KING ABDULAZIZ UNIVERSITY HOSPITAL CARDIAC SURGERY UNIT

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KING ABDULAZIZ UNIVERSITY HOSPITAL CARDIAC
SURGERY UNIT

• Dr. Khalid Al-Ibrahim Dr. Hussein Jabbad
• Dr. Khalid Medhat Dr. Ragab Shehata

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STARTED From 28th Feb. 2006 once
weeklyTill may 2006 then twice weekly
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Total No. 53cases

• Coronary artery bypass graft
• CABG ( 35cases )
• 
  
• Age 45 69 years
• Mean age 52.5 years
• No of graft 1- 5 grafts
• Mean No. 3.4 grafts

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Valve replacement ( 15 cases )

• - Aortic Replacement 2cases.
• - Mitral Replacement 5 cases.
• - Aorticmitral 2 case.
• Mitraltricuspid 2 cases
• Mitral repair 3 cases
• - Combined (Valve Rep CABG ) One case

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Rheumatic aortic valves Normal aortic
valve
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Different types of prosthetic valve
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Valve replacement

• - Age 13 - 43 years old
• Mean 31.7 years
• Total No. of valves 11 valves
• - Tissue 5 valves
• - Mechanical 6 valves
• - Rings One ring for tricuspid valve repair
• 3 mitral

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Other cases

• Ascending aortic aneurysm in a marfan
• Ruptured interventricular septum

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Operative field in cardiac surgery
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Operating room for cardiac surgery
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Noncardiac cases

• PDA surgical ligation (7).
• Pacemaker insertion.
• Oesophageal enteric cyst excision.
• AAA repair ( 2 ).
• PA banding.
• Fem-Pop bypass graft .

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PACEMAKER INSERTION IN 30 DAYS OLD INFANT
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PRE OP.
POST OP.TERATOMA EXCSTION IN 17 Y OLD GIRL
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C-T chest of 17 ys old girl showing Teratoma
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SVC Aneurysm

• CXR of 50 years old female

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C-T chest of the same patient
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C-T chest of 31 y old female with enteric cyst of
the esophagus
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RESULTS

• One case postoperative mortality
• Successes rate 98
• Mortality rate 2

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MORBIDITY

• ( 1 ) Perioperative MI- 4 cases
• - ? cardiac enzyme troponin 3 cases
• - S-T changes 4
  cases
• - New Q wave 2
  cases
• - New left bundle block 2 cases

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(2) Postoperative bleeding( Re-exploration)

• ( No Patients need re-exploration).
• Avarage total drain 370 ml
• Avarage blood given 2 unit
• Avarage ffp given 3 unit
• Avarage plat. Given 2 unit

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(3) Post operative Arrhythmia

• - Atrial fibrillation 3 cases, all regained
  SR
• - Heart block No cases
• - PVCs 2 cases
• - Bigeminy one case
• - V. T( NS ) one case
• - V. F No case

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(4) Wound infection

• - Superficial wound infection in 5 cases,
• With frequent dressing healed within one
• week.
• One case of deep leg wound infection.
• No cases of Deep sternal wound infection
• - No cases of mediastinitis

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(5) Low cardiac output

• Occurs in 3 cases-
• - 2 cases Need IABP.
• - One case Need LVAD.

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(6) Postoperative DVT

• One case P/ CABG developed DVT in
• unusual site, axillary brachial veins,
• (predisposed by central line insertion)
• - Readmitted to hospital and treated medically,
• - Improved and discharged.

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Successful case of ascending aortic aneurysm
repair

• A 43 y old Indonesian man
• 12cm asc aortic aneurysm
• Congestive heart failure
• Renal and liver impairment

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Ruptured interventricular septum

• 65 years male post acute anterior M.I.
• Cardiogenic shock requiring I.A.B.P
  Inotropes
• Emergency open heart
• Transventricular
  incision
• Pericardial patch repair
  
  Teflon sheet enforced ventricular closure

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ICU stay 2 6 days Mean 3 days

• - Hospital stay 7 23 days
• Mean 11 days

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Follow up

• All patients are followed up regularly in out
  patient clinic

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FUTURE OF CARDIAC SURGERY IN KAUH

• 1- Increase the OR days up to 3 days weekly
• 2- Plan to sit Cardiac surgery for pediatrics
• 3- Private cases
• 4-Expand cardiology
• 5- Haematology clinic for valve patients

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THANK YOU