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[Music] good morning everybody good morning now first disclosure Im a surgeon at a critical care conference which means for the next ten minutes you are going to have to suspend the surgeon bashing even the orthopods really sorry so talking about buttcheeks closing I like to call them Brown trouser moments these are three Brown trouser moments from my unit in the last 12 months a 15 year old girl who exsanguinated after her dissection repair in front of her friends in the community on day 12 this young lady in the middle who is only 40 who arrested within an hour after returning to intensive care from a 10 hour reader a aortic root procedure and this 72 year old lady who arrested after a bradycardic arrest from an aortic valve replacement the only patient who survived was the lady on the right happily though cardiac arrest post heart surgery is relatively uncommon and I think we should all pat ourselves on the back for that because cardiac surgical patients are becoming increasingly c