Potential risk factors for surgical site infection after isolated coronary artery bypass grafting in a Bahrain cardiac centre: a retrospective, case-controlled study

Objective: The purposes of this study were to determine the incidence of surgical site infections [SSI] and associated risk factors in patients undergoing isolated coronary artery bypass grafting [CABG] in our cardiac center during a 2?year period

Materials and Methods: Retrospective case-control analysis for 80 patients who underwent isolated cardiac surgery CABG. These patients were divided into the SSI study group [n = 40] and the noninfected control group [n = 40]. Eight potential perioperative risk variables were compared between the two groups using univariate logistic regression analysis

Results: Univariate analysis was carried out for eight potential risk factors. The risk factors found to be significant were: Impaired estimated glomerular filtration rate [P = 0.011] and impaired left ventricular ejection fraction [P = 0.015]. However, Factors found to have no significant influence on the incidence of SSIs were: Perioperative length of hospital stay [days], urgency of surgery, use of bilateral internal mammary artery [BIMA] grafting, prolonged cardiopulmonary bypass duration, elevated body mass index

Conclusion: Patients with comorbidities of impaired renal function and/or impaired left ventricular systolic function are at high risk of developing SSI. There appears to be a relationship between SSIs in CABG patients and impaired renal or LV function [low ejection fraction]. CABG with BIMA grafting could be performed safely even in diabetics. Future studies should consider further scrutiny of these and other factors in relation to SSIs in a larger surgical population

Atypical early aspergillus endocarditis post prosthetic mitral valve repair: a case report

A 64-year-old female operated 1 month previous for mitral valve repair presented with acute respiratory distress and dyspnea. Echocardiography showed large echogenic valvular mass measuring 2.3 x 1.3 cm with severe mitral regurgitation and dehiscence of the mitral ring posteriorly. The mass was attached subvalvularly to the ventricular septal-free wall and eroding through it, which required complete aggressive dissection of the infected tissues. Diagnosis was confirmed after resection of the valve by multiple negative blood cultures and positive valvular tissue for Aspergillus fumigatus endocarditis. She was treated with high dose of voriconazole for 3 months. Her postoperative period was complicated by acute-on-chronic renal failure. She responded very well to the management