behnam gholizadeh

 One of the most common cognitive disorders after major surgery is delirium which can increase morbidity and mortality. This study compared the effect of dexmedetomidine with or without melatonin to reduce delirium following coronary artery bypass graft (CABG) surgery.

 This trial was a double-blind, randomized, controlled clinical trial. Eighty patients in two different groups with the administration of dexmedetomidine alone or with melatonin undergoing CABG surgery in Golestan Hospital, Ahvaz, 2022 - 2023, were randomly allocated. This study evaluated the occurrence, onset, and length of delirium, haloperidol, the time required for weaning, and the duration of stays in the intensive care unit (ICU) and hospital.

 The occurrence of delirium was lower in the melatonin/dexmedetomidine group (15%) than in the dexmedetomidine group (30 %) (P = 0.09). Additionally, the melatonin/dexmedetomidine group had a significantly lower duration of delirium than the dexmedetomidine group (1.95 (0, 20) and 8.46 (0, 40) P = 0.04). However, no significant difference was observed in the onset of delirium between the two groups (P = 0.25). The length of hospital stays in the melatonin/dexmedetomidine group was significantly shorter than in the dexmedetomidine group (7.53 (7, 10) and 8.60 (7, 15), P = 0.03). However, the two groups demonstrated no significant difference between extubation (P = 0.38) and length of ICU stay (P = 0.19).

 The administration of melatonin and dexmedetomidine reduced the incidence of post-cardiac surgery delirium, shortened its duration, and decreased the impact of many risk factors observed in those not receiving the added melatonin.

Mitral Valve (MV) disease is responsible for a considerable number of open cardiac surgeries. Selecting a befitting prosthetic valve is a matter of consideration. Thus, accurate definition of mitral apparatus characteristics, particularly mitral annulus dimensions, preoperatively can shed some light on the situation. The less invasive nature of three-dimensional Transesophageal Echocardiography (3D-TEE) can turn it into a practical modality for preoperative investigation of mitral anatomy.

The present study aimed to investigate the correlation between the size of mitral annulus attained through 3D-TEE and intraoperative size as well as the valve or ring size finally placed in mitral position.

The study was conducted on 28 patients suffering from MV disease who were candidates for MV surgery. All the patients underwent 3D-TEE. Mitral annulus diameters including anteroposterior and intercommissural diameters were measured delicately by using the Mitral Valve Navigation (MVN) tool. In the midst of surgery, a mitral ring sizer was utilized in order to suggest the proper prosthesis size.

The study results demonstrated that the sizer instrument was strongly associated with the inserted prosthesis size and moderately with echocardiographic annulus diameters. The correlation between the deployed prosthesis size and annulus size obtained by intraoperative sizer and 3D echocardiography was assessed, as well. The results indicated that ring sizer showed a strong positive relationship with the intercommissural echocardiography diameter and a moderate positive relationship with the anteroposterior echocardiography diameter.

The results revealed a good correlation between the echocardiography measurements and intraoperative examination along with the deployed prosthesis size. Thus, 3D-TEE could be considered a practical modality for the preoperative investigation of mitral anatomy.

Regardless of the cause, pulmonary hypertension can increase patient complications and mortality. This study compared the effect of nebulized versus intravenous (IV) milrinone on reducing pulmonary arterial pressure in patients with pulmonary hypertension candidates for open-cardiac surgery.

This double-blind, randomized clinical trial was performed on 32 patients undergoing elective on-pump cardiac surgery during January 2021-January 2022 in the Cardiac Operating Room of Golestan Hospital, Ahvaz, Iran. Patients were randomly divided into test groups nebulize milrinone (N = 16) and IV milrinone (N = 16). The medication was administered after the cross-clamp of the aorta opening. The outcome variables included hemodynamic data, cardiac output, cardiac index, stroke volume, mean arterial pressure (MAP), central venous pressure, mean pulmonary artery pressure (mPAP), systemic vascular resistance, pulmonary vascular resistance, MAP/mPAP ratio, time until extubation, duration of hospitalization in the Intensive Care Unit (ICU), and duration of hospital stay.

In the nebulized group, MAP and MAP/mPAP were significantly higher than in the IV milrinone group (P = 0.09 and P < 0.0001, respectively). The time of extubation (P = 0.001), duration of hospitalization in the ICU (P = 0.009), and duration of hospital stay (P = 0.026) in the nebulized milrinone group were significantly shorter than in the IV milrinone group.

Nebulized milrinone administration before weaning off cardiopulmonary bypass (CPB) can be accelerated and facilitate weaning off CPB. Moreover, despite maintaining MAP, nebulized milrinone significantly reduces mPAP. According to the results of this study, nebulized milrinone is recommended in patients undergoing cardiac surgery with pulmonary hypertension.

Pain is a common complication after heart surgery that can cause problems for the patient. This study aimed to investigate the effect of Holy Quran voice on pain and hemodynamic indices after cardiac surgery.

Subjects and Methods:

This single-blind randomized clinical trial was performed on heart surgery patients admitted to Golestan Hospital in Ahvaz in 2018. In the intervention group, after extubation, two times each day, for ten minutes, the voice of the Quran was broadcast. For the control group, the usual care was continued. Data collection tools consisted of demographic and clinical and visual analog scale (VAS) as well as hemodynamic indices including systolic blood pressure, diastolic blood pressure, and heart rate. Data were analyzed by SPSS software version 22 using Chi-square, independent t-test and repeated ANOVA test.

There was no significant difference between qualitative and quantitative variables between the two groups, so the two groups were similar. Repeated ANOVA test showed that the use of Holy Quran voice was effective in reducing the pain intensity of patients (P <0.001). Also, the results showed the positive effect of Holy Quran voice on systolic blood pressure (P <0.001) and no significant effect on diastolic pressure and heart rate.

The results of the study showed that the Holy Quran voice is effective in reducing pain and systolic blood pressure in patients after open-heart surgery. Therefore, this method can be used as non-invasive nursing care.

Anxiety and depression are common complications after heart surgery. This study aimed to determine the effect of Holy Quran Voice on anxiety and depression after cardiac surgery.

This randomized single-blind randomized clinical trial was performed on 108 open heart surgery patients admitted to Golestan Medical Center of Ahwaz in 2018 using randomized block sampling. In the intervention group, after extubation and gaining alertness, 2 times each day, for ten minutes, the Quran was broadcast. For the control group, the usual care was continued. Data were collected by demographic and clinical data and Hospital Anxiety and Depression Scale (HADS). Data were analyzed using SPSS V22 software using Chi-square, independent t-test, and Mann-Whitney test.

Comparison of changes in anxiety and depression scores in the two groups showed that the mean of anxiety reduction after intervention in the control group was 44.4 ± 2.06 and in the control group was 7.39 ± 2.22. According to the Mann-Whitney test, there was a significant difference between the means of anxiety in the two groups (P = 0.01). Also, the study of changes in depression level by Mann-Whitney test showed that there was no significant difference in the level of depression between the two groups (P = 0.421).

The results of the study showed the positive effects of music on reducing the anxiety of patients after open-heart surgery. Therefore, this method can be used as a cheap and non-invasive nursing care.

Many patients have trouble sleeping after heart surgeries. The aim of this study was to investigate the effect of the Holy Quran Voice on improving the quality of patients' sleep after cardiac surgery.

This randomized clinical trial was conducted from December to March 2012 on 108 patients undergoing elective open heart surgery in the Golestan Hospital of Ahvaz. The data collection tools included demographic data, clinical variables and the Richard Campbell Sleep Questionnaire. In the intervention group, the sound of the Holy Quran was broadcasted twice a day each lasting for 10 minutes. The sleep quality was assessed every day.

Due to the lack of sphericity, the Greenhouse-Geisser correction showed that the use of the Holy Quran voice was effective on the sleep quality of the patients (F = 12.451 and P <0.001).

According to the findings of this study, the use of the Holy Quran voice increased the quality of sleep after cardiac surgery.

Coronary artery spasm (CAS) is defined as a reversible, sudden epicardial coronary artery stenosis that causes vessel occlusion or near occlusion.CASE REPORT: In this article, we present a clinical case of CAS in a 48-year-old woman undergoing elective aortic valve replacement surgery for aortic stenosis. On the 3rd post-operative day, the patient suffered from chest pain and dyspnea. Emergent coronary angiography demonstrated a significant spasm of the ostium portion of the right coronary artery. This case shows that delayed coronary spasm should be considered as a cause of hemodynamic instability after valvular surgery.

The aim of this study was to investigate pulmonary valve replacement cases after previous TF repair. This study conducted in Rajaei cardiovascular medical and research center during 2004 -2011. We collected the information including CI (cardiac index)، (left ventricular ejection fraction) LVEF، (left ventricular end systolic volume index) LVESVI، (left ventricular end diastolic volume index) LVEDVI، (right atrial pressure) RA pressure، RVEF (right ventricular ejection fraction)، (right ventricular end systolic volume index) RVESVI، RVEDVI (right ventricular end diastolic volume index)، tricuspid regurgitation grade، Net forward flow and Pulmonary regurgitated fraction Totally there were 28 cases of PVR. There were 18 and 10 cases of mechanical and biological valves. In comparison between PVR and non PVR cases, the severity of right ventricular dysfunction was higher in PVR cases. The transanular patch was the most commonly used method for repairing TOF, it was used 69. 7% and 47. 4% in PVR and non PVR cases respectively, and this difference was significant. There were significant improvements in severity of pulmonary stenosis before and after PVR, severe PS were 35. 7 and 20% before and after PVR respectively. There were also significant improvements in PAP after PVR (21. 3 and13. 5 before and after PVR respectively) It seems that using transanular patch in repairing TOF is a risk factor for PI which leads to PV. Delay in PVR operation can increase the severity of RV dysfunction and frequency of arrhythmia.