CC: 81 y.o. white male coming to ED after found in the bathroom.  + LOC, no amnesia.  Responsive on arrival.
C/o stroke like symptoms:headache,confusion,left sided weakness,unable to turn the head to the left side

PMHx:
HTN well controlled on Lisinopril and HCTZ
Type 2 DM well controlled by diet/exercise
Prostate cancer (on Megestrol)
Occasional CP (no AMI in the past)
COPD
PVD

PSHx:
Inguinal hernia repair
Umbilical hernia repair

Past Anesthesia Hx:
No complications with GA

Laboratory and studies report:
ECG: NSR~100 BPM, nonspecific S-T changes, no signs of acute ischaemia
ECHO: 19 July 2002: EF 74%, no ischaemic changes
Adenosine myocardial perfusion test: 19 July 2002: NSR, left axis anterior hemiblock, mild S-T changes. No evidence of ischaemia.  Normal test.

Intraoperative events:
Proximal aortic graft required resuturing
Episode of hypotension/clotted pump filter
Marked reduction in systolic function after weaning from bypass
Unresponsive to iv epi/norepinephrine, but responsive to intracardiac Epinephrine 1 mg
Blood gas revealed PaO2=45 mmHg
Delayed reinstitution of CPB/clotted oxygenator
Persistent lactic acidosis on bypass
Low urine output
Weaned from bypass, with persistent hypoxemia and lactic acidosis, and hematuria
Return to bypass for the 3rd time
Weaned from the bypass after 1 hour and 25 minutes
Blood clot removed from right atrium

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