Page 41 - ANZCP Gazette NOVEMBER 2022

AROUND THE PUMP ROOM
Wellington and Christchurch Hospitals in NZ — Three years in the making! Britney Westbrook CCP, FANZCP
Over three years ago, I contacted Amber Blakey and Russell Millar, Chief Perfusionists of Wellington and Christchurch hospitals, about the potential of visiting their perfusion units. I finally made it on the 1st of August 2022, in the company of Courtney Adams, our current trainee at the Waikato District Health Board.
We had an interesting start, with cancelled and delayed flights out of Waikato due to fog. We should have known then that we were in for an alluring trip! To our delight, we finally arrived at Windy Wellington late Monday afternoon, which unfortunately meant we missed the chance to view any cardiac cases on Monday. We brought bad luck with us, striking again, with all cardiac on Tuesday being cancelled due to no nursing staff being available. Nonetheless, Amber showed us around their pump room and operating theatres. They have lovely facilities, two side-by-side theatres, with windows!
Wellington Hospital has a team of six perfusionists, including Amber Blakey, Val Haripershed, Johnny Fitzgerald, James Holder, Manel San Pablo and Andrew Hickman. They have a similar bypass set-up to us in Waikato. We both use the Sorin S5 bypass machine, Inspire 8 LivaNova oxygenator and disposable packs. These packs are only temporary for Wellington, as the Medtronic Affinity oxygenator packs are their regular disposable packs. However, due to their frequent troubles of shipping issues into NZ and COVID delays, they have the Inspire 8’s as a temporary replacement. One of the main differences was the direction of their roller pumps. It was opposite to ours, which made us feel back-to-front.
Wednesday brought lots of excitement. Amber had been called in overnight for a Type A aortic dissection. It was all hands-on deck at 7:00 a.m. when we arrived. Manel was taking over, and she was running ACP while they were working on the proximal end of the graft, suturing it to the aortic root. Their bypass time had only just clicked over 200 minutes, which was very fast. We laughed with Amber that we didn’t order this type of excitement, but we were delighted to watch the second half of an emergent case! The rest of the case went very smoothly. Following this, Johnny had a redo redo REDO AVR with Dr Sean Galvin. Again, the case was very seamless. They put in a beautiful Perceval sutureless aortic valve with an excellent 60 minute clamp time. Wellington put on a lovely show for us. It was fantastic to learn about how their team coped under pressure and the cohesive approach to these complex high-risk operations.
Wellington Regional Hospital
We flew out Wednesday evening and arrived in the beautiful Christchurch sunset, flying over the snowy alps. Neither Courtney nor I had ever been to Christchurch, so we were thrilled to say the least. The drive from the airport into the city was beautiful, driving past the new construction since the earthquakes. The city was noticeably clean and beautiful. On Thursday morning we had a crisp walk through the Christchurch Botanic Gardens to the hospital, where Luise was there to greet us. They have a team of four perfusionists, Russell Millar, Jill Benner, Wendy Thompson, and Luise Van Wyck.
The cardiac theatres are situated in their new hospital, which underwent construction for many years and was completed late 2020. The new 62,000-square-metre building has 12 operating theatres and over 400 beds, with state-of-the- art technology and facilities. It is New Zealand’s largest ever public hospital project. Jill was scheduled for the day to pump the two CABGs. They use the Terumo System bypass machine and RX 25 oxygenators. Seeing the Terumo System in action was a new visual and clinical experience for the both of us. There were distinct features, including a pole-mounted central control screen, self-adjusting tubing inserts and flexible roller pump modules. The whole case went very effortlessly, and Jill kept us occupied by showing us the unique features of their pump, mobile hand-held blood gas machine and lovely collegial environment in the operating theatre.
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