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Replies to Msg. #1114776
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 Msg. #  Subject Posted by    Board    Date   
50533 Re: My surgery notes...
   sounds scary to me.... You been through a lot de! wowser!... 		micro   POPE 5   02 Feb 2020
 12:06 AM
50530 Re: My surgery notes...
   ...reads like a capn nemo subaru engine repair. [b]Incision in the... 		ribit   POPE 5   01 Feb 2020
 11:30 PM

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My surgery notes...

By: Decomposed in POPE 5
Sat, 01 Feb 20 11:23 PM
Msg. 50529 of 62138
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Just found surgery notes in my on-line medical records. They're kind of interesting, but it seems like a lot of fuss to replace a valve that probably just needed a little roto-rootering...

Procedure Description:

TECHNIQUE: The patient was brought to the Operating Room and placed on the
Operating Room table in supine position. Following the induction of general
anesthetic by endotracheal technique and the placement of appropriate
monitoring lines, he was prepped and draped using sterile prep. Incision in
the mid sternal region was carried down through the sternum fascia lata with a
saw. A mediastinal retractor was positioned. The pericardium was opened. He
was heparinized and cannulated for bypass. He was brought on bypass. The
aorta was cross clamped. The heart was arrested with cold hyperkalemic blood
cardioplegia. Additional doses of the cardioplegia were given throughout the
cross-clamp intervals indicated by any significant rise in myocardial
temperature or the return of any cardiac electrical activity. The aortic root
was opened 1.5 cm cephalad to the right coronary artery orifice. The above
findings were noted. The valve leaflets were sharply excised. The annulus
was debrided of excess calcium using pituitary rongeurs. The left ventricular
cavity was irrigated with a copious amount of saline to remove all residual
calcific debris. The annulus was then rimmed with polyester-backed horizontal
mattress sutures. The annulus was appropriately sized for a 23-mm prosthesis
which was selected, secured with annuloplasty sutures and tied in. The aortic
root was closed using 2 running 4-0 prolene sutures which were tied upon
themselves. The patient was placed in the head-down position with the aortic
root then placed on high suction. Blood was transfused to the patient with
the heart massaged to remove residual air. The cross clamp was then removed.
He was electrically defibrillated, fully rewarmed on bypass. While being
rewarmed several maneuvers were executed to remove all residual air from the
left ventricular cavity as was confirmed by intraoperative echo. Once fully
rewarmed on bypass, he was separated from bypass without difficulty. The
above echo findings were noted. Protamine sulfate was administered. He was
decannulated. Hemostasis was secured. Mediastinal drains were placed. The
sternum was reapproximated with surgical wire. Soft tissues anterior to the
sternum were reapproximated using layered suture closure. Sterile dressings
were applied and he was taken to the Cardiothoracic Intensive Care Unit in
hemodynamically stable condition.


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