Incidence of complications after cardiac surgery, single unit experience

The objective of this study was to determine the incidence of complications after cardiac surgery in a single unit. This was an observational study. This study was conducted in the department of Cardiac surgery of Civil Hospital Karachi, Dow University of Health Sciences Karachi, over the period of 1 year. This being a prospective, observational study, therefore all patients undergoing cardiac surgery were included in this study, only exclusions being those patients who had redo or reopen procedures. Any complications that took place were noted in the proforma. This study was based on proforma that included patients profile, pre operative investigations, operative data, included date of surgery, type of surgery [whether coronary, valvular or others]. Both intra and post operative complications, like cardio vascular complications, respiratory complications, neurological complications, renal implications, infective complications and miscellaneous complications were noted and entered in the proforma. Over the period of one year, 312 patients have their cardiac surgeries in the department of cardiac surgery, Civil Hospital, Karachi. Over all rate of complications were 118 [37.8%], cardiovascular complications were in 65 patients, neurological in 8 patients, respiratory in 27 patients, renal in 5, infective in 10, and miscellaneous complications in 3 patients. There were two [.6%] mortalities in our study group. This study concludes that cardiac surgery is not free of complications. Therefore it must be done with care and with all the possible supportive measures. The incidence of complications in our unit is about the same as in other renowned centers of the world, but central nervous system complications were less as compared to others, probably related with younger age group of patients in our study

Off-pump coronary artery revascularization trend in Karachi: a local survey

A survey of local cardiac surgeons was carried out to know their views about off-pump coronary bypass surgery [OPCAB]. A questionnaire was developed and all the local cardiac surgeons, who were either consultants or in waiting, were approached and requested to provide required information. This information was accepted as it was and tabulated to see the trend. Twenty one surgeons were approached. Nineteen surgeons were involved in coronary bypass surgery. OPCAB was performed by all with a varying frequency. Majority of surgeons felt that OPCAB was more difficult and the anastomosis not as accurate. They however felt that the procedure was beneficial for high risk patients. It was almost unanimous that off-pump technique was difficult to pass on to the trainess. OPCAB was performed by all the cardiac surgeons, doing coronary surgery, in Karachi. The practice is however not regular. This probably is due to not availability of avenues for CME locally. This would discourage surgeons to pass on the skill to the trainees and the interest may dwindle completely in future

Blood transfusion is associated with increase resource utilization and bacterial infection

To observe the association of blood transfusion and clinical outcome in cardiac surgery patients. Forty patients underwent cardiac surgery during a period of two months in a single institution. Coronary artery bypass surgery [CABG] was performed in 21 [52.5%] patients, Mitral valve replacement [MVR] in 15 [37.5%] patients, aortic valve replacement [AVR] in 2 [5%] patients and Atrial septal defect [ASD] was closed in 2 [5%] patients. The mean age of the patients were 41.7 +/- 18 years, 80% were male. Twenty five [62.5%] patients required blood transfusion. Transfusion group showed chest wound infection [7.5%], pulmonary oedema [12.5%] and shortness of breath [10%]. Total leukocyte count and platelets count were significantly lower in transfusion group. We conclude that blood transfusion is associated with increased rate of infection and pulmonary oedema, with high cost and resource utilization. Blood transfusion should be used with appropriate caution