[HSF] Acute abdomen plus unstable LM stenosis

[hgrmd at aol.com]

Don,
? Could the patient have had a LM PCI?? That's one of the few situations in which I would be in favor of it.

Hal


-----Original Message-----
From: Donald Ross <donross at bigpond.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Thu, 6 Dec 2007 12:21 am
Subject: Re: [HSF] Acute abdomen plus unstable LM stenosis


70yr male with unremarkable past history presented with acute abdomen and rest angina. ( WCC 20,000 )?
Urgent cath showed subtotal LM, 90% LAD, normal dominant RCA, good LV function.?
Balloon placed and emergent cabg ( opcab rima to LAD and lima to OM.)?
Laparotomy next day revealed dead colon which was successfully resected but patient fading fast with septic shock despite haemofiltration.?
?
Q1. Cause of dead gut in the absence of AF or infarct??
Q2. Timing of laparotomy : before, during or sooner after cabg??
Don?
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