[HSF] Valve Dysfunction - failure of Closure

[A]

It all seemed so quick I am sorry about that. Years ago there was a valve
called "Duromedic" I had a similar incident with it but right on the table
as we came off and started to close the valve became stuck in the open
position back on the pump looked at the valve no reason for it to do that.
Came off again the same scenario happened. I went back on the pump and put a
St. jude instead and the patient did fine. The same happened to my partner
and we called the manufacturer eventually Duromedic was taken off the market
and that was one of the reasons. It is important to get in touch with the
manufacturer and inform them. By the way what was the valve type? Thanks

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of Nasser F.
Abou'Seada
Sent: Tuesday, December 12, 2006 12:46 AM
To: OpenHeart-L at lists.hsforum.com
Subject: RE: [HSF] Valve Dysfunction - failure of Closure

I'd like to ask for the opinion of the forum members in a case of an adult
male patient, postoperative day 1, after AVR for rheumatic AVD, Mechanical
bileaflet prosthesis, simple procedure, totally stable, off ventilator,
speaking, to be transferred to HDU next morning. He was reported from CSICU
as being speechless for 2-3 seconds, during which his eyes were widely open,
gazing upwards, then returns back in 2-3 seconds totally normal. blood
pressure curve on monitor disappeared for a second. 
What is to be done ?? 

in a few minutes, before doing the ECHO, the attack was repeated twice in a
minute. 
?? reaction ??? 

in a few minutes the attack was repeated but never resolved back. Heart
beating, No clicking valve on auscultation, pressure curve up and down. 

Patient was re-intubated. CPR started, 
What is to be done then ?? 

Hanging of the valve leaflets with failure to close was suspected first
time. Echo -ready next room- was requested, yet second attack happened
before echo was done. 
Third time, the patient never came back, heart was beating vigorously, no BP
curve, no clicking of the valve. rapid intubation with CPR initiated, yet
never came back .... 
Faculty on call took the patient immediately to OR .... where the chest was
opened and patient was tried to be got on bypass ..... the aorta was so soft
to be cannulated ..... precious minutes were lost during trials of
cannulation. Pupils were dilated fixed already when aorta was cannulated at
last. Patient never made it back. 

Opinions about what should have been done ....?? ...... comments ???? 

NFA 

_______________________________________________
OpenHeart-L mailing list

Send postings to:
 OpenHeart-L at lists.hsforum.com

To UNSUBSCRIBE, to CHANGE email address, or to view archives:
http://mmp.cjp.com/mailman/listinfo/openheart-l

All messages transmitted by the OpenHeart-L are subject to the policies and 
disclaimers posted at:
http://www.hsforum.com/listdisclaim
-----------------------------------------