[HSF] Another Victory for the LAD Stent.....

[Michael Firstenberg]

We put him on ecmo to buy time but he is not waking up......

There must be a paper in these events 

Michael Firstenberg <msfirst at gmail.com>

-----Original Message-----
From: "Ani Anyanwu" <anianyanwu at hotmail.com>
To: openheart-l at lists.hsforum.com
Sent: 2/8/2008 5:01 PM
Subject: RE: [HSF] Another Victory for the LAD Stent.....

Michael
 
What did you do with the patient? 
 
Today saw a lady to evaluate for LVAD - she had bare metal stents to RCA and LAD staged over two weeks in october 2007 (She did not have drug eluting stents because her insurance company wont pay for Plavix). At time of her angioplasty, her EF was 60%. She had an acute MI in December due to occlusion of her LAD stent and now is inotrope dependent with an EF of 15%. Cant have transplant because of severe peripheral vascular disease, carotid disease, age. 
 
I suppose a two vessel CABG could have prevented this state of affairs - who knows. How could we scientifically make this determination?
 
Ani
 



> Date: Fri, 8 Feb 2008 10:51:26 -0500> From: msfirst at gmail.com> To: OpenHeart-L at lists.hsforum.com> CC: > Subject: [HSF] Another Victory for the LAD Stent.....> > All we know about this guy, we got from his driver's license.> > 59 year/old - called EMS from a local hotel with chest pain.> > Found in obvious respiratory distress with severe C.P.> Scooped and run to our ED - intubated in ED instantly, then taken to cath> lab...... very quick door to needle time.> > Cath - multiple LAD stents - occluded prox. unable to pass a wire> Circ - occluded, severe RCA disease> Has ICD> > tachycardic to 120-150's> mild hypotension> > echo in cath lab ----> almost dead heart.> > severe pulm edema, severe respiratory acidosis (ph: 6.9 pCO2=90 sats in> 70's)> given lasix, heparin, reopro> > we are called........> > > > I guess he has not read the recent studies..............> > > > -michael> _______________________________________________> 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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