Evaluation Of The Early Results Of The Initial 500 Cardiac Operations Performed In A New Center
Kemal Uzun, Turan Erdoğan
Keywords: Cardiac Surgery, hospital mortality.
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. Method: A total of 500 patients underwent cardiac 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 vetricular aneurysm), 46 patients had coronary artery disease with heart valve disease (of these two had ascending aortic aneurysm, one had left vetricular aneurysm, one had rupture of sinus valsalva aneurysm), 30 patients had valvular heart disease (One also had patent ductus arteriyosus), four patients had type one aortic dissection, four patients had ascending aortic aneurysm (three also had aortic valve disease), four patients had coarctation of the aorta, and one of the patients underwent surgery with the diagnosis of secundum atrial septal defect. Results: In-hospital mortality rate was 2% (n: 10). The reasons of mortality were; low cardiac output in three, renal insufficiency in two, peroperative myocardial infarction in two, bleeding in one, lung complications in one and cardiac tamponade in one. Fifteen patients (3%) due to bleeding underwent re-exploration. Postoperative atrial fibrillation developed in 97 patients (19.4%). Four patients (0.8%) suffered from 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 persistant tonic-clonic convulsion). Prolonged entubation, prolonged intensive care unit stay and re-admission to the intensive care unit 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 perioperative myocardial infarction and mortality, also 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 systolic dysfunction and mortality