[HSF] Ain't that big !!

[Tea Acuff]

You really expand our reality, Prasanna.
tea


----- Original Message ----
From: prasannasimha <prasannasimha at gmail.com>
To: "OpenHeart-L at lists.hsforum.com" <OpenHeart-L at lists.hsforum.com>; ccm <ccm-l at ccm-l.org>
Sent: Monday, November 20, 2006 12:12:03 PM
Subject: [HSF] Ain't that big !!


Patient with 97 % CTR, Giant LA , Mitral stenosis (MVOA 0.8) with MR 
Grade II with LA body clot.
Underwent today MV repair + LA thrombectomy + eMAZE  +Kawazoe type of 
plication to decompress the compression on the right lung.. Second X Ray 
in the Panel is the immediate post op X Ray showing the "atelectatic" 
lung opening up slowly.
At present the patient is being given "open lung ventilation"  with 
ventilation  @ 7ml/Kg tidal volume with PEEP of 14 mm Hg with hourly 
increase of PEEP @ 20mm Hg  for 45 - 60 seconds hourly to expand the 
chronically compressed lung and will probably be extubated in a few hours.
Papery thin LA in certain areas !!
I am getting a spate of giant LA's - todays other case also required an 
atrioplasty + MV repair (though that giant LA has a CTR of 80 % - less 
dramatic than the 97 % !!)!! When it rains it pours !!
Prasanna
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