There are three surgeries at 3rd operating room. The second was special .The patient was eighty-eight years-old, male, has been diagnosed with Bile duct placeholder. He has a history of coronary heart disease (CHD) and chronic obstructive pulmonary disease(COPD) and high blood pressure for about 10 years, and also cerebral arteriosclerosis history for 10 years, and prostate cancer history for two years.Blood routine test, coagulation function, renal function were normal. But Liver function was severely abnormal. In the Arterial blood gas analysis (ABG), the oxygen partial pressure was 74mmHg.In the pulmonary function test, FEV1 was 78%, MVV was 52%.The ECG shows complete right bundle branch block(CRBBB). Heart Doppler ultrasound show that left heart atrium was 40mm, the thickness of interventricular septum was 13mm, ejection fraction was 56%, left ventricular diastolic function decreased, mitral valve calcified. The patient was evaluated for ASA Ⅲ level , Mallampati Ⅲ level and cardiac function Ⅱlevel.
Good morning, everyone. One internal fixation surgery of intertrochanteric fractures was arranged in the operating room 7. The patient ,84-years-old,female, , had suffered AD for several years after the right ankle fracture. Physical examination and laboratory tests appear normal. No X-ray chest , lung functional examination and ABG were found. ECG showed ST -T shape changed. Echocardiography showed normal ejection fraction , decreased diastolic function, aortic valve calcification and mild valvular regurgitation. The patient was evaluated for ASA Ⅱlevel , Mallampati Ⅱlevel and cardiac function Ⅱ level. Due to poor coordination ,the patient will accept the general anesthesia.
Which denied hypertension, coronary heart disease, diabetes mellitus[,da??'bi?ti?z]
Good morning, everyone. The first surgery in the operating room 4 was special. The patient, 84-years-old, female, has been diagnosed with kidney stones , who had suffered hypertension, coronary heart disease and diabetes mellitus for about 10 years. She also suffered myocardial infarction 7 years ago and cerebral infarction 2 years ago.
Physical examination found that muscle tension on the left side was zero level.
The ECG shows complete right bundle branch block(RBBB) and ST -T changed. X-ray chest shows a small amount of pleural effusion on the left side and arterial stiffness . Lung functional examination, ABGA and echocardiography were not carried out.
The patient was evaluated for ASA Ⅲlevel , Mallampati Ⅱlevel and cardiac function Ⅲlevel. the patient will accept epidural anesthesia.
Good morning, everyone. Doctor Liu and I will take charge of one Aortic Valve Replacement surgery in the operating room 12. The patient, 78-years-old, female, has been diagnosed with aortic stenosis., who had suffered coronary heart disease for about 30 years. Diabetes mellitus, hypertension, and other lung disease were denied. Laboratory tests appear normal. ABG was normal. Lung Computer Tomography showed ??. Lung functional examination showed FEV1 was 78%, and MVV test was not performed. Echocardiography showed EF was 60%,ventricular septal hypertrophy,Aortic valve moderately to severe ly
calcification and narrow,mitral valve and tricuspid valve mild regurgitation, left ventricular diastolic dysfunction.Coronary angiography showed no obvious narrow ,but right coronary artery was absent. The patient was evaluated for ASA Ⅲlevel , Mallampati Ⅱlevel and cardiac function Ⅲlevel. The patient will accept the general anesthesia and cardiopulmonary bypass.
2014-05-19
Good morning, everyone. Two Off Pump Coronary Artery Bypass Grafting(OP-CABG) surgerys will be performed today. The first patient,60-year-old,male, suffered acute myocardial infarction(AMI) 2 weeks ago and Old Myocardial Infarction ( OMI ) ten years ago,(unstable angina[?n'd?a?n?] pectoris ['pekt?r?s] (UA),. [t?'m?ɡr?f?] He also had Diabetes Mellitus for about ten years.
Arterial blood gas analysis showed oxygen partial pressure value 60 mmHg
The Troponin I value was 1.9 and BNP value was 653 pg/ml.
The ECG showed that pathological[p?θ?'l?d??k(?)l] Q wave appeared in V1,V2,V3 lead and inverted T wave appeared in V4,V5,V6,Ⅱ,Ⅲand AVF.
Echocardiography showed EF was 40%,l eft heart insufficiency, segmental wall motion abnormality.
Coronary angiography revealed total occlusion of left anterior descending(LAD), 70%-80% stenosis in the left circumflex coronary artery(LCX) and the right coronary artery(RCA).
The patient was evaluated for ASA Ⅲlevel , Mallampati Ⅱlevel and cardiac function Ⅲlevel.
That is all. Thank you .
2014-05-27
Good morning, everyone. One mitral valve replacement surgery will be performed today in operating room12. The patient,59-year-old,male, 47kg,has been diagnosed with congenital heart disease.
The patient was given anticoagulation,and INR value was 1.17.
Arterial blood gas analysis showed oxygen partial pressure value 79 mmHg
Lung Computer Tomography showed pulmonary congestion.
The ECG showed atrial fibrillation, complete right bundle branch block(RBBB) and ST -T changed.
Coronary angiography was generally normal.
Echocardiography showed EF was 65%,atrial septal defect,pulmonary arterial hypertension,hydropericardium.
The patient was evaluated for ASA Ⅳlevel , Mallampati Ⅱlevel and cardiac function Ⅲlevel.
The patient will accept mitral valve replacement,r epair of auricular septal defect ,and tricuspid valve plasty with general anesthesia and cardiopulmonary bypass.