The main goal of our study was to evaluate possible perioperative risk factors for occurrence of atrial fibrillation in the postoperative period in patients after CABG operations. The study included 140 patients after CABG, divided into two groups - Group I - 64 patients with new onset of POAF and Group II - 76 patients without postoperative atrial fibrillation occurrence. In both groups possible risk factors for atrial fibrillation onset (preoperative and postoperative) were analyzed.Results showed that we can predict new onset of atrial fibrillation after CABG if the following preoperative factors are present - low ejection fraction (less than 40%), LAd > 40mm, higher body mass index (BMI over 30), presence of COPD and older age. Important perioperative factors for onset of atrial fibrillation in our study were longer extracorporeal circulation, increased dose/number of inotropic drugs, blood transfusion and elevated WBC count postoperatively.
Introduction:This study evaluated the frequency of domination of the coronary arteries types in patients treated by surgical myocardial revascularization. The aim of the study was to determine whether the left coronary circulation dominance is a prognostic factor for poorer outcome in patients undergoing coronary artery bypass surgery.Material and methods:A total sample consisted of 100 patients with coronary artery disease that were treated with coronary artery bypass grafting at the Clinic for Cardiac Surgery, Clinical Center of the University of Sarajevo. To all patients on the basis of preoperative coronary angiography was determined the dominance of the coronary arteries. Patients included in the study were divided into two groups, with the left and right with coronary dominance.Results:Left coronary dominance in a sample of patients was present in 21/100 (21%), right in 69/100 (69%) and balanced in 10/100 (10%) cases. Female gender was significantly more frequent in patients with left coronary dominance and proved to be a stronger predictor of poorer outcome, especially in combination with left main stenosis of the left coronary artery and left coronary dominance. Inability of revascularization of the r. interventricularis posterior (RIVP) was statistically significantly higher in case of left dominance 9/21 (42.9%), compared to the right 16/79 (20.3%), p=0.033. Lethal outcome was more common in case of left dominance in relation to the right (9.4% vs 0.9%). The incidence of surgical complications, respiratory, neurological and renal complications was not significantly different between groups, while the length of hospital stay was significantly higher in the group of patients with left dominance, p = 0.003.Conclusion:Left coronary dominance is an important risk factor for patients undergoing surgical myocardial revascularization.
Background: Motion tracking during live surgeries may be used to assess surgeons' intraoperative performance, provide feedback, and predict outcome. Current assessment protocols rely on human observations, controlled laboratory settings, or tracking technologies not suitable for live operating theatres. In this study, a novel method for motion tracking of live open-heart surgery was developed, and evaluated.Materials and methods: Three-D-printed 'tracking die' with miniature markers were fitted to DeBakey forceps. The surgical field was recorded with a video camera mounted above the operating table. Software was developed for tracking the die from the recordings. The system was tested on five open-heart procedures. Surgeons were asked to report subjective system related concerns during live surgery and assess the weight of the die on blind test.The accuracy of the system was evaluated against ground truth generated by a robot. Results:The 3D-printed die weighed 6 g and tolerated sterilization with hydrogen peroxide, which added approximately 13% to the mass of the forceps. Surgeons sensed a shift in the balance of the instrument but could on blind test not correctly verify changes in weight.When two or more markers were detected, the 3D position estimate was on average within 2-3 mm, and 1.1-2.6 degrees from ground truth. Computational time was 30-50 ms per frame on a standard laptop. Conclusions:The vision-based motion tracking system was applicable for live surgeries with negligible inconvenience to the surgeons. Motion data was extracted with acceptable accuracy and speed at low computational cost.
This study has been conducted in an effort to establish more suitable and accurate scoring model we use in everyday practice. Among the specific outcome prediction models, in 1989 Parsonnet et al elaborated a method of uniform risk stratification for evaluation of the results of cardiac surgery procedures. We have tested two forms of the Parsonnet score, Initial and Modified Parsonnet score, in our patients. In the first half of the year 2007, 145 patients were operated in Sarajevo Heart center. All operated patients in that period, have participated in this study. The overall hospital mortality was 4,13 (6 deaths). This study shows that the initial and modified Parsonnet's scores are predictive for operative mortality in adult cardiac surgery patients.
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