Behind the Scenes of Heart Surgery: The Crucial Role of a Cardiac Perfusionist

By Vaishnavi Malvankar

Born in Mumbai, the city of dreams, I’ve always been drawn to medicine and dreamt of being a doctor. My father sometimes recalls how the first toy I ever loved to play with was a doctor’s play kit. According to him, I would carry it everywhere, pretending to treat my family members. I always believed that I was meant to be a doctor.

But things don’t usually go as planned. Reality hit me when my 12th class results were out. I scored average marks, and I knew that it was going to be difficult to achieve my goal. For a brief time, I considered taking a break and preparing for the NEET exams, but my family had financial limitations. I wasn’t ready to give up on my dreams.

I started searching for other career paths in the healthcare industry that aligned with my interest in medicine and my passion for helping people. I knew I could not be a doctor, but I could still contribute to the world of medicine.

In the middle of my research, I got an opportunity to attend a career seminar at D.Y. Patil University, Navi Mumbai. Attending that seminar turned out to be the best decision of my life. There were many career options discussed in that seminar, but what caught my attention was Cardiac Perfusion. At that time, I understood that a Cardiac Perfusionist is a healthcare professional who assists in open-heart surgery by operating a heart-lung machine. But that’s not it; what really convinced me to pursue my career in this field were the words that came from Dr. James Thomas, Vice Chancellor and Director of the Cardiac Department, D.Y. Patil Hospital:

“There are three pillars in a cardiac surgery: the Cardiac Surgeon who repairs the defect of the heart, the Anesthetist who helps manage the pain and helps the patient sleep through the surgery, and the Cardiac Perfusionist who keeps the patient alive even when the heart is stopped,” said Dr. Thomas. At that moment, I knew what my new goal was. I wanted to become a Cardiac Perfusionist.

What Does the Perfusionist Do?

A Cardiac Perfusionist plays a crucial role in open-heart surgery. Let’s take a look at a perfusionist’s responsibilities:

Operates the Heart-Lung Machine, also known as the Cardiopulmonary Bypass Machine:
During an open-heart surgery, the surgeon might have to lower the patient’s temperature and arrest the heart for a clear field and better visibility. Here, a perfusionist steps in. A Cardiac Perfusionist assembles the cardiopulmonary bypass circuit on the heart-lung machine and carries out the cardiopulmonary bypass. In this process, all the deoxygenated blood from the patient’s body is drained into an oxygenator and returned to the patient after oxygenation. This way, the heart-lung machine takes over the function of the heart and lungs. To achieve a clear and visible field, the perfusionist arrests the human heart by giving a drug named cardioplegia.

Monitoring & Managing the Blood Flow, Temperature, and Vital Parameters:
A perfusionist has to monitor and manage the patient’s blood flow, oxygen flow, and vital parameters by managing the heart-lung machine’s flow and administering necessary fluids and medicines required to keep the patient stable. They also have to manage the patient’s temperature, depending on the surgery and phases of surgery. Sometimes the temperature has to be low, down to 21 degrees Celsius, and sometimes it is required to be as high as 34 degrees Celsius.

Supports Organ Functions:
A perfusionist has to ensure the functions of vital organs such as the brain, liver, and kidneys and prevent any complications.

Good Coordination with the Team:
Cardiac perfusionists work very closely with the cardiac surgeon, the anesthesiologist, and the nurses. They have to make sure to give and follow proper and clear commands in the operating room and maintain coordination with the team.

Post-Operative Checks:
Long-term bypass can cause some complications in the patient post-surgery. Perfusionists have to monitor the patient’s labs post-surgery as well.

How to Become a Cardiac Perfusionist

If you are someone like me whose interest lies in the world of medicine but could not achieve the goal of becoming a doctor, maybe perfusion can be your new dream. To pursue a career in Cardiac Perfusion, one must enroll in a Bachelor's in Cardiac Perfusion, which comes under Allied Health Sciences. It is a 4-year course with 3 years of theory and practicals and a 1-year internship.

Final Thoughts

My journey might have taken a different path than I initially thought, but now I know that dreams do come true. You just have to change gears and try a different route. Today, I am a proud Cardiac Perfusionist with 6 years of experience in adult and pediatric cardiac surgeries. Many people are unaware of this important and exciting career path. As we can say, perfusionists are the unsung heroes behind the scenes in an operating room who save lives.

_MSM