Heart Patient Awake During Surgery

Tuesday, August 15th 2000, 12:00 am
By: News On 6

MIAMI (AP) — A 61-year-old man stayed awake for the entire 4-hour, 10-minute open heart surgery operation performed on him by a team of three doctors.

Dr. Mark Anderson of the Miami Veterans' Affairs Medical Center performed a single coronary artery bypass graft Thursday using only an epidural, an anesthetic shot injected into the spinal cord.

The operation began at 8:10 a.m. and was over at 12:20 p.m. The patient, whose name was not made public, was reported to be in stable condition at the hospital Thursday evening.

The two doctors who assisted in the operation, Juan Restrepo and Gerard DeSouza, said they believed the operation was just the second of its kind to be performed in the United States. They said they had heard reports another one was previously performed in Pittsburgh.

``This is a very tricky operation,'' Restrepo said after the procedure. ``As well as upsides, there are risks in doing it this way.''

The anesthetic procedure meant doctors did not have to insert a tube down the patient's windpipe. Using an epidural instead of a general anesthetic also reduces a patient's recovery time, in part because there is much less stress response on a respirator.

The downside, said DeSouza, is that a higher level of anesthesia is injected into the spinal cord than is used with general anesthesia. That means the anesthetic has to be closely monitored because it can stop a patient from breathing.

``This can only be done for a single bypass surgery, maybe a double,'' said DeSouza. ``When the heart needs to be lifted or the posterior part of the heart needs to be worked on, it won't work.''

DeSouza and Restrepo said the patient asked not to be fully sedated for the operation because he didn't want a tube stuck down his throat. The doctors said they told him they couldn't promise that general anesthesia wouldn't be used, if needed.