[HSF] Cardiac arrest after redo CABG in a young patient

[Prasanna Simha M]

The heart will dilate after arrest wether it is tamponade or not (depending
on the amount of myocardial ischemia so I would not pay much attention to
that.Another thing is that RCA graft  occlusion may at times present
with sudden arrest. Opening may be life saving or at least an intellectual
post mortem.
Prasanna

On Dec 4, 2007 12:45 PM, <zzhoumd at pol.net> wrote:

> Dear Peasana,
>
> You do have a point, on TEE the heart just dilated without contraction.
> Usually, if it is tampnade, you will see a different picture. Due to the
> last surgery and this surgery, all the conduits were used including both
> radial arteries.
>
> If his brain fuction comes back, I can take him back to OR or send him to
> cath lab to study him. But so far, he has not waken up yet.
>
> Z Zhou
>
> Sent via BlackBerry by AT&T
>
>  -----Original Message-----
> From: "Prasanna Simha M" <prasannasimha at gmail.com>
>
> Date: Tue, 4 Dec 2007 07:11:41
> To:OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Cardiac arrest after redo CABG in a young patient
>
>
> No investigation is fool proof including TEE for tamponade. I have seen
> cases where the cardiologists swore that there was no collection but there
> was alocal tamponade compressing a graft causing LCOS which was relieved
> by
> removing the clot. No patient in cardiac surgery should die without having
> inspected the heart (radical statement but may be life saving occasionaly)
> Prasanna
> On Dec 4, 2007 5:41 AM, <zzhoumd at pol.net> wrote:
>
> > To forum members,
> >
> > This weekend I was on call. One of my partners patients developed
> cardiac
> > arrest. He is only 57 year old had redo CABGx5 4 days ago. Weight about
> > 300LB. After 30 minutes CPR, he is still asystole. Considering his young
> > age, I placed him on ECMO. I thought about BiVAD, but I just do not know
> if
> > his brain will come back. Just wonder if anybody will do anything
> different.
> > I did not reexplore him as TEE show no tampnade and he has no more
> conduit.
> >
> > Thanks!
> >
> > Z Zhou
> > Sent via BlackBerry by AT&T
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>
> --
> Prasanna Simha M
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-- 
Prasanna Simha M