Multidisciplinary Cardiovascular Annals
Volume:4 Issue: 4, May 2012

OFFPump CABG surgery (opcab) is performing worldwide and the rate of coronary revascularization without CPB (cardiopulmonary Bypass) is growing significantly. The aim of this study is to evaluate the risk factors for early mortality after OPCABG. From April 2009 to April 2011, data were collected from a total of 920 patients who underwent OFFPump CABG. Variables that were recorded were age, gender, EF, preoperative Cr, any comorbidity diseases like DM, HTN, Hyperlipidemia, Valvular pathology especially MR and TR. In postoperative period, need for Reexploration and any neurologic complications. Older age was a risk factor for early mortality (30 days) after OFFPump CABG, but female gender was not a risk factor. Although in dead patients the average EF was lower but low EF was not an important risk factor for early mortality. Mild Cr elevation was not a risk factor for early mortality as well. In CAD patients, valvular pathology is a known risk factor for mortality. In our study Sever TR was a risk factor for early mortality but MR was not a risk factor for early mortality. Need for early reexploration was a factor for early mortality. risk factors of CABG- Ischemic heart disease- cardiopulmonary bypasscoronary heart disease- OPCAB post operative mortality

Heart disease is one of the leading causes of disability in major thalassemia patients. Timely diagnosis and effective treatment in these patients are essential. The aim of this study is to evaluate the diagnostic value of BNP in the diagnosis of heart involvement compared with echocardiographic findings in patients with major thalassemia. This case-control study was carried out in patients with major thalassemia aged 9-25 years old admitted to Aliasghar hospital from October 2010 to November 2011. Patients with no obvious cardiac abnormalities were included. 80 major thalassemia patients with 80 healthy children matched by age and sex were entered and for both, echocardiography was performed by a pediatric cardiologist. The serum level of Brain Natriuretic Peptides (BNP) was also evaluated. The data were analyzed by SPSS17. The groups studied were matched well regarding age and gender (P =0.1346, 0.429). Regarding the echocardiographic results, some of the parameters of the left heart in case group were significantly higher than control group as well as some of the parameters of right heart. The mean value of BNP in case group was higher significantly. There was a significant correlation between BNP and right heart MPI (r = 0.229, P = 0.041) and age (r = 0.237, P = 0.035). Based on the results, systolic and diastolic function in patients with major beta thalassemia were impaired. Therefore, measurement of BNP level in addition to serial echocardiography is recommended to early diagnose heart involvement in patients with major beta thalassemia without clinical symptoms.

We evaluated the effects of tissue and organ perfusion and Coagulation status and hemorrhage in open heart surgery with the use of Cardiopulmonary Bypass with Starch (colloid) or crystalloid (Lactated ringer’s) as prime solution. In this prospective randomized-controlled trial study, 40 patients undergoing on-pump open heart surgery were randomly assigned to receive either colloid (Starch) or crystalloid (Lactated ringer’s) as prime solution, for initiation of cardiopulmonary bypass machine procedure. Tissue and organ perfusion markers and Coagulation test including lactate, and renal function tests and PTT, INR were measured sequentially Although the differences in PTT/INR/ Cr/ Plt Count between two groups was not significant but Bleeding and drainage in 6 and 24 interval after operation was higher in Starch group and also Urine Out Pout during operation in Ringer Lactate group was higher than Starch group. In Tissue and Organ perfusion variable there was no Statistical differences but Priming with Starch have tendency to excessive Bleeding and Coagulopathy.

The aim of this study is a review of clinical progress of ventricular septal defect in children referred to Aliasghar Center of Zahedan during 2001 to 2011. In this research we have studied all files existing in the archive of the patients referred to Aliasghar Diseases Center of Zahedan, from 2001 to September 2011. The cases with ventricular septal defect diagnosed by echocardiography were selected and required data including location and size of VSD, patient’s age along with the manner of VSD closure (spontaneously, surgery, intervention) were collected. Among 1750 patients with congenital heart diseases, 621 cases 35.5%) were suffering from VSD. In 32.3% of cases, the defect was closed spontaneously, 12.7% underwent closed heart operation, and 53% received medical therapy. Based on the defect location, there were 11.9% muscular, 72.8% perimembranous, 8.1% outlet, and 7.2% inlet type. Also the size of the defect in patients with isolated VSD was as follows: 45.1% small type, 25.9% moderate type, 29% large type. In general, serious complications have been occurred in 4.34% of the patients in long term follow up. In this study, it has been indicated that the incidence of spontaneously closure of small defects has been increased with time and a large number of moderate defects convert to minor defects by time and few number of large defects spontaneously closed by time. The incidence of serious complications in long term was 4.34% and mostly the results were similar to the results of other studies in this regard.

Primary tumors of the heart are rare, as opposed to metastatic lesions in this organ. Among the primary tumors, cardiac myxoma is the most prevalent neoplasia. Here, we discuss the varied nature of myxoid lesions, which may be mistaken for myxomas, in two categories: benign and malignant. Not only should the pathologist, but also the cardiac surgeon, be familiar with the diagnostic pitfalls and the differential diagnoses of myxoid lesions of the heart. Echocardiographic findings, the rapidity of symptom development, and the location of the tumor, all serve as clues to a better approach in such patients.

Surgical repair is the gold standard for treatment of a secundum type of atrial septal defect (ASD). Recently major advances have been made in device closure of ASDs. Although percutaneous transcatheter ASD closure provides superior cosmetics it is not completely risk free. In this article we have reported a late fistula formation between aorta and left atrium following transcatheter closure of secundum type ASD. Review of similar complications shows that lifelong follow-up of patients whose ASD is closed by devices seems mandatory to detect potentially serious late device-related complications.

Brucellosis is an extremely important disease around the world, especially in developing countries. Its clinical manifestations and severity vary with the patient population studied and the species of Brucella involved. Endocarditis is a rare focal complication of brucellosis but the most common cause of mortality. We present a 35 year old man with brucellosis of Aortic valve with complete destruction of valve. Diagnosis was confirmed with echocardiography and surgery was done with excision of infected valve and aortic valve replacement was done. Endocarditis was very uncommon presentation of brucellosis and aortic valve is the most common site for infection. Treatment was surgical and antimicrobial therapy, and mortality without treatment is very high.

Entrapment of hardware is a rare complication of PCI and its incidence is reported to be 0.2 to 0.8 percent. Percutaneous retrieval is advised first but if it failed, surgery should be attempted. Here, we report and discuss the management of a 72-year-old man with entrapped stent balloon during PCI of right coronary artery mandating emergency surgery due to hemodynamic instability and ischemic changes.

Coronary artery fistulas are rare abnormalities with an estimated frequency of 0.002% in the general population. The majority of these fistulas arise from the right coronary artery. The left coronary artery is rarely involved. This study presents a 5-year old girl with a left coronary artery fistula to right atrium who underwent a successful surgical operation