T????????

1
www.ctspap.gr
2
???S?????????1?? ???????? 2013

• G.?.T. G. ????????????
• ??????? ???????G???S TO????S-??????S-??G??O?
  ?GG??O?
• ????S G.?. ???S?S

3
???S????????? 1?? ???????? 2013

• 385 ??????S??S
• ?a?d???e????????? pe??stat??? 240
• T??a???e????????? pe??stat??? 109
• ???f??a ???a pe??stat??? 36

4
???T??S ??? ????S ??????S?O? ??????S

• 240 ??????S??S
• 156/240 (65) ???????G??? S??F?????O? ?GG??O?
• 65/240 (27) ???????G??? ?????????T??O?
• 11/65 (17) p?ast???? d?????se??
• 34 AVR 11 AVR CABG
• 5 MVR 4 MV plasty 2 ?VR CABG 1 MVR AVR
• 5 ?V plasty CABG 1 afa??es? ???µß?? p??s?et????
  ßa?ß?da?
• 1 MV plasty p?ast??? TV µe da?t????
• 1 da?t????? t????????a?

5
???T??S ??? ????S ??????S?O? ??????S

• 4/240 ????S ??????S??S
• 2 s????e?s? ASD
• 2 afa??es? µ???µat?? ?? ???p??

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???T??S ??? ????S ??????S?O? ??????S

• 19/240 (7.9) ??????S??S S??? ?????
• 4 Bentall
• 2 Bentall CABG
• 6 ??t??at?stas? a????s?? a??t?? µe e??? µ?s?e?µa
• 1 ??t??at?stas? a????s?? µe e??? µ?s?e?µa
• CABG
• 3 ??t??at?stas? a????s?? µe e??? µ?s?e?µa AVR
• 1 ??t??at?stas? a????s?? ?a? t???? µe e???a
  µ?s?e?µata
• 1 ??t?µ? st???s?? a????s?? a??t??
• 1 ?p??at?stas? ???a???????a??? a?e???sµat??

7
?????? as?e??? (µ?s?? ???? se ?t?)
????G????????? ?????????S????

• 63.3 ? 10 et??

8
?????S ???????S????S ????????S ???S??????S
?????G????????? ?????????S????

• 9.6 6.3 ??e?
• ???µes?? 7 ??e?
• (40 lt6h)

9
?????S????G?????????S ??S?????S
?????G????????? ?????????S????

• 6.2 ? 3.6 ?µ??e?

10
?a?d???e????????? pe??stat?????????S?????????
T???????? 30 ?µe???

• ???????????? T????????
• ?at? EuroSCORE ?
• 4.8
• ?at? EuroSCORE ?I
• 1.9

• ????????????? T????????
• 6/240 (2.5)

11
?????? T???????? (a?? ?at?????e?
epeµß?se??)

• Isolated CABG 2/156
  1.28
• VALVES
• VALVES/CABG
• S????? ??????O?
• ??????S???O?

2/65 3
2/17 11.7
12
Cardiothoracic surgery Dept G. Papanikolaou vs
STS national averages, 30-d mortality isolated
CABG
13
Cardiothoracic surgery Dept G. Papanikolaou vs
STS national averages, 30-d mortality CABG,
VALVES, CABGVALVES
14
??s???t?ta

• S??????? ??s???t?ta
• 19/240 (7,9)
• ???e?a?? e??efa???? epe?s?d??
• 2/240 (0.8) 1-2 Eur J Vasc Endovasc Surg.
  2002 Apr23(4)283-94.
• ?? t? ß??e? ???µ??e?? ste???t?µ??
• 5/240 (2.1) 0,5-5 Ann Thorac Surg. 1987
  Aug44(2)173-9.
• ??ap?e?st??? a?ep???e?a
• (epa?ad?as?????s? ? ad??aµ?a/d?s???e?a
  ap?d?sµe?s?? ap? µ??. ae??sµ?)
• 6/240 (2.5) 2-10 Ann Thorac Surg. 2013
  Mar95(3)1122-9.

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??s???t?ta

• Acute Kidney Injury 30/240 (12.5) 10-20
• Stage 1 14/30 (46.6)
• Stage 2 8/30 (26.6)
• Stage 3 7/30 (23.3)
• Stage 4 1/30 (3.3)
• Renal failure 8/240 (3.2)
• Renal Replacement therapy
• 4/8 (50)
• 4/240 (1.6) 1-2

Kidney Int. 2007 Sep72(5)624-31. Epub 2007 Jul
11.
16
Cardiothoracic surgery Dept G. Papanikolaou vs
STS national averages On-pump isolated CABG,
major complications or operative mortality
observed rate
17
Cardiothoracic surgery Dept G. Papanikolaou vs
STS national averages On-pump isolated
CABGRenal failure observed rate
18
Cardiothoracic surgery Dept G. Papanikolaou vs
STS averages Perioperative MI 4/240 cardiac
operations (1.7)3/156 isolated CABG (1.9)

• 2011 STS data
• Elevation of biomarkers (CK or Troponine) to gt 5
  of the normal during the first 72h after a CABG
  plus
• i. new Q waves or LBBB or
• ii. Angiographically documented or
• iii. Imaging evidence of new loss of viable
  myocardium

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Cardiothoracic surgery Dept G. Papanikolaou vs
STS national averages Reoperation for bleeding

• S?????
• 12/240 - 5
• Isol. CABG
• 3/156 1.9

20
???T??S ??? ????S ??????S?O? TO????

• 69 ??????S??S ??????? ???S????S?
• 22 ?????????S (1 sleeve)
• 4 ???????????S
• 9 ?????????????S
• 1 ????????????
• 9 ?????????S??S ?????????S ???F???OS?
• 8 TO???????? ??????
• 2 TO???????? ?F????S? ????S
• 4 TO???????? ?????? ??F?S??. ??S??O?
• 3 S????F? ????S ??S?F?G??
• 1 S????????? ?????? ????S
• 5 ???????????? ????T???
• 1 TO???????? - ????S??S?

21
???T??S ??? ????S ??????S?O? TO????

• 40 ??????S??S TO????S??????
• (36.7)
• 6 VATS ?????????
• 4 VATS SF???????S ?????? ????????
• 5 VATS ??????
• 9 VATS ?????? AEP ??S??O?
• 2 VATS ?????? ??S???O? ???O?
• 1 VATS T????????
• 9 ??S?TO????S????S??S ??????
• 3 ONE - PORT ??????
• 1 ONE - PORT ??S? S??F?S?O?

22
?????? as?e??? (µ?s?? ???? se ?t?)
????G????????? ?????????S????

• 54.4 ? 17.7 et??

23
?????S ???????S????S ????????S ???S??????S
?????G????????? ?????????S????

• 59 / 109 ??? ???S?????? ?????
• 8.8 13.1 ??e?
• ???µes?? 5 ??e?

• 50/109 (45.8) ??????? S?? ?/?
• 30/59 M????? ???????S ???
• 4/59 AMET / MAA

24
?????S????G?????????S ??S?????S
?????G????????? ?????????S????

• 6.2 ? 5.4 ?µ??e?

25
T??a???e????????? pe??stat?????????S?????????
T???????? 30 ?µe???

• 0/109 (0)

26
T??a???e????????? pe??stat?????S???????

• ???µ??e?? t?a?µat?? 4/109 (3.7)
• 1 ???? ??s?f????
• 1 ?p?t??p? t?a?e????s?fa????? s????????

27
S??????? ??????S????????? T???????? 30 ?µe???

• 6/ 385 (1.5)

28
S?GG??F??? ???S?????????
Early post-cardiotomy chylopericardium and the
imaging value of magnetic resonance
thoracic-ductography. Koutsogiannidis C. et
al. Heart, Lung and Circulation. 2013
Apr. Isolated chylopericardium is a rare
postoperative complication after cardiac surgery.
A delay in diagnosis or an inappropriate
management can lead to serious consequences. The
treatment, which may either be conservative or
surgical, is controversial and it depends on the
duration and volume of effusion. We report a case
of chylopericardium after atrial septal defect
repair in a young woman. The patient was treated
initially with total parenteral nutrition for ten
days. After drainage diminished, low fat diet
containing medium chain triglyceride was
instituted. Postoperatively, the role of magnetic
resonance thoracic ductography was important for
the assessment of the treatment strategy. IF
1.254
29
?a???s??se?? se s???d??a

• Preconditioning t?? e??ef???? µe e?????µ?????
  st?? ????? ?????f????? pa?s?. ??e???? ?e????????
  ß??s?µ?t?ta?-p???µa ap?te??sµata.

• ???ts???a???d?? ?.
• ???f????? a?a?????s? st? 12? ???e??e??ad???
  ?a?d???????? S???d???, Tessa?????? 30 ?a???-01
  ??????? 2013.
• ?p???µ? t?? 2?? ??aße??? p??f??????
  a?a?????se?? t?? s??ed????.

30
?a???s??se?? se s???d??a

• ???t?stefa??a?a pa???aµ?? se µ??t??a t?? ?a??ß?
  µe a?t????s? ???µß?pe??a ??af??? pe??stat????
• ??a???d?? ?.
• ???f????? a?a?????s? st? 12? ???e??e??ad???
  ?a?d???????? S???d???, Tessa?????? 30 ?a???-01
  ??????? 2013.
• EUROSCORE ? EUROSCORE II ??a t?? ?p?????sµ? t??
  ???d???? ???t?t?ta? st?? ?a?d???e??????????
  epeµß?se??
• ??p????? ?.
• ???f????? a?a?????s? st? 12? ???e??e??ad???
  ?a?d???????? S???d???, Tessa?????? 30 ?a???-01
  ??????? 2013.

31
?a???s??se?? se s???d??a

• ???a? asfa?e?? ?? ?a?d???e?????????? epeµß?se??
  se as?e?e?? µe ?????a a?µat??????? ??s?µata
• S??e?? ?.
• ???f????? a?a?????s? st? 12? ???e??e??ad???
  ?a?d???????? S???d???, Tessa?????? 30 ?a???-01
  ??????? 2013.
• ?a?????te? ???d???? ??a a????? µ? epeµßat????
  ae??sµ?? µet? ap? ?a?d???e?????????? epeµß?se??
• ?µpat??d?? F.
• ???f????? a?a?????s? st? 12? ???e??e??ad???
  ?a?d???????? S???d???, Tessa?????? 30 ?a???-01
  ??????? 2013.

32
???as?e? se ep??e?µe?a s???d??a

• Hypothermia provides protects the cortex in
  hypothermic circulatory arrest ultrastructural
  evidence.
• Koutsogiannidis C. et al.
• ?ral presentation at the 30th Annual
  Meeting of the American Association of Clinical
  Anatomists, hosted by the University of Colorado,
  Denver, CO, July 9-13, 2013.
• Erythromycin induced neuroprotection during
  prolonged hypothermic circulatory arrest .
• Koutsogiannidis C. et al.
• Poster presentation at the 30th Annual
  Meeting of the American Association of Clinical
  Anatomists, hosted by the University of Colorado,
  Denver, CO, July 9-13, 2013.

33
Poster presentation at the 30th Annual Meeting
of the AACA
34
???as?e? se ep??e?µe?a s???d??a

• Pericardial fat is strongly associated with
  atrial fibrillation after coronary artery bypass
  graft surgery.
• Drossos G. et al.
• ?ral presentation at the 27th European
  Association For Cardio-Thoracic Surgery, Vienna,
  Austria, October 5-9, 2013.

35
???as?e? se ep??e?µe?a s???d??a

• Validation of a nine parameter standard base
  excess model (Wolf and Deland, 2011) in a cohort
  of cardiac surgical patients.
• Agrafiotis M. et al.
• ?ral presentation at the 26th Annual
  Congress of the European Society of Intensive
  Care Medicine, Paris, France, October 5-9, 2013.
• Cardiac surgery in octogenarians A single center
  experience .
• Ampatzidou F. et al.
• ?ral presentation at the 26th Annual
  Congress of the European Society of Intensive
  Care Medicine, Paris, France, October 5-9, 2013.
• Risk factors for non invasive ventilation
  requirement in postoperative cardiac surgical
  patients
• Ampatzidou F. et al.
• ?ral presentation at the 26th Annual
  Congress of the European Society of Intensive
  Care Medicine, Paris, France, October 5-9, 2013.