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KING ABDULAZIZ UNIVERSITYKING ABDULAZIZ UNIVERSITY
HOSPITAL HOSPITAL CARDIAC SURGERY UNITCARDIAC SURGERY UNIT
Dr. Khalid Al-Ibrahim Dr. Hussein JabbadDr. Khalid Al-Ibrahim Dr. Hussein JabbadDr. Khalid Medhat Dr. Ragab ShehataDr. Khalid Medhat Dr. Ragab Shehata
STARTED STARTED
From 28From 28thth Feb. 2006 Feb. 2006 once weekly once weekly
Till may 2006 then Till may 2006 then twice weeklytwice weekly
Total No. : 53casesTotal No. : 53cases Coronary artery bypass graftCoronary artery bypass graft
CABG ( 35cases CABG ( 35cases )) - Age : 45 – 69 yearsAge : 45 – 69 years
Mean age : 52.5 yearsMean age : 52.5 years
- No of graft : 1- 5 graftsNo of graft : 1- 5 grafts
Mean No. : 3.4 graftsMean No. : 3.4 grafts
Valve replacementValve replacement ( ( 15 cases )15 cases )
- - Aortic Replacement : 2casesAortic Replacement : 2cases..
- - Mitral Replacement : 5 casesMitral Replacement : 5 cases..
- - Aortic+mitral : 2 caseAortic+mitral : 2 case..
Mitral+tricuspid 2 casesMitral+tricuspid 2 cases
Mitral repair 3 casesMitral repair 3 cases
- Combined (Valve Rep + CABG ) : One case- Combined (Valve Rep + CABG ) : One case
Rheumatic aortic valves Normal aortic valveRheumatic aortic valves Normal aortic valve
Different types of prosthetic valveDifferent types of prosthetic valve
Valve replacementValve replacement
- -Age 13 - 43 years oldAge 13 - 43 years old
Mean 31.7 yearsMean 31.7 years
Total No. of valves 11 valvesTotal No. of valves 11 valves
- Tissue : 5 valves - Tissue : 5 valves
- Mechanical: 6 valves- Mechanical: 6 valves
- Rings : One ring for tricuspid valve repair- Rings : One ring for tricuspid valve repair 33 mitralmitral
Other casesOther cases
Ascending aortic aneurysm in a Ascending aortic aneurysm in a marfan marfan
Ruptured interventricular septum Ruptured interventricular septum
Operative field in cardiac surgeryOperative field in cardiac surgery
Operating room for cardiac surgeryOperating room for cardiac surgery
Noncardiac casesNoncardiac cases
: PDA surgical ligation (7).: PDA surgical ligation (7).
: Pacemaker insertion.: Pacemaker insertion.
: Oesophageal enteric cyst excision. : Oesophageal enteric cyst excision.
: AAA repair ( 2 ).: AAA repair ( 2 ).
: PA banding.: PA banding.
: Fem-Pop bypass graft .: Fem-Pop bypass graft .
PACEMAKER INSERTION IN 30 DAYS OLD INFANTPACEMAKER INSERTION IN 30 DAYS OLD INFANT
PRE OP. POST OP.PRE OP. POST OP.
TERATOMA EXCSTION IN 17 Y OLD GIRLTERATOMA EXCSTION IN 17 Y OLD GIRL
C-T chest of 17 ys old girl showing TeratomaC-T chest of 17 ys old girl showing Teratoma
SVC AneurysmSVC Aneurysm
CXR of 50 years old femaleCXR of 50 years old female
C-T chest of the same patientC-T chest of the same patient
C-T chest of 31 y old female with enteric C-T chest of 31 y old female with enteric cyst of the esophaguscyst of the esophagus
RESULTSRESULTS
One case postoperative mortalityOne case postoperative mortality
Successes rate 98Successes rate 98% %
Mortality rate 2Mortality rate 2% %
MORBIDITYMORBIDITY
) )11 ( ( Perioperative MIPerioperative MI:- 4 cases:- 4 cases
- -↑↑ cardiac enzyme & troponin 3 casescardiac enzyme & troponin 3 cases
- -S-T changes 4 casesS-T changes 4 cases
- -New Q wave 2 casesNew Q wave 2 cases
- -New left bundle block 2 casesNew left bundle block 2 cases
))22 ( (Postoperative bleedingPostoperative bleeding( Re-exploration)( Re-exploration)
) ) No Patients need re-explorationNo Patients need re-exploration.).)
Avarage total drain : 370 mlAvarage total drain : 370 ml
Avarage blood given : 2 unitAvarage blood given : 2 unit
Avarage ffp given : 3 unitAvarage ffp given : 3 unit
Avarage plat. Given : 2 unitAvarage plat. Given : 2 unit
))33 ( (Post operative ArrhythmiaPost operative Arrhythmia
- -Atrial fibrillation : 3 cases, all regained SRAtrial fibrillation : 3 cases, all regained SR
- -Heart block : No casesHeart block : No cases
- -PVCs : 2 casesPVCs : 2 cases
- -Bigeminy : one caseBigeminy : one case
- -V. T) NS ) : one caseV. T) NS ) : one case
- -V. F : No caseV. F : No case
))44 ( (Wound infectionWound infection
- -Superficial wound infection in 5 casesSuperficial wound infection in 5 cases,,
With frequent dressing healed within oneWith frequent dressing healed within one
weekweek..
- One case of deep leg wound infection.One case of deep leg wound infection.
- No cases of Deep sternal wound infectionNo cases of Deep sternal wound infection
- -No cases of mediastinitisNo cases of mediastinitis
))55 ( (Low cardiac outputLow cardiac output
-Occurs in 3 casesOccurs in 3 cases-:-:
- -22 cases Need IABPcases Need IABP..
- -One case Need LVADOne case Need LVAD..
))66 ( (Postoperative DVTPostoperative DVT
One case P/ CABG developed DVT inOne case P/ CABG developed DVT in
unusual site, axillary & brachial veinsunusual site, axillary & brachial veins , ,
) ) predisposed by central line insertionpredisposed by central line insertion ) )
- -Readmitted to hospital and treated medicallyReadmitted to hospital and treated medically,,
- -Improved and dischargedImproved and discharged..
Successful case of ascending aortic Successful case of ascending aortic aneurysm repairaneurysm repair
A 43 y old Indonesian manA 43 y old Indonesian man 12cm asc aortic aneurysm12cm asc aortic aneurysm Congestive heart failureCongestive heart failure Renal and liver impairmentRenal and liver impairment
Ruptured interventricular septumRuptured interventricular septum
6565 years male post acute anterior M.Iyears male post acute anterior M.I.. Cardiogenic shock requiring I.A.B.P Cardiogenic shock requiring I.A.B.P
+Inotropes+Inotropes
Emergency open heartEmergency open heart Transventricular incisionTransventricular incision
Pericardial patch repair Pericardial patch repair
Teflon sheet enforced ventricular Teflon sheet enforced ventricular closureclosure
- ICU stay : 2 – 6 daysICU stay : 2 – 6 days Mean 3 days Mean 3 days
- Hospital stay: 7 – 23 days- Hospital stay: 7 – 23 days
Mean 11 daysMean 11 days
Follow upFollow up
All patients are followed up regularly in out All patients are followed up regularly in out patient clinicpatient clinic
FUTURE OF CARDIAC SURGERY FUTURE OF CARDIAC SURGERY IN KAUH IN KAUH
11 - -Increase the OR days up to 3 days weeklyIncrease the OR days up to 3 days weekly
22 - -Plan to sit Cardiac surgery for pediatricsPlan to sit Cardiac surgery for pediatrics
33 - -Private casesPrivate cases
44--Expand cardiologyExpand cardiology
55 - -Haematology clinic for valve patientsHaematology clinic for valve patients
THANK YOUTHANK YOU