Outcome of open heart surgery in patients with age above 75 years.

Objectives: Open heart surgery is considered as high risk procedure in elderly patients. We study the operative outcomes of open heart surgery in patients of age above 75 years in geography of world where life expectancy is around 67 years. Study Design: Retrospective Study. Setting: Research of Rawalpindi Institute of Cardiology (RIC). Periods: From January 2014 to December 2018. Material & Methods: Demographic and baseline characteristics of patients were retrieved from cardiac surgery database (cascade, Lahore) of RIC. For all patients who underwent open heart surgery and had age above 75 years. Operative mortality, neurological outcome, low cardiac output state(LCOS), peri-operative myocardial infarction, postop.erative atrial fibrillation (POAF), acute kidney injury (AKI), chest reopening, ICU stay, hospital stay and 1-year survival etc. Are analyzed from retrieved data. Results: Operative mortality is 5.71%, type II neurological deficit is 16.42% and POAF is 25%. Incidence of peri-operative mi, lcos, aki and chest reopening etc is low along with acceptable ICU stay and hospital stay durations. 1-years survival is 95.46%. Conclusion: open heart surgery can be offered to patients with age above 75 years with low operative mortality and morbidity except with relatively higher incidence of type ii neurological deficit and POAF. 1- years survival is impressive with figures of 95.46%.

Download Full-text

Coronary Artery Bypass Surgery in a Patient with a Functional Single Lung

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230501300419 ◽

2005 ◽

Vol 13 (4) ◽

pp. 377-379 ◽

Cited By ~ 1

Author(s):

Levent Yazicioglu ◽

Atilla Aral ◽

Ozge Uymaz ◽

Hakki Akalin

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Heart Surgery ◽

Operative Mortality ◽

Artery Bypass ◽

Open Heart Surgery ◽

Postoperative Management ◽

Open Heart ◽

Mortality And Morbidity

Destructed lung and pneumonectomy are associated with anatomic and physiologic changes that may interfere with the conduct of subsequent open heart surgery. Here we report a case of an autopneumonectomized patient who required open heart surgery. The preoperative, intraoperative and postoperative management of this patient was unique. Open heart procedures on patients with a single lung can be performed with acceptable operative mortality and morbidity.

Download Full-text

Axillary artery: An unanticipated choice of access in the cath lab!

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211026445 ◽

2021 ◽

pp. 021849232110264

Author(s):

Puneet Varma ◽

Bharath A Paraswanath ◽

Anand Subramanian ◽

Jayaranganath Mahimarangaiah

Keyword(s):

Hospital Stay ◽

Heart Surgery ◽

Septal Defect ◽

Axillary Artery ◽

Open Heart Surgery ◽

Open Heart ◽

Ventricular Septal Defects ◽

Septal Defects ◽

Rare Site

Ventricular septal defects are increasingly being closed by transcatheter technique, with lesser morbidity and shorter hospital stay compared to open heart surgery. We report a case of embolization of a duct occluder deployed in a posterior muscular septal defect. The rare site of embolization necessitated an unusual approach for retrieval prior to subsequent closure using a double-disc device.

Download Full-text

Normothermic versus hypothermic cardiopulmonary bypass in low-risk paediatric heart surgery: a randomised controlled trial

Heart ◽

10.1136/heartjnl-2018-313567 ◽

2018 ◽

Vol 105 (6) ◽

pp. 455-464 ◽

Cited By ~ 3

Author(s):

Massimo Caputo ◽

Katie Pike ◽

Sarah Baos ◽

Karen Sheehan ◽

Kathleen Selway ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Hospital Stay ◽

Heart Surgery ◽

Open Heart Surgery ◽

Postoperative Hospital Stay ◽

Low Risk ◽

Open Heart ◽

Intubation Time ◽

Organ Systems ◽

Randomised Controlled

ObjectiveTo compare normothermic (35°C–36°C) versus hypothermic (28°C) cardiopulmonary bypass (CPB) in paediatric patients undergoing open heart surgery to test the hypothesis that normothermic CPB perfusion maintains the functional integrity of major organ systems leading to faster recovery.MethodsTwo single-centre, randomised controlled trials (known as Thermic-1 and Thermic-2, respectively) were carried out to compare the effectiveness and acceptability of normothermic versus hypothermic CPB in children with congenital heart disease undergoing open heart surgery. In both studies, the co-primary clinical outcomes were duration of inotropic support, intubation time and postoperative hospital stay.ResultsIn total, 200 participants were recruited; 59 to the Thermic-1 study and 141 to the Thermic-2 study. 98 patients received normothermic CPB and 102 patients received hypothermic CPB. There were no significant differences between the treatment groups for any of the co-primary outcomes: inotrope duration HR=1.01, 95% CI (0.72 to 1.41); intubation time HR=1.14, 95% CI (0.86 to 1.51); postoperative hospital stay HR=1.06, 95% CI (0.80 to 1.40). Differences favouring normothermia were found in urea nitrogen at 2 days geometric mean ratio (GMR)=0.86 95% CI (0.77 to 0.97); serum creatinine at 3 days GMR=0.89, 95% CI (0.81 to 0.98); urinary albumin at 48 hours GMR=0.32, 95% CI (0.14 to 0.74) and neutrophil gelatinase-associated lipocalin at 4 hours GMR=0.47, 95% CI (0.22 to 1.02), but not at other postoperative time points.ConclusionsNormothermic CPB is as safe and effective as hypothermic CPB and can be routinely adopted as a perfusion strategy in low-risk infants and children undergoing open heart surgery.Trial registration numberISRCTN93129502.

Download Full-text

Duration of Intubation and ICU Stay after Open Heart Surgery

Survey of Anesthesiology ◽

10.1097/00132586-198006000-00027 ◽

1980 ◽

Vol 24 (3) ◽

pp. 167

Author(s):

W. A. LELL ◽

P. N. SAMUELSON ◽

J. G. REVES ◽

S. D. STRONG

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Icu Stay

Download Full-text

Fast-track Cardiac Surgery in Children: Feasibility in Bangladeshi Setting

Cardiovascular Journal ◽

10.3329/cardio.v3i1.6427 ◽

1970 ◽

Vol 3 (1) ◽

pp. 50-54 ◽

Cited By ~ 1

Author(s):

SA Quader ◽

R Sarker ◽

F Ahmed ◽

MK Hasan ◽

AK Beg ◽

...

Keyword(s):

Cardiac Surgery ◽

Hospital Stay ◽

Fast Track ◽

Heart Surgery ◽

Open Heart Surgery ◽

Postoperative Mortality ◽

Control Group ◽

Mortality And Morbidity ◽

Surgical Closure ◽

Fast Tracking

Background: Fast-track recovery protocols in cardiac surgery is gaining worldwide popularity and have contributed to significant reductions in the postoperative hospital stay and cost without any increase in postoperative mortality and morbidity. The aim of this study was to find out the feasibility of fast track paediatric cardiac surgery in Bangladeshi setting. Method: It was a prospective study conducted in National Institute of Cardio-vascular Diseases, Dhaka, from July 2009 to June 2010. All patients, between 3 to 18 years, underwent surgical closure of atrial or ventricular septal defect under cardio-pulmonary bypass. 20 patients from our unit served as fast track group and 30 patients from other units of the same hospital served as conventional group. Fast track patients were extubated in less than 6 hours after surgery, shifted from ICU in less than 24 hours and geared up to discharge home within 3 days of surgery. Result: 18 (90%) of the 20 patient of the fast track group were discharged within 3 days of surgery, 2 patients cannot be discharged within this time frame. Mean post operative hospital stay for study group was 3.1 days, whereas the mean hospital stay in the control group was 7.5 days. Follow-up was 100% complete at 30 days. There was no major in-hospital or out-of-hospital complications in either group. No patient was readmitted at our centre or elsewhere for any complication arising from this process. Conclusion: Fast tracking is feasible and safe in low-risk paediatric open-heart surgery in Bangladeshi scenario. A multidisciplinary approach with a set protocol is required to achieve this goal in a safe and reproducible manner. Keywords: Cardiac surgery; Congenital heart disease; Fast track; Hospital discharge. DOI: 10.3329/cardio.v3i1.6427Cardiovasc. j. 2010; 3(1): 50-54

Download Full-text

Open Cardiac Surgery without Blood and Blood Products Transplantation

The Heart Surgery Forum ◽

10.1532/hsf.1898 ◽

2017 ◽

Vol 20 (6) ◽

pp. 239 ◽

Cited By ~ 1

Author(s):

Mehmet Kaplan ◽

Tolga Can ◽

Anil Karaagac ◽

Murat Acarel ◽

Adlan Olsun ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Urine Output ◽

Heart Surgery ◽

Open Heart Surgery ◽

Morbidity And Mortality ◽

Open Heart ◽

Blood Products ◽

Mortality And Morbidity ◽

Significant Difference

Background: Blood transfusions are the most common type of tissue and organ transplantation. Perioperative and postoperative transfusions may cause morbidity and mortality and transfusion should based on only hematocrit values but also on hemodynamic and clinical parameters of the patient, which cannot be ignored.Methods: A prospective study was conducted between January 2015 and October 2016 with adult patients undergoing elective open heart surgery. In these patients, a protocol was established, and patients were divided into two groups as transfusion (-) and transfusion (+). In the first 24 hours in the intensive care unit, patients’ drainage, 24-hours urine output, awakening and extubation times, and lactate and bilirubin levels in arterial blood gases were recorded. Thirty-day mortality and morbidity, and hemodynamic and clinical data were compared between these two groups.Results: We have performed a total of 138 cases; no blood and blood products were transfused in 71% (n = 98), and in 29.0% (n = 40) blood and blood products were transfused. Thirty-day mortality and morbidity (arrhythmia, infectious and pulmonary morbidity, myocardial infarction, cerebrovascular accident, renal dysfunction, sternal revision) were compared between these two groups and no statistically significant difference was observed. Patients’ awakening, extubation time, cardiopulmonary bypass period, cross-clamp time, and days in intensive care unit and hospital were compared, and there was no statistically significant difference between the two groups. Conclusion: In this study, we conclude that open heart surgery without blood transfusion may be accomplished with decent peri/postoperative management. The patients who did not receive any blood or blood products were not compromised clinically or hemodynamically. No extra morbidity and mortality were seen in the non-transfusion group. Transfusion decision was based on clinical and hemodynamic parameters such as persistent hypotension or tachycardia, hyperlactatemia, low urine output, and anemic symptoms.

Download Full-text

Comparison Effect of Nebulized Milrinone and Intravenous Milrinone in Patients With Pulmonary Hypertension Who Candidate of Open-heart Surgery: a Double Blind Randomized Clinical Trial

10.21203/rs.3.rs-764237/v1 ◽

2021 ◽

Author(s):

Sara Joreirahmadi ◽

Fatemeh Javaherforoosh zadeh ◽

Marziyeh Babazadehdezfuli ◽

Behnam Gholizadeh ◽

Nima Bakhtiari

Keyword(s):

Blood Pressure ◽

Pulmonary Hypertension ◽

Vascular Resistance ◽

Heart Surgery ◽

Venous Pressure ◽

Open Heart Surgery ◽

Open Heart ◽

Double Blind ◽

Icu Stay ◽

Extubation Time

Abstract Objective: This study was aimed to compare the effect of nebulized milrinone versus intravenous administration of milrinone in pulmonary hypertension patients who are candidates for open-heart surgeryMethod: A total of 32 patients candidates for open-heart surgery complicated by pulmonary hypertension were involved in this study and were arbitrarily classified into the nebulized milrinone group (n=16) and intravenous milrinone group (n=16) that they received drug after the opening of the cross-clamp of the aorta and before weaning off CPB. Heart rate (HR), cardiac output (CO), cardiac index (CI), stork volume (SV), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (mPAP), Systemic vascular resistance (SVR) pulmonary vascular resistance(PVR) and MAP/mPAP ratio, Extubation time, ICU stay and hospital stay were collected. Results: MAP and MAP/mPAP ratio increased significantly, however, mPAP was significantly lower in the nebulized milrinone group than in the intravenous milrinone group. Extubation time, ICU stay and hospital stays decreased significantly in the nebulized milrinone group than in the intravenous milrinone group.Conclusion: the administration of the nebulized milrinone before weaning off from CPB, accelerated and facilitated separation from CPB as it significantly decreases mPAP and preserves MAP.Trial registry: Registered under No. IRCT20201104049266N1

Download Full-text