scholarly journals Coronary Artery Bypass Graft Surgery in Tanzania: 5 Years of Experience at Jakaya Kikwete Cardiac Institute

2020 ◽  
Author(s):  
Mohamed Yakubu Janabi ◽  
Evarist Nyawawa ◽  
Bashir Nyangasa ◽  
William Ramadhani Ramadhan ◽  
Ramadhani Hassan Hamis ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Open Heart Surgery ◽  
World Health

Abstract Cardiac surgery is not widely available in most developing countries, and most patients have no choice but to live in morbid conditions and managed conservatively or the few who are referred abroad for surgical procedures costs the respective countries millions of hard earned foreign currency. The World Health Organization projects that over the next ten years the continent of Africa will experience the largest increase in death rates from cardiovascular disease. The Jakaya Kikwete Cardiac Institute (JKCI) is a government owned National Specialized and Teaching Hospital that serves patients from all the regions of the United Republic of Tanzania with a population of nearly 60,000,000 people and also serves beyond the borders (Rwanda, Burundi, DR Congo, South Sudan, Comoro, Malawi and Zambia) for advanced cardiovascular medical, intervention, vascular and open heart surgery, the Institute was established in 2015. Methods: Here we report all patients who underwent coronary artery bypass surgery grafting only performed at the Centre since its inauguration in 2015- till 2019. Data were collected for basic demography, diagnosis, investigations, clinical and surgical outcome parameters. Results: A total of 85 patients with heart diseases and underwent coronary artery bypass surgery grafting (CABG) are analysed in this study. There were 64 (75%) male and 21 (25%) female patients. Their age ranged from 41–85 years old with almost half 42 (49%) of the cohort being between the age between 61–70 years old. Most of the patients had two or more grafts and an internal mammary artery graft was used over 80% of the procedures. The overall 30-day mortality was 7.1%, incidence of stroke 0.2%, duration of mechanical ventilation was an average of 9.98 hours and intensive care unit (ICU) stay post CABG was an average of 6.48 days and final discharge from the centre ranged from 10–16 days.Conclusion: This study has demonstrated that coronary artery bypass surgery grafting in low/middle income country is safe and feasible. A sustainable program demands highest level of governmental support as seen in this case, and a dedicated multidisciplinary team with profound know how in cardiac pathologies. Furthermore, a need for good local data to know the prevalence of coronary disease is mandatory to determine the magnitude of coronary artery disease in each country.

Late Cardiac Tamponade by Chylous Pericardial Effusion after Coronary Artery Bypass Surgery: Case Report

2011 ◽  
Vol 14 (3) ◽  
pp. 195 ◽  
Author(s):  
Anders Albåge ◽  
Gösta Eggertsen ◽  
Paolo Parini
Keyword(s):  
Coronary Artery ◽  
Pericardial Effusion ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Successful Outcome ◽  
Pericardial Fenestration

Chylopericardium is an uncommon but serious complication after open heart surgery that often necessitates surgical treatment. We describe a case of continuous and severely symptomatic chylous pericardial effusion after coronary artery bypass grafting in which the diagnosis was established by lipid electrophoresis. Initial conservative management failed, and ligation of the thoracic duct and pericardial fenestration were finally required for a successful outcome.

scholarly journals Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial

2019 ◽  
Author(s):  
Fatemeh Hosseini Kasnavieh ◽  
Hassan Rezaeipandari ◽  
Mehdi Hadadzadeh ◽  
Mahmood Vakili ◽  
Fatemeh Hosseini Biouki
Keyword(s):  
Clinical Trial ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Control Group ◽  
Open Heart

Introduction: Delirium has been considered as the most common cognitive disorder after major surgery. Melatonin therapy is effective in reducing the incidence of delirium after open heart surgery with pain relief mechanism and adjustment of the sleep cycle and the absence of specific side effects. This study was conducted to determine the effectiveness of melatonin on prevention of delirium after coronary artery bypass surgery.   Methods: The double blind randomized controlled clinical trial  recruited 140 patients, equally decided, who underwent  coronary artery bypass surgery in Afshar Hospital, Yazd city, 2016. All participants of the two groups were evaluated for the presence of delirium  on the day of surgery and three days after by the Confusion Assessment Method for ICU (CUM-ICU). Respectively, The intervention and control group received 3 mg melatonin and 3 mg placebo orally before and after the operation. Data were analyzed by Chi-square, T-test, paired t-test and Cochran tests.   Results: The incidence of delirium in the melatonin and the control group was 35.7% and 5.7% on the day of operation, 68.6% and 31.4% three days after the operation, respectively. The results showed that there was a significant difference in the frequency of cognitive test of CAM-ICU on day of surgery and three days after surgery between the two groups (p <0.001).   Conclusion: Despite the efficacy of melatonin therapy in reducing delirium, further studies on the effects of other effective drugs on the treatment of delirium, such as antipsychotics and receptor blockers, should be considered.  

scholarly journals Performance of EuroSCORE II and logistic EuroSCORE in Bangladeshi population undergoing off-pump coronary artery bypass surgery: A prospective cohort study

2019 ◽  
Vol 8 ◽  
pp. 204800401986212 ◽  
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Sabita Mandal ◽  
Sanjoy Kumar Saha ◽  
Kamrul Hasan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Brier Score ◽  
Artery Bypass Graft ◽  
Logistic Euroscore

Introduction European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to identify patients who may have a greater postoperative risk for adverse effects following adult cardiac surgery. This study evaluated the discriminatory potential of using the EuroSCORE system in predicting the early, as well as late, postoperative outcomes following coronary artery bypass graft surgery in Bangladesh. Methods A total of 865 patients who underwent isolated coronary artery bypass graft surgery were evaluated with the EuroSCORE risk scoring system. Moreover, we also compared the discriminatory potentials between the EuroSCORE II and the original logistic EuroSCORE. Results Operative mortality was best predicted by EuroSCORE II (area under the curve (AUC) 0.863, Brier score 0.030) compared to the original logistic EuroSCORE (AUC 0.849, Brier score 0.033). However, the overall expected-to-observed mortality ratio for EuroSCORE II was 1.1, whereas the observed ratio for the original logistic EuroSCORE was 1.7. EuroSCORE II was predictive of an intensive care unit stay of five days or more (AUC 0.786), prolonged inotropes use (AUC 0.746), stroke (AUC 0.646), de novo dialysis (AUC 0.810), and low output syndrome (AUC 0.715). Moreover, a high EuroSCORE II quintile significantly predicted the risk for late mortality (p < 0.0001). Conclusions EuroSCORE has an important role in predicting the early, as well as late, postoperative outcomes following coronary artery bypass surgery. However, the performance of EuroSCORE II is significantly better than the original logistic EuroSCORE in predicting postoperative morbidity and mortality after isolated coronary artery bypass graft surgery among Bangladeshi patients.

Profile of Coronary Artery Bypass Surgery in United Arab Emirates: Dubai Hospital Experience

1998 ◽  
Vol 6 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Rajan Sadanandam ◽  
Najib Al Khaja ◽  
Mohd A Aziz ◽  
Murdo A Turner
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
United Arab Emirates ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Chronic Stable Angina ◽  
Male Predominance

Although coronary artery bypass surgery has become a common procedure, there were no data available regarding this type of surgery in the United Arab Emirates. Therefore, we undertook this retrospective study of the first 522 consecutive patients undergoing coronary artery bypass graft surgery between October 1992 and July 1997. The mean age was 49.1 years at operation with a 97.1% male predominance. Patients of Asian origin accounted for 75.8%, Arabs 22.4%, and Europeans 1.7%. Chronic stable angina was the most frequent presenting symptom (70.4%) and 62.1% patients had at least one prior myocardial infarction. There was a 44.6% incidence of hypertension and 32.9% of patients were diabetic. Other prominent risk factors were smoking (55.7%), hyperlipidemia (53.9%), and family history of ischemic heart disease (10.7%). Left main coronary artery obstruction was evident in 6.5% of patients. An average of 3.4 grafts per patient were performed using reverse saphenous vein and endarterectomies were needed in 2.2%. The early mortality rate in elective cases was 2.4%. This study suggests that in spite of a high incidence of multiple risk factors, our patients tolerated coronary artery bypass surgery well. Our findings highlight the trend towards more urgent operations and the decreasing age of patients with severe coronary artery disease.

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