Prior to heart surgery, the operating room is buzzing with activity as surgical staff prepares. Each team member in the room is critical to the procedure.
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The perfusionist has a particularly unique role and one that many may not know. They prepare and manage the heart lung machine which acts as the person’s heart and lungs for the duration of the surgery. It is the perfusionist’s job to provide the surgeon with a bloodless and motionless field in which to perform the surgery.
Through a complex set of tubing connecting the patient’s heart and body functions, a “chamber” in the heart lung machine receives the blood from the body, which normally flows into the heart’s right atrium.
From there, the machine operates like the heart’s right ventricle pumping it through an oxygenator. This removes the CO2 and adds oxygen, which is normally done by the lungs. The heart lung machine then pumps the oxygenated blood back to the body completely bypassing the heart.
As he manages the heart lung machine throughout the critical part of the surgery, perfusionist Bob Foster, CCP, is acutely aware of each and every metabolic function of the patient, continually adjusting settings to assure proper oxygen levels, body temperature, etc. His prime objective: Keep the patient alive and protect his or her vital functions.
In his 36 years as a perfusionist, Bob has been involved in many technical enhancements to the heart lung machine, first developed in the 1950s. “It is incredibly exciting,” says Bob, who loves coming to work each day. “Every patient is unique and you really have to be able to respond quickly.”
Bob Foster, CCP
When the procedure is completed, the perfusionist works with the surgeon to restart the heart – “an amazing event” each time it happens, Bob says. Once this is done, he salvages the blood from the heart lung machine and returns it to the patient.
Today, 27 certified clinical perfusionists do five or six surgeries a week at Cleveland Clinic’s Heart & Vascular Institute where staff continues to advance surgical techniques and use the most state-of-the-art technology.