[HSF] Fwd: STS MEMBER ALERT: FDA Issues StatementonUseofAprotinin(Tra...

[Claudia Teles]

I have just monitored today with rotational thromboelastometry a re-do  CABG
(LIMA to LAD and two saphens) in a patient who had a thromboelastographic
profile of a defective coagulation activation mainly in the extrinsic
pathway of coagulation, and also a fibrinogen assay (FIBTEM) in the inferior
range of normality, characterizing a low hemostatic reserve.
The patient had been on aspirin, clopidogrel and enoxaparin which have been
stopped 5 days earlier.
No diabetes, only hypertension, and normal renal function.
The team decided to administer aprotinin, and the patient is not bleeding at
all, 5 hours after leaving OR, already extubated.
Urine output is just fine.
Let´s see how it gets along.


claudia


2007/10/31, hgrmd at aol.com <hgrmd at aol.com>:
>
>
> Michael,
>
> ? Refresh my memory on the patient you are talking about.?
>
> ? You are fortunate to live in the Midwest.? I don't think people's
> attitudes are generally as malignant as in South Florida.?
>
> Hal
>
>
> -----Original Message-----
> From: Michael Firstenberg <msfirst at gmail.com>
> To: OpenHeart-L at lists.hsforum.com
> Sent: Wed, 31 Oct 2007 6:37 am
> Subject: Re: [HSF] Fwd: STS MEMBER ALERT: FDA Issues
> StatementonUseofAprotinin(Tra...
>
>
>
>
> Hal,
>
> I do not know how you can practice in that type of environment.  Even when
> some of our patients dont do well (yes, it does happen from time to time)
> the families are grateful that we at least tried.  So, far I have not
> heard
> from too many lawyers - although the patient who had the recall and called
> a
> lawyer from her hospital room wants to come home with me.  She is back by
> the way with bilateral DVTs and a PE - any comments on that?  I have many
> but will stay quiet for now......
>
>
> -michael
>
>
>
>
> On 10/31/07, Hgrmd at aol.com <Hgrmd at aol.com> wrote:
> >
> > Tony,
> > I guess that's the difference in my and yours patient  population.  A
> few
> > of my patients are obviously looking for an angle to  finance a few more
> > cruises.
> >
> > Hal
> >
> >
> >
> > ************************************** See what's new at
> > http://www.aol.com
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-- 
Claudia Teles
Hemostasis Section - INCARDIO