2 ^nd World Congress on Cardiac Surgery and Medical Devices October 11-12, 2021 Vancouver, Canada

Biography:

Dr. Zara Shirazi,University/Organization; City, State and Country: National Institute Of Cardiovascular Diseases ; Karachi, Pakistan.

Abstract:

Abstract

Background

Isolated mitral valve replacement is a routinely performed procedure at our institute due to higher prevalence of rheumatic heart disease in every age category. Hardly any researches are available that dictate the predictors of surgical mortality in isolated mitral valve procedure. The aim of this study was to identify the most prevailing pre-operative factors in patients who had mortality after isolated mitral valve surgery.

Methodology

A retrospective observational study of two years was performed from January 2018 to December 2019 at the Adult Cardiac Surgery Department of a tertiary care cardiac center in Karachi, Pakistan. Patients of either gender of age ranging from 16 to 65 years who had mortality within 30 days after isolated mitral valve surgery were included in the study. Variables assessed from records were anemia, New York Heart Association (NYHA) functional classification, prolonged symptoms, poor nutritional status, degree of left ventricular (LV) dysfunction, valve pathology, pulmonary artery hypertension, and cardiac arrhythmias.

Results

We report our isolated mitral valve mortality rate of 5.5% (38/697) in the two-year duration. The most commonly encountered pre-operative factors were severe mitral regurgitation and pulmonary artery hypertension, which were observed in 32 (84.2%) and 23 (60.5%) patients, respectively. Other factors that were common to these patients were higher NYHA functional class (class III in 23 [60.5%] and class IV in 9 [23.7%]), prolonged duration of symptoms (20 [52.6%]), and right ventricular dysfunction (moderate in 21 [55.3%] and severe in 7 [18.4%]).

Conclusions

The outcome of our study suggests that severe mitral regurgitation, pulmonary artery hypertension, high NYHA functional class, LV dysfunction, and prolonged symptoms were the common predisposing factor in patients with peri-operative mortality after isolated MVR.

Biography:

Mrs.Rachael Farmilette,United States,Department of Physician Assistant Studies The University of Texas Medical Branch, Galveston, Texas 77555.

Abstract:

• Heart failure affects approximately 6.5 million adults in the U.S. and in 2017 was the cause of 1 in 8 U.S. deaths. [1] • The left ventricular assist device (LVAD) has become a life saving option for patients unwilling and/or unable to undergo heart transplantation. • LVADs may serve as bridge to transplant (BTT) therapy and even as a destination therapy (DT). • Driveline site infection (DLI) is a serious complication of LVAD use. Even with sterile dressing changes and perioperative antibiotic use, DLI rates remain high. It is clear that variables aside from site contamination impact the incidence of infection--including obesity. • It has been shown that excess adipose tissue dysregulates the body’s immune response via decreased immune surveillance, diminished chemotaxis, and irregular macrophage differentiation. [6]

Biography:

Dr.Souvic Sarkar completed his M.B.B.S from Medical College Kolkata,and doing MD in Anaesthesiology in Medical College Kolkata.He has presented cases and paper in national and state conferences.He has been co-author in an article published in Indian Annual Update of Anaesthesia  2019.

Abstract:

Reperfusion-induced ventricular fibrillation after aortic cross clamp is one of the important complications of open heart surgery. This study aimed toevaluate the efficacy of Amiodarone, Lignocaine and Magnesium sulphate by the way of pump circuit 3-5 minutes before ACC release and observe the haemodynamic alterations in intra-op and post op period and compare the results in randomised controlled trial.A total of 150 patients undergoing elective open heart surgeries under CPB was evaluated after dividing into 3 groups consisting of 50 patients in each group. Aortic cross clamp time,occurrence of VF,HR,ABP,CVP,Post operative arrhythmias will be analysed with  statistical tests.There were statistically significant data which depicted that after 10 mins of releasing ACC the occurrence and persistence of irregular cardiac rhythm was much lower in Group A who received amiodarone 24%(12) than Group L who received lignocaine 44%(22) and than Group M who received magnesium sulphate 54%(27).The assiociation of rhythm at 10 mins interval vs group was statically significant(p value 0.0036).The occurrence of post operative arrhythmia was also lower in the study population of amiodarone(12%) than lignocaine(16%) and magnesium sulphate(24%).

Amiodarone also had a significant role in preventing cardiac arrhythmias in post-operative period. Though internal defibrillation is still considered as the standard technique for treating reperfusion induced cardiac arrhythmias but pharmacological agents like amiodarone when used prophylactically before releasing acc can decrease the incidence of cardiac arrhythmia in the immediate intra-op and even post-op period and reduces the morbidity and mortality of patients undergoing cardiac surgeries.

Biography:

Chery Lou M. Cabanero the primary author in this study fnished her medical school education in Davao Medical School Foundation Inc in 2013. She had her post graduate internship in Southern Philippines Medical Center. After passing the board examinations for doctors in 2014, she started her residency training program for General Surgery in Southern Philippines Medical Center Davao City Philippines. She graduated from residency training in 2019 in the same institution. At present the author is a prefellow in training in the Cardiac Surgery section in Southern Philippines Medical Center.

Abstract:

Worldwide, only <3% of the general population are diagnosed with the disease. In this ten year report, the authors described thirteen cases of Sinus of Valsalva defects in the first cardiac center in Mindanao. All were Filipinos and came from different regions in Mindanao. There was a bimodal age distribution with a mean age of diagnosis 14.18- 36.74 years old. All patients were presenting with signs and symptoms of heart failure with an ejection fraction of >55%. Preoperative two dimensional echocardiography revealed coexistent cardiac conditions which are ventricular septal defect (25%), aortic (22%), ventricular (22%) and atrial (11%) dilation, pulmonary hypertension (14%) and pericardial effusion (3%). Majority of the cases described had an initial presentation of dyspnea. Signs and symptoms depend on the degree of left to right shunting. In this study, common coexisting cardiac defect were aortic regurgitation and a subpulmonic ventricular septal defect. Sakakiboro and Konno types I and IIIv were noted among the patients in this study, all of them underwent repair under cardiopulmonary bypass. Repairs were done using a Sauvage Patch for RCSOV and VSD while dysfunctional valves were replaced with a mechanical valve. Mean CPB time in this ten year report was 2.58hrs for type I and 2.45hours for type IIIv. When compared both CPB types had a p-value of 0.783 indicating no significant difference between the two types of RCSOV. There were no reported mortalities in this ten year analysis, with a 100% survival rate.