A clinical study of normothermic open heart surgery

Abstract

Background: Normothermic open heart surgery is a new approach which is envisaged for better myocardial protection during cardiac surgery based on the concept that chemically arrested heart is perfused continuously with blood and maintained at 37ºC.Methods: This study was conducted in 50 patients at Super Specialty Hospital, Jammu in the Department of CTVS for a period of one year from 2015 to 2016. The patients of all age groups and both sexes were taken up for surgery which included patients of congenital and acquired heart diseases. All patients were undergone thorough history taking, investigations like cardiac enzymes estimation, LFT, RFT, echocardiography, ECG. Cardioplegia used during surgery consisted of warm oxygenated blood, KCL, sodium bicarbonate, hydrocortisone, Mannitol.Results: Majority of patients were in age group of 11-20 years which comprised 30% of all patients. the male and female patients were equal and ratio was 1:1. Per-operative diagnosis was same as pre-operative echocardiographic diagnosis except that one (2%) patient had ASD with partial anomalous pulmonary veins opening into right atrium. One patient (2%) had single ventricle with pulmonary stenosis. Maximum number of patients underwent mitral valve replacement followed by ASD repair. Mean aortic cross-clamp time was 62 patients and mean total CPB was 71.5 minutes. Mean value of volume of blood cardioplegia used was 1100 ml and for priming solution it was 1500 ml. Cardiac enzyme level showed peak rise above normal after 24 hours after surgery in majority of patients.Conclusions: Normothermic open heart surgery can be used in any diverse surgical procedure safely and effectively.