so I will post my case today for discussion. 60's yo M for spine surgery. Planned procedure is anterior interbody fusion L4-S1, lateral interbody fusion L1-4 and PSF L1-S1. PMH: severe dilated cardiomyopathy with EF 25%, CAD with stents in RCA, LAD, and Cx all over 5yrs old. AICD Bivent pacer placed for Vtach, recent run of VT and currently in Afib since June. CHF, Capable of <4mets. DM with HgA1c 7.2, OSA, Interstitial Lung Disease with O2 req. PHTN (PAP50mmhg) 1+pitting edema, severe confusion with last GA lasting 2days while in ICU. Anemia (hct 33), HTN, Vitals: 188/94, Sats 94% on 2lpm, paced at 80bpm, Echo: I don't recall everything but the gist is EF 25%, with moderate AI, TI. No rev ischemia, hypo kinetic everywhere. Labs: H/H -11/34 others WNL. Plan?