[HSF] RE: OpenHeart-L Digest, Vol 46, Issue 22

[Nasser F. Abou'Seada]

Dear Roberto
Lucky case.
just curious, ... where was the rupture of the membraneous trachea ?? ...
what level ?? ... what was the proposed cause of the rupture of the
membranous trachea ? ... was it due to faulty intubation ? ... or rather
patient coughing vigorously during extubation ?? ... was the decompensation
immediate after extubation ?? what is the time interval ?? ...

- another curious point ... what was the pathology of the tricuspid regurge
III - in the absence of Mitral affection? -

NFA


On 4/14/08, Dr. Roberto Battellini <battr at medizin.uni-leipzig.de> wrote:
>
> John,
> Sometimes the intensivists are of help.
> For example my second Friday´s case, a 65 year old obese female, needed
> AVR
> and Tricuspid ring for severe As and TI III. Uneventful AVR Perimount 21
> and
> tricuspid ring (we have data that in our institution de Vega has less
> survival). The patient was send to fast track, intermediate care,
> extubated.
> In the middle of the night decompensated, pneumothorax left, had a drain.
> Further decompensated,, needed reintubation, pneumomediastinum, sent to
> ICU.
> A Bronchoscopist(the chief of ITS) saw a rupture of the pars membranacea
> of
> the trachea, the patient was operated on Saturday morning early by a
> thorax
> surgeon (I assisted him) and did a suture in the trachea, she was
> extubated
> yesterday evening.
> Good intensivists save lifes!!
> BTW, has anyone seen that complication before??
> Roberto
>
>
> -----Ursprüngliche Nachricht-----
> Von: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von Pigott, John
> D
> III
> Gesendet: Samstag, 12. April 2008 18:12
> An: openheart-l at lists.hsforum.com
> Betreff: [HSF] RE: OpenHeart-L Digest, Vol 46, Issue 22
>
> Dear Tea Ani and Hal,
> Actually I would prefer to have my operation in the center with the lowest
> risk-adjusted mortality with reasonable volume.  If the mortality is
> higher,
> all the intensivists, PA's etc aren't much help.  This goes back to Hal's
> comment about the intra-operative conduct of surgery, which is the single
> most important facet of the care (IMHO).
>
> John
>
>
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com on behalf of
> openheart-l-request at lists.hsforum.com
> Sent: Sat 4/12/2008 7:29 AM
> To: openheart-l at lists.hsforum.com
> Subject: OpenHeart-L Digest, Vol 46, Issue 22
>
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