[HSF] [Fwd: Re: ccml Quiz for Christmas]

[Tea Acuff]

All ventricular dysfunction is worsened by the cross clamp. Hopefully one has otherwise improved its function and that it is only temporary.
Tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Thursday, December 28, 2006 9:49:31 AM
Subject: Re: [HSF] [Fwd: Re: ccml Quiz for Christmas]


Basically a case with severe TR and RV dysfunction worsened temporarily 
by CPB.
Prasanna

Tea Acuff wrote:
> Etiology?
> Tea
>
>
> ----- Original Message ----
> From: prasannasimha <prasannasimha at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wednesday, December 27, 2006 9:38:35 AM
> Subject: Re: [HSF] [Fwd: Re: ccml Quiz for Christmas]
>
>
> No.
> The curve was  showing a CVP trace with a prominent X descent suggestive 
> of either early tamponade or a dilated RV "restricted by the chest wall 
> / pericardium. There was simultaneous increased delta dip showing a 
> decrease in LV preload despite a CVP of 11 (volume loading was initially 
> tried) as the RV was not "sending" volume to the left side adequately.
> Echo showed do diastolic collapse and RV dysfunction and was managed by 
> increasing support for the next 6 hours and was weaned off after the X 
> descent disappeared. Incidentally the chest tubes were removed as hey 
> were not draining and removal gave a little more "space " for the RV.
> V. Aldrete, M.D. wrote:
>   
>> Hi Prasanna,
>>
>> Did you have a drainage catether across the PA obstructing pulmonary 
>> flow?
>>
>> Victor
>> On Dec 25, 2006, at 4:56 AM, prasannasimha wrote:
>>
>>     
>>> Part2 of the same quiz
>>>
>>>
>>>
>>> Same case next day morning. Stable and off inotropes prior to removal 
>>> of lines.
>>> Prasanna
>>>
>>>
>>>
>>>
>>> <quiz26answerfollowup.jpg>
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>
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