Description of Event or Problem · 0
THE PATIENT UNDERWENT AORTIC VALVE REPLACEMENT AND CORONARY ARTERY BYPASS GRAFTING X 3 ON (B)(6) 2024. THE PATIENT WAS TAKEN OFF CARDIOPULMONARY BYPASS DURING SURGERY. DECREASED VENTRICULAR FUNCTION WAS NOTED. SHE WAS PLACED BACK ON CARDIOPULMONARY BYPASS. THE DECISION WAS MADE TO PLACE AN INTRA-AORTIC BALLOON PUMP. THE SURGEON ATTEMPTED TO PLACE THE BALLOON BY THE TRANSFEMORAL ROUTE ON THE LEFT SIDE BUT WAS UNABLE TO THREAD THE WIRE UP TO THE THORACIC AORTA. THE INTRA-AORTIC BALLOON PUMP WAS THEN PLACED VIA THE TRANSAORTIC ROUTE. VENTRICULAR PERFORMANCE IMPROVED. THE DECISION WAS MADE TO CONVERT TO ECMO SUPPORT. THE PATIENT WAS HEMODYNAMICALLY STABLE AT THE END OF SURGERY. IN THE AFTERNOON, BLOOD WAS NOTED IN THE HELIUM LINE, AND THE PATIENT'S HEMOGLOBIN WAS DECREASING. THE PATIENT WAS TAKEN EMERGENTLY BACK TO THE OR FOR MEDIASTINAL EXPLORATION AND CONTROL OF BLEEDING. THE BLEEDING WAS NOTED OVER THE AORTA. THE MAJOR BLEED WAS FOUND TO BE AROUND THE INSERTION SITE OF THE INTRA-AORTIC BALLOON PUMP. SUTURES WERE PLACED AROUND THE INSERTION SITE. BLEEDING WAS CONTROLLED. PRIOR TO TRANSFER, THE BALLOON WAS NOTED TO BE RUPTURED. THE DEVICE WAS CLAMPED AND UNHOOKED FROM THE PATIENT. SHE WAS TRANSFERRED TO (B)(6) HOSPITAL FOR FURTHER TREATMENT. THE PATIENT RECEIVED A TOTAL OF 87 UNITS OF BLOOD PRODUCTS. PLATELETS 55 X 10'3- (B)(6) 2024 THE PATIENT REQUIRED THE FOLLOWING BLOOD PRODUCTS: 17 UNITS RBC AS-3 LR, 5 UNITS RBC AS-1 LR/IR, 19 UNITS RBC AS-1 LR, 5 UNITS PLATELET PHER B, 3 UNITS PLATELETS PHER C, 22 UNITS THAWED CRYO, 5 UNITS PLATELET PHER, 11 UNITS THAWED FP 24 CPD. TOTAL UNITS- 87.