Comparison of Post Operative Outcomes Following Del Nido Cardioplegia Versus Howards Cardioplegia in Adult Cardiac Surgery at Pakistan Institute of Medical Sciences
Adnan Shah,
Attiya Hameed Khan,
Hammad Ahmed,
Aamir Naveed,
Faridullah Khan,
Javeed Iqbal,
Adnan Tahir
Issue:
Volume 6, Issue 1, January 2020
Pages:
1-6
Received:
19 November 2019
Accepted:
18 December 2019
Published:
4 February 2020
Abstract: This study compares post-operative outcomes for ionotropic support, defibrillator need and duration of hospital stay in adult patients of cardiac surgery following Del Nido cardioplegia versus Howard’s cardioplegia and also compare pre and post operative Cardiac enzymes and serum potassium levels, assessment of pre and post operative Arrthymias. It was an Observational study conducted at Pakistan Institute of Medical Sciences Islamabad Pakistan. Patients were divided into 2 groups. Group (A) patients were Del Nido cardioplegia and Group (B) patients were Howard’s cardioplegia. Data was collected by using non-probability Consecutive Sampling technique. 100 patients were enrolled in this study randomly allocating 50 to each study group. Results of the study show that Post-op CKMB level after 24 hours for Howard group was (127.5200±103.59069) and for DN group (67.3540±23.21292). Similarly post op Potassium level for Howard group was (4.9742±.77010) and for DN group was (4.5590±.65033), Duration of hospital stay for Howard’s group was (9.60±.857) and for DN group was (8.58±1.486). High ionotropic support was required in Howard’s group as compared to DN where it was mild to moderate. 40% patients required defibrillation in Howards as compared to DN with only 20%. It is concluded that Cardioplegia is intended for brief cardiac arrest, which is an important function during cardiopulmonary Bypass surgery. After comparing two cardioplegic solutions namely Del Nido and Howard’s cardioplegia. Our study concludes that Del-Nido cardioplegia provide better myocardial protection and less cross clamp and bypass time. Cardiac enzymes, serum potassium level and post-op arrthymias show better profile in Del-Nido as compared to Howard’s cardiolpegia. Our data clearly advocate the efficacy and safety of Del-Nido over Howard’s cardioplegia. It is very safe and effective as compared to Howards.
Abstract: This study compares post-operative outcomes for ionotropic support, defibrillator need and duration of hospital stay in adult patients of cardiac surgery following Del Nido cardioplegia versus Howard’s cardioplegia and also compare pre and post operative Cardiac enzymes and serum potassium levels, assessment of pre and post operative Arrthymias. It...
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Morbidity and Mortality of Pediatric Cardiac Surgery: About 84 Cases Operated at the Cardio-Pediatric Center Cuomo: Retrospective Study over 9 Months
Diagne Papa Amath,
Diop Momar Sokhna,
Ba Papa Salmane,
Ba Papa Ousmane,
Ba El Hadj Boubacar,
Sarr El Hadj Mbacké,
Sene Etienne Biram,
Leye Mohamed,
Ciss Amadou Gabriel,
Ndiaye Mouhamadou
Issue:
Volume 6, Issue 1, January 2020
Pages:
7-16
Received:
3 February 2020
Accepted:
24 February 2020
Published:
2 March 2020
Abstract: The general objective of this study was to evaluate the results of pediatric cardiac surgery over 9 months at the Cuomo cardio-pediatric center in Fann, Senegal. The specific objective was to assess morbidity and mortality over the same period after heart surgery in children. Our study focuses on 84 children with congenital or acquired heart disease. This is a retrospective single-center study that took place over a period of 9 months in 2017. An Excel sheet has been prepared to collect antecedents, clinical signs, paraclinical signs, as well as the operative protocol and the postoperative follow-up of the patients. A statistical analysis of the data was performed with the Stata software and the Excel spreadsheet. We found a male predominance with a sex ratio M/F of 1.1. We found dyspnea on 89.3% children and 94% had a heart murmur. The average of left ventricle ejection fraction (LVEF) was 66%. Congenital heart disease (58.3%) is represented by cyanogenic heart disease (15.5%), left-right shunts (33.3%) and obstructive malformations (9.5%). Acquired heart disease (41.7%) is represented by rheumatic heart disease (40.5%) and chronic constrictive pericarditis (1.2%). There was a complication in 46.4% of cases in intensive care and 4.8% of cases in hospital. Overall mortality was 2.4% with an operative mortality of 1.2% and a late mortality of 1.2%. Mitral disease was found only in the MORBIMORTALITY group (14.9% of cases) and this difference was significant (p=0.014). Among the procedures performed, there was more mitral surgery in the UNCOMPLICATED group (83.3% vs 30%). Whereas in the MORBIMORTALITY group there was more mitral valve replacement (70% vs 16.7%), this difference was significant (p=0.003). The average total length of hospital stay was 19 days. The length of stay in intensive care unit was longer in the MORBIMORTALITY group (5 vs 3 days, p=0.0027) and the duration of hospitalization (18 vs 11 days, p=0, 0004). At 3 months postoperative clinical improvement was noted in 85.7% of patients and there was no mortality. Surgery improves the quality of life for children who have congenital and acquired heart disease. This surgery is practicable in Senegal with satisfactory results. A better knowledge of the characteristics of patients with a complication or deceased can allow a better management in our center.
Abstract: The general objective of this study was to evaluate the results of pediatric cardiac surgery over 9 months at the Cuomo cardio-pediatric center in Fann, Senegal. The specific objective was to assess morbidity and mortality over the same period after heart surgery in children. Our study focuses on 84 children with congenital or acquired heart diseas...
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