Onira

Heart

*Friday (same week) *

Claire was now in her class, first period. Her professor, Ms. Jones just came in and now, she was telling them something about an article about a surgery done by a doctor in St. Bonaventure. She adds that it was almost an impossible surgery.

"I want you all to read this article about a heart surgery by the outstanding Dr. Neil Melendez of St. Bonaventure." Ms. Jones said.

Why do I keep seeing Dr. Melendez this past few days? Claire thought. She has been seeing the doctor in the café and even had an interaction with him in the hospital. Claire didn't think too much about it, but a corner in her brain thinks that maybe the universe wants them to meet.

Ms. Jones clicks on the presentation in front of them and showed a picture of Dr. Melendez. A series of murmurs were heard some were about how good he looked and his girl would be lucky to have him. Claire chuckles knowing those who wanted to get with him wouldn't have a chance since the doctor was taken.

"I want you all to analyze this surgery because this would be the basis for your final exam in my subject." Ms. Jones added. Groans erupted from the room knowing they won't go by their books, but that's how it works now. Claire's now scrolling the internet about it and it was actually fairly short but really complicated case. She then decided to write this on her to dos for later.

Claire is now at home and freshened up. She sat on her desk, opened her laptop and started reading the article. This surgery was done just last Wednesday, very early to be releasing this article, Claire thought but shrugs it off.

-Article-

"Today we realize a dream seeing our international humanitarian program come to fruition. Our cardiothoracic surgeon, Dr. Neil Melendez, in consultation with our head cardiologist, Dr. Avi Mehta, evaluated children from Tanzania to Malawi to Guinea. They screened over 100 candidates, each of them needing life-saving surgeries. Ultimately, we decided on a particularly inspiring young boy named Gabriel, who hails from the Democratic Republic of Congo, with severe congenital heart anomalies." -Allegra Aoki (St. Bonaventure Hospital's Vice President)

"The first thing we did to confirm the state of Gabriel's heart was to do a transesophageal echocardiogram" -Dr. Avi Mehta

A transesophageal echocardiogram is used to assess the structure and function of the heart. During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves. When the transducer is placed at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or "echo" off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer displays the echoes as images of the heart walls and valves. (John Hopkins Medicine, n.d.)

The defects found in the little boy's heart were hypertrophic obstructive cardiomyopathy, atrial septal defect, abnormal insertion of the mitral valve leaflet. This actually shocked Claire. With these types of anomalies there is barely any surgery that would work for the little boy.
The surgery was done by moving the mitral valve, it was believed that the abnormal insertion of it can be effective.

Heart's mitral valve is located between the left upper and lower chambers of your heart, and it functions as a one-way valve that ensures that blood flows in the right direction—from the lungs through the heart and into the body. It's integral to circulation but when problems develop with this valve, they tend to do so slowly. It may be years before mitral valve problems bring noticeable symptoms. (Yale Medicine, n.d.)

A septal myectomy will open the outflow tract, and the mitral valve can be re-implanted into a more normal position.

Septal myectomy is a type of open-heart surgery for hypertrophic cardiomyopathy (thick heart muscle). It decreases symptoms of the condition. A muscular wall called the septum separates the left and right ventricles, the 2 lower chambers of the heart. In hypertrophic cardiomyopathy, the walls of the ventricles and septum may thicken abnormally. The septum may bulge into the left ventricle and partially block the blood flow out to the body. This causes the heart to work harder. It also contributes to many symptoms of the disease, such as fatigue and shortness of breath. During septal myectomy, a surgeon removes excess muscle from the thickened septum. This allows the blood to empty from the ventricle more easily. (John Hopkins Medicine, n.d.)