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[20171103]_chorus_seoul_2017_live_case_slide_04.pptx
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LIVE Case #4

Brief Case Summary
Age / Sex: 81/M
C/C : Dyspnea (NYHA FC III), Pitting edema  (onset : 2MA)  
Past medical history

• 1996’ DM, HTN medication start
  
• 2002’  Admitted d/t Syncope  

# Dx. : Vertebro-basilar insufficiency d/t PSVT 
# EKG : r/o WPW syndrome, Echo : Moderate AS
# Tx. : Ablation and medication (anti-arrhythmics)

• Operation - 2005
  

​Due to AS progression & 2VD on CAG
Operation
- AVR with C-E Perimount 25mm
- CABG (LITA to LAD, RITA (Y-graft from LITA) to PDA) done
POD #1  Postop bleeding →  Bleeding control Op.
POD #15  Wound dehiscence → Wound debridement and repair
POD #30  Discharged

Hospital Course:

• 2014’   Palpitation (Sustained VT) → ICD insertion
• Till 2016: Four times of Hospitalization (d/t NSVT & ICMP) 
• 2017.02  Admission d/t dyspnea, pitting edema

  HD #2  GW transferred, Work-up (TTE, Rt. heart cath)
  HD #5  Sustained VT (3 min, Self-terminated)
  Multidisciplinary HF team discussion for LVAD
  Familial Conference → Decided to insert HVAD
  HD #7  (One day before elective op. date)
  In-hospital cardiac arrest d/t Sustained VT
  (CPR duration : 3min, no intubation, alert mentality)

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Preop. TTE

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Surgical Operation