Which Factors Unexpectedly Increase Depressive Symptom Severity in Patients at the End of a Cardiac Rehabilitation Program?

OBJECTIVE: To investigate predictors of depressive symptom aggravation at the end of a cardiac rehabilitation (CR) program. METHODS: The design of the study was retrospective. The administrative data were obtained from the database of the CR department of a heart hospital in Iran. The demographic and clinical information of 615 CR patients between January 2000 and January 2010 was analyzed using binary logistic regression analysis. RESULTS: The results showed that 10.7% of the patients completed the CR program with aggravated depressive symptoms. After adjustment for gender, age, and pre-intervention depression score, lower education level (p<0.05) and smoking (p<0.01) were significant predictors of increased depressive symptoms at the end of the program. Our model variables could explain 6% to 13% of the dependent variable variance. CONCLUSION: The results suggest that targeting patients who are less literate or who smoke could allow for taking the required measures to prevent or control depression at the end of a CR program. It is suggested that future studies consider other variables.

Suction tip migration to internal iliac vein during cardiac surgery

During the cannulation of the inferior vena cava in a 29-year-old patient undergoing mitral and aortic valve replacement, the pump suction tip was inadvertently lost in the right atrium. After starting CPB and cardioplegic arrest of the heart, the right atrium and ventricle were searched for the foreign body, but it became evident by reontgenography that the foreign body had migrated to the pelvic veins. At the end of the operation, extraction with a Fogarty catheter was attempted but was not successful and the foreign body was extracted via laparatomy