[HSF] acute aortic insuffiency dure to BE

[David Harris]

For THIS case I would have had the pump primed and
ready, and would have gone on pump immediately, with
cooling, to protect brain. Would have considered
femoral bypass whilst colleague continues to massage
chest.

--- erdinç naseri <enaseri at hotmail.com.tr> wrote:

> Dear forum members,
> On monday morning we took the patient with Acute AI
> and bacterail 
> endocarditis to operation.( blood culture showed
> enterococci sensitive to 
> VM).Induction of anasthesia lead to deep hypotension
> and bradycardia 
> followed by cardiac arrest.10 minutes of external
> chest massage and 
> adrenaline and dopamine ,cardiac activity
> returns.was not sure about the 
> neurologic condition so didn't proceed with
> operation and took the patient 
> back to the ICU.Informed the family about the
> possibility of neurologic 
> damage.She woke after 10 hrs and now is without
> deficit.Family refused 
> operation for 3 days but today they accepted the
> operation again. BTW 
> anesthesia inadvertently put a catheter in her left
> subclavian artery(blood 
> running up to the fluid bottle) and I am planning to
> take it out in the 
> operation room.We used CVVHDF in these 3 days. very
> effective lowering of 
> blood creatinin and K levels.(we don't have any
> nephrologist so we manage 
> the CRRT).Control Echo :mobile mass originating from
> NCC 5 
> mm,AI+++,MI++,TI++.Will try once again.
> ERdinc
> 
> 
> >From: Hgrmd at aol.com
> >Reply-To: OpenHeart-L at lists.hsforum.com
> >To: OpenHeart-L at lists.hsforum.com
> >Subject: Re: [HSF] acute aortic insuffiency dure to
> BE
> >Date: Mon, 19 Feb 2007 07:21:27 EST
> >
> >Bob,
> >   Actually, it's my case, and I'm leaving in a few
> minutes to take  care 
> >of
> >it.  In my opinion, this pt's AI if chronic.  I
> noticed in his  chart that 
> >he
> >had been treated by a rheumatologist for
> "rheumatica myalgia"  since last
> >September.  SBE was probably the culprit.  If you
> look at  the patient, he 
> >seems
> >fine.  In fact, he's roaming the halls with wide
> open  AI, mod MR, and
> >mod-severe TR.  I'll let HSF know what I find
> >Hal
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Dr. David G. Harris, FCS, MMED,
Cardiothoracic Surgeon        
Suite A2                                
Tygerberg Hospital, 7505       
Cape Town, South Africa.            
Tel +27-21-9762347             
Fax +27-21-9761157      Mobile +27-83-3309587