The first cut is made quickly, a nine-inch slide of the scalpel from the jugular notch, just below the neck, down the middle of the chest along the sternum. To slow bleeding, severed veins are cauterized with a hot knife, sending wisps of acrid smoke spiraling towards the powerful lamps above. While Parr and scrub nurse Carol Falzo concentrate on the chest, Cesareo, the physician s assistant, works at removing the saphenous vein from the patient s leg. Once removed, the vein will be cut in three, to replace arteries in the patients chest ready to fail due to age, poor diet, and diabetes. Parr cuts the sternum in half using a specialized saw.
Retractors pull back the two side of the chest, giving the team more room to work.
At times during the surgery, four hands will be in the chest cavity at once, deftly maneuvering needles, knives and scissors inside the tight space. Norm Norton, a medical technician, comes into the room to run the heart-lung machine. This elaborate contraption duplicates the functions of the heart, enriching the patient s blood with oxygen while the surgeon and his team of assistants work on the actual organ. Norton is also responsible for pumping ice-cold solution into the heart to lower its temperature and drop the organ s metabolism, insulating it against the trauma of surgery. The two circulating nurses in attendance, Holly Floersheimer and Janice Taurozzi, take charge of the logistics behind the surgery making sure enough sponges are on hand to sop up blood, lining up needles and scissors for Parr and Cesareo, checking and rechecking the suction machine.