Published
Last year, we had a redo and it was a CABG x8 - probably the worst case of my CVOR FA career. Had to do open harvesting of both arms, both breasts and both legs. We had 9 people scrubbed because the number of grafts we needed. Getting into his chest was an absolute nightmare b/c of previous adhesions - required both sternal oscillating saw and gigli to get through all of that scar tissue. Heart was very grey and flabby. We ended up trying to dissect his heart out of all of the adhesions which took FOREVER. We were trying to stay inside the pericardium without stripping layers off the heart. We go into the RA multiple times and it was damn near impossible. We never even made it all the way around the left side of the heart for fear we would damage his previous vein grafts and LIMA that remained patent from the previous operation. We got the graft sewn on but the bleeding was absolutely horrendous. We gave every blood product under the sun in addition to K-centra and Factor 7. We never got control of it and we lost the guy on the table. It was a 15+ hour case with a terribly disappointing ending but there was truly nothing more we could do. We had done his second sternotomy case too and the operative notes outlined how AWFUL his adhesions were. He wanted the surgery though and insisted on undergoing the operation with full knowledge of the risks. It was a sad case but we tried absolutely everything and nothing worked.
TigerGalLE, BSN, RN
713 Posts
Hey guys. My friend's dad had a CABG Thursday morning after having some chest pain and a cardiac cath. He had to have 8 grafts and the doctor said it was the worst case he has ever done. He is still in ICU on the ventilator and sedated. This guy is in his 50s and a small, active guy. Just wondering if anyone has ever heard of someone having this many grafts? The most I've heard of is 4, but I'm no heart nurse!!
Keep him in your prayers please.
Tiger