Week with RT

Question 1

LG

Answer 1

Bed 1 Lynda Gnibekan

Question 2

LG issues

Answer 2

Cardiogenic shock

Bed 1 Lynda Gnibekan

bioprotehtetic MVR for severe MS

V-A ECMO retrival from Noumea with right heart failure secondary to failing tissueMVR
Also severe pulmonary htn and RV hypertrophy impairment

#MVR
-previous due to rheumatic mitral valve disease in2017 or 18 by bannon, complicated by GN endocarditis, mediastinis and osteomyelitis
#PHTN
-on iloprost and macitentan
#VV-A ECMO
#GNR
-meroepenm for klebsiella and morganella blood cultures
#Anuric renal failure
#bilirubineaia
#Headlice

BG also has ppm

Question 3

TO

Answer 3

bed 3 Timothy O’Connor 67M

Question 4

TO full issues

Answer 4

bed 3 Timothy O’Connor 67M

redo sternotomy and bioprosthetic AVR

sig lvh
normal LV function

Question 5

FF

Answer 5

Bed 5 Francesco Finucci

Question 6

FF full

Answer 6

Bed 5 Francesco Finucci

AVR and cabg x1, LIMA to LAD

LV normal

Question 7

AS

Answer 7

Bed 6 Andrew Stevenson

Question 8

AS full

Answer 8

Bed 6 Andrew Stevenson

septal myectomy

lv 65%

Question 9

SW

Answer 9

Bed 7 Si Wang

Question 10

SW full

Answer 10

Bed 7 Si Wang

redo sternotomy and mechanical MVR

10/8 presented to crhg with osb, found to have deterioation of prosthetic mitral valve
toe left atrial thrombus
iv heparin
tf to rpa on 28/8

lv nad
rv mod-severe impairment

Question 11

SQ

Answer 11

bed 8 Scott Quested

Question 12

SQ full

Answer 12

Streptococcus parasanguinis native MV IE with severe MR

bed 8 Scott Quested

bioprosthetic MVR on 29/8
converted to VAV ecmo intra-op
toe post op rv decompressed, lv 10% no thrombus
bleeding post op requiring chest re-opening in icu day 1

#anuric renal failure
#ischemic hepaitis
#heparmooragic knee effusion
#coffee ground apisrate

on benpen

Question 13

LL

Answer 13

Bed 9 Lesley Lake

Question 14

LL full

Answer 14

Bed 9 Lesley Lake

tMVR and tAVR

-#infective endocarditis
-for step mutans on tissue culture
-cef and vanc
#multifacotiral hap copd and apo
-re-intubated day one post op and extubated 29/8
#diarrhea-resolved
#new af with RVR requiring DCCV–successfully reverted
-on amiodarone
#AKI likely sepsis and drug-related

pre-op toe: reasonable global systolic function, dilated lv

Question 15

TE

Answer 15

Bed 10 Tony Elbatti

Question 16

TE issues

Answer 16

Bed 10 Tony Elbatti

mechanical bentalls + total arch replacement and frozen elephant trunk for TAAD

-takeback day zero for bleeding
#partial open chest

peri toe
good lv, mod ldv, mod dil

Question 17

JS

Answer 17

Bed 11 Justin Simpson

Question 18

JS ful

Answer 18

vasoplegia post op resolving

Bed 11 Justin Simpson

redo tMVR4-pre-existing mvr 15 years ago, developed IE requiring replacement

#heartblock
-pacing dependent post-op

post-op Toe
-mild lv impairment
moderate rv impairment
valve funtioning well

Question 19

RD

Answer 19

Bed 12 Robert Davis

Question 20

RD full

Answer 20

Bed 12 Robert Davis

tissue bentalls + total arch replacement + froazen elephant trunk and extra anatomical bypass of let subclaivan artery

issues
#post TAAD
#child pugh b cirrhosis
#AF on amiodarone
#sepsis
- biliary improving following perc chole
#encephalopathy
-non lateralizing
#IJ thrombus on heparin as well for AF
#AKI on CRRT - bilateral renal cortical infarction, will likely need life long dialysis

known background
alcohol missue
alcoholic cirrhosis
oesopgeal varicies
ex ivdu

Question 21

CTS History

Answer 21

pre-op
-indication
-echo
-angiogram

ot
-grade airway
-products and bleeding
-toe
-cbt

icu
-drain outputs
-cardiac indexes
-can we extubate
-paced