Participants: Dr James Marcum (Host), James Zellner
Series Code: BRX
Program Code: BRX00003A
00:01 Are you confused by the conflicting health reports
00:03 in the news today?
00:05 In this well marketed world is hard to know who or
00:08 even what to believe, but there are answers
00:10 you can depend on.
00:11 Hi, I'm Dr. James Markham.
00:14 Join me for Bible RX, a program exploring the
00:18 healthcare world.
00:19 Looking at all aspects of healing, using the Bible
00:23 and biblical prescriptions as the ultimate
00:26 source of truth.
00:50 On today's program we are going to be talking
00:52 about Touching Hearts.
00:55 With us today we have a very special guest.
00:58 Dr. Jim Zellner, he's a Cardio Vascular Surgeon
01:01 who works at Memorial Harden and actually he has
01:03 touched the hearts of many of my patients.
01:05 Not only physically touched, but he also touches
01:07 his patients spiritually.
01:09 We are glad you have joined us as we talk about
01:11 Touching Hearts today.
01:14 One of the questions that I get asked about most is
01:17 questions regarding
01:19 surgery and the heart.
01:20 As I mentioned earlier
01:22 today we have an esteemed
01:23 guest with us, Dr. Jim Zellner.
01:25 Jim I want to welcome you here to Bible Prescriptions.
01:31 Tell me how did you get involved in surgery?
01:33 What got your interest in it?
01:35 What made you go in this direction when there are
01:37 so many other things that you could have been doing?
01:39 Well I think my interest in
01:43 surgery first came about very
01:46 early in my life with picking
01:49 up animals and looking at the different organs.
01:54 In school many opportunities to really use some anatomy.
01:58 I fell in love with anatomy I think.
02:00 That was the first, and then through surgery,
02:03 through medical school we got the opportunity as
02:06 you did to assist in surgery.
02:10 He was a beautiful almost symphonic display of
02:13 different talents that came together to help
02:16 different people and the ailments that they may have.
02:20 It was during that time that I fell in love
02:22 with the heart.
02:24 The things that led up to that had to do with being
02:29 able to see the work that we do,
02:32 impact upon organ immediately.
02:35 You do not have to wait very long before the fix,
02:39 that you put on a heart really helps it.
02:43 Now how many hearts would you say that you actually
02:45 operate on in about a year period?
02:47 What would be in average number?
02:49 Well our group, in Chattanooga, averages around
02:55 1400 to 1500 heart operations per year.
02:59 Personally I do somewhere in the neighborhood
03:01 of 300 to 350 hearts per year.
03:04 Do you give much time off?
03:06 Do you get to rest your heart some?
03:08 Well I think it depends on who you talk to.
03:12 I think if you asked my wife there is probably a not
03:15 enough time off and certainly the family would voice
03:19 that same opinion, but it is such an enjoyable thing
03:22 to me that it is hard to get away very long.
03:24 Well I am glad you are here with us today.
03:26 What we have done, is that we have collected
03:28 questions from literally all over the world
03:31 from Heartwise Ministries.
03:32 We collect peoples questions about their heart
03:35 and we group them together on the topic of,
03:38 specifically, cardiovascular surgery.
03:41 We are going to tackle some of these questions.
03:44 The first question today comes from a gentleman
03:46 named Stan in Michigan and Stan says:
04:10 What does a minimally invasive approach mean?
04:12 What does that mean?
04:13 Right! Traditionally the heart surgeries are done
04:17 through what we call a Median Sternotomy.
04:20 In this approach an incision is made on the front
04:24 of the chest.
04:25 It stems from up here on a notch above the breastbone
04:30 and all the way to the bottom of the breastbone.
04:32 Now do you cut through the breastbone?
04:34 Yes we do divide the breastbone.
04:35 It allows us good exposure to the heart,
04:39 all areas of the heart and allows us to be able
04:43 to handle any emergency that may occur
04:45 during this operation.
04:47 Median Invasive Techniques have been around quite awhile
04:50 and have fallen out of favor.
04:53 Now some are coming back into favor as approaches
04:57 to do some of these operations.
04:59 As you know we do some minimally invasive operations
05:03 on the valvular work, but bypass operations are limited
05:07 because the exposure is much more difficult to all
05:09 the areas of the heart.
05:11 There are certain areas of the heart that you can get
05:13 to in a minimally invasive technique.
05:15 Basically, through minimally invasive technique,
05:18 they are small incisions that are made between the
05:21 ribs on the sides, or at the bottom of the heart,
05:25 or chest area, to gain access to the heart.
05:28 It sounds like a big advantage of the minimally invasive
05:31 is that you are not cutting the breast bone?
05:34 Right! - the big disadvantage is that you cannot
05:37 have your hands on everything as well?
05:38 Correct! It limits your ability to get to all the
05:42 areas of the heart and to be able to handle certain
05:45 emergencies that may arise during the operation.
05:48 What if you had an emergency, when you are working
05:50 for one of these minimally invasive, would you then
05:53 have to open things up to get better visualization?
05:56 Correct, and that can take a little bit of time.
06:00 Most of the time it goes well, but of course seconds
06:05 really matter when you are dealing with the
06:07 heart and blood loss.
06:08 Now when you compare the recovery time verses the
06:11 sternotomy verses the minimally invasive,
06:14 what is the average time in recovery?
06:17 Well we tell people that it takes about 2 to 3 months
06:21 for the breast bone to completely heal.
06:23 The incisions that you make in the minimally invasive
06:26 technique can actually heal over a period of
06:28 3 to 4 weeks, so you can dramatically reduce the amount
06:32 of time for full functional recovery.
06:35 How soon might they be able to get out of hospital
06:37 with a minimally invasive procedure?
06:39 It varies depending on what procedure the physician
06:44 is performing and how extensive and operation it is.
06:47 That is according to what has happened? - Right!
06:51 Well Stan, I hope that answered
06:53 your question from Michigan.
06:55 The next one comes from Thelma, and Thelma is writing
06:58 us from Vermont and Thelma says:
07:14 Wow that is a question.
07:16 That is a very - does that make you think differently?
07:19 That is a very important question that is asked often.
07:23 It has been extensively studied.
07:25 It is not really a loss of intellect,
07:28 we call it a cognitive dysfunction.
07:31 This is mostly relating to doing complex mathematic
07:40 equations or remembering recent phone numbers.
07:43 Long term memory is not affected, but learning
07:46 intricate detailed information can be affected
07:50 after bypass surgery for up to a year.
07:53 What we have found is that the people who are
07:57 over the age of 70 have a higher likelihood
08:00 of having this problem.
08:01 However, 90 percent of all the patients recover their
08:06 cognitive dysfunction by one year after the surgery.
08:10 Most of the time it is something that passes.
08:13 Now what I have seen in some of my patients,
08:16 unfortunately a few patients I have actually sent
08:19 with Alzheimer's disease, mild Alzheimer's,
08:21 but have noticed that sometimes,
08:23 after their bypass surgery the
08:24 Alzheimer's seems to progress either quicker or
08:27 I just notice it more.
08:28 Or it is because I'm seeing it more often.
08:30 Have you seen that happen?
08:31 Yes we have, and that is one of the real problem areas
08:35 that we have to watch out for.
08:37 People who have Dementia, or Alzheimer's,
08:39 or early Alzheimer's symptoms often time can have
08:43 their symptoms made worse.
08:45 Not so much I don't think that the bypass operation
08:48 itself, but a combination of the heart and lung bypass
08:52 machine, stopping the heart and a general anesthetic.
08:56 As you know people have these problems who undergo
08:59 general anesthetics for any operative intervention,
09:02 often have memory or progression in their Dementia
09:05 or Alzheimer's afterwards.
09:07 I'm just curious, just curious.
09:08 What is the oldest patient and the youngest that
09:11 you have operated on?
09:13 I think the oldest patient that I operated on is in
09:17 their mid 90's and unfortunately the youngest patient
09:21 that I have operated on for coronary artery disease
09:25 which is the most frequent operation we do,
09:27 is the age of 10 years.
09:30 Ten years old! - Ten years
09:32 - Was it a congenital metabolism problem?
09:35 It had to do with a malignancy in the child's birth and
09:40 he received radiation therapy.
09:43 That can cause premature atherosclerotic
09:48 disease in the vessels.
09:50 Atherosclerosis in a ten year old? Wow!
09:52 Wow, that is incredible!
09:53 At this time we are going to take a brief break
09:56 and we will be right back!