[HSF] PO MVR -LA Thrombus

[Nasser F. Abou'Seada]

I'd Operate on an URGENT basis - first list- with fem-fem cannulation,
NO touch to the heart before cross clamping, SSI, initial ANTEGRADE CP, .
RE-REPLACEMENT of the valve, keep on GIK, SE preop, treat as potential
hepato-renal, till proved otherwise. highly consider a tissue valve for non
compliance.

awaiting complications ??

NFA


On Thu, Feb 14, 2008 at 6:10 AM, yadav del <yadavluck at yahoo.com> wrote:

> We have a patient admitted with LA thrombus.
>
>  She underwent MVR 2 months back and stopped all her medications including
> warfarin for 20days. She was seen at some other hospital in cardiogenic
> shock  and was intubated. Echo showed LA thrombus and one leaflet of
> carbomedics valve not moving normally.
>
>  She was transferred to us after 2 days stay in that hospital . Repeat
> echo at our hospital showed normally functioning vlave , large LA thrombus
> and EF 25%. She was in hepatic[ bilirubin 18] , and renal failure[creatinine
> 2.5] at admission which improved over next 2 days and was extubated.
>
>  Should we operate her   for LA Thrombus?
>
>
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