This study aimed to assess risk factors that predict the length of stay and 30-day mortality in subjects undergoing CAGB to evaluate the impact of IABP support in patients with low ejection fraction. The prospective study was conducted in the Cardiology Department of Punjab Institute of Cardiology Lahore from January 2022 to January 2023. A total of 315 patients were included in the study. The sample was divided into a study group (n=110, having LVEF ≤ 30%) and a control group (n=205, having EF > 30%). Pre-operative and intraoperative data of the patients were recorded. Post-operative complications were recorded, including LOS in the hospital and 30-day mortality. Patients in the study group required more emergency CABG ( P = .005), and IABP was also used more frequently in patients having EF< 30% (P<.001). LOS in hospital (P<.001) and ICU (P<.001) and 30-day mortality (P=.009) were higher in the study group. According to multivariate logistic regression analysis, in the study group history of cerebrovascular disease ( P = .018), peripheral vascular disease ( P = .004), congestive heart failure ( P = .027), and IABP use ( P = .002) were associated with the rate of 30-day mortality. Moreover, the increased length of hospital stay in these patients was associated with an increase in age (P<.001), hypertension (P=.040), and IABP use (P=.009). Based on the results, it can be concluded that the low ejection fraction positively affects increased LOS and 30-day mortality in subjects undergoing CABG; IABP insertion is a significant predictor of increased LOS and 30-day mortality and increases post-operative complications.
This retrospective study was designed to assess the impact of perioperative dexmedetomidine on the outcome of open-heart surgery. This study was conducted at the Faisalabad Institute of Cardiology Faisalabad from 01 Jan 2022 to Dec 2022. A total of 350 fulfilled the inclusion criteria and were included in the study. Informed consent of the participants was taken. The ethical board of the hospital approved the study. Subjects were divided into the dexmedetomidine group (who were administered dexmedetomidine peri operatively, 179 (51%)) and non-dexmedetomidine group (who were not helped dexmedetomidine peri operatively, 171(48.8%).0.24-0.6 μg/kg/h was infused intravenously after cardiopulmonary bypass. The was continued for more than twenty-four hours postoperatively.10 out of 350 subjects (2.8%) died in hospital, and 14 (4%) died within thirty days. Perioperative dexmedetomidine infusion resulted in a significant reduction in hospital and 30-day mortality. In-hospital mortality in the dexmedetomidine and non-dexmedetomidine group were 1.22% and 4.6%, respectively (P=.008). 30-day mortality in the dexmedetomidine and non-dexmedetomidine groups was 1.8% and 5.2%, respectively (P=.002). Perioperative dexmedetomidine significantly reduced post-operative sepsis (0.8% vs. 2.2%, P=.043) and other complications (46.19% vs. 56.07%, P=.0205). There was no difference in the duration of hospital stay, ICU stay, post-operative ventilation time, and incidence of delirium and MACEs. So, it can be concluded that perioperative intravenous dexmedetomidine results in improved hospital and thirty-day survival and is associated with a decrease in post-operative delirium and overall complications.
This study aimed to assess the effect of pulmonary hypertension on the outcomes of mitral valve surgery in terms of operative mortality, dependence on inotropic agents, duration of ventilation, length of ICU, and hospital stay. This comparative study was conducted at the Department of Cardiac Surgery, Faisalabad Institute of Cardiology, from January 2018 to July 2018. A total of 138 cases (69 in each group) were included in the study. Patients with mild or moderate PHT were enrolled in group A, and patients with severe PHT were in group B. Required surgery was performed. Outcomes, including operative mortality, duration of mechanical ventilation postoperatively, dependence on inotropic agents in ICU, and length of stay in ICU as well as hospital, were noted in both groups during intensive care stay. Difference between the two groups in terms of mean duration of mechanical ventilation (10.58±2.79 vs. 10.96±3.42 hours; p-value=0.480), mean duration of inotropic support (8.55±2.75 vs. 9.45±3.92 hours, p-value=0.122), mean length of ICU stay (2.97±1.34 vs. 3.32±1.40 days, p-value=0.138) and mean length of hospital stay (12.3±3.8 vs. 12.6±4.1 days, p-value=0.684) was not statistically significant. In patients with severe pulmonary hypertension, mitral valve replacement was found equally safe compared to those with mild to moderate pulmonary hypertension.
This study assessed QOL, cognitive profile, and psychiatric symptoms before and after open heart surgery. The prospective study was conducted at the Faisalabad Institute of Cardiology from January 2022 to January 2023. A total of 95 patients were included in the study. All patients underwent neurological and physical evaluations. Every measure was assessed preoperatively and postoperatively. The effects of treatment-related factors and patient-related ones were analyzed. 27 (28%) patients had preoperative anxiety, which decreased to 10 (10.5%) after 1 week of surgery and to 6 (6.3%) after 6 months. 18 (18.9%) patients had preoperative depressive symptoms, which decreased to 7 (7.3%) patients after 1 week of surgery and 6 (6.3%) after 6 months. There was a significant improvement in the mean value of anxiety over the study period (P<.001). Regarding depressive symptoms, there was no significant improvement after 1 week (P<.208). Diabetes mellitus and age were inverselycorrelated with anxiety and depression; this correlation was statistically significant. Delirium, ischemic time, total bypass time, age, and hypertension were significant predictive factors of cognitive performance. Based on the results, it can be concluded that anxiety and depression adversely impacted the quality of life and were improved gradually over time. Cognitive function declined early after surgery and improved after 6 months.
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