[HSF] 20 year old year S/P DORV repair, Kawashima type spiral tunnel with...

[Hgrmd at aol.com]

Bill,
  I'm not exactly sure what your references to me mean in regard to  early 
extubation after complex congenital surgery.  I'm in awe that you are  able to 
routinely turn out these cases in strange OR's.  However, I'm not  against 
early extubation.  On day's I do 2 cases, the morning case is often  extubated by 
the time I arrive in the unit with my 2nd case.  What I don't  see the 
rationale is on table extubation.  The case I did yesterday was a  77 yo man with 
severe AI, severe MR, and severe TR, 2VD, chronic AF with an EF  of 25%..  I did 
an AVR, mitral and tricuspid repairs, CABG X 2, and a  cryomaze. Extubated 9 
hours later, he's doing fine this AM.  I still fail  to see the advantage of on 
table extubation.  What if the patient is  bleeding?
  Again, congrats on the great work you continue to do.
 
Hal 



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