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TV programme
- by piglet22
- 2024-06-04 05:27:28
- General Posting
- 260 views
- 3 comments
Watched a UK documentary last night on heart transplants and a patient having a pacemaker replaced.
Unhelpfully, the surgeon doing the pacemaker talked about battery replacement but later corrected himself by changing that to generator.
A relative of mine whose mother had a PM always insisted it was a battery change.and it took 10 minutes to do. Holter monitor possibly. I don't bother arguing.
The girl was in her 20s, but surprisingly they gave her a general anesthetic. They didn't give a reason but in my experience, it's not the norm in the UK.
Impressive spreader in use, old device (10 years) removed and disconnected. Expressed concern about infection.
The heart transplant attempt was abandoned as the surgeon decided the donor heart had been starved of oxygen for too long.
The poor chap had to be fitted with an implanted mechanical pump which was only good for 30 days.
He had a second chance the following day which was successful
3 Comments
Heart transplant
by atiras - 2024-06-04 16:11:35
If he was on an LVAD or BIVAD he will have been waiting in hospital on the super urgent list. Even then stand-downs are quite common. However the volume of heart transplant activity in the UK is increasing as more donor hearts are becoming available due to changes is legislation (opt out instead of opt in) plus advances like Heart in a Box to improve transit conditions for donor hearts, and the capability to use DCD donors as well as DBD donors.
Talking to the Transplant team in Birmingham last week they're struggling to arrange follow up appointments. They used to run two clinics a week but are having to try to increase that. As they say its a nice problem to have but it places pressure on all the other hospital services.
Transplant donors
by AgentX86 - 2024-06-04 22:56:31
The opt-out sounds like a good idea. It would be hard here but I certainly think it would be worthwhile. The dynamic of having to opt-out, rather than ignore one's mortality to opt-in seems to be a good way to go. It would reverse the tables. One would have to face their mortality to opt-out.
If not that, have it a standard checkbox on the DNR, medical power of attorney forms and DNR tags. At least people would think about it while they're doing stuff they don't want to think about.
BTW, I'm no different, not that I have any pieces anyone would want. I'm just trying to keep them together long enough for me.😉
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"""Battery change"
by AgentX86 - 2024-06-04 14:59:06
It's often called a "battery change" because the problem is that the battery ran out. What do you do when batteries die? You replace them. Pacemakers are a bit unusual in that the whole toy is replaced. Ten minutes is a bit stretching it, I think, but replacing the generator isn't a big deal and is pretty quick.
A general anesthetic is pretty extreme. General anesthisa puts the patient into a coma such that even breathing ceases.Intubation is required. Because of this, and possible allergic reaction, the anesthetic is more dangerous than the replacement of the PM. It also requires a much longer recovery and observation period, after. That means a place to put the patient where they can be observed = expensive.
I had my initial PM implanted with just a local but "conscious" sedation is most often used. One isn't necessarily conscious through it but it often makes one drowsy enough to go to sleep. The intention is to paralize the body and wipe any memory of the procedure clean. The patient isn't so far under that the autonomic bodily functions cease.
There is a pretty good YouTube channel ("Medical Secrets"), owned by an anesthesiologist, that goes through this sort of thing in detail. It's not a dry tutorial. It's rather interesting, including what people say and do when they're under.
Two tries at a heart transplant has to be tough. He's lucky there was another donor heart available so quickly. It had to be hard on the body, having two such major surgeries in two days.