[HSF] Inotropes, ventricular fibrillation and myocardial protection

[Ben Bidstrup]

Why the amiodarone. Surely with some perfusion, the electrolyte 
imbalances within the myocardium would correct and SR ensue. If 
anything use lidocaine. Less toxic and cheaper, not a negative 
inotrope. It is what Yacoub taught me many years ago, and I have used 
it to good effect (infrequently I might add).


>Tohru,
>   I did an AVR on an 87 yo man as a 2nd case just a couple of hours  ago. 
>Again, no LV vent, only a sump.  While closing the aortotomy, I  began the
>continuous warm retrograde blood.  The heart began fibrillating 
>after a couple of
>minutes.  I gave amio and then cardioverted.  The  heart had a slow junctional
>rhythm until the clamp was released.  A sinus  rhythm developed shortly
>afterwards.  He came off with no inotropes.   It's much easier on 
>the heart and
>your nerves to cardiovert a clamped, flaccid  heart rather than 
>trying to do it
>after the clamp has been released.
>   I look forward to your visit at the STS.  As I said before,  I'll try to
>have a couple of interesting cases for you and other interested 
>members of HSF
>to watch and criticize to your heart's content.
>
>Hal
>
>
>
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-- 


Two things are infinite; the universe and human stupidity; and I am 
not sure about the universe.
Albert Einstein

The greatest obstacle to discovery is not ignorance --- it is the 
illusion of knowledge.
Daniel J Boorstin

Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon