Posted by Pete Reed on January 15, 2004 at 22:18:50:
Okay, I'm back. It was time for my nightly two hour nap. Just so everyone knows, I did not have any procedures prior to this one, and, my heart is normal and strong post procedure, except for the afib and PVC's. I was a basketball referee for 27 years, so my heart received plenty of exercise. When not in afib, my heart rate is typically in the 50's or 60's.
I was told to arrive at Hahnemann at 6:30 A.M. on the day of the procedure. Mostly, I did a lot of waiting around. I changed into a gown and signed the normal battery of paperwork. I believe that I was wheeled out at around 9:00. I was taken to a room on a gurney in the procedure area, where I met one of Dr. Maleki's assistants. We spoke for awhile. Dr. Maleki stopped by in street clothes and gave me a thumbs up. I was wheeled to the procedure room, where I was introduced to a couple of nurses. It was there that we discussed making Hahnemann history, this being their second such PVI ablation. I will qualify that they do other types of ablations. I drifted off to sleep shortly thereafter. I don't remember anything else until after the damage had been done. It was about 10:00 A.M. My wife and daughter were in the waiting room nearby. At about noon, a nurse came by to inform my wife that all was going well. Dr. Maleki had completed the ablation on one pulmonary vein, and was moving on to the second. The nurse told my wife that she would come back out at 2:00 with an update. I'm not exactly clear what all happened next or what may have been said, but I'll give it as i know it. 2:00 P.M passed. After some time, my wife heard a call go out to the surgeons, and, since I was the only procedure, she deduced that I was the problem. I believe that a nurse did come in to inform her that there had been complications. At some point, my wife saw Dr. Maleki in the hallway, obviously shaken. Later, Dr. Samuels, the surgeon, met with my wife. He informed her that I had had a tamponade, which is caused by leaking blood that fills the sac surrounding the heart. Obviously, Dr. Maleki had nicked the heart with a catheter. It only takes about two teaspoons of blood in the sac, the pericardium, to cause serious problems. This problem can be reversed by perfoming a pericardiocentesis, a needle that draws blood from the sac.There is no indication in the operative report that any of the EP doctors attempted this procedure. Dr. Maleki's group did perform a TEE, a type of echo that goes down my throat, and they determined by that I was indeed having a tamponade. Dr. Samuels tried to perform the pericardiocentesis, but my BP dropped, so he had to go in with the saw. CPR was administered, joules, heart massage, etc. Dr. Samuels found no evidence of the leak. It had sealed itself. I later spoke to Dr. Samuels' nurse practitioner, who told me that I was in arrest for two to three minutes. She also told me that the procedure room became a makeshift ER. I didn't get to the OR until being sewn up. She said blood was flying everywhere. She learned to put a saw together on the job. Quite a scary scenario for her. I was transfused, but I don't know how much. From what I've briefly read on your site, the sternum is cut in the MAZE procedure, which is planned. Now imagine having your chest and rib cage ripped open. Not a pretty thought. Once I was stabilized, I was taken to the OR and patched up. I was on a vent for about 10-12 hours. I remember waking up twice. My wife and daughter came to recovery twice, but I only remember seeing them once. I was gagging on the vent. I couldn't understand why I couldn't speak. I began to sky write letters, telling my wife that I was gagging. She told me that I was on the vent, and that I would be okay. My daughter, who was 13 at the time, was crying. I gave her a thumbs up. They left to go to their hotel room. The next time I was awake, a priest was in the room giving me last rites, although at this point I was very stable.
I'll continue later with my hospital stay. Might as well keep this all in sequence.