Medical Text: Admission Date:  [**2138-6-9**]     Discharge Date:  [**2138-6-12**]

Date of Birth:   [**2111-2-28**]     Sex:  M

Service:  Cardiothoracic Surgery

PREOPERATIVE DIAGNOSIS:
1.  Bicuspid aortic valve.
2.  Dilated aorta.
3.  Aortic insufficiency.

HISTORY OF PRESENT ILLNESS:  The patient has had a heart
murmur since childhood and found to have a bicuspid aortic
valve on echocardiogram, and recently had an increase in the
size of the ascending aorta.  Otherwise, the patient denies
any other medical problems.  [**Name (NI) **] did have surgery in [**2124**] for
an undescended testicle.

SOCIAL HISTORY:  Denies a smoking history.  Occasional
alcohol, maybe once per week.

FAMILY HISTORY:  Noncontributory.

MEDICATIONS ON ADMISSION:  Prophylactic antibiotics.

ALLERGIES:  No known drug allergies.

LABORATORY ON ADMISSION:  Preoperative vital signs were a
heart rate of 78, blood pressure 102/68, respiratory rate
of 18.  He was a healthy, 27-year-old male.  Lungs were
clear.  Heart had a 3/6 systolic ejection murmur.  Otherwise,
the examination was within normal limits.

HOSPITAL COURSE:  So, on [**2138-6-9**], the patient
underwent homograft aortic root replacement, resection, and
grafting proximal aortic arch.  He underwent general
anesthesia.  There were no intraoperative complications.
Postoperatively, the patient was transferred to the recovery
room on a nitroglycerin drip in normal sinus rhythm.  He was
transferred from the recovery room to the Intensive Care
Unit, and on postoperative day one was transferred to the
floor, where he continued with an uncomplicated postoperative
course.

The patient did experience some tachycardia with a heart rate
of around 117.  For this tachycardia the patient's beta
blockers were increased, and he did respond.  His beta
blockers were increased to 75 mg p.o. b.i.d.   Potassium was
repleted.  The patient was diuresing about 4 liters per day.

The patient had very good pain control.  He was ambulating
around the halls without difficulty on his own.

CONDITION AT DISCHARGE:  Stable.

DISCHARGE STATUS: Discharged to home with prescription.  No
services needed.

MEDICATIONS ON DISCHARGE:
1.  Lopressor 75 mg p.o. b.i.d.
2.  [**First Name5 (NamePattern1) 233**] [**Last Name (NamePattern1) 1002**] 40 mEq p.o. q.d. times five days.
3.  Iron sulfate 325 mg p.o. t.i.d.
4.  Percocet 5 one to two tablets p.o. q.6h. p.r.n.
5.  Aspirin 81 mg p.o. q.d.




                          [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D.  [**MD Number(1) 414**]

Dictated By:[**Last Name (NamePattern1) 8344**]

MEDQUIST36

D:  [**2138-6-12**]  23:01
T:  [**2138-6-13**]  18:17
JOB#:  [**Job Number 13750**]

ICD9 Codes: 4241