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KING ABDULAZIZ UNIVERSITY HOSPITAL CARDIAC SURGERY UNIT

KING ABDULAZIZ UNIVERSITY HOSPITAL CARDIAC SURGERY UNIT. Dr. Khalid Al-Ibrahim Dr. Hussein Jabbad Dr. Khalid Medhat Dr. Ragab Shehata. STARTED From 28 th Feb. 2006 once weekly Till may 2006 then twice weekly. Total No. : 53cases. Coronary artery bypass graft

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KING ABDULAZIZ UNIVERSITY HOSPITAL CARDIAC SURGERY UNIT

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  1. KING ABDULAZIZ UNIVERSITY HOSPITALCARDIAC SURGERY UNIT Dr. Khalid Al-Ibrahim Dr. Hussein Jabbad Dr. Khalid Medhat Dr. Ragab Shehata

  2. STARTED From 28th Feb. 2006 once weeklyTill may 2006 then twice weekly

  3. Total No. : 53cases Coronary artery bypass graft CABG ( 35cases ) • Age : 45 – 69 years Mean age : 52.5 years • No of graft : 1- 5 grafts Mean No. : 3.4 grafts

  4. Valve replacement ( 15 cases ) - Aortic Replacement : 2cases. - Mitral Replacement : 5 cases. - Aortic+mitral : 2 case. Mitral+tricuspid 2 cases Mitral repair 3 cases - Combined (Valve Rep + CABG ) : One case

  5. Rheumatic aortic valves Normal aortic valve

  6. Different types of prosthetic valve

  7. Valve replacement - Age 13 - 43 years old Mean 31.7 years Total No. of valves 11 valves - Tissue : 5 valves - Mechanical: 6 valves - Rings : One ring for tricuspid valve repair • 3 mitral

  8. Other cases Ascending aortic aneurysm in a marfan Ruptured interventricular septum

  9. Operative field in cardiac surgery

  10. Operating room for cardiac surgery

  11. Noncardiac cases : PDA surgical ligation (7). : Pacemaker insertion. : Oesophageal enteric cyst excision. : AAA repair ( 2 ). : PA banding. : Fem-Pop bypass graft .

  12. PACEMAKER INSERTION IN 30 DAYS OLD INFANT

  13. PRE OP. POST OP.TERATOMA EXCSTION IN 17 Y OLD GIRL

  14. C-T chest of 17 ys old girl showing Teratoma

  15. SVC Aneurysm • CXR of 50 years old female

  16. C-T chest of the same patient

  17. C-T chest of 31 y old female with enteric cyst of the esophagus

  18. RESULTS One case postoperative mortality Successes rate 98 % Mortality rate 2 %

  19. MORBIDITY ( 1 ) Perioperative MI:- 4 cases - ↑ cardiac enzyme & troponin 3 cases - S-T changes 4 cases - New Q wave 2 cases - New left bundle block 2 cases

  20. (2) Postoperative bleeding( Re-exploration) ( No Patients need re-exploration). Avarage total drain : 370 ml Avarage blood given : 2 unit Avarage ffp given : 3 unit Avarage plat. Given : 2 unit

  21. (3) Post operative Arrhythmia - Atrial fibrillation : 3 cases, all regained SR - Heart block : No cases - PVCs : 2 cases - Bigeminy : one case - V. T( NS ) : one case - V. F : No case

  22. (4) Wound infection - Superficial wound infection in 5 cases, With frequent dressing healed within one week. • One case of deep leg wound infection. • No cases of Deep sternal wound infection - No cases of mediastinitis

  23. (5) Low cardiac output • Occurs in 3 cases:- - 2 cases Need IABP. - One case Need LVAD.

  24. (6) Postoperative DVT One case P/ CABG developed DVT in unusual site, axillary & brachial veins, (predisposed by central line insertion) - Readmitted to hospital and treated medically, - Improved and discharged.

  25. Successful case of ascending aortic aneurysm repair • A 43 y old Indonesian man • 12cm asc aortic aneurysm • Congestive heart failure • Renal and liver impairment

  26. Ruptured interventricular septum • 65 years male post acute anterior M.I. • Cardiogenic shock requiring I.A.B.P +Inotropes • Emergency open heart • Transventricular incision • Pericardial patch repair Teflon sheet enforced ventricular closure

  27. ICU stay : 2 – 6 days Mean 3 days - Hospital stay: 7 – 23 days Mean 11 days

  28. Follow up All patients are followed up regularly in out patient clinic

  29. FUTURE OF CARDIAC SURGERY IN KAUH 1- Increase the OR days up to 3 days weekly 2- Plan to sit Cardiac surgery for pediatrics 3- Private cases 4-Expand cardiology 5- Haematology clinic for valve patients

  30. THANK YOU

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