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Evaluation of the Early Results of the Initial 500 Cardiac Operations Performed in a New Center

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Author(s): Kemal Uzun | Turan Erdoğan

Journal: Koşuyolu Kalp Dergisi
ISSN 1300-8706

Volume: 14;
Issue: 3;
Start page: 79;
Date: 2011;
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Keywords: cardiac surgery | hospital mortality

ABSTRACT
Background: The initial 500 cases of a new center which is established in a province having no history of open heart surgery are evaluated with respect to mortality especially.Methods: A total of 500 patients underwent operations at our clinic between March 2008 and November 2009. Of these patients 373 (74.6%) were male, 127 (25.4%) were female and the mean age was 64.15±11.54. Four hundred eleven patients had coronary artery disease (19 had left ventricular aneurysm), 46 patients had coronary artery disease together with heart valve disease (of these 2 had ascending aortic aneurysm, 1 had left ventricular aneurysm, 1 had rupture of sinus valsalva aneurysm), 30 patients had valvular disease ( 1 had also patent ductus arteriosus), 4 patients had type 1 aortic dissection, 4 patients had ascending aortic aneurysm (3 had aortic valve disease), 4 patients had coarctation of the aorta, and 1 of the patients underwent surgery with the diagnosis of secundum atrial septal defect. Results: In-hospital mortality rate was 2% with 10 patients. The reasons of deaths were; low cardiac output in 3, renal insufficiency in 2, peroperative myocardial infarction in 2, bleeding in 1, lung complications in 1 and cardiac tamponade in 1. Fifteen patients (3%) due to bleeding caused for surgical re-exploration. Postoperative atrial fibrillation developed in 97 patients (19.4%). Four patients (0.8%) suffered wound infections on saphenous vein region, one patient (0.2%) developed mediastinitis. Three patients (0.6%) had neurological complications (two patients developed hemiplegia, one suffered from persistent tonic-clonic convultion). Prolonged entubation, prolonged intensive care unit stay and readmission to intensive care were other complications with rates of 20 (4%), 31(6.2%) and 13(2.6%) respectively. Conclusion: Our study showed that there is a strong relationship between peroperative myocard infarction and mortality, and patients who had diminished renal functions preoperatively are under greater risk when compared with patients who are already dialysis-dependent. Unpredictably, no correlation was encountered with increased age or high degree of left ventricular sistolic dysfunction and mortality

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