[HSF] Bentall +CABG

[erdinç naseri]

Further information about the patient
Unresponsive,No fever
Intubated (IPPV,FIO2 %50,!'/min,PEEP6 mmHg):PH7.31,PO2 81,PCO2 38,Lactic acid 5.1,SO2 %97
Repeat cranial CT:Completely normal: no infarct, no edema ( as far as CT can tell),Has bouts of focal and time to time generalized convulsions ( on Diazepam,clonazepam,Depakene)
Abdominal CT: no fluid in peritoneal cavity,no sign of MVA.Abdominal distention with negative tap and clear N/G fluid
Repeat Thoracic CT:  marked decrease in mediastinal air density,no perigraft collection,Bilateral pleural effusion(R>L): R tube thoracostomy.
AST:900 ALT:667: Bilirubin(total/direct):6.01 /3.48,PT :17 sec,aPTT:96
wbc:2200!,Platelet:40000,HB:13.1,Di-dimer:>10000
BUN:170,Creatinin:3.4,Na :132,K:4.6
FreeT4 :0.54,freeT3 :0.41,TSH:25.6( previously had thyroidectomy and was euthyroid preop),Giving tefor from N/G satrting 2 days ago.
Total protein 4.5 Alb:2.6 : 200 cc 20 % alb everyday+ plasma.
Prassana,claudia,michael and others, any thougt
erdinc
> Date: Thu, 10 Jan 2008 15:47:31 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at hsforum.com; ccm-l at ccm-l.org> CC: > Subject: [HSF] Image of the week> > 25 year old male with infundibular pulmonary stenosis (PS) and a> ventricular septal defect(VSD). Both the VSD and the PS are seen> particularly well in this case. Note the endocardial fibrosis around the> infundibular os and the ease at which it could have been mistaken for a VSD.> The last frame shows the VSD patch and after infundibular resection with> excision of a hypertrophied septal band.The RVOT gradient dropped to 9 mm Hg> on echo with laminar flow and the peak RV pressure was 32 mm Hg after> resection on direct recording versus a systemic of 102 mm Hg. It is not> often that we can get a photographable intracardiac anatomy in this subset> !!> > -- > Prasanna Simha M