which was identifying where the new vessels were going to be grafted on to the heart. During this time, Julius and I took turns to stand by the anesthesiologists station and look down onto the heart and what was going on. After the back vessels had been attached to the patients heart, Dr. Krieger looked up and asked what we were doing in the hospital, our reply was that we were graduate students in the Immersion program and we were observing. He replied, “Observing? You’re not observing. Get up here and see what we’re doing.” Now this was an amazing treat, we were able to stand again right by the anesthesiologists station and look down on the front part of the heart as it continued to beat. During this part of the procedure the surgeons took the aorta and clamped it, and then punched holes into it to attach the vessel grafts that were sewn onto the punched holes. While this was going on, Dr. Krieger was talking to us and describing the whole procedure in all its details. The patient was taken off the heart and lung machine afterwards without needing his heart restarted because it had continued to beat during the whole procedure and no bleeding was evident. The fellow then closed up the patients chest and the procedure was over in under 6 hrs. To say the least, that procedure was just amazing.

The rest of the week was spent trying to got old MRI records of patients restored on the workstation so that I could begin tracings for my project with Dr. Weinsaft, but that did not happen till Wednesday. I managed to complete a few tracings before I left, but ended up having to leave the rest of the project for Dr. Janik (a fellow scientist who had been working with Dr. Weinsaft on a previous collaboration). In addition to working on the project, I was able to sit in on a few more MRI/CT readings and go in for a few more morning rounds with the residents on 4 North.

Wednesday evening we had our wrap up meeting with Dr. Yi Wang and had a great meal at an excellent sushi place (except for the air conditioning breaking down), while on Friday it was one last trip to the 55^th Street MRI building to see a few more readings, followed by a quick lunch with Dr. Weinsaft, and then last minute packing and laundry before the bus left back to Ithaca.

Overall I must say that the experience this summer was an amazing one. Getting to work at the medical hospital allows us engineers to see how the medical system works, how the doctor and patient interactions occur, how current techniques are used to treat and diagnose disease, and how we can use our own skills to help improve specific problems that currently exist in the medical field. This opportunity that is afforded by Cornell should be extended and modeled at other schools that have a Biomedical program because through these programs, the students really begin to see what the fields really need in terms of devices and new inventions that can bridge the biological and engineering gaps that exist.