Description of Event or Problem · 1
ON (B)(6) 2009, TRANSFERRED HERE FROM THE FIELD BY HELICOPTER FOR STEMI. FILMS REVEAL 99% MID RCA LESION AT THE LEVEL OF ACUTE MARGINAL, FELT TO BE THE CULPRIT VESSEL. TWO 3.0X28 MULTI-LINK VISION STENTS DEPLOYED. DISCHARGED ON ASA AND PLAVIX. ON (B)(6) 2010 AGAIN TRANSFERRED FROM THE FIELD BY HELICOPTER FOR STEMI. PT REPORTS RECENTLY COMING OFF PLAVIX ALTHOUGH CANNOT GIVE EXACT DATE. EMERGENTLY TO CCL, FILMS REVEAL 100% OCCLUSION WITH THROMBUS OF PREVIOUSLY PLACED STENTS. PLAN IS FOR ATTEMPTED PCI. A 2.5X20 APEX TO DILATE. SOME REPERFUSION WITH INFLATIONS, BUT HEART RATE DECREASED TO 40'S, AND ARTERIAL PRESSURE TO 30'S, NON-INVASIVE BP 60-70'S. DOPAMINE, TEMPORARY PACER, AND MORE INFLATIONS PERFORMED. HYPERTENSION CONTINUES. IABP INSERTED AND THEN FURTHER FILES TAKEN THAT REVEAL RESTENOSIS. WITH CARDIOGENIC SHOCK AND KNOWN DISEASE IN LAD AND CIRC, EMERGENT CAB FELT TO BE BEST CHANGE AT COMPLETE REVASCULARIZATION. CAB PERFORMED (B)(6) 2010, DISCHARGED TO EXTENDED HEALTHCARE FACILITY (B)(6) 2010.