seyed jalil mirhosseini

Congenital heart disease is a massive structural abnormality in the heart or large vessels inside the chest that is potentially important. Vitamin D is essential for the recovery of organs. This study aimed to evaluate the effect of serum vitamin D levels on clinical outcomes after pediatric open-heart surgery. Recent studies in infants have shown that vitamin D deficiency and hypocalcemia are associated with heart shock.  The following descriptive cross-sectional study was conducted in the Cardiology Unit of Shahid Faghihi Hospital in Shiraz from April 2021 to October 2022, involving 115 patients aged one to seven years old. Serum levels of vitamin D were measured to evaluate the correlation between vitamin D levels and postoperative clinical outcomes. Data was gathered using SPSS.v16 software and analyzed through statistical tests.  The mean age of the patients in this study was 29.20± 53.10 months. The average vitamin D level of the patients was 24.52± 10.3 ng/ml. The study's findings indicated that infants eligible for heart surgery with normal vitamin D levels had significantly shorter durations of Inotropes, ventilators, chest tubes, and Intensive Care Unit (ICU) stay (P<0.001).  Decreased vitamin D levels in children with abnormal vitamin D can delay the improvement of heart and myocardial function and increase the use of inotropes, ventilators, and chest tubes. It also increases the number of days hospitalized in the ICU after Cardio Pulmonary Bypass (CPB) surgery.

Coronary artery revascularization is the standard treatment for patients with severe left main coronary artery disease (LMCAD). In cases where the patient refuses surgical revascularization or PCI, medical treatment will be the only option. The purpose of this study was to compare the one-year outcomes of patients with (LMCAD) in terms of surgical or medical treatment. This prospective cohort study was conducted on 139 patients (91 men and 48 women) with severe left main coronary artery disease who were diagnosed by coronary angiography from 1st Mar 2014 to 28th Feb 2014. Patients were followed up for one year as to major adverse cardiac and cerebral events (MACCE) including death, non-fatal myocardial infarction, stroke, and hospitalization. From total of 2661 coronary angiographies, 139 patients (5.2%) with a mean age of 63.2±7.2 years had LMCAD. The mortality rate in the medical treatment group and the surgical group appeared to be 16.7% (6 cases) and 8.7% (9 cases) respectively (p =.156). The rate of stroke in the medical group turned out to be 5.6% (n=2) and in the surgery group 2% (n=2) (p =.27). The rehospitalization rate was 19.4% in the medical treatment group but 4.9% in the surgical group (p =.013). During one year, the survival rate was significantly lower in the medical group than the group undergoing coronary artery bypass graft surgery (58.3% vs. 84.5%) (p =.002). In the short term, the optimal medical treatment of patients with LMCAD was not significantly different from that of CABG patients in terms of fatal cardiac and cerebral events. However, rehospitalization was more common due to recurrent angina pectoris.

Heart failure is one of the most common chronic cardiovascular diseases, which often triggers disability or death. Health-related Quality of life (HRQoL) is one of the most critical factors in deciding how to treat these patients. In this study, we want to figure out the effect of different factors on the quality of life in patients.

This cross-sectional study was performed on 129 patients with heart failure referring to the center of Afshar Hospital in Yazd City, Iran 2017-2018. The standard (Shot Form survey) SF-36 questionnaire was used to measure different dimensions of quality of life.

In the present study, 77 men and 52 women with heart failure were included and the relationship between comorbidities, heart failure classification factors, age, sex, and history of hospitalization with quality of life was measured. The result revealed a significantly higher quality of life in patients under 50 years (P = 0.005) as well as in men (p<0.001). And in the total population, the average quality of life appeared to be 45.46.

Quality of life in patients with heart failure is related to gender and age, so in women over 50 years, the quality of life proved lower but not related to factors such as, hospitalization, type of failure and stage of the disease. Among diseases related to heart failure, only people with high blood pressure showed lower quality of life scores. The total quality of life index score among our subjects was reported to be moderate to low.

Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA1c is a measure of glycemic control. This study aimed to determine the effect of glycemic status on the complications of coronary artery bypass graf (CABG) surgery in diabetic patients. This cross-sectional study was performed on 300 diabetic patients including 186 (62%) men and 114 (38%) women who underwent CABG from March 2010 to August 2011 and selected via census method. Preoperative blood glucose control status was determined using HbA1c levels, and the patients were evaluated for postoperative in-hospital complications. The mean age of the patients was 62.3 ± 6.9 years. In-hospital mortality was 1.0% (3/300). New-onset atrial fibrillation was the most common complication (35%). HbA1c level above 7.5% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio 1.9, 95٪ CI: 1.1-3.2, p = 0.006). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA1c level in two groups with or without complication. Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA1c measurement can be a predictor of high-risk patients.

No abstract

Atrial fibrillation is the most common arrhythmia after coronary artery bypass grafting (CABG) and occurs in up to 30% of patients with heart failure. Mesenchymal stem cells (MSCs) can regenerate and improve cardiac function after tissue damage and are used in clinical trials. Due to the possible ability of MSCs to improve cardiac functions, in this work, we aimed to examine the probable association of the MSCs proliferation rate with the requirement for antiarrhythmic drugs in patients with severe left ventricular dysfunction after off-pump CABG.

Bone marrow samples were obtained from the sternum of 30 patients who underwent off-pump CABG at Afshar Hospital and Seyed Al-Shohada Hospital. For calculating MSCs doubling time, the cells were counted after 4, 7, and 14 days using trypan-blue color and a hemocytometer.

There were no significant differences between MSCs'doubling time and the patient's age and gender. The percentage of women patients who require antiarrhythmic medicine was significantly higher than men after surgery. Also, we demonstrated that the BMSCs doubling time in female patients who received antiarrhythmic drugs was less than that of male patients who received antiarrhythmic drugs, but these differences were not significant.

Based on this research, we concluded that women patients who received antiarrhythmic drugs were significantly higher than men, but there was no apparent relevancy between MSCs doubling time and antiarrhythmic drugs requirement in patients with severe left ventricular dysfunction.

Severe left ventricular dysfunction patients with ejection fraction≤30% are at a higher risk for complications and mortality than patients with ejection fraction>30%. The death of cardio-myocytes at injured regions leads to myocardium dysfunction. Bone marrow-derived mesenchymal stem cells are undifferentiated cells that have been used for the regeneration of damaged cardio-myocytes. Due to the inherent capability of mesenchymal stem cells to improve cardiac functions, in this research, our objective was to explore the possible association of the mesenchymal stem cells proliferation rate with Coronary Artery Bypass Grafting outcomes in patients with severe left ventricular dysfunction after off-pump Coronary Artery Bypass Grafting.

For investigating the possible association of mesenchymal stem cells proliferation with Coronary Artery Bypass Grafting outcomes (ejection fraction, hypertension risk, and the time of hospital stay), we collected bone marrow samples from 30 patients (18men and 12women) who underwent off-pump Coronary Artery Bypass Grafting at Afshar Hospital and Seyed Al-Shohada Hospital(Yazd, Iran). Mesenchymal stem cells were isolated and cultured; then, cells were counted after 4, 7, and 14 days using trypan-blue color, and doubling times were calculated.

There was an association between doubling time and ejection fraction after surgery. Ejection fraction in postoperative patients increased, but this association was not significant. Also, our study showed that the risk of hypertension is equal in male and female patients. There were no significant differences in mesenchymal stem cells doubling time with hypertension and the time of hospital stay in the ICU.

Based on this study, we concluded that there was no significant relationship between the rate of mesenchymal stem cell proliferation and Coronary Artery Bypass Grafting outcomes in patients with severe left ventricular dysfunction.

Metabolic syndrome (MetS) is one of the world’s largest health epidemics, and its management is a major challenge worldwide. The aim of this 10‑year follow‑up study was to assess the most important predictors of MetS persistence among an Iranian adult population.

In this cohort study, 887 out of 2000 participants with MetS aged 20–74 years in the central part of Iran were followed‑up for about 10 years from 2005–2006 to 2015–2016. MetS was defined based on the criteria of NCEP‑ATP III adopted for the Iranian population. Cox proportional hazards regression was conducted to evaluate the predictors of MetS persistence in crude‑ and multivariate‑adjusted models.

Our analyses showed that 648 out of 887 participants (73%) completed the follow‑up and 565 (87.2%) of them had persistence of MetS after 10‑year follow‑up. There was a significant association between age, weight, body mass index, triglyceride, and waist circumference in participants who had MetS compared to those without MetS after 10‑year follow‑up (P < 0.05). There was a direct association between increases in the mean changes of systolic/diastolic blood pressure, waist circumference, and low HDL‑C and risk of MetS persistence after adjusting the model for sex and age in the total population (Ptrend < 0.05). The trends were the same for women except in diastolic blood pressure. After adjustment for potential confounders, the risk of MetS persistence in men was significantly higher than women (HR = 1.98, 95% CI: 1.38–2.85, Ptrend = 0.001).

Most of the risk factors of MetS were positively associated with persistence of MetS. Therefore, modification of lifestyle is recommended to reduce MetS.

Chest physiotherapy (CPT) is a care that increases the mobilization of several structures from both muscle and subcutaneous tissue. We planned to investigate the effect of classic CPT on pain, fatigue, satisfaction, and hospital length of stay (LOS) in patients undergoing off-pump coronary artery bypass graft (CABG). This study was a randomized controlled trial that conducted on 50 patients undergoing elective off-pump CABG. The patients have been randomly divided into two groups; in the group A (n=25) patients received physiotherapy at a single session of classic CPT, 4 times during 2nd to 5th days for 15 minutes in every session, in the group B (n=25) patients had not protocol of this exercise therapy (control). The average age of all participants was 62.08 ±9.08 years. Of the 50 patients, 33 (66%) was male. Classic CPT significantly decreased pain (P=0.04), hospital LOS (P=0.010) and could increase in patients’ satisfaction (P<0.001). However, it had no considerable effect on fatigue (P=0.725). According to our findings, classic CPT could improve postoperative care after off-pump CABG surgery.

There is limited data about the effects of smoking cessation (SC) strategies among the candidates for coronary artery bypass graft (CABG) surgery.
This study aimed to compare the effects of nicotine replacement therapy (NRT) and nursing counseling (NC) on SC among the candidates for CABG.
This randomized controlled trial was made in the heart center of Afshar hospital, Yazd, Iran. Sixty candidates for elective bypass graft were recruited and were randomly allocated either to a NC or a NRT group. Study interventions were implemented from 3 weeks before to 3 weeks after the surgery. Before and after hospitalization for the surgery, patients in the counseling group received telephone counseling while during their 1-week hospital stay, they received face-to-face counseling. Patients in the NRT group received nicotine gums before and after hospitalization and were treated with nicotine patches during their 1-week hospital stay. Data were collected through three questionnaires. The Chi-square and the independent-sample t tests were run to analyze the data.
SC rate in the counseling group was significantly higher than the NRT group (63.3% vs. 33.3%; P = 0.038). Moreover, cessation rate among the participants with lower nicotine dependency was significantly greater than those with moderate-to-severe dependency (P = 0.01).
NC is more effective than NRT in improving SC rate among the candidates for CABG.

Metabolic Syndrome (MetS) is rapidly growing in today''s world as an important predictor for type 2 diabetes and cardiovascular disease.

The present study aimed at assessing the incidence of MetS and the most powerful components as predictors of MetS in a cohort study in central Iran.

This cohort study was a follow-up of participants (n = 2000 and aged 20 to 74 years), who were selected using multistage random cluster sampling method from urban areas of Yazd, Iran, during year 2005 and repeated in 2015. Metabolic Syndrome was defined using a modified version of National cholesterol education program adult treatment panel III (NCEP III) definition. To assess hazard ratio of components of MetS for crude and adjusted values in two models, Cox proportional hazard regression was used.

Prevalence of MetS was 44.8% (n = 887) at baseline. Therefore, we followed subjects without MetS (n = 809) in 2015. After about 10 years, MetS was developed in 56.1% (n = 454) of subjects. Incidence of MetS in males and females was 56.1/1000 person-years and 58.7/1000 person-years, respectively. The analysis revealed that incidence of MetS significantly increased with age and higher level of socio-economic status and decreased with high level of education. In females and males the most powerful component for incidence of MetS was high fasting blood glucose (HR = 16.6, 95% CI: 1.91 - 22.82) and hypertriglyceridemia (HR = 1.64, 95% CI: 1.02 - 2.6), respectively.

The current study showed a high incidence of MetS in males and females residing in central Iran. Furthermore, community-based interventions that reduce MetS in the population are needed.

Renal dysfunction is a risk marker in patients who candidate for coronary artery bypass graft (CABG). Renal disorder is associated with prolonged stays in intensive care unit and hospital, morbidity and mortality. Aim of this study is specific evaluation of association between preoperative creatinine (Cr) with atrial fibrillation (AF) after elective off-pump CABG in non-diabetic male patients with normal ejection fraction. Two hundred non-diabetic male patients with normal ejection fraction undergoing elective off pump CABG surgery enrolled in this cross-sectional study and were stratified by present or absence of postoperative atrial fibrillation: patients with postoperative new-onset atrial fibrillation (n=100) as group 1 and patients without new-onset postoperative atrial fibrillation as group 2 (n=100). Preoperative serological test of the participants, such as serum creatinine, were recorded in their medical dossiers. Data were analyzed in SPSS-16 software and tested for association between atrial fibrillation with creatinine level by using student t test, chi-square test or logistic regression. Cr level in patients with and without AF three days before surgery were 1.8±0.3 and 1.0±0.4 respectively (P value for Cr=0.00). On surgical day, mean Cr level in patients with and without AF were 1.6±0.2 and 1.1±0.5 respectively (P value for Cr = 0.00). Of the 100, male patients with postoperative AF, duration and frequency of recurrence of AF were not associated with Cr at three days before surgery and on surgical days (P>0.05). Patients with postoperative AF had unsuitable status of renal function compare to patients without AF; however, preoperative serum creatinine cannot associate with duration and frequency of recurrence of AF.

Mediastinitis is an infrequent complication after coronary artery bypass graft (CABG) that is associated with prolonged intensive care unit and hospital stay, and increased early and late morbidity and mortality. Patients with mediastinitis have an osteoporotic, fragile, and broken sternum. All foreign bodies as well as infected tissue should be removed. Osteomyelitis of sternum often perseveres after debridement for mediastinitis. In this report, we describe an unusual case of costochondritis caused by aspergillosis following off pump CABG surgery in a male patient in Yazd-Iran.

During off-pump coronary artery bypass (OPCAB), the heart is subjected to ischemic and reperfusion injury. Preconditioning is a mechanism that permits the heart to tolerate myocardial ischemia. The aim of this study was to compare the effects of Adenosine preconditioning with ischemic preconditioning on the global ejection fraction (EF) in patients undergoing OPCAB. In this single-blind, randomized controlled trial, sixty patients undergoing OPCAB were allocated into three equally-numbered groups through simple randomization: Adenosine group, ischemic group, and control group. The patients in the Adenosine group received an infusion of Adenosine. In the ischemic group, ischemic preconditioning was induced by the temporary occlusion of the left anterior descending coronary artery twice for a 2-minute period, followed by 3-minute reperfusion before bypass grafting of the first coronary vessel. The control group received an intravenous infusion of 0.9% saline. Blood samples at different times were sent for the measurement of creatine kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTnI). We also recorded electrocardiographic indices and clinical parameters, including postoperative use of inotropic drugs and preoperative and postoperative EF. History of myocardial infarction, hyperlipidemia, diabetes mellitus, kidney disease, preoperative arrhythmias, and utilization of postoperative inotrope was the same between the three groups. The incidence of postoperative arrhythmias was not significant between the three groups. Also, there were no significant differences in preoperative and postoperative EF and the serum levels of enzymes (cTnI and CK-MB) between the groups. Based on the findings of this study, there was no significant difference in the postoperative EF between the groups. Although the incidence of arrhythmias was higher in the ischemic preconditioning group than in the other groups, the difference between the groups did not constitute statistical significance.

Cardiovascular disease is the leading reason of morbidity in older people. Coronary artery bypass graft (CABG) surgery is the most common type of operations in world. This study was designed to characterize comparison of early clinical outcome following on pump vs. off pump in patients over 70 years old with triple vessels disease and severe left ventricle dysfunction. 80 patients were divided into two groups: In group A (n=40) on pump CABG was performed with hypothermic cardiopulmonary bypass and cold blood cardioplegic arrest and in group B (n=40) the patients had off pump coronary artery bypass (OPCAB) surgery. Exclusion criteria included emergency or urgent operation, combined valve surgery, history of renal insufficiency (Cr >2 mg/dl), stroke. Early postoperative complications such as occurrence, duration and frequency of recurrence of atrial fibrillation were recorded. All patients underwent Holter monitoring after ICU discharge during their hospital stay. The average age of patients was 79.5±7.5 years. Post operative atrial fibrillation (POAF) occurred in 24 cases (30%); 17 cases (42.5%) related to on pump CABG group and 7 cases (17.5%) related to OPCAB group (P=0.03). The frequency of the recurrence of AF in the on pump group was 3.8±1.3 days and in the off pump group was 2.4±1.1 days (P=0.02). ICU stay in on pump group was 3.6±1.80 days, while for the off pump was 2.5±0.6 days (P=0.001). Also hospital stay duration was 8.5±2.1 days for the on pump group compared to the other group that was 6.34±1.06 days. Off pump in patients over 70 years old with triple vessels disease and severe LV dysfunction is safer than on pump and can reduce POAF, ICU and hospital stay and some early surgical complications.

In this study, it was surveyed to know whether an oral single dose of oleuropein could mimic the cardiac preconditioning in rats’ hearts or whether its prolonged oral administration could protect the heart against the aconitine-induced arrhythmia in rats. Eighty male Wistar rats were divided into two series (n = 8 in each group). In the first series, all groups (except the control (Con) group) were given a single oral dose of oleuropein (20 mg/Kg) 1, 3, 24 and 48 h before the infusion of aconitine. In the second series, except the Con group, the other four groups were given oral oleuropein (20 mg/Kg/day) for 3, 7, 14 and 28 days, before the infusion of aconitine. Electrocardiogram was recorded to monitor arrhythmia. Data of the first series showed that the initiation time of arrhythmia, the initiation of ventricular tachycardia (VT), the numbers of reversible ventricular fibrillation (VF) and the death time had no significant difference compared with Con group. In the second series, a significant protection was occurred only in the 28 days group that was evident with increased initiation time of arrhythmia, increased initiation time of VT, and increased the number of reversible VF and death time in compared to the Con group. The findings of this study show that the oral administration of a single dose of oleuropein could not mimic the preconditioning effects in rat hearts, but the prolonged administration of oleuropein for about four weeks could protect the heart against aconitine-induced arrhythmia.

Diabetic mellitus (DM) is a major risk factor of morbidity, mortality and economic cost to society. Diabetic patients are at risk of having microvascular or macrovascular disorders of diabetes. Postoperative anemia have wide spectrum of some early complications that require more care in hospitalization stays. Therefore, this study was designed to evaluate effect of preoperative anemia on short-term clinical outcomes in diabetic patients undergoing elective off-pump CABG. This study conducted on 86 diabetic patients underwent elective off-pump CABG surgery from August to October 2011, in Afshar Cardiovascular Center, Yazd, Iran. The patients had hemoglobin concentration between 10-12 mg/dl, patients with preoperative atrial fibrillation and renal and respiratory dysfunction were excluded from this study. Participants were randomly assigned into two groups; the normal group (n=42) that had hemoglobin concentration ~ 12-15 g/dl and the anemic group (n=44) had hemoglobin concentration~7-10 g/dl. We evaluated post-CABG variables including incidence of atrial fibrillation and early morbidity such as infection, vomiting, renal and respiratory dysfunctions, ICU or hospital stay and early mortality. Data were analyzed by ANOVA, Chi-square and Fisher''s exact test for quantitative and qualitative variables. The mean age of the patients was 52.51±6.9 years, from all of patients 64 cases (74.4%) were male and 22 cases (445.6%) were female. Postoperative atrial fibrillation was observed in 17 cases (19.8%), 7 cases (16.7%) of whom were in normal group and 10 cases (22.7%) of whom were in anemia group. anemia could significantly increase hospital stay (P=0.0001) but no ICU stay. Preoperative anemia did not affect the incidence of atrial fibrillation and early complications and mortality in patients undergoing off-pump CABG. However, anemia could increase postoperative hospital stay and renal dysfunction significantly.

General concept and major emphasis on off-pump coronary artery bypass surgery (OPCAB) is maintaining quality of care and patient safety while reducing cost and resource utilization. OPCAB probably avoids the potential complications of cardiopulmonary bypass. However its acceptance depends on clinical and economic outcome. The aim of this study is to compare clinical and economic outcome of off-pump and on pump coronary artery bypass surgery. This is a report of an analytic cross-sectional study on 304 patients underwent coronary artery bypass surgery that were randomized into conventional on pump and off-pump groups. Variables and costs were obtained for each group and these data were analyzed using parametric methods. There was no difference between the two groups with respect to perioperative and intraoperative patient's variables. OPCAB reduced the need for postoperative transfusion requirement (P<0.05) which was statistically significant and showed a trend towards reduction of morbidity although didnt reach statistical significance (P>0.05). There were no statistically significant differences in surgical re exploration and length of stay between the two groups. The mean cost for an on pump surgery was 8312000 ± 2859 Rials per patient that was significantly higher than an off-pump surgery. Based on the findings of this study, clinical outcome has no statistically significant difference between on pump and off-pump CABG but the costs are significantly higher in the on pump group.

The duration of ICU (intensive care unit) stay in cardiac surgery patients has an important role in the rate of complications and costs. The aim of this study was to determine the role of perioperative risk factors in clinical outcome based on the time of ICU discharge. In this descriptive study, 219 patients undergoing off-pump coronary artery bypass (OPCAB) surgery in Afshar Hospital in Yazd, an Iranian city, were divided into early (≤24 hrs) and late (>24 hrs) ICU discharge groups according to the duration of ICU stay. The preoperative, intraoperative and postoperative risk factors, the complications and the outcome were evaluated. Age, sex, hyperlipidemia, diabetes mellitus, previous myocardial infarction, renal failure, cerebrovascular accident, and level of hematocrit and creatinine were not significantly different between the two groups. Patients with hemodynamic instability, respiratory dysfunction, ejection fraction <35%, hypertension, inotrope administration, left main coronary artery involvement, use of intraaortic balloon pump (IABP) and arrhythmia had significantly higher mortality and longer ICU stay (>24 hrs) compared to others (P value <0.05). The duration of intubation was significantly lower in the early discharge group (7.8 ± 3.8 hrs compared to 17 ± 9.9 hrs) than in the late discharge group. Time of ICU discharge depends on perioperative risk factors, and risk factor modification may improve clinical outcome.

Atrial fibrillation (AF) is the most common arrhythmia after cardiothoracic surgery. AF following coronary artery bypass graft (CABG) is associated with an increase in morbidity, mortality, hemodynamic instability, thromboembolic events, severity of heart failure and ICU and hospital stay. Corticosteroids have a variety of beneficial effects on recovery after elective surgery. This study was designed to test the hypothesis that low dose of Methylprednisolone (MP) can affect post-CABG AF and early complications in patients with severe left ventricle dysfunction who underwent elective off-pump coronary artery bypass. A total of 120 patients with LV dysfunction undergoing elective off- pump CABG randomly received either MP or placebo. Diabetic patients and those who were receiving corticosteroids were excluded. The MP group received 5mg/kg of MP intravenously after induction of anesthesia and the placebo group received an equal volume of normal saline. We evaluated Post-CABG variables including incidence, duration and frequency of AF recurrence and early morbidity such as bleeding, infection, vomiting, renal and respiratory dysfunctions, ICU or hospital stay and early mortality. The mean age of patients was 62.11 ± 12.34 years with the 2.4 male to female ratio. AF occurred in 23(19.2%) patients. No significant difference in the incidence of new AF was found between the placebo (21.7%) and MP group (16.7%) (P=0.47). MP did not affect postoperative bleeding, infection, vomiting, renal and respiratory dysfunction and mortality; however, MP significantly reduced ICU and hospital length of stay. MP did not affect the incidence, duration and frequency of AF recurrence in patients with severe LV dysfunction undergoing off-pump CABG. However, MP could reduce ICU and hospital stay significantly in these patients.

Proper drainage of the mediastinal and pleural spaces following Off-Pump Coronary Artery Bypass (OPCAB) surgery is essential for the prevention of pleural and pericardial effusions, cardiac tamponade and late complications such as constrictive pericarditis. Drainage tubes themselves may induce some complications which can negatively affect the result of the surgery. In this study we assessed a new technique for chest drainage following OPCAB.

One of the most important components of coronary artery bypass graft surgery is need for blood transfusion that increases morbidity and mortality.

Aortobronchial fistula (ABF) is a rare and late complication of cardiac surgery. If untreated, mortality rate is approximately 100% secondary to exsanguinations haemoptysis. Early diagnosis and treatment are essential for successful management. Open surgical repair is associated with high morbidity and mortality rate, ranging from 25% to 41%. Endovascular treatments of ABF is a less invasive treatment modality and have become an important alternative to open surgical intervention in aortic pathologies. We present a case of ABF that successfully is managed by endovascular approach.