Emmanuel Mbaka: The African Perfusionist - The Perfusionist Perspective Part 2

Aortic Hope is proud to welcome Emmanuel Mbaka from Kenya to our community!

Emmanuel is a cardiac perfusionist and has joined Aortic Hope as a volunteer Medical Social Media Contributor. Through his new educational series, “Inside Aortic Surgery: The Perfusionist’s Perspective,” Emmanuel will take us behind the scenes of complex cardiac and aortic surgery and introduce our community to a vital member of the surgical team that patients may not always hear about—the perfusionist.

When we think about aortic surgery, we often think about the surgeon and the repair itself. But behind every complex operation is an entire team working together, preparing for every possibility and focusing on one patient.

The perfusionist plays an important role during surgery, operating the heart-lung machine when it is needed and helping manage blood flow, oxygenation, temperature, and other critical aspects of cardiopulmonary support.

Through this series, Emmanuel will explain what happens before, during, and after aortic surgery, helping patients and families better understand the preparation, planning, technology, and teamwork involved.

His goal is not only to educate, but to help patients feel more informed, more prepared, and a little less afraid when facing an aortic operation.

Part 2: Why Does the Heart Have to Be Stopped During Aortic Surgery?

"If you're operating on my heart, why does it have to be stopped?"

It's one of the most common questions patients ask before surgery.

At first, the idea can be frightening. We've spent our entire lives believing that if the heart stops, it's an emergency. So why would a surgical team intentionally stop it?

The answer is actually quite simple.

Imagine trying to repair the engine of a moving car while it's still running. Every moving part makes the repair more difficult and less precise.

The heart is no different.

During many aortic operations, surgeons are repairing blood vessels that are directly connected to the heart. To perform these delicate repairs safely, they need the heart to be completely still and free of blood. A beating heart would make that almost impossible.

But here's the important part:

The heart is never left without support.

Before the heart is safely stopped, we connect you to the heart-lung machine.

As the cardiac perfusionist, I operate this machine. Once you're connected, it temporarily takes over the work of your heart and lungs, continuously circulating oxygen-rich blood throughout your body. Your brain, kidneys, liver, and other vital organs continue receiving the oxygen they need while the surgeon performs the repair.

To safely stop the heart, the surgical team gives a special solution called cardioplegia. I like to think of cardioplegia as giving the heart a chance to rest.  It allows the heart to stop beating in a controlled way while also protecting the heart muscle during surgery. Instead of working continuously, the heart is able to conserve its energy while the repair is performed. 

Stopping the heart isn't the goal. Creating the safest possible conditions for a successful repair is.

One thing I've learned from working in aortic surgery is that this moment is never rushed. Before the heart is stopped, every member of the operating room team is ready. The surgeon, anesthesiologist, perfusionist, nurses, and technicians communicate through each step, making sure everyone is prepared before moving forward.

Every decision is deliberate. Every step is planned. Every person has a role.

Once the repair is complete, our attention shifts to helping the heart beat on its own again and supporting it as it takes over the work it has done every second of your life.

We'll explore that moment in a future post.

~Emmanuel Mbaka The African Perfusionist

💙 Accurate Information. Greater Understanding. More Hope.

Welcome to Aortic Hope, Emmanuel!

We are grateful to have you sharing your knowledge and perspective with our community.

By the Community. For the Community.

This article is intended for educational purposes only and is not a substitute for medical advice. Please speak with your healthcare team about your individual condition and treatment.