Chiu Kit Yi is one of 15 perfusionists at the NHCS, and her job is to make sure that blood continues circulating through the patient's body after the surgeon stops the heart temporarily to operate on it.
Her job is not widely known but she is a vital member of the cardiovascular surgical team
When a patient has open heart surgery such as coronary artery bypass graft or valve repair/replacement, the surgeon will stop the heart temporarily and let the heart-lung machine take over. This is when the perfusionist’s job begins.
The heart-lung machine sits beside the operating table. The perfusionist uses it to regulate the patient’s blood supply, which is diverted to it through a tube. The machine infuses the blood with oxygen, removes carbon dioxide from it, filters it, and pumps it back to the heart.
It is a crucial but little-known job. Not many people know what perfusionists are or what they do. Ms Chiu Kit Yi, 30, is one of 15 perfusionists at the National Heart Centre Singapore and among the estimated 50 in Singapore.
A Life Sciences major, her interest was piqued when she spotted a job advertisement in a newspaper. “I had to google to find out what a perfusionist was. I liked the thought of saving lives and found it interesting that a machine could replace the function of the heart and lungs. I applied and got the job,” she said.
Her first day on the job was a baptism of fire – she witness open heart surgery. “I wasn’t prepared for it. It was overwhelming.” Up until then, the only surgery she had done was dissecting a rat in university.
What hit harder, though, was seeing patients die on the operating table. “It was heartbreaking. I had nightmares. It took me six months to overcome this but my colleagues were very encouraging.”
Mentored by a senior perfusionist, she learnt to prepare and operate different life support machines including the Extra-Corporeal Membrane Oxygenator (ECMO).
When rostered, she is on call even in the middle of the night, and has to rush in to the hospital within 30 minutes. “Once I had to cut a taxi queue to do this, explaining to people what I had to do!”
Ms Chiu has been on the job for seven years. Two years of on-the-job training prepped her well. She sometimes travels to other hospitals in Singapore to undertake perfusion duties, as some hospitals do not have perfusionists. One of these is KK Women’s and Children’s Hospital, where she does perfusion on children. “It’s more challenging with children because their anatomy, physiology and pathology can be very different from adults. They are more vulnerable,” she said. One case made her weep: A young girl, felled by a virus that attacked her heart, was sustained by ECMO for several days, but it became clear that she would not survive. “I cried so much that the doctors asked me if I was related to the patient,” Ms Chiu said.
Her greatest satisfaction is when patients recover. “When I see them pull back from the brink, walking about, talking to their families, I feel very happy that I played a part in it.”