need help please

heart123

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36830,93971,26 am i in the ball park,

attention was then turned to the left infraclavicular area or the connection was palpated through the skin and identified with the help with duplex ultrasound. A 5 cm longitudinal incision over the connection and graft and the stent was made and the complex was dissected circumferentially. 2 cm in diameter dilation of the graft was seen 1 cm proximal to the connection site: On puncturing the pseudoaneurysm puslike discharge is expressed-was sent for microbiology; the areas washed out and clamps were placed on the graft and a special green clamp was placed on the stent: The whole pseudoaneurysm and connection part of the hybrid graft is sectioned off and is sent for pathology.
Patient was heparinized and thrombectomy of the graft part is made with expression of a large amount of thrombus until good forward bleeding is encountered. Same thrombectomy for 40 balloon is used for the stent component with expression of a long thrombus; the stent is slightly pulled out to allow connection with a new connector: Doing so the length of the stent is shortened and the tip of the stent is not in the most distal SVC or in the right atrium, and x-ray shows the tip in the proximal aspect of the SVC. Both ends were flushed and a new connector was brought into the field and is connected to both the graft and the stent. The graft is inspected for flow with duplex ultrasound and adequate flow is seen all throughout its length. The wound was then closed in 3 layers, as usual.The patient tolerated the procedure well and was taken to PACU is stable conditions.
 
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