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During cardiac surgery cases, the function of the patient’s heart and lungs rests on the capable shoulders of Perfusionist Amy Patel, CCP.
A patient’s heart must be bloodless and still for a surgeon to operate, so the heart-lung machine—run by perfusionists—ensures blood circulation and oxygenation to the rest of body during surgery. “You have to be able to focus and not be nervous,” said Patel, one of 11 BWH perfusionists.
A vital member of the cardiac surgery team, Patel is in the OR from start to finish for heart surgery cases, preparing to support the patient with the heart-lung machine, which consists of a blood pump, artificial lung and reservoir.
The perfusionist also monitors the patient’s critical physiologic parameters, such as blood pressure, anticoagulation, temperature and blood gases during cardiopulmonary bypass, until surgery is complete. When the patient’s normal cardiac function returns, they are safely weaned from the heart-lung machine.
“We communicate with the entire OR team about how the patient is doing throughout the case,” Patel said, emphasizing that the cohesiveness of the surgical team is important.
At BWH, perfusionists have access to top-of-the-line heart-lung machines, but Patel knows what it’s like to use less reliable equipment. During a recent volunteer mission to Rwanda with BWH’s Team Heart, she and fellow perfusionist Mike McAdams, CCP, kept their cool when the heart-lung machine’s heater/cooler system overheated.
“That happened during our first case,” she said. While the team tried to obtain a newer machine, Patel and McAdams brainstormed with their colleagues back at BWH to come up with a manual way to do their job.
They used tubing, a foam ice box and a pump and ran back and forth to the Rwandan hospital’s kitchen for jugs of hot water to maintain the patients’ temperature. For cases that required cooling, they used blocks of ice from a restaurant. With their skills and extensive knowledge, the manual system ran smoothly, and 11 cardiac surgery cases were completed successfully in Rwanda.
Using blocks of ice and hot water probably wasn’t what Patel had in mind when she first became interested in perfusion after watching her brother, a cardiac surgeon, perform a case.
“I thought perfusion was interesting, so I quickly enrolled in perfusion school to get started,” said Patel, who at the time was working at a small computer company after studying biology and computer science at Youngstown State University in Ohio. She is originally from Toronto and trained in perfusion at Texas Heart Institute before coming to BWH almost five years ago.
Patel still thrives on the intensity of this fast-paced work and the rewarding feeling of being part of a surgical team and saving lives.
“Every time I go on bypass, I am still amazed at it all,” said Patel, who also works on general surgery cases that involve major blood loss, heated chemotherapy for mesothelioma surgery and ventricular assist devices. “Cardiac surgery cases are my most frequent and favorite. They involve a lot of thinking and a lot of attention.”