[HSF] Pericardial effusion post-AVR

[Tea Acuff]

Back to you. 
Even the concept of informed consent (see the rest of your discussion) is a misnomer. Maybe it would be better stated in the negative: nothing to hide.

Keep thinking it brings a smile...

tea



----- Original Message ----
From: Ani Anyanwu <anianyanwu at hotmail.com>
To: openheart-l at lists.hsforum.com
Sent: Monday, March 24, 2008 4:19:41 PM
Subject: RE: [HSF] Pericardial effusion post-AVR

Interesting - just last week we were hearing how a pacing wire that perforated an RV in a patient with prior sternotomy could not cause tamponade and now we start hearing that tamponade is indeed possible distantly after prior sternotomy. 

Reinforces why I am often very skeptical of things I read or hear - rarely do they represent the whole truth - the task is to find the (hopefully little) falsehood in every truth. Even michael's story seems to lack the whole truth - puzzles me why (if this has really been building up over a year) the fluid would not drain through a catheter. 

I also found it interesting that 54 year old patients (or their surgeons) still chose mechanical valves and leads me to wonder how informed such decisions truly are... that of course is another topic.

Ani




> Date: Sun, 23 Mar 2008 09:44:12 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Pericardial effusion post-AVR> CC: > > Happens rarely especially if anticoagulated (as in this case) and> there was possible persistent fluid that prevented adhesions from> forming.> Prasanna> > On Sun, Mar 23, 2008 at 2:40 AM, Michael Firstenberg <msfirst at gmail.com> wrote:> > 55 year/old s/p mechanical AVR 1 year/ago (yes 1- year) presented> > with worsening SOB. Echo showed large percardial effusion with RV> > compression (which I saw and agree with). Attempted perc tap in cath> > lab unsuccessful (with INR=3), repeat under ultrasound guidance also> > unsuccessful (INR=1.8). I was called - just got a CT scan which> > confirms the effusion and a moderal pleural effusion (also now with> > slight drop in HCT).> >> > Granted probably now needs to be cleaned out (probably left VATs) -> > but more to the point/question - anyone see
 tamponade 1 year out?> >> > something sounds very odd....> >> > -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> > -----------------------------------------> >> > > > -- > Prasanna Simha M> _______________________________________________> 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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