Fred Weber in the operating room
Einstein Untold: Unsung Heroes and Unknown Stories

He Bypasses the Heart and Lungs So Healing Surgeries Can Happen

By on 12/14/2020
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One in an ongoing series

Fred Weber has a favorite quip about his occupation that goes like this: “My mother always told me I was going to be a heart stopper.”

She couldn’t have known how accurate she’d be.

Because that’s literally what Fred Weber’s job is at Einstein Healthcare Network. As the operator of the heart-lung machine during cardiovascular surgery, he stops a patient’s heart to hook it up to the machine to keep blood flowing. And he restarts the patient’s heart when surgery is over.

Weber is chief of the perfusionist staff at the network, supervising a staff of five. “When a surgeon wants to operate on a heart, in most cases they want to stop the heart so they put the patient on the heart-lung machine which takes over for the beating heart,” he says. “We’re not doctors, we’re not nurses, we’re not respiratory technicians – we’re perfusionists.”

Most people have never heard of the profession, Weber says. Neither did he until a customer at his uncle’s garage, where he worked as a mechanic while attending college, told him about it.

Taking Over Breathing and Blood Flow

Perfusionists are part of the operating room team and work in conjunction with nurses, surgeons, technicians and anesthesiologists. Weber’s job is to connect the patient to the pump that takes over blood circulation  and breathing functions, and monitor it throughout the surgery to maintain the patient’s vital functions.

The pump – which diverts blood from the heart, adds oxygen and returns it through a plastic tube to circulate through the body – is used in common procedures such as coronary bypass operations, heart valve repair and replacement, and aneurysm repair.

Weber calibrates the machine to a patient’s heart output and other individual measures.

“We base it on the patient’s Body Surface Area and Body Mass Index and try to mimic the norm,” he says. “If the patient is a big, burly guy and his cardiac output is seven liters, we try to mimic that. If the patient is frail or elderly, we’ll do three or four liters.”

Weber monitors the patient’s vital signs and the machine throughout the surgery and always has a backup in the operating room, in case any problems arise – which is exceedingly rare.

He administers the medication that stops the heart, but, like many professionals who perform in the realm of life and death, he isn’t preoccupied with the metaphysical significance of that act. Still, he acknowledges, “It can be intense.”

500 to 600 Cases a Year

While a perfusionist’s job may be obscure, it’s a very busy one. “We do it on a daily basis,” Weber says of the surgeries performed at Einstein Medical Center Philadelphia and Einstein Medical Center Montgomery. “There are days we do three or four cases a day and rarely a day goes by when we don’t do at least one. We do between 500 and 600 cases a year at both hospitals,” he says.

Weber was an undergraduate at Villanova University and working as a mechanic at his uncle’s gas station when he found out there was such a thing as a perfusionist. “I wanted to do something in the medical field but I wasn’t sure exactly what,” he says.

A customer who had befriended him told him the Philadelphia hospital where he was an executive was starting a school of perfusion and invited him to the hospital to learn more about it.

“I went down to the hospital and witnessed an open-heart operation and I fell in love,” Weber says. The job combined his interests in medicine and mechanics. “I said, ‘This is it. This is my calling.’”

Weber completed college and training to become a perfusionist. And in so doing, he fulfilled his mother’s prediction that he’d be a heart stopper. He always gets a chuckle out of that.

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