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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 55481
Experience:  GP in the United States
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My daughter age 14 years recently underwent a PVR and an ASD

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My daughter age 14 years recently underwent a PVR and an ASD closure she had pulmonary valve regurgitation ( severe) and her RV was severely dilatated, Josie is a repaired Fallots patient. ( repaired in infancy Op 1 BT Shunt Op 2 Full repair age 3 months and 6 months consecutively . November 2013 she is an hour into bypass and in cooling process and there is a power outage, there was in turn a failure of some UPS to kick in, one of the failures was the heater/cooler and bubble catcher it shut off completely for around 8 minutes. Perfusionist and Surgeon decided when power came back to terminate the operation and rewarm Josie and get her off bypass. Josie was sent to ITU and kept anesthtised using Propofol , she was mechanically ventilated, sternum left open etc. the next day she is taken to theatre again still anesthetised and put back onto bypass and procedures were completed.

When she woke up in intensive care she was blurred in vision and very thirsty, this was on Tuesday night, her last drink was Sunday night, after a few hours she became hysterical, confused, violent and paranoid, she became a danger to herself and actually hurt her incision wound. When she calmed down she remained in a trance like state, eyes hazy and would smile at appropriate times but refused to talk, it was awful. Josie refused morphine and believed that the nurses were trying to harm her and put her back to sleep. .

When we left hospital Josie became pale, we took her to our local hospital she needed a transfusion, her C REACTIVE protein levels were at 97 but no infection came, her Levels the cardiac hospital were high too, and only when they dropped to 33 would they discharge her.

Josie now is suffering from short term memory loss, ( bad) Unable to retain information for long periods, so is unable to be educated, she gets words all jumbled up and they almost fall out of her mouth and she doesn't realise she is doing it. She refuses to go and see asny friends and hasn't done since coming home from operation. Do I need a Neurologist? What is wrong with her? What caused this? She had 40 plus hours of ventilation with deep sedation using propofol she was unconscious, two runs on the pump, enough ketamine to render a horse into a coma and it has obviously done something to her
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Phil, MD replied 3 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Hi. Still need help?
Customer: replied 3 years ago.

Yes please


 

Customer: replied 3 years ago.

Oh what other information do you need? I will try my best


 

Expert:  Dr. Phil, MD replied 3 years ago.
I'm very sorry about this. How long ago was surgery?
Customer: replied 3 years ago.

It was November 18th 2013, so not that long ago.. I have a feeling that it was left too late to get the repair , but why the tricuspid valve leaking now? How I wish I was a Cardiologist!

Expert:  Dr. Phil, MD replied 3 years ago.
This will get better. She has "pump head". This is the common term for the memory loss and confusion after bypass surgery. She has youth on her side and her brain will recover.

It will just take time.

As for the tricuspid valve, it might be due to increased pressure from the other valve repair. I'm sorry
Customer: replied 3 years ago.

Would the pressure been as a result of the power loss , or the fact she had two operation in 16 hours both requiring bypass? I promise this is the last question!

Expert:  Dr. Phil, MD replied 3 years ago.
I would surmise that it was due to the 2 operations but the power loss likely contributed to increased stress on the brain
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Expert:  Dr. Phil, MD replied 3 years ago.
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