Reconstruction of the heart

I offer you a photo report on the hard work of surgeons.

The most valuable thing a man can have - it is the heart and soul. And if the healing of the soul can help a lot: from religion to books for the proper functioning of the heart surgeons responsible. In this feature, we look to you to AlmatySemaHospital and go with the patient all the difficult stage of heart surgery. If you are not sure that your heart will stand such a sight better avoid watching.

Many photos.





Zhamaldin Bolush in search of the best surgeons arrived from Kyrgyzstan: "At home, I was looking for good doctors, but my cardiologist suggested to be treated in this clinic." Extract from history Zhamaldin "Coronary heart disease. Angina. Three-vessel coronary artery disease. Related diagnosed with Type II diabetes mellitus, severe course. Decompensation. Chronically obstructive pulmonary disease »



Heart problems I started because of prolonged smoking (I have 30 years of seniority). In 2008 came the first pain in the heart, in that year, the first time I had a heart attack, was the second this summer. In Bishkek, the defeat revealed 3 major vessels of the heart, it is urgently recommended to have surgery. In addition, I have four years of suffering from diabetes ...



On the day of surgery preparation process starts from 8am



My wife helps Zhamaldinov change into a special form



Tansel Turkoglu - an experienced cardiovascular surgery, backed by 15 years of working in prestigious Turkish hospitals. Working in Turkey, he spent up to 800 similar surgeries per year. Since the spring of this year in Almaty operates Tansel



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The doctor in charge of a hospital, explains the close of the patient where he directed and about when they will be able to see him again



Heart surgery requires vysokoprofessionnalnoy training anesthesiologists



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When applying anesthesia administered drugs, relaxing all the muscles in the body, including those responsible for respiratory activity



After installing the breathing tube is connected ventilator. Anesthesiologist Feruz Babashov presses the mask-to-face for a better oxygen saturation light



Once connected, the system of artificial respiration Feruz check lung function in patients



For the administration of drugs used during surgery large vessels



There is a puncture of the jugular vein for the subsequent introduction of solutions



Operating nurse anesthetists is waiting for completion of the work to start processing the surgical field and the patient. Around it all sterile, touch the table, the nurse and the instruments strictly prohibited. If this rule had been violated, it would have to postpone the operation for a new sterilization



Tools used in cardiac surgery



A nurse holds a tray with a solution of iodine



Operational field must be sterile in order to avoid festering wounds after surgery



Legs are processed for subsequent capture of vessels



After the surgical field is processed, go beyond a certain limit in addition to the operating surgeon and nurses strictly prohibited



The first operation starts nurse Yasemin Selcuk. It should take saphenous veins to the ground to replace vessels in the heart. At Yasemin behind 12 years of experience in cardiac surgery, because of the great experience of the surgeon she trusted the responsible operating stages



. At this time, a heart surgeon Tansel Turkoglu in the other room watching coronary angiography to clarify places transplant vessels



When everything is ready, he enters the operating room. Wash hands with a special solution, then processes the liquid with a high alcohol content



He puts on sterile gown and sterile gloves. Operation can begin!



First retractor opened the chest and sternum



During the operation in the blood vessels of the heart flows with a solution, suspend heartbeat



Heart-Lung Machine in operation. It enters the blood from the vena cava, oxygenated and fed into the aorta for circulation through the body



The device acts as the heart and lungs of the patient during the operation



Perfusionist controls hemodynamics during cardiopulmonary bypass, it is responsible for maintaining the level of emissions and waste products in the blood



Register full cardiac ECG



Apparatus for reducing the temperature of blood as the blood oxygen enrichment takes place at low temperatures



Yasemin has almost finished its work



Veins in the legs lie under the skin surface and deep into the muscles. When the operation uses surface vessels. In the future flow of blood through the vessels of the deep



The surgeon prepares the place for suturing blood vessels in the heart



Measure the length of the vessel. It is important for it to be correctly sized to the motion of the heart was not damaged or stretching vessels



The vessel was sutured over the constriction of coronary artery



When working on the vessels using microsurgical instruments and materials. Threads subsequently dissolve when the vessel is fully accustomed to the new location



Anaesthesiologists watch the operation. It is important to introduce the drug in certain stages



The patient is sleeping soundly. A stable condition. During the operation, the eyes are closed so as not to dry the cornea of ​​the eye (which could then cause such diseases as keratitis), as in some patients during anesthesia eyelids reveals little



The clinic has a special air cleaning system: getting into the operating room, the air passes through the filter and comes already clean. Later, before the air supply to the street, he again is cleaned to prevent the spread of possible infections



Work on vessels requires microsurgical precision, every millimeter counts and glasses with surgical loupes - need during surgery



The work of the surgeon is finished, it is removed, entrusting the last phase of the operation Yasemin



Today we had a classical operation with cardiac arrest and cardiopulmonary bypass connections, - says the surgeon during his vacation. - We also make operation on a beating heart. Such operations have adopted recently. Usually we use them when shunting one vessel, but in July, for example, we had a shunt 4 vessels on the beating heart. After these operations, the rehabilitation period is reduced, reducing the risk of complications. On the Internet there are videos with minimally invasive access to heart in the intercostal space



After each surgery a young surgeon Nurali asks questions that have arisen in the operation. In Turkey assistants after 6 years of study at the university for 5 years to specialize in a narrow direction. To gain access to the operating room, an intern for one year only oversees the management of patients in the ICU, and then take it to assist in the operation



In the operating room are counting napkins. This might sound a joke if it were not sad cases where the patient's body left napkins and tools



Making sure that everything is in place, Yasemin starts suturing of the sternum



The skin is sutured cosmetic suture thread subsequently absorbed



Total blood loss during surgery an average of 400 ml



Duration of operation for 1 hour and 54 minutes



Taking off clothing, Tansel goes to the patient's loved ones to announce the successful operation produced



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While the surgeon is talking to relatives in the area continue to run operating. The nurse passes the tools used in the processing operation and sterilization. At this time, the clinic is able to produce up to 3 heart surgeries during the day



The patient is ready for transfer to the intensive care unit



Shifting the patient from the operating table. It is very important to do it carefully, because all patient's muscles are relaxed. There is a count: "one-two-three» ...



... And gently move the patient to move to a special bed



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Resuscitation room is next to the operating room, it has everything necessary for emergency first aid. The main clinic staff worked in hospitals in Turkey. Their main task - to provide quality health care and training of Kazakhstani specialists, for onward transmission to the clinic in good hands



Drainage pipes installed in the pleural cavity and pericardial cavity for accumulating liquid outflow in the first day after surgery



Switching monitor surveillance



The doctor controls the main vital signs



After surgery the patient sleeps for 6-8 hours before it transferred to an independent breathing apparatus without



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Pending the outcome of a complex operation exhausted all. In those few hours with relatives have time to relax



At six o'clock in the evening relatives already dress in a special form to visit the intensive care



The patient is ready to receive visitors



Brother Zhamaldin glad to see in good health



My wife barely holding back tears



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The patient should be in for a day in the intensive care unit for monitoring the state in the early postoperative period. Today he had a difficult day ...



Exactly a week later. Zhamaldin is already in an ordinary ward and will soon be ready to be discharged



Pressure measurement in the House comes every half hour



The main problem after the surgery - a long recovery of the full functioning of the lungs. If the patient has smoked for many years, the recovery process is prolonged



After the operation was all right, everything is fine ...- broken voice repeats Zhamaldin. - Changes immediately felt before the surgery even the most simple movement caused my rapid heartbeat, I felt tired, my heart was working erratically, and now nothing disturbs sleep well, I go right. There is pain, but this is just the healing of wounds. All the doctors who work here, thank you very much!

On this, let finish.

Photo © Karl Nur, together with the text of the Nurali Shakirov



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