February 16, 2017

Question

80 year old female with arteries clogged did not want open heart surgery and opted to have less invasive procedure with stints put in via way of the vein. Procedure went extremely well, female was up walking and eating and scheduled to be discharged at 11 a.m. the next morning. After dinner, Nurse came to gave patient two pills which she explained was to prevent patient from having a stroke. Approximately two hours later patient felt tired, laid on bed, started wheezing and daughter ran to nurses to advise that something was wrong. Medical personnel took patient out of room and did not appear again until approximately four hours later to inform family that they were doing a MRI. Medical staff did not circle back with an update until another fours hours later at which time the surgeons came to inform family that patient had three strokes. Family feels strongly about the two pills that were administered. One of the surgeons who performed the procedure was seasoned and the other one looked like a resident. Please advise.

Answer

I'm going to speculate that the procedure you described is a 'TAVR' - transcatheter aortic valve replacement, for which stroke is a known risk - but to prepare for the operation, a patient needs to be weaned off any blood thinners they may already be taking, and this can expose them to the risk of stroke. It's a trade-off, since TAVR is done when a patient would usually (due to age or comorbidities) not survive open heart surgery. The pills given afterwards were probably blood thinners that were safe to dispense after the surgery. Unfortunately, no procedure is risk-free, and I assume a consent was signed (which typically lists stroke as a known risk). The patient has a right to a copy of her chart, so if you have further questions, your first step would be to get a copy of the chart and have it reviewed.


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