Open Heart Surgery in National University Hospital(1959-1993)

1994 ◽  
Vol 24 (6) ◽  
pp. 753
Author(s):  
Kyung Phill Suh ◽  
Joon Ryang Rho ◽  
Yong Jin Kim ◽  
Hyuk Ahn ◽  
Yung Kyoon Lee
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Open Heart ◽  
National University

scholarly journals Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Taimur Asif Ali ◽  
Khuzaima Tariq ◽  
Areej Salim ◽  
Saulat Fatimi
Keyword(s):  
Renal Replacement Therapy ◽  
Renal Dysfunction ◽  
Replacement Therapy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
University Hospital ◽  
P Value ◽  
Open Heart ◽  
Creative Commons ◽  
Postoperative Serum

Objectives: In this study we determined the frequency of renal dysfunction and its outcomes in terms of morbidity and mortality in patients who underwent open heart surgery at the Aga Khan University Hospital, Karachi, Pakistan. Methods: A total of 175 patients aged between 15-80 years having open heart Surgery(OHS) were included. Preoperative and postoperative serum creatinine (SCr) was noted and the glomerular filtration rate (GFR) calculated by Cockcroft-Gault equation. Their hospital course was charted and followed-up for 30-day. Results: The mean age and mean BMI were 58.1±12.6 years and 26.4±4.3 kg/m2 respectively. Females were 18.3%, out of which 51.4% hypertensive, 46.9% diabetics, 45.1% had dyslipidemia, 2.9% had preoperative renal dysfunction and 40% had moderate ejection fraction. On follow up, 30.3% developed postoperative renal dysfunction within 30-days after OHS with mean SCr and GFR as 1.6±0.7 and 56.9±24.5, respectively. In RD group more patients showed positive outcomes i.e. prolonged inotropic requirement (75.5% vs. 18%, p-value <0.005), diuretic infusion usage (47.2% vs. 3.3%, p-value <0.005), dialysis/renal replacement therapy (17% vs. 0%, p-value <0.005), requirement for prolonged ventilation (35.8% vs. 6.6%, p-value <0.005), prolonged ICU and hospital stay (15.4% vs. 1.6%, p-value <0.005 and 41.5% vs. 17.2%, p-value <0.005), sepsis (20.8% vs. 1.6%, p-value <0.005) and death (9.4% vs. 2.5%, p-value 0.05). Conclusion: Timely recognition of renal dysfunction, early renal replacement therapy, diuretics or dialysis and proper nutritional and inotropic support to maintain adequate hemostasis shows survival benefits. doi: https://doi.org/10.12669/pjms.37.7.3865 How to cite this:Ali TA, Tariq K, Salim A, Fatimi S. Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3865 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Effect of Home-Based Cardiac Rehabilitation Program on Exercise Capacity in Open Heart Surgery Patients at Naresuan University Hospital

2017 ◽  
Vol 35 (4) ◽  
pp. 285
Author(s):  
Phavinee Paorod ◽  
Weerapong Chidnok ◽  
Jarun Sayasathid
Keyword(s):  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Rehabilitation Program ◽  
University Hospital ◽  
Open Heart ◽  
Cardiac Rehabilitation Program ◽  
Home Based

Objective: To investigate the effects of home-based cardiac rehabilitation program on exercise capacity using the six-minute walk test (6-MWT) in open heart surgery patients, Naresuan University Hospital.Material and Method: In a quasi-experimental study design, seventy patients who were diagnosed with heart diseases and received open heart surgery at Cardiac Center, Naresuan University Hospital were enrolled and collected data from October 2015 - September 2016 (n=70). The patients completed 8-12 weeks home-based cardiac rehabilitation program. The patients were performed the 6-MWT before hospital discharge, the first and second follow up time point. Data were expressed as average mean and chi-square test were used to determine the relationships among outcome parameters.Results: There was a significant within-group in 6-MWT distance after completed home-based cardiac rehabilitation program (377.0±69.0 meters) compared to before hospital discharge (209.0±62.0 meters) and the first follow up time point (4-8 weeks) (306.0±88.0 meters) (p-value<0.050).Conclusion: The 8-12 weeks home-based cardiac rehabilitation program exhibited significant positive effects on exercise capacity in open heart surgery patients, Naresuan University Hospital.

scholarly journals Išilginės apsukinės siūlės naudojimas gydant infekuotą žaizdą po širdies operacijų

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Vytautas Antanas Pronckus ◽  
Dobilas Barysas
Keyword(s):  
Quality Of Life ◽  
Heart Surgery ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Open Heart ◽  
Monofilament Suture ◽  
Infected Wounds

Vytautas Antanas Pronckus, Dobilas BarysasVilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661, VilniusEl paštas: [email protected] Įvadas / tikslas Gydant infekuotas žaizdas po širdies operacijų vis didesnę reikšmę įgauna gydymo trukmė, ligonio gyvensenos kokybė ir pasiekiamas kosmetinis efektas. Apsukinės siūlės naudojimas gali pagerinti ligonių savijautą, sumažinti gydomųjų procedūrų skaičių, pagreitinti žaizdos gijimą. Metodai Infekuotos žaizdos išplaunamos, jų kraštai atnaujinami, pašalinamos detritinės masės. Esant indikacijų, drenai paliekami priekiniame mediastinume ir (arba) virš krūtinkaulio. Minkštieji audiniai (fascijos, raumenys, poodis) susiuvami monofilamento apsukine monofilamento siūle 5–6 cm segmentais. Oda susiuvama intrakutanine monofilamento 4–5 cm ilgio segmentais. Tvarsčiai keičiami du kartus per dieną. Gydymas paprastai trunka 14 dienų. Rezultatai Šiuo būdu gydomos infekuotos žaizdos gijo greičiau, pakartotinai žaizdų revizuoti nereikėjo, gydomi ligoniai jautėsi geriau ir buvo pasiektas santykiškai geras kosmetinis efektas. Išvados Manome, kad toks infekuotos žaizdos po širdies operacijų gydymo būdas yra tinkamas ir klinikinėje praktikoje taikytinas dažniau. Pagrindiniai žodžiai: infekcija, gydymas Longitudinal running suture in treatment of infected wounds after heart surgery Vytautas Antanas Pronckus, Dobilas BarysasVilnius University Hospital „Santariškių klinikos“, Cardiac Surgery Centre,Santariškių str. 2, LT-08661, VilniusE-mail: [email protected] Background / objective The duration of treatment’s, patient’s quality of life and the cosmetic result of the treatment currently become increasingly important in the treatment of infected wounds after open heart surgery. Application of running suture may improve the quality of life, decrease the number of therapeutic procedures and facilitate recovery in these patients. Methods After washing and debridement of the wound, the sides of the wound are renewed. If necessary, the drains are left in anterior mediastinal space and / or above the sternum. Soft tissues (i. e. fascia, muscles and subcutaneous tissue) are sutured using running monofilament suture in 5–6 cm long segments. The skin is closed by means of intracutaneous monofilament suture (segments of 4–5 cm). The dressings are changed twice a day. The treatment usually lasts 14 days. Results While using this method, the wound healing was faster, the patients required no additional wound revisions, the quality of patient’s life was better and the treatment resulted in relatively improved cosmetic results. Conclusions We conclude that this method is appropriate for treatment of infected wounds after open heart surgery and might be applied more frequently. Key words: infection, treatment

scholarly journals Pulmonary complications after open heart surgery: A retrospective study

2021 ◽  
Vol 5 (1) ◽  
pp. 01-12
Author(s):  
Abdul-Monim Mohammad Batiha ◽  
Ibtisam Al-Zaru ◽  
Majdee Saiah AL-Shaarani ◽  
Fadwa N Alhalaiqa
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Open Heart ◽  
Assessment Sheet ◽  
Patients At Risk ◽  
Prolonged Hospital

Despite significant advances in open heart surgery over the last two decades, postoperative pulmonary complications (PPCs) are considered the most important causes that contribute to patient morbidity, mortality and prolonged hospital stay. The ultimate goal of this paper was to investigate the risk factors which increasing the incidence rate of pulmonary complications after open heart surgery of Jordanian patients. A retrospective design using an existing coronary artery surgery database of adults (n = 200) who had undergone open heart surgery between August 2014 and July 2015 at a University Hospital in Jordan. A structured PPCs instrument was used to assess ‘PPCs risk factors assessment sheet’. According to the results, the proposed model provides a preliminary indication of risk factors placing open heart surgical patients at risk of PPCs. Determining patients who are at risk of developing PPC’s after cardiac surgeries are the first step towards its prevention. This reduces its burden in term of morbidity, mortality and cost.   Keywords: Jordan, open heart surgery, predictors, pulmonary complications, risk factors.

Different Types of Heater-Cooler Units and Their Risk of Transmission of Mycobacterium chimaera During Open-Heart Surgery: Clues From Device Design

2018 ◽  
Vol 39 (07) ◽  
pp. 834-840 ◽  
Author(s):  
Richard Kuehl ◽  
Florian Banderet ◽  
Adrian Egli ◽  
Peter M. Keller ◽  
Reno Frei ◽  
...  
Keyword(s):  
Water Samples ◽  
Heart Surgery ◽  
Flow Direction ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Water Tank ◽  
Open Heart ◽  
Air Samples ◽  
Ensure Patient Safety ◽  
The Individual

OBJECTIVEWorldwide, Mycobacterium chimaera infections have been linked to contaminated aerosols from heater-cooler units (HCUs) during open-heart surgery. These infections have mainly been associated with the 3T HCU (LivaNova, formerly Sorin). The reasons for this and the risk of transmission from other HCUs have not been systematically assessed.DESIGNProspective observational study.SETTINGUniversity Hospital Basel, Switzerland.METHODSContinuous microbiological surveillance of 3 types of HCUs in use (3T from LivaNova/Sorin and HCU30 and HCU40 from Maquet) was initiated in June 2014, coupled with an epidemiologic workup. Monthly water and air samples were taken. Construction design was analyzed, and exhausted airflow was measured.RESULTS Mycobacterium chimaera grew in 8 of 12 water samples (66%) and 22 of 24 air samples (91%) of initial 3T HCUs in use, and in 2 of 83 water samples (2%) and 0 of 41 (0%) air samples of new replacement 3T HCUs. Moreover, 7 of 12 water samples (58%) and 0 of 4 (0%) air samples from the HCU30 were positive, and 0 of 64 (0%) water samples and 0 of 50 (0%) air samples from the HCU40 were positive. We identified 4 relevant differences in HCU design compared to the 3T: air flow direction, location of cooling ventilators, continuous cooling of the water tank at 4°C, and an electronic alarm in the HCU40 reminding the user of the next disinfection cycle.CONCLUSIONSAll infected patients were associated with a 3T HCU. The individual HCU design may explain the different risk of disseminating M. chimaera into the air of the operating room. These observations can help the construction of improved devices to ensure patient safety during cardiac surgery.Infect Control Hosp Epidemiol 2018;834–840

scholarly journals Referral to and enrolment in cardiac rehabilitation after open-heart surgery in the Netherlands

2021 ◽  
Author(s):  
D. Conijn ◽  
R. A. F. de Lind van Wijngaarden ◽  
H. M. Vermeulen ◽  
T. P. M. Vliet Vlieland ◽  
J. J. L Meesters
Keyword(s):  
Cardiac Rehabilitation ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Survey Study ◽  
Open Heart ◽  
Phase 2 ◽  
Medical File ◽  
Professional Guidelines

Abstract Aim Although referral to phase 2 cardiac rehabilitation (CR) following open-heart surgery is recommended in professional guidelines, according to the literature, participation rates are suboptimal. This study investigates the referral and enrolment rates, as well as determinants for these rates, for phase 2 CR following open-heart surgery via sternotomy. Methods A cross-sectional survey study was conducted among patients who underwent open-heart surgery via sternotomy in a university hospital. Data on referral and enrolment rates and possible factors associated with these rates (age, sex, type of surgery, educational level, living status, employment, income, ethnicity) were collected by a questionnaire or from the patient’s medical file. Univariate logistic regression analysis (odds ratio) was used to study associations of patient characteristics with referral and enrolment rates. Results Of the 717 eligible patients, 364 (51%) completed the questionnaire. Their median age was 68 years (interquartile range 61–74) and 82 (23%) were female. Rates for referral to and enrolment in phase 2 CR were 307 (84%) and 315 (87%), respectively. Female sex and older age were independently associated with both non-referral and non-enrolment. Additional factors for non-enrolment were surgery type (coronary artery bypass grafting with valve surgery and miscellaneous types of relatively rare surgery), living alone and below-average income. Conclusion Phase 2 CR referral and enrolment rates for patients following open-heart surgery were well over 80%, suggesting adequate adherence to professional guidelines. During consultation, physicians and specialised nurses should pay more attention to certain patient groups (at risk of non-enrolment females and elderly). In addition, in-depth qualitative research to identify reasons for non-referral and/or non-enrolment is needed.

Intraoperative variables associated with extubation time in patients undergoing open heart surgery

2017 ◽  
Vol 4 (2) ◽  
pp. 237-244
Author(s):  
Ozlem Ibrahimoglu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Operation Time ◽  
University Hospital ◽  
Open Heart ◽  
Early Extubation ◽  
Bentall Procedure ◽  
Extubation Time ◽  
Clinical Benefits

Decreasing mechanical ventilation and early extubation in patients has many clinical benefits. Hence, an awareness of some variables, associated with extubation time can help nurses to plan convenient care aimed at making a safe and early extubation. The purpose of this study was to investigate whether any intraoperative variables had a significant effect on extubation time following open heart surgery. The research was conducted on 60 open heart surgery patients who met inclusion criteria between April 2014 and November 2014 in a cardiac and vasculer surgery clinic of university hospital in Istanbul, Turkey. The data were collected by using a “Questionnaire Form” which includes some intraoperative variables (type of surgery, the number of grafts, the duration of time of the cardiopulmonary bypass, aortic crossclamping, total operation time, and the extubation time). The data was analyzed by descriptive and analytical methods. Type of the surgery procedure was 40 (66%) patients were CABG, 10 (16,6%) were valvuler surgery, 6 (10%) were ASD/VSD primer repair and 4 (3,3%) were Bentall procedure. Extubation was achieved for 60 patients in a mean time of 8.33±1.99 h. 18,3% (11) of the patients were extubated in ≤6 h and 81,7% (49) of them were extubated in >6 h after surgery, classifying them into the early and delayed extubation groups, respectively. On statistical analysis, the duration of the cardiopulmonary bypass (CPB) and aortic cross-clamping were found to have a significant effect on the extubation time.This study revealed that the duration of the cardiopulmonary bypass and aortic cross-clamping might play a role in the extubation time. Therefore, it is recommended that nurses consider this in their assessment of extubation as a shorter cardiopulmonary bypass time and aortic cross-clamping time might lead to earlier extubation.  Keywords: Open heart surgery; extubation; intraoperative variables.

scholarly journals The Dose-Dependent Effects of Ketoprofen on Dynamic Pain after Open Heart Surgery

2017 ◽  
Vol 6 (20;6) ◽  
pp. 509-520
Author(s):  
Christian Dualé
Keyword(s):  
Postoperative Pain ◽  
Heart Surgery ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pilot Trial ◽  
Open Heart Surgery ◽  
University Hospital ◽  
Low Doses ◽  
Open Heart ◽  
Double Blind

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce postoperative pain, in both static (i.e., at rest) and dynamic contexts (e.g., during coughing or mobilization), and reduced doses could improve their efficacy/tolerance balance. Objectives: To test this hypothesis of efficacy after open heart surgery, in which NSAIDs are poorly used, particularly for safety concerns. Study Design: Randomized, double-blind trial. Setting: Single-center, French university hospital. Methods: Patients. One hundred patients at low risk of postoperative complications undergoing scheduled open heart surgery (97 analyzed). Intervention. We tested intravenous ketoprofen, at a dose of 0.5 mg/kg-1 every 6 hours during the 48 hours following the end of sedation, after surgery. This standard protocol was compared to a similar one in which half doses were administered, to one with quarter doses, as well as to a placebo group. Analgesia was supplemented by acetaminophen plus self- and nurse-administered intravenous morphine. Measurement. The primary outcome was the intensity of dynamic pain, assessed over 48 hours on an 11-point numerical rating scale (NRS). Results: Only the full-dose ketoprofen group showed reduced dynamic and static postoperative pain vs. placebo (P < 0.00001 for both). The evolution of dynamic pain suggested a delayed and therefore non-significant effect with the low doses. Ketoprofen did not affect either the postoperative morphine consumption or the tolerance outcomes, such as the volumes of chest tube drainage and the renal function. Limitations: This pilot trial was undersized to test major tolerance outcomes. Conclusions: Although we failed to demonstrate any analgesic effects with low doses of ketoprofen, we confirmed the good efficacy/tolerance balance with this propionic NSAID of intermediate COX2 -selectivity. Lower doses of NSAIDs, potentiated by a loading dose, should be tested in the future. IRB approval: CPP Sud-Est VI (Clermont-Ferrand, France), on 12/23/2013. Clinical trial registry: EudraCT (2013-003878-27); ClinicalTrials.gov (NCT02180087)

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