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Minimal sternotomy surgery in comparison to standard sternotomy in the coronary bypass Surgery

Background Median sternotomy is the gold standard incision for most cardiac operations. However, with the advent of minimal invasive surgery, a new approach emerged in cardiac surgery named mini-sternotomy and has been successfully used to perform a variety of operations.

 The aim of this paper is to present our experience of using mini-sternotomy to harvest the left internal mammary artery (LIMA) for off-pump revascularization of the left anterior descending artery (LAD)

 Methodology Over a 2-year period (October 2012-October 2014), 100 patients underwent coronary artery bypass grafting (CABG) via conventional median sternotomy (CMS) (n=80) and mini-sternotomy (MS) (n=20). The 2 groups were compared regarding length and difficulty of surgery, postoperative pain and respiratory function, stay in the intensive care unit (ICU), wound infection, shoulder stability and other variables.

 Results One patient (5%) with LMS was converted into CMS due to inadequate exposure. The blood loss was less in LMS patients. Lung atelectasis and pleural effusions were less in group 2. A higher PaO2, lower PaCO2 and a shorter assisted-ventilation time were observed in LMS group. Early postoperative pain score & analgesic requirements were less in LMS patients and their hospital stay was shorter (4-5 days) than CMS. Moreover, LMS patients could return to their jobs and drove cars earlier than group 2 patients. There were 9 deaths (11.3%) in CMS group vs. one death (5%) in LMS group; however, this difference was not statistically significant (p˂0.05)

 Conclusions This study shows that off-pump coronary surgery through mini-sternotomy incision is feasible and safe.

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Use of Retrograde Cardioplegia in Coronary Artery Bypass Graft Surgery

Background: Retrograde Cardioplegia is a widespread method for myocardial protection in coronary bypass surgery and to abroad range of open heart surgical procedures in addition to antigrade Cardioplegia,
Objectives: Is to evaluate the use of retrograde cardioplegia and its advantages in coronary bypass surgery at Ibn Al-Nafees Teaching Hospital, Department of Cardiac Surgery,
Patients and methods: This is a retrospective study that was conducted at Ibn Al-Nafees Teaching Hospital from the first of January to the first of October 2015, fifty patients with coronary artery dieses were admitted to the hospital and coronary artery bypass graft (CABG) surgery was done under cardiopulmonary bypass using retrograde cardioplegic canula thr

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effects of Hypothermia on Renal Functions for Patients undergo Coronary Artery Bypass Graft Surgery

Objective: To determine the effectiveness of hypothermia on renal functions for patients undergoing
coronary artery bypass graft CABG surgery.
Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery
bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the
intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function
test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was
determined first week post operative and post operative renal function was classified on the base of peak of
the serum creatinine level and decline of glomeru

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Publication Date
Wed Jan 05 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Early complications associated with obesity following coronary artery bypass graft surgery: Obesity and post-CABG morbidity

Background: One of the major health concerns and possible risk factors in open heart surgery is the increasing prevalence of obesity among patients.

Methodology: Over a period of sixteen months (February 2017 to June 2018), 246 patients underwent coronary artery bypass graft surgery (CABG) in Slemani Cardiac Hospital (SCH). The patients were divided according to the WHO classification into two groups: The obese (BMI ≥ 30) and the non-obese  (BMI < 30) and were compared in regard to the rate of occurrence of early postoperative complications.

Objective: To evaluate the impact of obesity [body mass i

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Cardiac Rehabilitation Instructional Program on Health-related Quality of Life for Patients Undergone Coronary Artery Bypass Graft Surgery

Objective(s): evaluation of effectiveness of cardiac rehabilitation instructional program on health-related quality of life and to find out the relationship between health-related quality of life and patient’s socio-demographic and clinical characteristics. 

Methodology: A descriptive study design was carried out from 8th August, 2022 to 10th January, 2023.

A non-probability purposive sample of (50) patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases using pre-experimental design. The data were collected by direct interview with sample using questionnaire composed of three parts: part (1) Socio-demographic and clinical ch

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Off-Pump Coronary Artery Bypass Graft

Background: Coronary artery bypass graft is routinely performed on an arrested heart using cardiopulmonary bypass with aortic cross clamping and Cardioplegia. Off-pump coronary artery bypass graft (OPCABG) is being increasingly used in selected cases as an attempt to decrease morbidity and mortality.
Objective: The main objective of this study is to clarify those patients who are indicated for OPCABG despite it is surgically demanding technique and to evaluate the mortality and morbidity associated with such procedures.
Patients and methods: It is a retrospective study of 28 patients with coronary artery disease, in need for coronary artery bypass graft admitted and surgically treated at the Iraqi Centre fo

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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Surgery In Infective Endocarditis

Background: Early surgery during the active phase of infective endocarditis was considered to carry high morbidity and mortality due to technical difficulties on an inflamed tissues.

Objectives: Is to focus a light on the increasing indications for surgery during the active phase of infective endocarditis which lead to significant drop in the hospital mortality.  

Patients and Methods: Eighteen patients with bacterial endocarditis and valvular dysfunction were admitted to Iraqi center for heart diseases during the period from January 2008 –April 2013. All of them were fully investigated and adequately prepared for open heart surgery.

Result:

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Comparison Between Mechanical and Non Mechanical Bowel Preparation Prior To Elective Colorectal Surgery

Background: Bowel preparation prior to
colonic surgery usually includes antibiotic
therapy together with mechanical bowel
preparation which may cause discomfort to the
patients, prolonged hospitalization and water
& electrolyte imbalance.
Objective: to assess whether elective colon
and rectal surgery may be safely performed
without preoperative mechanical bowel
preparation.
Method: the study includes all patients who
had elective large bowel resection at Medical
City – Baghdad Teaching Hospital between
Feb, 2007 to Jan, 2010. Emergency operations
were not included. The patients were randomly
assigned to the 2 study groups (with or without
mechanical bowel preparation.
Results: A to

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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Surgery in Varicose Veins

Background: Varicose veins are common in Iraq. Increasing incidence is associated with available jobs of bodyguards, barbers and computer workers.

Objectives: To highlight the frequency, presentation, methods of accurate diagnosis and surgical procedures which are commonly used by Vascular Surgeons in Medical City Teaching Complex, Al-Shaheed Ghazi Al-Hariri Subspecialties hospital and to compare this study with other international studies.

Patients and methods:  This is a retrospective study of hundred patients with varicose veins, who were admitted and surgically treated at Al-Shaheed Ghazi Al-Hariri subspecialties hospital during one year period (1st of July 2010

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Prevalence, risk factors and association of renal artery stenosis with coronary artery disease in patients undergoing coronary angiography in Ibn-Al Bitar center for cardiac surgery

Background:-Atherosclerosis is a systemic disease that often affects multiple vascular distributions in a single patient. The increased prevalence of renal artery stenosis in association with coronary artery disease has been well documented.
Objectives:-To examine in detail the prevalence of renal artery stenosis in patients undergoing cardiac catheterization for suspected coronary artery disease.
Patients &methods:-Between April 2010 and February 2011, two hundred patients underwent coronary and renal angiography at the same session in Ibn Al-bitar Hospital for Cardiac Surgery. Clinical and procedural data for patients undergoing renal angiography were prospectively collected and entered into database specially designed for th

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Publication Date
Sun Feb 21 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Mitral valve surgery: comparison between superior septal and left atrial approaches: Surgical Approaches to the Mitral Valve

Background Mitral valve (MV) is one of the most complex structures in human heart with a challenging exposure. Traditionally, MV is approached via left atriotomy (LAA) while superior septal approach (SSA) is an alternative.
Objective
:  is to highlight the merits and demerits of these two approaches in providing access to the MV in term of the aortic cross clamp time (ACCT), quality of exposure, and potential complications in view of the published literature.

Patients and Method: Over an 18-month period ending at June 30th, 2019, 56 patients with MV disease ± other cardiac diseases were enrolled in this study. Twenty patients had surgery via LAA (one surgeon) w

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