Although none of the editors are participating in his care, InsideSurgery has noted the recent reports of Major League ballplayer Aaron Boone undergoing open heart surgery on March 26, 2009 at Stanford Medical Center.
Boone reportedly underwent a procedure to replace a section of his aorta and to repair a defect in his valve. The aorta is the main artery carrying blood from the heart to the rest of the body.
Although it is often difficult to reconstruct what actually happened to cause the condition and how it was repaired without reading the operative report, there are several conditions that could have required an aortic root (i.e. the proximal or first part of the aorta) replacement and valvuloplasty. It is not always clear if a dilated aortic root leads to aortic valve disease or a diseased aortic valve leads to a dilated aortic root.
Some conditions where aortic root and valve disease occur include Marfan’s disease, aortic dissection (the condition that reportedly led to the death of actor John Ritter), and aortic valve regurgitation or insufficiency. AI is characterized by the valve not closing completely in diastole (the time between beats of the heart.)
Regardless of the cause, if the procedure is done “open” it requires a median sternotomy (the breast bone is sawed down the middle) and cardiopulmonary bypass. Depending on how much of the aortic root needs to be repaired, it might also require full cirulatory arrest. This is a serious, complication-laden procedure where the patient is cooled to 30 degrees C. The head is usually packed in ice and all blood flow to brain and body is halted while the surgeons cut out the diseased segment and quickly sew in an artificial graft.
Aaron Boone’s father, former baseball player Bob Boone, was in California for his son’s treatment and was reportedly taken aback by the “number of wires” coming out of his son, most likely meaning wires and tubes coming out of his son. For patients’ families seeing their loved ones immediately after surgery can be alarming. Listed below are the typical wires and tubes that a patient has when they come out of open heart surgery.
Endotracheal tube – this is the white plastic tube coming from the patients mouth that enables the ventilator to breathe for them.
Nasogastric tube – a smaller, flexible tube inserted in one of the nostrils. This allows suction to be placed on the stomach to empty it of stomach juices and air. It also allows administration of liquid or pill form medications.
Pulmonary artery catheter
Arterial line – a small plastic catheter about 8 cm long and about the width of a piece of linguine. It is usually placed in one of the radial arteries in the wrist. This is for second-to-second monitoring of the blood pressure and for obtaining blood samples for laboratory studies.
Sternal chest tubes
Thoracic chest tubes
Atrial pacing wires
Ventricular pacing wires