Deirdre Murphy presents everything that can go wrong in cardiac surgery. Deirdre will impress on you that cardiac surgery is by no means a safe procedure! Murphy’s Law stipulates everything that can go wrong, will go wrong. Subsequently, Finagle’s corollary will tell us, it will be at the worst possible moment. In this talk Deirdre attempts to prove these theories in the world of cardiac surgery. Cardiac surgery can vary from being routine elective surgery to time-critical emergency surgery. The term encompasses a broad range of procedures carried out on patients from neonates to nonagenarians. In the 63 years since the first open heart surgery was performed using cardiopulmonary bypass enormous advances have been made in the field such that an average person presenting for coronary bypass grafting in 2016 can expect a very low chance of peri-operative morbidity or mortality. When things go wrong however, they can go badly wrong and at the worst possible moment. The list of problems that occur is extensive. Deidre steps through some of the more common issues that arise post cardiac surgery. She describes pneumonia, mediastinitis, haemorrhage, ischaemia, and neurological issues, amongst others. Along the way she provides clinical pearls as to what to look for, what not to miss and what to do about it. Through her extensive experience, Deidre has seen more than her fair share of post-cardiac surgery complications. She provides a number of clinical scenarios she has encountered, and in doing so gives useful insights to be aware of. Her top tips are to prevent complications if possible. If not possible, recognise the complications early and finally train for ‘avalanches’ – those critical and scary situations that will put your patients at immediate risk of demise.
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