RESUMEN
Objective: our aim of study was to determine early and late outcomes of CABG in patients with poor left ventricular function. The CABG surgery is beneficial in patients who have poor left ventricular function manifested by an ejection fraction 30% or even less. These are the high risk patients but CABG surgery not only promotes their survival but also improve their functional status. They are easy victims of increased operative mortality and diminished long term survival
Methods: in our study we identified 63 patients who underwent CABG surgery despite poor LV function. Data was collected during their follow up visits or telephonic follow up conducted by us. We used pre op. IABP in 2[3.17%] patients. Among these 63 patients 36[57.14%] were documented as healthy and Stable, 9[14.29%] were expired during follow up and in 18[28.57%] follow up was not continued because 4[6.35%] have no contact numbers and 14[22.22%] phones were switched off. The average duration from 2008 to 2015 was taken to be 42.5 months approximately. Each patient necessarily received at least one IMA. : The surgical strategy included approach through median sternotomy. All cases were started as off-pump CABG. Elective conversion to on-pump CABG was done for cases not tolerating off-pump
Results: in this retrospective study we have analyzed the early and late outcomes of CABG in low EF group. Main findings of the study are an acceptable hospital mortality i.e. mortality rate among patients with EF <30% is 1.59% at our tertiary care center However, post-surgery complications prevailed.3 [4.7%] patients encountered deep wound infection and same ratio suffered renal failure. We observed the early outcomes i.e. in hospital mortality evaluated to be 1.58%. These results reflect improving results of surgery in this high risk group
Conclusion: our study demonstrated that all of our patients received at least one arterial graft i.e. internal mammary artery. The minimum standard set by STS is that at least 95% of the patients must receive internal mammary artery. This contributes to the survival benefit of the patients and also improves the quality of life and reduces reoperation rates. In this retrospective study we have analyzed the outcome of CABG in low EF group. Main findings of the study are acceptable hospital mortality. We concluded that acceptable morbidity and mortality rates prevailed among this high risk group at our tertiary care center. We believe that improvements in cardiac anesthesia, surgical technique, extracorporeal perfusion, perioperative care and postoperative management have contributed significantly to better outcomes
RESUMEN
Aneurysm of sinus of valsalva is a rare anomaly. Here, we analyze retrospectively patients operated at PIC during 93 and 98.Sixteen cases of'ruptured aneurysm of sinus of valsalva were operated upon at PIC. The majority arose from the right coronary sinus. The right ventricle was the most common chamber of rupture [62.5%]. Ventricle septa] defect was associated in 7 patients, of which 5 were supracristal type. The VSD was most common in aneurysm arising from the right coronary sinus 5 cases. Aortic regurgitation was found in 7 patients. In only 2 cases it was severe enough to have aortic valve replacement. The defects were closed through aortic root alone in two patients, while in rest of the cases combine approach was used [aortic root and chamber of rupture were opened]. In only two cases aortic valve repair was done. There was no immediate mortality, only one patient died in late follow up. Repair of RSVA through an aortotomy with or without cardiotomy permits inspection of the aortic root complex and facilitate aortic valve repair. Surgery for aneurysm of sinus of valsalva yields gratifying result and it should be as soon as the condition is diagnosed