[HSF] Another disaster endocarditis......

[wftjrtyler at aol.com]

i bet this fellow is funded via contract,etc(a convicted  criminal)    yet 
millions of Americans are not(non  criminals)   Tea,Bob ,or Ani  please 
reconcile this paradox  to me      bill turner   
 
 
In a message dated 12/1/2008 5:53:51 P.M. Central Standard Time,  
msfirst at gmail.com writes:

OK - you  think we could get these problems sorted out.

71 year/old prisoner was  found "down" in his cell
Intubated by EMS in route.
Presumed cause was a  large (and I mean large) right MCA CVA with diffuse
hemispheric  edema.
Initial blood cultures positive to MSSA (allergic to PCN) - current  set
negaitve x1 day
Chronic dialysis - surprisingly has a fistula  (presumed source)
Untreated Hep C (liver numbers OK, but dont know viral  titers or HIV status)
Recent diagnosis of Gleason (sp?) 9 prostate  adenoCA

Large vegetation on mitral with severe MR.  Thickened  aortic valve with mild
AI, no obvious AS or signs of  infection.

Currently intubated on minimal settings (CXR shows diffuse  pulm edema) and
sedate, but awake follows commands but not moving left  side.

Obviously needs cath
Would like to see him off the vent first  - if possible.

I favor operate sooner rather than later (i.e. before  worse CHF and more
complications) - like in the next couple of days.   Surprisingly Cardiology
want to wait and tune him up???

Plan for  MVReplace (tissue obviously) (grafts based upon cath) and probably
leave  the aortic alone - depending on AI.........


or any "mitral  reference surgeons" want to accept the transfer and plan  a
repair?


-michael
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