Abnormal post-operative bleeding in patients with congenital heart diseases undergoing open heart surgery

To report the incidence of postoperative bleeding and to evaluate perioperative parameters and its relationship with the volume of blood loss and blood transfusion requirement. This was a retrospective study of 49 patients with congenital heart diseases undergoing open heart surgery developing abnormal post operative bleeding in Ibn Al-Bitar hospital for cardiac surgery from January 1st, 2004 to December 31st, 2008, There were 29 males [59%], and 20 females [41%]. Age ranged from 3-38 years with an average of 20 years. The study involved data obtained when the patients arrived at the intensive care unit [ICU] and for the following 24 hours. Young children, female gender, lower body weight and surface area, cyanotic heart diseases, types of procedures, longer time of CPB and aortic clamping time, low temperature, type of oxygenator used in CPB [affinity], higher total intra- operative doses of heparin and protamine, all were shown to significantly increase postoperative blood loss and transfusion requirement. The incidence of postoperative bleeding was 9.35%. Twelve percent needed reoperation to control hemorrhage. The morbidity was 24.3% and the mortality was 4.1%. Factors that may contribute to increased blood loss and transfusion requirement include age below 10 years, female gender, low body weight and surface area, prolonged duration of CPB, hypothermia, preoperative anemia, and high doses of heparin and protamine

Experience at Ibn Al-Nafis cardiovascular hospital of left atrial myxoma

Seven [7] cases of left atrial myxoma were diagnosed during a period of [5] years. The clinical manifestations simulated mitral disease but M-mode Echo and angiography were diagnostic. The tumour was resectable in all patients and surgery was curative in all of them