Off-pump Coronary Artery Bypass Grafting in BMA Medical College and Vajira Hospital

Abstract Off-pump Coronary Artery Bypass Grafting in BMA Medical College and Vajira Hospital Suksan        Kanoksin                         MD, FICST* Suphakarn Techapongsatorn          MD, FICST* Petchsree  Charoensombatamorn BS (nursing)** Siriwan       Tankittiwat                      BN, MSc (nursing administration)** * Department of Surgery, BMA Medical College and Vajira Hospital ** Nursing Department, BMA Medical College and Vajira Hospital Objective: To compare the results between off-pump and on-pump coronary artery bypass grafting. Study design: Cross-sectional study. Subjects: A total of sixty-two patients with coronary heart disease underwent coronary bypass at the Department of Surgery, Bangkok Metropolitan Administrtion Medical College and Vajira Hospital during November 2003 to April 2005 were enrolled. Methods: Hospital records and operative note records were collected and analyzed. Main outcome measures: Preoperative risk factors, intra-operative clinical markers and postoperative outcomes. Results: From the study, the differences between both groups in terms of age, sex, blood pressure, hyperlipidemia and diabetic mellitus were not significant. But there were statistically significant differences between both groups in terms of chronic obstructive pulmonary disease, renal disease, heart failure and number of vessel disease. According to result from intraoperative clinical markers, there was statistically significant differences between both groups in terms of numbers of bypass grafts. From the result of postoperative outcomes, on-pump coronary artery bypass group had more mortality rate, stroke incidence, wound infection rate, reoperation rate for stop bleeding, blood transfusion, drainage volume, rising of cardiac enzyme, longer period of ICU stay, longer ventilator dependence period, and longer hospital admission period. Conclusion: The outcomes of off-pump coronary artery bypass grafting was better than on-pump coronary artery bypass grafting for treatment of coronary heart disease patients. This procedure can reduce the post-operative blood transfusion, post-operative ventilation usage, post-operative ICU stay, and hospital stay. Vajira Med J 2007 ; 51 : 171 - 177

Endovascular Abdominal Aortic Aneurysm Repair: the First Experience in BMA Medical College and Vajira Hospital

Abstract Endovascular Abdominal Aortic Aneurysm Repair: the First Experience in BMA Medical College and Vajira Hospital Suksan                 Kanoksin                         MD, FRCST, FICS* Navin                    Suraphakdee                 MD.** Suphakarn           Techapongsatorn        MD, FRCST, FICS* Worawong           Slisatkorn                      MD, FRCST, FICS*** * Department of Surgery, BMA Medical College and Vajira Hospital ** Department of Emergency Medicine, BMA Medical College and Vajira Hospital *** Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University           This report presents the first experience of endovascular aortic aneurysm repair (EVAR) in the patient with infrarenal abdominal aortic aneurysm at BMA Medical College and Vajira Hospital. The patient was a 73-year-old male, who had abdominal pain which referred to perineal area for 1 year. The physical examination showed pulsatile abdominal mass and the computer tomography revealed infrarenal abdominal aortic aneurysm with a dimension of 6 cm. The patient underwent the EVAR with an uneventful postoperative outcome. At 3-month follow up, neither major complications nor endoleak was observed. Vajira Med J 2008 ; 52 : 265-273