Wednesday, September 7, 2011

Final Surgery Update

First and most important, the surgery is done and they are working on closing him up. Dr. J. said that the surgery was challenging, but obviously successful. They did not go through the sternum like last time, they did something called a "subcostal" incision, which means they went in under the ribs. There was a fair amount of scar tissue already built up in the ribcage, so they had to put the pump in at an angle and the first time they did it they broke an o-ring on the pump. That is why he had to go back on bypass - so they could fix it. They found a large clot around the cuff that attaches to the heart. They suspect pieces of it were breaking off and getting into the pump, causing the problems he's had for the last few days. They can't see inside the pump right now, but they suspect the company will find a piece of the clot inside it and stuck. During the surgery he started producing urine and it was clearing up. That's not to say that his kidneys are completely ok at this point, but it's encouraging. He may still need dialysis, but they won't know for sure until things have settled down more from the surgery. Dr J. said he was confident that whatever his kidneys might need right now is only temporary. This whole thing could happen again, although it's not common for this model of pump. Dr J. felt that the clot started to form when they had to back down his anti-coagulation meds to account for the GI bleed he had a month or so ago. This time around they will be more aggressive with the anti-coagulates and not as sensitive to the GI bleed. "It's all a balancing act" was the quote. He's on a vent until probably tomorrow. They'll also hopefully get a mental evaluation tomorrow, or whenever they get him off the vent. Dr J. did tell us to expect him to act like he did the first time, if not a little worse. Apparently the affected parts of the brain from a stroke hold onto the anesthesia longer than the rest of the brain. It should clear up in a few days though. Recovery in the hospital will likely be longer than last time, but it's way too early to know for sure. Dad got back to his room about midnight and looked pretty good all things considered.

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