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Beating Heart Surgery

Dr. Abdul Ghaffar shares the early phase experience in coronary artery surgery at Punjab Institute of Cardiology, Lahore, from February 2003 to October 2006. The cases involved coronary artery bypass grafting, valvular heart surgery, and congenital cardiac lesions, with detailed demographic and procedural data provided. The techniques included blood cardioplegia, intermittent fibrillatory arrest, and beating heart surgery, with insights into IMA harvesting and post-operative complications. Beating heart surgery proved to be reproducible, with a safe and cost-effective learning curve.

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Beating Heart Surgery

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  1. Beating Heart Surgery Punjab Institute of Cardiology, Lahore

  2. Early Phase Experience in Coronary Artery Surgery atPunjab Institute of Cardiology, Lahore Dr. Abdul Ghaffar; FCPS (Cardiac Surgery) Assistant Professor of Cardiac Surgery, Consultant Cardiac Surgery, Punjab Institute of Cardiology, Lahore.

  3. Duration February , 2003  October, 2006 Case Distribution Total Cases=797 Coronary Artery Bypass Graft (CABG)=482 Valvular Heart Surgery =176 Congentital Cardiac lesions =139

  4. Coronary Artery Bypass Grafting Age Distribution = 32 - 87 Years ( 56y) Sex Distribution Male = 372(77.6%), Female = 110(22.4%) Risk Factors Distribution Diabetes Mallitus =156 Cases(32.4%) Hypertension =239(49.85%) Smoking = 94 (19.5%) Hyperlipidiamia (Obesity) = 238 (49.83%)

  5. Extent of Disease Single vessel disease =8(1.66%) Two vessel disease =104(21.57%) Tripple vessel disease = 370 (76.76%) Ejection Fraction (EF%) Poor EF 15-20 = 24 (4.98%) Low EF 20-30 = 76 (15.76%) Moderate to normal EF above 30% = 382 (79.25%) CLOT in LV Cavity = 7 (1.5%)

  6. Per Operative Techniques Blood Cardioplegia =7 (1.45%) Intermittent Fibrillatory arrest = 377 (78.21%) Beating Heart Surgery = 98 (20.33%)

  7. IMA Harvesting

  8. Beating Heart Surgery Technique

  9. Number of Grafts Cardioplegia 1-3 ( 2.3) Intermittent Fibrillatory arrest 2-6 (3.7) Beating Heart Surgery 2-5 (3.6)

  10. Grafts Used LIMA =479 (99.38%) SVG=In (Addition to LIMA) Blood Used =(354)Cases Number of Blood Bags used= 1-6 (1.9)

  11. ICU Stay Cardioplegia 1 - 3 ( 1.7) Days Intermittent Fibrillatory arrest 1- 5 (1.4) Days Beating Heart Surgery 1 - 3 (1.3) Days

  12. Institutional Stay (Post Op) Cardioplegia 7 - 23 (9) Days Intermittent Fibrillatory arrest 6 - 42 (7.9)Days Beating Heart Surgery 5 - 18(6.7) Days

  13. Post OP Complications Reopening = 7 (1.45%) Woond Infection:- Superifical = 23 (4.77%) Deep = 8 (1.66%) Central Nervous System : CVA = 2 (0.41%) Gastro- Intertimal & Biliary Mild = 21 (4.36%) Severe = 01 (0.20%) Renal = 18 (3.73%)

  14. Mortalities (seven Days Post OP in Hospital) Total = 3 (0.62%) 1st Case =ICU- Post Operative 2nd Case = Renal shutdown (7th Post Op Day) 3rd Case =Hepatic/ Renal Shut down (5th Post Op Days)

  15. INFERENCES Beating Heart Surgery Reproducible result Learning Curve Safe Cost effective

  16. Thanks

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