[HSF] 21 Year old S/P TOF repair with Moderate to Severe AI, 1 cm residual VSD and 30 mmHg RVOTO

[ghassan ????? baslaim]

Assessment of the pulmonic valve (PI?), Aortic valve repair/replacement and VSD repair +/- PVR.
 
G. Baslaim
Jeddah, KSA> To: OpenHeart-L at lists.hsforum.com> Date: Thu, 15 Nov 2007 04:05:29 -0500> From: ichfno at aol.com> CC: > Subject: [HSF] 21 Year old S/P TOF repair with Moderate to Severe AI, 1 cm residual VSD and 30 mmHg RVOTO> > Polling the group, what would you do with 21 year old, 12 years post-op TOF repair, valve sparing, now with 10 mm residual VSD, under aorta, moderate to severe AI and 30 mm Hg RVOT obstruction? > > WNovick> > > -----Original Message-----> From: Prasanna Simha M <prasannasimha at gmail.com>> To: OpenHeart-L at lists.hsforum.com> Sent: Thu, 15 Nov 2007 1:58 pm> Subject: Re: [HSF] I used aprotinin today> > > > Thanks for the follow up.> What is procrit and why cannot just plain oral Fe and good nutrition do -> along with a wholesome diet and probably some protein supplementation like> ensure do ?.> A Hb of above 8.00 Gm/dL with normal oxygen extraction and lactates is> sufficient. We should just treat physiology and not some whimsical number.> In fact raising the Hb may in fact make blood more viscous and clot grafts.> If she is doing well it may be wise to leave her alone to mend her self now> !!> Prasanna> > On Nov 15, 2007 8:57 AM, <Cysmd613 at aol.com> wrote:> > > I operated on my Jehovah's Witness patient today. Her pre op Hgb this> > morning was 12.2 and HCT 37.4. I "chickened out" and used amicar instead> > of> > aprotinin, given that she is an 80 yo woman and with all the media> > attention. Her> > renal function is normal. I did CABG x 5 including LIMA and 4 SVGs. The> > anesthesiologist took off about 350cc of blood pre bypass. Her HCT prior> > to> > coming off bypass was 22. Her HCT before giving back her own blood plus> > about> > 300cc of cell saver was 24. It took more than 30 minutes before the> > first> > drop of blood came out of the mediastinal chest tube. In the 9 hours> > since> > surgery, she has put out a total of only 140cc. I only got 1 blood gas> > post op> > (only because the O2 sat monitor wasn't picking up) which had her HCT at> > 30.4. She is doing very well. She is not extubated yet because she is> > still> > sleepy, but hopefully soon.> > Now, post op, since her Hgb is less than 12, the hematologist is willing> > to> > give more procrit and IV iron.> >> > Thank you to all who gave advice.> >> > Carmi> >> >> >> > ************************************** See what's new at> > http://www.aol.com> > _______________________________________________> > OpenHeart-L mailing list> >> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages transmitted by the OpenHeart-L are subject to the policies> > and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> >> > > > -- > Prasanna Simha M> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> > > ________________________________________________________________________> Email and AIM finally together. You've gotta check out free AOL Mail! - http://mail.aol.com> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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