Cardiac Transplant Evaluation (Case 53)

Chapter 72 Cardiac Transplant Evaluation (Case 53)



Case: A 55-year-old man with severe coronary artery disease and hx of heavy smoking presented with an acute myocardial infarction not amenable to percutaneous revascularization. After being taken to the operating room for surgical revascularization, he developed profound cardiogenic shock unresponsive to medical therapy. A ventricular assist device (VAD) was placed. He remained in the ICU, awaiting heart transplantation.





PATIENT CARE






Tests for Consideration































































 
• Blood type, antibody screen, CBC, CMP Panel-reactive antibody HLA typing and crossmatch (completed when donor identified). $240

 
• CBC to look for anemia, thrombocytopenia $21
• Comprehensive metabolic panel $30
• CXR and pulmonary function tests $190
• EKG to look for cardiac disease; echocardiography, right and left heart catheterization, coronary angiography $2,500
• B-natriuretic peptide (BNP) $50
• U/A and creatinine clearance $85

 
• Anergy panel, PPD, HIV test $115
• Culture urine/sputum/blood to r/o infection $45
• Hepatitis panel (hepatitis B/C) $65
• HBsAg, HBsAb, HBcAb; hepatitis C antibody; and RNA assay by PCR $65
• Cytomegalovirus (IgG, IgM titer) $45

 
• Prostate-specific antigen (men > 50 years) to r/o prostate cancer $65
• PAP smear/mammography (women > 40 years) to r/o malignancy $125
• Colonoscopy (men/women > 50 years) $625


Mar 20, 2017 | Posted by in GENERAL SURGERY | Comments Off on Cardiac Transplant Evaluation (Case 53)
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