The Hearts “little brain”​-Clinical case

 Lela Dzneladze MD​

        Cardiologist, Hospitalist​

                                             Council member of association of “Panvascular Medicine”​

“Aversi Clinic”​

26.05.24​

​

​

The relationship between the patient

And doctor is based on trust,

Knowledge, attention and empathy

​

HEART AND ART

A Clinical Case�

• Male, 78 years-old
• Severe pain in the back and abdomen
• Diagnoses: CAD, previous infarction, angioplasty (2016), atrial fibrillation, heart failure HFrEF-18%, Diabetes

​

Echocardiography: Dilation of the left chambers of the heart, severe hypertrophy, abnormal regional contractility.

Total body CT angiography�

•   Abdominal aortic aneurysm-the diameter of the abdominal aorta-10,6 sm. Aneurysm tightly adheres duodenum, inferior vena cava, anterior abdominal wall, peri-vertebral space  causing compression, deformation and  deviation of this organs.

�

The surgical treatment�

• Cardio-vascular complication >15%
• Risk of rupture of the aorta –very high >50%
• Expected complications: myocardial infarction, stroke, renal failure, bleeding, Thromboses, death
• Before operation coronarography

The team work �

• Surgeon with his assistants
• Anesthesiology team
• ICU team
• Cardiology team
• Laboratory and imagine modalities
• Insurance network communication department

Work done from the heart�

• The operation: 3hr and 35 min
• ICU-3b/d
• Word 3 b/d
• The Discharge status-Active, physical activity without pain,  arterial pressure and saturation-N, temperature-N, no symptoms of angina OR heart failure.

�

�

BEFORE

AFTER

�

Take-home message�

• The only way to do great work is to love what you do.

​

​

Steve Jobs

​

Question and Answer...

Thank You