PP-270 AN INTERVENTRICULAR SEPTUM RUPTURE PRESENTING WITH CARDIAC TAMPONADE: DIAGNOSIS AND TREATMENT

gavenoinformationaboutanyliverproblemandnoscreeningforhepaticfunctionwasperformedbythistime.Therewasnosymtomorsignofcongestiveheartfailureinthepreoperativeperiod.Results: The patient underwent coronary artery bypass graftingprocedure. Laboatory findings on postoperative 1st day and 2nddayrevealedelevatedliverfunctiontests(AST1430,ALT880,LDH3360andAST6680,ALT2600,LDH9150,respectively).Thepatientdiedonthe2ndpostoperativedayduetofulminanthepaticfailureand metabolic encephalopathy. Postoperative period was highlyprogressivewithaggressiveworseningofhepaticfunctionswhichcausedmultiorganfailureandeventuallydeath.Conclusions: Fulminanthepaticfailureisarareconditionseenafteropenheartsurgeryisconstantlyprogressiveandfatal.PreoperativeHbsAgpositivityshouldbetakenunderconsiderationasastrictriskfactor. Careful preoperative evaluation should be performed andHbsAgpositivityshouldforcethedoctorstoeveluateliverfunctionin detail. To minimize fulminant hepatic failure, further effortsshould focus on off-pump surgery, shorter X-clamp time, shortercardiopulmonary bypass time, avoidance of potential hepatotoxicmedication.PP-266SURGICAL MANAGEMENT OF INFECTED RIGHT ATRIALTHROMBUS RELATED TO TEMPORARY UNTUNNELLEDHEMODIALYSIS CATHETER IN END-STAGE RENAL DISEASEA.I.Rezk.