[HSF] Valve Dysfunction - failure of Closure

[Nasser F. Abou'Seada]

valve type ?? .... one of the very good brand named sacred valves ..... !!!

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of A
> Sent: Tuesday, December 12, 2006 4:12 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: RE: [HSF] Valve Dysfunction - failure of Closure
> 
> 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
> 
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