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

[Prasanna Simha M]

I would consider opening the chest well before 30 minutes !!  That is what I
meant by saying the chest needs to be opened rapidly post cardiac surgery.
Looking forwards to meeting you. Hal is now in Croatia and is also expected.
We must take a photograph with Roberto and all of uson HSF to post in the
HSF List. Will be very nice to add faces to the names. Be warned I am short
and fat !! Donald Ross and Ben Bidstrup can vouch for that !!
Prasanna

On Dec 4, 2007 6:45 PM, Ani Anyanwu <anianyanwu at hotmail.com> wrote:

> > No patient in cardiac surgery should die without having> inspected the
> heart (radical statement but may be life saving occasionaly)> Prasanna
>
> I had a mentor who trained in India who used to say the same thing so must
> be a dictum in the indian surgical school! After 30 minutes of external CPR
> would you still reopen? Effective CPR in a cardiac patient by this means for
> prolonged periods, without identification and treatment of a known cause
> (none identified in this case), is likely not recoverable (as seen here as
> patient should have woken up by now). Assuming one arrived 30 minutes into
> the 'code' then there may be a case for doing nothing. Certainly though, if
> I  am to go the extent of ECMO (very unlikely), I would first open the chest
> to exclude tamponade (and also to see if there is anything I can do to
> achieve cardiac recovery post-ECMO.
>
> PS - hope to meet you in Leipzig later in the week.
>
> Ani
>
>
>
> > Date: Tue, 4 Dec 2007 07:11:41 +0100> From: prasannasimha at gmail.com> To:
> OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Cardiac arrest after
> redo CABG in a young patient> CC: > > 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> 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