European Stars and Stripes (Newspaper) - December 11, 1990, Darmstadt, Hesse A t surgery s Frontier by Elisabeth Rosenthal new York times the operating room at the Columbia presbyterian medical Center in new York City was alive with the sounds and lights of High technology a medical equipment. A at the Center of the commotion Lay a 24-year-old patient already rendered unconscious by anaesthesia and about to lose even the vestige of brain activity As surgeons prepared to. Stop his blood flow and Cool his brain to a Timbo just Short of death. A a v / a a Quot / the operation offered the Only Chance of repairing a Straw thin blood vessel near the Center of his brain which had ballooned to the size of a Golf Ball and was pressing on vital brain centers threatening imminent death the novel and risky operation about to begin would push at the frontiers of brain surgery Aswell As at the limits of the human body s tolerance. A. V two brain surgeons a cardiac surgery team three Anaesthesiologist a and More than two dozen nurses and technicians crowded around the tiny operating table Quot the Din was overwhelming. A heart Monitor emitted rhythmic bleeps a Respirator who shed the. Bone Drill High pitched squeal As it carved a three Inch Hole in the right Side of the patient s Skull. /. A Quot / r dozens of monitors displayed Neon Waves of color the Pink splash on the ultrasound screen representing blood flow to the brain the yellow Squiggle following pressure deep within the heart the Green digital read outs of temperature in the patients blood his Throat his brain. A television Creen carried a real time image of the Young Many a beating heart. A a a a y / a. A a by Quot lets Start Cooling Quot or. Robert a. Solomon the neurosurgeon in charge said As he finished Clearing out a two Inch deep Crater Over the bulging vessel a a a a a a the patient Donald Rogers jr., of Kansas City Kan was then attached to a cardiac bypass machine which cooled his blood As it circulated. A. A a a As his body temperature fell the colors slowly ebbed and the silent. At 86 degrees the rippling brain Waves on the eeg Monitor calmed and his heart rate Quot a slowed to50 boats a a you a a a \ with each degree the temperature dropped his heart dragged More at 80 degrees 40 beats at 75,30. At 72 degrees it seemed to shiver then abruptly stopped a Normal ohm Sologic response to cold the image on the. Television us h went. Clicking and. Whirring the bypass machined Mokover a circulation m t 0 Groos or. Mig a Smith the cardiac. , s r d with masterminding the body a Bloodline Jun 1 i i / a 1 of a to in to Tho netherworld of cons Tou Iky y a a / a a a a Quot a a a a a ��&Quot./. Everybody Leady Quot he asked As Solomon resumed his seat Over Tiro Hole in the head. Quot Ali right. Bypass off. D a circulatory aim St. Lot / a Quot a a a the blood halted its habitual pumping course through the Young mans arteries. It drained still Pool in a sterile chamber on the floor. A a a a. A a /. A Quot a the Linos on the monitors fell ominously Flat most of the digital displays went silent and Blank a Small Patch of skin showing Between the surgical drapes appeared ghostly / a Quot. A a a a a a a for the next half hour Donald Rogers wasting inanimate object a patient in limbo not measurably alive but not quite dead either. A a suspended animation. A Staple of science fiction is now being used at a few hospitals to allow surgeons to operate on certain badly deformed blood vessels that cannot be repaired while full of blood. By a. Y these deformities known As aneurysms Are Plages where weak spots puff out from the Wall of the blood vessels of the brain or Aorta. It when the puffs Are Small and accessible surgeons can fix them while the blood is flowing. But when the aneurysms Are Large and lie deep within the brain like Rogers the a coursing blood makes repair work too dangerous a neurosurgeon in Kansas City mo., had Given Rogers a 10 percent Chance of survival using conventional a anaesthesia. Quot a with Normal blood pressure operating on a giant aneurysm is like operating on a balloon Quot Solomon said Quot its tense arid fragile and once you break it the patient is a a lost a. B Quot but with no circulation and no blood pressure the situation is much belter. The vessels collapse and become soft and manageable.�?T1 the notion that the body can survive without circulation at very Low temperatures arose from cases in which children who have lost consciousness in very cold water have been revived after hours of submersion 1 when the body is cooled its Energy n eeds decrease dramatically and the organs can survive prolonged periods without new blood and the oxygen it brings. Quot the main reason we have to do All this is that the brain Only lasts three to five minutes without blood flow Quot said or. William l Young who with dry Gilbert Stone provided the anaesthesia for the operation Quot but when its cold its much less sensitive Quot /. Men with visions of eternity have Long dreamed of chilling patients with term Inal in Ines be s an d d e fro s Ling t h pm in the future when a cure is known. But the goal of the aneurysm operation is to cheat death not Tor centuries but for minutes allowing surgeons time to Complete the delicate operation. At a body temperature of by degrees almost 40 degrees below Normal the patient has about an hour before Prairi damage occurs. The organs cannot withstand much lower temperatures Smith said. / a v a we Are pushing the limits of the human body a. Tolerance Quot said or. Eric raps neurologist who is a studying the effects of the procedure on patients Quot i be seen this a number of times and its always amazing . It is Ai Best a risky move reserved Only Quot for the direst of a a cases. Quot Baird Young less than half a dozen hospitals use , known As hypothermic arrest Tor brain a a a. Surgery. / a a a a -. A Inge Briary t989donald.Rogers began to have blinding. A headaches that forced m iss Many Days of work at a grocery store. A. A a j a brain scan revealed the giant aneurysm which doctors told him was an. Goper Able condition that one Day would Quot a shatter and kill ii in. I be quit his Job and waited. A last sep 1.-23, Lye Wai Iris opt aptly ended a tin his and a Dey eloped. A d Quot tool ibo Civ along Ai Lother cat scan showed that the. A a. Aneurysm Haki or Najy a quantum leap and Yves a a a a. Compressing his brain Stem the Mairi thorough of of the a brain. A a. A Quot Over the Neid few weeks has condition deteriorated. A Irio soon tie could to longer write Shower and he was vomiting from the pressure of the swollen blood vessel in his head. \ a a a a a a a Quot it was to the Point where he did t have any Choice but Jaq try surgery Quot said his Quot Mother Kay Rogers As the patient Jay recovering in intensive care. Quot he was choking on his a food because t work walk across a room because he would fall. He knew he was dying that soon he would have trouble i. -. Quot he did t want to be on a Respirator Quot his father Donald Rogers or. Said. "h�4pld us did t want to live like that Quot of the Many neurosurgeons in the United states and Canada who were reached Only Solomon would take the Case Quot without being Able to Stop the circulation i n even have tried Quot Solomon said. Quot but it s hard to say no when you see a 24-year-old dying in front of your eyes and i have been delighted with our far Quot a Rogers is the 10th patient to have the surgery at Columbia presbyterian medical Center of the first nine All Are alive and leading Independent lives except for one who is in rehabilitation after suffering a stroke during surgery doctors first tried to induce similar hypothermic arrests for surgery in the Early 1960s but the results were usually disastrous and the procedure was quickly abandoned raps a / /. / v but because of improved intensive monitoring. Capabilities and bypass equipment developed in the last decade the technique has recently been revived with Success Quot /. A a a a it is at the Pinnacle of High technology Medicine costing around $100,000 to pay for the two dozen people and the machinery that comes with them / before attempting the procedure Solomon had to wait for the completion of Columbia s new Hospital because the old operating rooms lacked space for the. Necessary equipment Sod were not wired with enough electricity to a since Rogers is uninsured the Hospital and doctors Are donating their services. A a. A a because of the location of Rogers s aneurysm and the we Are pushing the limits of the human body s tolerance. I be seen this a number of times and it s always amazing stuff. Or. Eric raps neurologist doctor Ottah Monitor to Donald Rogersjr. And paint is head and neck with Antiseptic novel and risky Drain surgery. Five hours later top photo the critical period begins As or Craig Smith uses a bypass machine to Cool Rogers to near death so surgeons can remove a deadly aneurysm. Off severe symptoms it was causing Solomon had expected a particularly difficult Case. In fact the nearly 20 cold minutes with were tilled with quiet and agonizing drama. Quot / a. / Quot a. A a a a under a single Light in the Center of a darkened operating room Solomon and his assistant or Dale Swift peered through a Microscope at the now flaccid Pale yellow Quot Quot. Aneurysm that was their adversary tiny knives. A and scissors around an stable course o f vessels and giants despite their minuscule size the third nerve which controls Eye movement the Superior. Here Beliar artery which feeds the balance Center of the a five minutes raps called out the time a a a a a. But of they probed its boundaries the aneurysm proved to be even More Fps Rani Davtd instead pulling out from the Side of an artery which neatly clipped off at its base., the entire blood a sol had. Ballooned. A l / Quot this is unbelievable Quot said Solomon. Quot it s pretty Yum. I i Don t know what in a going to do Quot to repair the aneurysm. He would have to Cut off blood flow to the entire vessel and potentially to whatever part of. The delicate brain Stem the Quot. Artery supplied. A./. A a a a a he had Only a Tew minutes to decide before the clock out on the patient s endurance. Based on his knowledge / that Many parts of the brain receive blood from More than one. Source Solomon took the Gamble. Y. After several minutes and. Mane vering he a placed a tiny Clamp around the artery just before where it began to balloon and cinched the Clamp shut. A a t the Region it irrigated would receive blood from other arteries. Quot of Start some flow please Quot Solomon said. And As the bypass machine began to Whir sending blood Back through Rogers s body a Small vessel on the screen not bloomed from still White to pulsating red it was a Good sign Solomon explained the brain to be a a getting blood from elsewhere -. A. Y y a y the subsequent warming was As Welcome As a y a springtime with various monitors jumping to life As the a patient s body Tern senature climbed. Quot a Quot. At 70 degrees the Hoard began to to itch and a it or. A few tical reset its i it turn it Organ to. Quot beat but since the eur Yum Trad been so a diff located Quot a Tjio Odds. Of. Rogers s Sui Vivion Aill Only 90 Peic enl Quot a Solomy Caid As he Ift Imp looking glum. A two Days later Rog woke up,.imyyod his Imvris and. Euh Ough of fire fac g via a = the Quot 0 a y Uncle line of surgical is apts . Followed t is hair inn he Lukl ins he Quot Felt bettor.�?T�?T. / a. A a a a / to encouraged and expecting very said Solomon who aided that to la to patient would Frame to spends. Months in rehabilitation to recover the abilities to lost during the surgery Ywe be cure Dur a . He has a Long Road Back but he certainly has an Opportunity to Lead a Normal tile Quot. -. Y a at the same time on the Hospital s eighth floor Beal Rice dams Whoso giant aneurysm was clipped on oct30, a was preparing to go Home feeling Quot a Little fuzzy Quot but cured of tie paralysing headaches that had incapacitated her. Since August. Quot it was petrify ing Quot said the 49year-old nurse i m alive and. In a glad to be a. Several Days later Rogers was preparing to leave. A a. A intensive care. He was breathing and moving on his own a Triumph in itself so soon after surgery he still has trouble forming words and his grip arid gait Are still unsteady. But before Long he should be heading Back to the Midwest to begin the hard work of recovery. Page 14 k Kir the stars and stripes a tuesday december 11,1990 the stars and stripes k k k Page 16
