Evaluation of patients with coronary artery disease for major modifiable risk factors for ischemic heart disease

Incidence of cardiovascular diseases is on the rise in developing countries. Deaths due to ischemic heart disease can be reduced by modifying the risk factors. The present study was conducted to evaluate the patients scheduled for Coronary Artery Bypass Surgery for the presence of major modifiable risk factors for ischemic heart disease [IHD]. It was a descriptive study. All patients who underwent elective Coronary Artery Bypass cardiac surgery between November 1, 2008 and February 28, 2009 at Rehman Medical Institute, Peshawar, were included in the study. Presence of Diabetes, Hypertension, Smoking, Dyslipidemia, Sedentary life style, and Obesity was looked for in these patients. A total of 104 patients were studied during this period. Majority [97.11%] of patients had at least one major modifiable risk factor for IHD. Sedentary life style [53.84%] was the most common risk factor present in these patients followed by hypertension and dyslipidemia [47.11% each], smoking [43.27%], diabetes [35.57%], and obesity [9.61%]. Multiple risk factors [two or more] were found in 78 [75.0%] of patients. Most of the patients with coronary artery disease, severe enough to warrant coronary artery bypass grafting, have at least one of the major modifiable risk factors for IHD. Modification of these factors may well reduce the disease burden of CAD and reduce the cardiovascular mortality.

Mitral valve repair for pure mitral regurgitation and mixed mitral valve disease

Out of all mitral valve salvage cases done at the Punjab Institute of Cardiology, Lahore between 1991 and April 1994, 60 cases operated upon by one surgeon were selected for study. There were 4 [6.67%] hospital and 2 late deaths. Three patients including one late death underwent mitral valve replacement at a later stage. Six patients were lost to follow up. The remaining 46 patients are being followed up to assess the success of the repair or otherwise in terms of the New York Heart Association [NYHA] functional class of the patients and echocardiographic findings. All our patients dad rheumatic involvement of the mitral valve. The associated cardiac lesions were ASD in 2 [3.33%], tricuspid regurgitation in 40 [66.67%] and aortic regurgitation in 23 [38.33%] patients. The age range was between 10 and 50 years. The follow up period was 3-43 months. Forty [86.96%] patients are in functional class I or II while 6 [13.04%] patients are in functional class III or IV. Twenty-five [54.35%] patients have trivial or mild mitral regurgitation on post operative echocardiogram while 14 [30.43%] have moderate mitral regurgitation. We conclude that satisfactory results can be obtained with repair even in cases with rheumatic mitral valve disease