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

[Ani Anyanwu]

All?
  ----- Original Message ----- 
  From: Tea Acuff<mailto:tacuff at swbell.net> 
  To: OpenHeart-L at lists.hsforum.com<mailto:OpenHeart-L at lists.hsforum.com> 
  Sent: Friday, December 29, 2006 12:15 AM
  Subject: Re: [HSF] [Fwd: Re: ccml Quiz for Christmas]


  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<mailto:prasannasimha at gmail.com>>
  To: OpenHeart-L at lists.hsforum.com<mailto: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<mailto:prasannasimha at gmail.com>>
  > To: OpenHeart-L at lists.hsforum.com<mailto: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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