Results of Coronary Artery Bypass Graft Surgery in Sharq Elmadina Hospital, Alexandria

Abstract

Background: coronary artery bypass graft (CABG) surgery has been shown to be an effective method for treating angina pectoris and prolonging life in patients with severe coronary artery disease. Aim of the Work: to assess postoperative short-term results of coronary artery bypass graft surgery in Shark Elmedina hospital, Alexandria. Patients and Methods: This retrospective study was conducted on 170 patients with isolated ischemic heart disease admitted to Shark Elmadina hospital from January 2016 to January 2017. In the current study, pre-operative data were collected to identify the risk factors that may affect the outcome of surgery and intraoperative data and post-operative complications. Results: The most common risk factors were dyslipidemia (64.7%), hypertension (57.1%), diabetes mellitus which represents 50%, smoking which represents 37,6%, peripheral vascular disease which represents 31,7%. Other risk factors which had a low percent were history of chronic hepatic disease, previous stroke or myocardial infarction or lung disease or renal disease. What is worth to mention that echo preoperative affects the outcome of surgery as in our study EF of patients’ ranges from 40% to 75%. Intraoperative data also affects the outcome of surgery as number of grafts as there was one patient had done 5 grafts and 34 patients have done 4 grafts. Another important event was LLIMA dissection as there were 9 patients have dissected LIMA during harvesting. Another event was endartrectomy as there were 11 patients have LAD endartrectomy, 6 patients have RCA endartrectomy. Long bypass time and clamp time affects the results of surgery maximum bypass time 200 minute and maximum clamp time 120 minute. Post-operative ICU and ward stay affects the results as maximum ICU or ward stay was 9 days. The most common complication was wound infection which had an incidence 7% and the second complication was renal impairment which had an incidence 5.2%, reopening (2.9%), elevated liver enzymes which represents 2,3% and other complications which had low incidence as pleural effusion, lung atelectasis and stoke. Finally, mortality was 1.1%. Conclusion: CABG surgery is safe and the risk of major complications is low. Although major complications occur rarely they pose a great challenge to the patient and the surgeon. Early recognition and management of major complications are paramount to long term outcome.