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Mon Jan 9 23:20:02 GMT 2006

In a message dated 09-Jan-06 16:25:15 Central Standard Time,  KMATTOX at aol.com 
writes:

Now I  need for everyone who has made comment in the past to give me their   
reflections and any new person can comment if they wish.     We really 
thought 
we would turn him around on the third day, but we  did  not.      I would 
also 
be happy to know what  anyone  might think that we would find different, if 
anything on  the  autopsy.    

Despite the coagulopathy, I'm still betting that there are  going to be some 
interesting blood clots in major vessels...sounds like he might  have both 
arterial as well as venous clots. I've been burnt by unsuspected large  clots in 
the pelvic veins before...ones that don't show up on standard  scanning or 
even much else than direct palpation in the OR or Necropsy Lab...and  it will be 
interesting to see if there are any mural thrombi inside the heart as  well. 
The description of the 'dilated ventricles and atria' when the first  attempt 
was made to close the chest strikes me as something that's almost as  much of a 
set up for thrombi as Afib...

Another thought, esp in the presence of the  Acinetobacter...what if he had 
an unsuspected sub acute bacterial endocarditis  with major vegetations on his 
mitral valve? His history of IV Drug abuse makes  him at higher risk for such 
a problem.

ck

Charles S. Krin, DO  FAAFP

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