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Beating Heart Surgery

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

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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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