Just the memory to use that stuff, people who designed and so on is mind boggling. I never thought of how much effort went into this stuff! FASCINATING!!

The surgeon who brought us the heart and lung machine we know today, he's the president of my church. I have so much respect for him as a surgeon. He helped pioneer so many medical things we have today

That is a serious amount of equipment and knowledge going with it, what a time to be alive! 🥳👍

Hi Dr. Feinstein, my name is Becky Anderson and I am Jim's wife that is why I use his name as my handle. Thank you for these informative, clearly explained anesthesia videos. I had mitral valve repair surgery in 2005. Your video today has helped me to know and understand what was done to me during this surgery. The central line was one of the last things to be removed after surgery and wow did that hurt! After the first few days I began to really feel the incision and that was also quite painful. When the pacemaker wire was removed I thought I was going to pass out because that was done when I was fully awake. Almost 18 years after this repair I STILL have incredible pain and cramps along the path that was used for the pacemaker wire. I am so glad that I am doing much better than expected now and I may be fortunate enough not to need valve repair surgery again! Anyway, thank you again 😷 doctor.

I had triple bypass last month... It's pretty cool seeing all kinds of equipments that were used. I personally didn't get look around too much in the OR prior to being sedated.

I had emergency open hart surgery about 7 years ago. I remember getting wheeled in . I had a quick look around the room and thought, wow there is a lot of stuff around here and all the people. I live in Canada, so I didn't have to pay for the operation. I had also thought of how much this would have cost me if I had to pay for it. Iove you videos, thanks

Thank you for sharing. I had open heart surgery almost two years ago. I find all of this very interesting, and am amazed at all that goes into the surgery. I am grateful for all medical professionals and others working in the hospital setting that care for patients in so many different ways.

I had open heart surgery recently so really cool to see how much actually went into it. Things happen so fast so never got to appreciate how much is involve. Wheeled me in, slid me on the table, strap my arms down and they knocked me out after introducing everyone. I had a Pericardiectomy done, so they didnt need to stop my heart, however they were still prepared for it just in case. Also I had a central line installed but I dont think they ever used it, no one prepares you for how long it is when its pulled out of your neck lol.

WOW! I can’t imagine the education and skill that goes into this set-up and surgery! Totally impressed!

Had a lithotripsy today for kidney stones, I’m 20 years old and was absolutely TERRIFIED of the anesthesia, far more than the procedure itself. Your videos helped me immeasurably when it came to calming myself down as well as feeling more grounded throughout the scenario. Thanks a lot, wish I would’ve had a chance to thank my anesthesiologist afterward.

Just wanted to leave a note here to say thank you for your videos in general. I had a minor ENT procedure last week where I was placed under general anesthesia for the first time in over two decades. Prior to this, my two fears in life were vomiting (haven't vomited since I was a kid) and surgery (the last time I vomited ... as a kid). I've always found comfort in researching as much information about a medical procedure as possible, so I watched a lot of your videos about the anesthesia process and videos on the procedure I was having. I was able to advocate for myself and speak clearly about my concerns. I knew the names/function of the drugs they gave me to calm me down and prevent nausea before surgery, and I generally felt completely at ease with the whole process from beginning to end. So your videos really are making a difference for more than just people who are looking into pursuing the field as a profession. Thank you!

I like the way you draw attention to things with your editing! The arrows and things do their job without being too much.

Helps you understand why this type of surgery is so expensive! The amount of equipment and training required is unbelievable! Thank goodness for doctors.

Woah, what an awesome video! My uncle had emergency open-heart surgery a few months ago, so this was an interesting video. :)

Love you doc! Thanks for all these amazing videos, love all your content. I wish I were an anaesthesiologist too!

I love cardiac anesthesia; so much variation during 1 case. Had the opportunity to practice TEE last week, still a nooby but it was as informative as it was challenging! Love the video!

It’s so cool to see all of the equipment I plan in my career as a medical equipment planner being put to use.

Thanks for sharing this. I am having heart surgery in the morning to replace my aortic valve, again. The first time I had a porcine valve that wore out (I am young and very active) but this time I’m getting a mechanical valve so should not have to be replaced again, hopefully. I am nervous but videos like this help. Somehow education makes it slightly less scary.

This is so cool! I was a former CVICU nurse and part of my training was to shadow an open heart surgery case (I watched a Bentall procedure) and then admit the patient postop. I’m in my didactic portion of CRNA school now so it’s fascinating to see the perioperative side now!

Thanks for the glimpse to Mt. Sinai’s Cardiac OT. As a final year Anaesthesiology resident from India I always wanted to have a glimpse into how other countries’ OTs function and operate. The stop cock arrangement was exquisitely soothing , pleasing. It soothes my mind to see such degree of organisation. Fumbling over entangled infusion lines sprawling all over is definitely a horrifying experience when an emergency occurs. Thanks again for the aesthetic video

Hi Max, Another great video. I recently had Gallbladder Removal surgery 2weeks ago and I was telling the Anestegiologist staff about your KZfaq Channel. I was able to recognize many of the monitors you discussed in previous videos. Thanks Again for educating me as a Patient about what to expect during Anestegia before surgery💖💖💖💖💖

Thanks so much. As a retired critical care nurse I find your videos very interesting and informative..

Wowza….. that was scary! That’s so much to go through with a heart surgery! Good job Max!!

I am so grateful to you for showing us what goes on. My other half has struggled with cardiac health and I always wondered what the OR his bypass took place looked like.....wow!

Fascinating video! I feel like anesthesia is a field that medical students do not get adequate exposure and education. Thank you for providing this very informative tour of how cardiac anesthesiologists keep things running smoothly during heart surgery!

The sheer complexity of things involved itself is overwhelming

I have had heart replacement surgery and continue to require left and right heart caths. Thank you for sharing this tour. I'm always looking at what these different tools do. Thank you for who you are and what you do!!!

This brings back bad memories of when I went under for my triple bypass back in 2012 I was 32 years old when this happened and and scared shitless it took them 14 hours for them to do my surgery

I’m having my second OHS December 1st to re-replace my left-sided mechanical tricuspid valve. I have CCTGA so I had my first surgery as a baby and don’t remember anything. It’s comforting to know how much time and hard work is put into making sure patients like me are well taken care of. Thanks for posting this. 😊

Just had a quintuple bypass 4 months ago. Interesting to see what the operating room set up was probably like for my surgery. The drugs did leave me with no memory from the time I arrived in the ER until a few days after surgery. I must have been conscious though, because I was told that I gave verbal consent for tests and the surgery and that I had spoken to various doctors prior to surgery. No memory at all of any of that. Seeing all the syringes of drugs prepared for the surgery sort of explains all that. Thanks for this video. I'm still piecing together my experience and this sort of helped that process.

Great tour ! I tried to go to college after I graduated high school in 08 to be a Anesthesiologist but It was gonna be too hard because of my cerebral palsy, I’m 31! I’m gonna become a Honorary Anesthesiologist soon! I love your videos! I always learn a lot

I had CABG (3 bypass) emergency in 3/2019. I really, really appreciate this tour of the operating room (of which I was totally unaware since I was the one getting cut open ) . . . Thank you!!!

Wow.. This is amazing ! We should all be thankful we live in the 21st century!

LOVE your channel and all your videos, thank you sir

We have been waitin' for EVER for a new vid. Much love!

Yay! He’s Back!!!

Your best and most interesting & Informative video to date, thank you very much for producing and posting.

Salute to all doctors 👏

Thank you Doctor, interesting content, well produced. I am a solid fan.

Great informative video. My husband had a mitral valve repair with maze procedure in 2017. B/c they could do only a replacement valve in Peoria and not a replacement, he had to go to Northwestern in Chicago. Dr. McCarthy said it was a lot more severe and complex then he anticipated and was on the bypass for almost 4 hrs. I'll never forget the swan catheter coming out of his neck after surgery - so many tubes/IV's. (Husband said it was a lot to take in when he went into the OR, but they knocked him out pretty fast).

What more can I say... EXCELLENT !

Wow Dr Max, that looks complicated! This is the one surgery I hope I never have to go through…I do love to look at all the stuff in the OR when I go in! Anesthesia always tells me to lay down. lol

Thanks for all your hard work!

Damn these people are geniuses

I had an awesome time and learned quite a lot when I worked as a Cardiac Anes. Tech. I miss the adrenaline rush. 😎

Great video Mark, thanks

Great video from a layman's point of view. I've had several surgeries over the years and for some odd reason always enjoyed anesthesia. I guess I'm kinda weird that way. Anyway, thanks for the in depth explanation.

Wow I just got my mind blown. I had no idea so many things that could go wrong with just equipment alone. Wow

ER DOC HERE ! LOVE THE QUALITY OF THE VIDEOS MAN GETTING SO GOOD. HOPE ALL IS WELL ! WE SOMETIMES HAVE TO PLACE EMERGENT TRANS VENOUS PACEMAKERS IN PATIENTS.

How did people figure out how to make those machines work and come up with the software to run it? That to me is amazing in of itself along with all the staff in the hospital that know how to use it.

Amazing man

That’s a Lot of equipment soo cool though to see what goes into such a complex procedure. Thanks for ur vids and take care. Cheers

just excellent

If you have multiple infusions running, and you have an infusion reaction, how would you able to tell which medication is causing the reaction?

“should we name this instrument something easy to remember, doctor?” “NO. you must use my name.”

Totally interesting

Amazing

Holy crap so much of a set up

Hello Dr. Feinstein. Thank you very much for posting this video. As it happens, I've got an ascending aortic aneurysm / dilated aortic root with some aortic regurgitation - the largest diameter is 4.6cm measured July 2022, which progressed from 4.1cm 2 years prior. My surgeon and I had a long discussion, and it's pretty much understood that I'll be going in for OHS sometime in the next few years to replace the aneurysmal section of ascending aorta with a dacron graft, and do whatever is needed at that time for the root and valve. Thank you for the look at the OR setup for OHS / cardiac bypass. This is very much what I'll be going through, when the time comes. One question. As a patient looking at all of this, I'm not so sure that being aware of all this equipment etc will be a pleasant experience when being wheeled into the OR. How should I ask to be given something for my nerves in pre-op? Maybe just come straight to the point with the anesthesiologist and say "I'm nervous" or something? I've been under general a few times, and the last few times propofol was used to induce anesthesia - it's amazing how quickly it takes hold, and how relatively uneventful coming back to consciousness is. I had knee surgery back in the early 1980's and sodium pentathol was the induction drug. I woke up feeling so very sick and stayed so all that afternoon/evening in the hospital room. Glad that the newer meds don't have quite the same after-effects and that additional meds are brought on board to combat post-op nausea.

This gives me anxiety thank goodness people are willing to do this type of work.

It would interesting to do the difference between the EP cardio anesthesia now.

Been there done that. I’m glad I was asleep.

Max, I have an ICD in my chest. I was under the impression that a Medtronic Tech was always with a patient with an ICD to turn off or turn on the ICD.

Brother.. Didn't told about airway management (DLT).

Hey Max, a couple of questions?, 1/ What happens in the case of a total electrical failure of the outside grid? I Would imagine back up generators are available but they would have to start and get on line which would take a few minutes? Does all the equipment have internal back up power to continue operating? 2/ With the computer equipment wouldn't it shut down momentarily with a 'black out' and have to 'reboot'. Obviously this would be fatal to the patient on bypass? Thanks for your interesting expose into the world of operations;-))

The pt is induced with ketamine, versed and verconium. Sevoflurane gas is being used. Now what happens when the pt is put on a cpb machine for almost 90 min, and the lungs are not being ventilated, so how are they maintained on general anesthesia? Do they wake up? What else is used till the lungs are being ventilated again?

yay u posted

Another excellent video. What you call the Monster is nicknamed the cage where I'm at. Those pressure area care stickers -do you have the brand name of those?

Thank you for sharing such amazing content. I had surgery a few months ago, and have to have surgery again soon and wondering what causes the ringing in your ears during the induction of anesthesia? The anesthesiologist did ask me to confirm if I was having ringing in my ears during the induction(I nodded as they were holding an oxygen mask). I am a registered paramedic. This made me very curious. What causes this?

Damn, I have to go in for a Cardioversion and I’m concerned about the anesthesia. Last time I was on propofol for a scope they kept me light. That’s just a tiny piece of this puzzle.

My dad had quadruple bypass and I've always been curious to know how that all works.

Thanks Dr Feinstein. As you might remember my brother is a cardiac anesthesiologist. Just yesterday he was doing a heart transplant. I have often wished one of these cases could be videotaped as the public (including me) has no idea what is involved. I know my brother often is in shock/trauma cases and I have to ask them how this all works when a critically ill patient is rushed in for surgery. In this video everything is laid out so nicely but how in the heck do you have time to get everything set up when time is of the essence?

Omg I can't imagine learning. All that! Wow so interesting. Holly smokes! So for bypass surgery do u have to have extra training training as a anesthesiologist? Thanks

Who knew all this stuff was necessary - now I better understand that BIG bill I got. :)

glad i didn't see this before heart surgery

Anyone know why the trans-esophageal echo machine’s screen was blurred out?

Wow that’s a lot of stuff. You made a comment about I think it was the central line where you said there’s lidocaine to make this a less uncomfortable procedure. Could you explain that more? Why would it be uncomfortable if they’re asleep? Also when a person needs to get some things like that why can’t they wait to put them in until they are asleep? One other general question I noticed that you have fentanyl there for pain does a person that is under general anesthesia do they still need pain relief medication I thought if they were knocked out they couldn’t feel anything could you speak into that maybe thank you

Hi How are you Would you like to talk about technical anesthesia about work and job in USA and study

I love doing cardiac Anaesthesia, is that going to be in your next rotation? If so I hope you enjoy it mate, heaps of fun but very long hours.

And all I asked the Doctor for is the location of the Keurig machine and he shows me all these gizmos and gadgets!

Been there 8 years ago for a double CABG and am now facing Aoritc Valve replacement and mitral valve prolapse. I am curious, I didn't ask last time because my mind was running 1,000 mph, is the heart/lung machine( I know that's not the proper medical term) what keeps the blood cold and does it keep the brain functioning while my heart is stopped? Thanks in advance and for all you do!.

I have a question you’re talking about arterial lines and central lines At what point do you say you know what this patient is healthy enough and remove the central line or arterial line

Great video, curious about the dose of push dose norepinephrine???? Ive been researching and can’t find it

What do you do if you need to give an infusion that cannot be run in the same line as another infusion being administered, since you cannot run it through the central stopcock?

Cool vide, thank you! Do they have sterile defib pads for OR use??

i'm at sinai...is there any good data out yet on isolyte's compatibility with these meds? i always push for LR If we're mixing a lot of different drips because it has much more data

your patient's 'cable management' is chef's kiss🤌

Hey Max, Can I pick your brain about your thoughts on ionm cases? I am going to be starting my clinicals in a month. I’d love to hear from you.

Hi, thanks for video :) I have some questions about cardiac anaesthesia, so where can I ask you if you permit?

Hi there! I'm have to get an MRI in a few weeks, but they want to do it under anesthesia because I go into nonepileptic seizures. Do you know how the anesthesia works for something like that? Love your videos

Potentially dumb question but how is the autotransfusion machine different from hemodialysis?

Any idea how to access Kaplans Cardiac question bank?

So, that how they do open heart surgery? I have never that frighten before. Bair hugger, haha!

As a patient, seeing all that equipment would be terrifying to me.

Why don’t you use a glide scope?

Would this be the same setup as a hear transplant or would that be different? Would appreciate ur feedback

Dr Feinstein I have a question. I have severe ankle pain. It is constant and nothing has ever helped me. Is it possible to permenantly sedate my ankle?

Do you see precedex being used more in cabg surgery instead of propofol?

What happens when you put a magnet near a pace maker?

I’m getting open heart surgery in 10 days but is it similar to closing an asd? Setup wise?