Total anomalous pulmonary veins connection: the perioperative risk factors

Operative reconstruction of total anomalous pulmonary veins connection [TAPVC] in the literature has high morbidity and mortality. The aim of the study was to investigate the perioperative risk factors to lower the mortality rate. We retrospectively studied the cases of 42 infants operated for Total Anomalous Pulmonary Veins Connection between August 2002 to August 2007 at Damascus University Cardiovascular Surgical Center. We evaluate the role of right ventricle pressure, Left Ventricle End Diastolic Volume [LVEDN], the anatomical type of anomalous, age and weight of patients, pulmonry infections and delay in doing surgery as perioperative risk factors. Our study demonstrates that neither Left Ventricle End Diastolic Volume nor RV pressure were risk factors. Pulmonary infections secondary to long-standing pulmonary congestion was the only important risk factor. It is highly recommended to operate in the first months of life before the occurring of any pulmonary infection

[Acute respiratory distress syndrome after heart surgery: a comparative study between coronary artery bypass operations and other cardiac operations in adults]

To study the role of the arterial hypertension, smoking, diabetes mellitus and low Left Ventricle Ejection Fraction [LVEF] in the incidence of Acute Respiratory Distress Syndrome [ARDS] after coronary artery bypass operations. This perspective study included 732 Coronary Artery Bypass Graft operations [CABG] and 912 other cardiac operations during the period between 1995 and 2005. While Acute Respiratory Distress Syndrome [ARDS] occurred in 2% of on-pump CABG operation, its incidence was only 0.4% is other on-pump cardiac operations. None of the off-pump CABG operations were complicated by ARDS. The role of arterial hypertension, diabetes mellitus, smoking and low LVEF is very important in inducing ARDS in on-pump CABG operations

[Of-pump coronary surgery is a well approved surgical method]

We studied the case of 171 patients who had CABG on a beating heart without CPB. 58 Patients had [EF < 30%] . All Patients had CABG for LAD, 98 Patients had CABG for RCA + LAD. 34 Patients had CABG for CX + LAD. only 5 % had post operative Myocardium infarction. Postoperative Mortality was 0.85% .Other complications were rare

[ surgical treatment of the ischemic aneurysm of the left ventricle]

We studied 67 cases of left ventricular aneurysm following a myocardial infarction through 1993 to 2002. 22 Patients had only aneurysmectomy 45 Patients had aneurysmectomy + CABC +/- Mitral surgery. Death percentage in the first year after surgery was 8.9 %. The good clinical and haemodynamical results are due to the clear indication of surgery on patients who had more than 25% of the LVDV involved by aneurysm