OmniSenseClinical
Aster Medcity · Kochi
Dr. Rajesh Menon CICU · Cardiologist · D001
RM

Your patients

11 patients · CICU + Cardiac Surgical Step-Down

Ms. Fatima Rahman, 28F · CICU 1 · Myocarditis
Mr. Sasi Pillai, 62M · CICU 12 · Post-PCI STEMI
Mrs. Latha Nair, 58F · CICU 8 · Decomp HFrEF
Mr. Hari Krishnan, 71M · CICU 3 · NSTEMI
Mr. Venu Rao, 68M · SD-4 · Pre-op CABG
Mr. K. George, 64M · CICU 5
Mr. Venu Rao Pre-op clearance CABG x3 tomorrow 07:30
68M · Cardiac Surgical Step-Down bed SD-4 · MRN AST-2026-04-0721 · Admitted Wed 09 Apr · Anaesthesia: Dr. A. Joseph
Summary
Journey
Body
📌
Pre-op risk · planned-care peer consult
EuroSCORE II 3.8 % · STS predicted mortality 2.1 % · intermediate risk. The medical questions waiting for you this morning are (a) DAPT hold timing, (b) metformin and ACE-i hold, and (c) glycaemic control plan given HbA1c 8.4 %. Anaesthesia wants a written sign-off before 09:00.
Hold-medication checklist · for OT 07:30 tomorrow
Hold now Ticagrelor 90 mg BD Last dose: 10 Apr 20:00 · 3-5 day hold per ESC, surgery in 23 h · bleeding risk if not held
Continue Aspirin 75 mg OD CABG-friendly · continue through surgery per surgeon preference (cleared with Dr. Menon)
Hold AM Metformin 1g BD Hold morning of surgery · resume POD-2 if eGFR stable
Hold AM Ramipril 5 mg OD Hold to reduce post-bypass vasoplegia risk
Continue Atorvastatin 80 mg OD Continue night-of-surgery dose
Continue Bisoprolol 5 mg OD Continue — beta-blocker reduces peri-op AF
Anaesthesia flags
Airway
Mallampati II
No prior difficult airway
Renal
eGFR 52
CKD stage 3a · CIN risk
Glycaemic
HbA1c 8.4%
target FBS 110-180 peri-op
Echo
EF 48%
mild AS · peak gradient 28
Hb
12.8
crossmatched 4 units
Coag
INR 1.0
PT/PTT normal
Coronary tree · 3-vessel disease · mild AS
RV LV BCT LCC LSA Aorta AS peak grad 28 L Main LAD 80% LCx 70% RCA 75% PDA Significant stenosis
Cath last month: LAD 80 %, LCx 70 %, RCA 75 %. SYNTAX 24. Ischaemic burden high — cardiology cleared for surgical revascularisation despite recent DAPT loading. Mild AS (peak gradient 28 mmHg) does not require intervention in the same procedure.
AI
OmniSense · pre-op summary draft draft only · for your review
68M with 3-vessel CAD (LAD 80, LCx 70, RCA 75), mild AS, T2DM 20y, CKD 3a, scheduled CABG x3 tomorrow. EuroSCORE II 3.8 %. Cleared from a cardiac standpoint. Recommendations to consider: ticagrelor held since 10 Apr 20:00 (will be 35 h pre-op — within ESC 3-day window), aspirin continued through, ACE-i and metformin held morning of surgery, sliding-scale insulin from 22:00 tonight, hydration with isotonic saline 1 mL/kg/h from 04:00 (CIN prevention). Crossmatched 4 units PRBC. Watch for: peri-op AF, vasoplegia on bypass weaning, post-op AKI given baseline eGFR 52.
ESC Myocardial Revascularisation 2024 STS CABG risk calculator v4.2 KDIGO AKI 2024 · CIN section Aster pre-op pathway v3.1
Reference only. Final clearance and orders rest with the treating cardiologist and anaesthetist.