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- Aug 19, 2006
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Young girl in late teens w h/o Loeys-Dietz syndrome for R vertebral-carotid reinsertion d/t many aneursyms. aside from the syndrome and its associated problems she is otherwise heathly, mild asthma.
as is c/w loeys-dietz she is full up of aneursyms including h/o thoracic ascending
aortic aneursym w aortic root dilitation s/p repair and AVR a few years ago and the above procedure on the L side that ended up getting into the subclavian as well.
pt reports poor functional class -- states she would be a little winded after climbing a flight of stairs. normal BMI.
the ;ast surgery came with several complications:
1. compartment syndrome of R forearm d/t combination of IV infiltrating + brachial arterial line placement w residual neuropathy and paresthesias -- R arm is mottled with muscle atropy in forearm and hand
2. severe intractable NV
3. uncontrolled pain
4. residual R LE paresthesias and pain apparently d/t femoral central line placement --
-- basic labs (cbc, cmp, coags all wnl)
anything else you care about in preop h and p, tests you wanna order?
what access you want and where?
thoughts?
as is c/w loeys-dietz she is full up of aneursyms including h/o thoracic ascending
aortic aneursym w aortic root dilitation s/p repair and AVR a few years ago and the above procedure on the L side that ended up getting into the subclavian as well.
pt reports poor functional class -- states she would be a little winded after climbing a flight of stairs. normal BMI.
the ;ast surgery came with several complications:
1. compartment syndrome of R forearm d/t combination of IV infiltrating + brachial arterial line placement w residual neuropathy and paresthesias -- R arm is mottled with muscle atropy in forearm and hand
2. severe intractable NV
3. uncontrolled pain
4. residual R LE paresthesias and pain apparently d/t femoral central line placement --
-- basic labs (cbc, cmp, coags all wnl)
anything else you care about in preop h and p, tests you wanna order?
what access you want and where?
thoughts?