Undergoing Open Heart Surgery Research Articles

Effect of Cross Clamp Duration on GFR and Creatinine Values Due to Renal Flow in Valve Patients Undergoing Open Heart Surgery

Effect of Cross Clamp Duration on GFR and Creatinine Values Due to Renal Flow in Valve Patients Undergoing Open Heart Surgery

Effect of a Nurse-Led Cognitive-Behavioral Therapy on Sleep Quality in Patients Undergoing Open Heart Surgery: A Prospective Randomized Clinical Trial

Background: Sleep disorders are one of the most common complications in patients undergoing open-heart surgery. Cognitive-behavioral therapy (CBT-I) is used as a way to improve sleep quality. Objectives: This study aimed to determine the effect of a nurse-led CBT-I on sleep quality among patients undergoing open-heart surgery. Methods: This prospective randomized clinical trial was conducted on 90 patients undergoing open-heart surgery in both intervention and control groups (N = 45). The control group received routine care. The intervention group received 10-12 sessions of nurse-led CBT-I. The demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. The data was analyzed in SPSS v. 22 software using X2, independent sample t -test, analysis of covariance (ANCOVA), and paired t-test. Results: The majority of samples were in the age range of 31 - 40 years (33.33%) and male (53.33%). The results of the independent t-test showed that the mean total PSQI score in the 2 groups before the intervention was not significantly different (P = 0.245). Also, the results of ANCOVA showed that the mean total PSQI score after the intervention has a significant difference in the 2 groups (P = 0.0001). Conclusions: Nurse-led CBT-I intervention helps to improve the sleep quality of patients after open-heart surgery by reducing their automatic thoughts that affect behavior. Thus, it is recommended that training in nurse-led CBT-I be included in the nurses' academic training program, as well as in continuing education programs for nurses working in heart surgery wards.

Causes of Excessive Bleeding in Patients Who Underwent Open-Heart Surgery During the Early Postoperative Period

Causes of Excessive Bleeding in Patients Who Underwent Open-Heart Surgery During the Early Postoperative Period

Effect of Age on Estimated Glomerular Filtration Rate and the Relationship between eGFR and Extubation Time in Patients Undergoing Open Heart Surgery

Effect of Age on Estimated Glomerular Filtration Rate and the Relationship between eGFR and Extubation Time in Patients Undergoing Open Heart Surgery

The Relationship Between Preoperative Anemia and Morbidity and Mortality in Patients Undergoing Open Heart Surgery

The Relationship Between Preoperative Anemia and Morbidity and Mortality in Patients Undergoing Open Heart Surgery

Practices of Physical Therapist Regarding Chest Physiotherapy for Patients Undergoing Open Heart Surgery in Karachi

Background: Despite the critical role of chest physiotherapy in the recovery process post open-heart surgery, there is a paucity of data on the practices of physical therapists in Karachi. With the high incidence of cardiovascular surgeries and the significant burden of postoperative complications, understanding current physiotherapy practices is essential for improving patient outcomes. Objective: The objective of this study was to evaluate the current practices of physical therapists regarding chest physiotherapy for patients undergoing open-heart surgery in Karachi and to identify potential areas for standardization and improvement. Methods: A cross-sectional study was conducted using a questionnaire survey among 40 physiotherapists working in cardiothoracic units across six major hospitals in Karachi. Participants were selected through non-probability convenient sampling, and data on preoperative and postoperative physiotherapy practices were collected. The survey included both open-ended and close-ended questions, with an emphasis on the types of treatments administered during the first five postoperative days. Statistical analysis was performed using SPSS version 25. Results: The mean age of the physiotherapists was 31.20 (SD = 6.8) years with an average working experience of 7.592 (SD = 6.7) years. On the day of surgery, physiotherapy was provided routinely by 7.5%, as needed by 62.5%, and was never provided by 30% of the respondents. From the first to the fifth postoperative day, routine physiotherapy was administered by an increasing majority, peaking at 100% on the second day. Written guidelines for the management of extubated and intubated patients were accessible to 35% and 10% of participants, respectively. Conclusion: There is a substantial engagement in chest physiotherapy post open-heart surgery among physiotherapists in Karachi. However, the variability in practice and the lack of standardized guidelines point towards a need for the development and implementation of standardized protocols to ensure consistent and evidence-based care.

To Determine the Frequency and Risk Factors for Significant Postoperative Bleeding in Children with Congenital Heart Diseases Undergoing Open Heart Surgery in a Tertiary Care Center

Aim: To determine the frequency and risk factors for significant postoperative bleeding in children with congenital heart diseases undergoing open cardiac surgery in our tertiary care hospital. Methods: A prospective observational study was carried out in the department of Paediatric cardiac intensive care Unit at National Institute of Cardiovascular diseases Karachi between [dates here].Children aged 0-18 years underwent open heart surgery for congenital heart defects. Those patients who had previous palliative surgeries for congenital heart defects were included in the study.The duration of bleeding, recurrence, and treatment given (tranexamic acid bolus/infusion, platelets, FFPs, Packed RBC/WB, Factor 7 concentrates) were also documented. The outcome of bleeding was recorded as either stopped or persistent. If bleeding persisted, any other intervention needed was also noted.

Factors Affecting Death Anxiety in Patients Undergoing Open Heart Surgery: A Cross-Sectional Study.

After the operation, death anxiety of patients is affected by many factors. This study aims to investigate the factors affecting death anxiety of patients undergoing open heart surgery. A descriptive, cross-sectional study. Data were collected using the 'Introductory Information Form,' the 'Templer's Death Anxiety Scale,' and the 'Spiritual Well-being Scale.' This study was conducted with 313 intensive care patients. The mean scores of the patients on the "Death Anxiety Scale" were moderate (7.96 (4.28)). According to the study findings, age, gender, length of stay in the intensive care unit, and spiritual well-being were found to be important predictors of death anxiety (F (4,308) = 16.149, p < .001). Considering gender differences in nursing care, it is thought that the intensive care period will be shortened, the level of spiritual well-being will increase and death anxiety will decrease.

Factors Affecting the Mortality of Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass at Dr. M. Djamil General Hospital, Padang, Indonesia

Background: Morbidity and mortality of patients after cardiac surgery can be influenced in the preoperative, intraoperative, and postoperative periods. This study aimed to explore factors that affect the mortality of patients undergoing open heart surgery with cardiopulmonary bypass at Dr. M. Djamil General Hospital, Padang, Indonesia.&#x0D; Methods: This study is an analytical observational research with a cross-sectional approach and uses secondary data obtained from the medical record installation of Dr. M. Djamil General Hospital, Padang, Indonesia. A total of 57 research subjects participated in this study. Univariate, bivariate, and multivariate analyses were carried out using SPSS software.&#x0D; Results: The final multivariate modeling results show that the variables that influence patient mortality are EuroSCORE II (p-value=0.003) and duration of CPB (p-value=0.003). With an odds ratio of 37.21 groups, EuroSCORE II high risk had a risk of death 37.21 times higher than the low-risk group (CI 3.325 – 416.324). Meanwhile, increasing the duration of CPB by one minute increased the risk of mortality 1.02 times (CI 1.006 – 1.030). Meanwhile, there is no influence of variables (NYHA, LV function, ACC duration) on the incidence of mortality in patients undergoing open heart surgery with a machine cardiopulmonary bypass at Dr. M. Djamil General Hospital, Padang.&#x0D; Conclusion: EuroSCORE II affects the mortality of patients undergoing open heart surgery with CPB. The duration of CPB affects the mortality of patients undergoing open heart surgery with CPB.

Postoperative Troponin Levels in Children Undergoing Open Heart Surgery With and Without Coronary Intervention.

We aimed to characterize the ranges, temporal trends, influencing factors, and prognostic significance of postoperative troponin levels after congenital heart surgery. This single-center retrospective study included patients from 2006 to 2021 who had ≥ 1 postoperative troponin-T measurement collected within 96h of congenital heart surgery (CHS). Patients were grouped as Anomalous Aortic Origin of the Coronary Artery-"AAOCA repair," or congenital heart surgery with "Other Coronary Interventions" other than AAOCA repair, or "No Coronary Intervention." In each group, information on concomitant surgery requiring one or more of the following-atriotomy, ventriculotomy, right ventricular muscle bundle resection, and/or septal myectomy-was collected. Clinical correlates of troponin values were analyzed in three postoperative windows: < 8, 8-24, and 24-48h. The highest median [range] troponin levels (ng/mL) for the samples were 0.34 [0.06, 1.32] at < 8h for "AAOCA repair," 1.35 [0.14, 12.0] at < 8h for those undergoing CHS with "Other Coronary Interventions," and 0.87 [0.06, 25.1] at 8-24h for those undergoing CHS with "No Coronary Interventions." Atriotomy was associated with higher median troponin levels in the AAOCA group at < 8h (0.40 [0.31, 0.77] vs. 0.29 [0.17, 0.54], P = 0.043) and in the Other Coronary Intervention group at 8-24h (1.67 [1.04, 2.63] vs. 0.40 [0.19, 1.32], P = 0.002). Patients experiencing major postoperative complications (vs. those who did not) had higher troponin levels in the AAOCA group as early as 8-24h (0.36 [0.24, 0.57] vs. 0.21 [0.14, 0.33], P = 0.03). Similar findings were noted in the Coronary Intervention (2.20 [1.34, 3.90] vs. 1.11 [0.51, 2.90], P = 0.028) and No Coronary Intervention (2.2 [1.49, 15.1] vs. 0.74 [0.40, 2.34], P = 0.027) groups but earlier at < 8h. In the AAOCA group, 2/18 (11%) troponin outliers experienced cardiac arrest in comparison to 0/80 (0%) non-outliers (P = 0.032). In the Other Coronary Intervention group, troponin outliers had longer median times to ICU discharge (10 vs. 4days) and hospital discharge (21 vs. 10days) (both P < 0.001). Postoperative troponin levels depend on a multitude of factors and may have prognostic value in patients undergoing congenital heart surgery with coronary interventions.

Effect of Simulation linked Problem-Based Learning Strategy on Nursing Students' Performance regarding Care of Children Undergoing Open Heart Surgery

Effect of Simulation linked Problem-Based Learning Strategy on Nursing Students' Performance regarding Care of Children Undergoing Open Heart Surgery

Impact of Cardiopulmonary Bypass Time and Aortic Cross Clamp Time on Immediate PostOperative Outcomes in Patients with Congenital Heart Disease Undergoing Open Heart Surgery

Objective: to find out the impact of cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) on immediate post-operative outcomes in patients with congenital heart disease (CHD) undergoing open heart surgery at a tertiary care centre.&#x0D; Study Design: Prospective longitudinal study.&#x0D; Place and Duration of the Study: Department of Paediatric, Cardiac Intensive Care Unit, National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan, from Jul to Dec 2021.&#x0D; Methodology: We enrolled 104 patients of both genders up to any age with CHD undergoing open heart surgeries. At the time of admission, age, gender, body weight, presence of cyanosis and types of CHDs were noted. Duration of mechanical ventilation, pediatric cardiac intensive care unit (PCICU) stay, and mortality was recorded. Baseline characteristics and postsurgery parameters were compared about CPBT and ACCT.&#x0D; Results: Of 104 patients, 58(55.8%) were males. Overall, the mean age was 7.9±5.1 years. Cyanosis was noted in 34(32.7%) cases. Mean CPBT was 74.6±42.9 minutes, while the mean ACCT was 43.5±29.5 minutes. Most types of CHDs were noted to be tetralogy of Fallot (ToF) 28(26.9%). An increase in the duration of CPBT and ACCT was found to have a significant association with post-surgical morbidity (p&lt;0.001).&#x0D; Conclusion: Increased cardiopulmonary bypass time and aortic cross-clamp time were found to have a significant association with post-surgical morbidity and outcomes among cases undergoing open heart surgeries for congenital heart diseases.

Modified Ultrafiltration and Acute Kidney Injury in Patients Undergoing Open Heart Surgery Using Cardiopulmonary Bypass

Objective: To determine the incidence of acute kidney injury (AKI) in patients undergoing open heart surgery using cardiopulmonary bypass (CBP) with and without modified ultrafiltration (MUF). Materials and Methods: A total of 150 patients who underwent open heart surgery using CPB in our hospital from Jan-2022 to Dec-2022. In group A patients MUF was performed during the CPB and atleast 1000 ml of volume was removed using MUF. While in group B patients, no filtration was performed during CPB. In ICU all patients were followed till three days after surgery to determine the incidence of AKI. Results: Mean age was 53.4±10.9 years in MUF group versus 55.6±11.8 years in control group, p-value 0.23. Majority, 53 (70.7%) patients were male in MUF and 57 (76%) in control group, p-value 0.55. Mean CPB time was 101.6±45.2 mins in MUF and 96.5±39.1 mins in control group, p-value 0.46. Mean X-clamp time was 47.5±19.3 mins in MUF and 51.4±21.6 mins in control group, p-value 0.43. The incidence of AKI was comparable, with frequency rate of 3 (4.0%) in MUF group versus 1 (1.3%) in control group, p-value 0.31. Conclusion: In present study, the incidence of AKI in MUF and control group was almost similar. So according to the results of present study, the use of MUF has no role in preventing or aggravating AKI in patients undergoing CPB. Keywords: Acute kidney injury, cardiopulmonary bypass, modified ultrafiltration.

Comparison of The Effect of Using Back Massage with Hand and Warm Towel on Muscle Pain and Pulmonary Function of Patients Undergoing Open Heart Surgery Hospitalized in Selected Military Hospital in Shiraz

Comparison of The Effect of Using Back Massage with Hand and Warm Towel on Muscle Pain and Pulmonary Function of Patients Undergoing Open Heart Surgery Hospitalized in Selected Military Hospital in Shiraz

Evaluation of Nursing Care Satisfaction of Patients Who Underwent Open Heart Surgery.

AimThis study aimed to determine the nursing services satisfaction level of patients who underwent open heart surgery.MethodOne hundred forty patients who were hospitalized for at least 2 days between the dates 20 November 2013 and 20 January 2014 in the cardiovascular clinics of three different public hospitals were included in this descriptive research. To collect data, a survey of 13 questions about individuals’ sociodemographic and informative features and the Newcastle Satisfaction with Nursing Scale that consists of 19 clauses was used. The data were analyzed using the statistical tests of number, percentage, average, standard deviation, minimum, maximum, Mann–Whitney U-test for two groups, Kruskal–Wallis for more than two groups, chi-square and chi-square trend for comparison of categorical variables.ResultsThe nursing care satisfaction level of patients who underwent an open heart surgery was determined to be high at the rate of 77.77 ± 15.93. Satisfaction status of the patients included in the study was comparatively analyzed with age, sex, marital status, level of income, health insurance, level of education, employment status, number of hospitalization, and length of hospitalization. Results indicate that variables did not have any effect on satisfaction scores.ConclusionThe nursing services satisfaction level of patients who underwent open heart surgery was determined to be high.

Assessment of Patients' Needs Pre and Post Open Heart surgery

Background: Assessment of Bio-psychosocial needs of patient pre and post open heart surgery are very important aspect of patient centered care. Aim: was to assess patients' needs pre and post Open Heart Surgery. Design: -A descriptive exploratory design was utilized in this study. Settings: This study was conducted at Cardio-Thoracic Intensive Care Unit of Educational Tanta University Hospital. Subjects: A convenience sample of (100) open heart surgery patients that had been admitted to Cardio-Thoracic Intensive Care unit and meeting the inclusion criteria. Tools of the study: Two tools was used in this study for data collection: Tool I:A structured Interview Schedule Tool II:Bio psychosocial Needs Interview Questionnaire which included three parts; part (1): Physical Needs for Patients undergoing Open Heart Surgery, part(2): Psychological Assessment for Patients with Open Heart Surgery and part (3) Social Dysfunction Rating Scale for Patients with Open Heart Surgery. Results: There was highly significant positive correlation between total Social Dysfunction of the studied patients and their total score of pain score and total score of psychological needs at (P= < 0.01). In addition, there were significant positive correlation between total score of pain score of the studied patients and their total score of psychological needs and total score of Social Dysfunction at (P= < 0.01). Conclusion: The study concluded that, three-quarters of the studied patient had unsatisfactory level of total knowledge about heart surgeries. Also, there was a marked increase in total patients’ dependency in Activities of Daily Living level at post heart surgery. Recommendations: Routine pre and postoperative assessment of patients who are undergoing open heart surgery is recommended to identify the different patient's biopsychosocial needs and consequently any risk factor and reduced the post-operative complications.

Investigation of Anxiety, Depression and Perceived Caregiving Burden in Parents of Pediatric Patients Undergoing Open Heart Surgery and Being Followed Up in Intensive Care

Introduction: This study aims to investigate the relationship between anxiety levels and perceived caregiver burden in mothers of children who had undergone congenital heart disease surgery and who were followed up in the intensive care unit with the surgical type and clinical variables applied. Patients and Methods: The study was conducted with the mothers of both patient groups who underwent palliative surgery (n= 32) or corrective (biventricular) repair (n= 35) in the pediatric cardiovascular surgery clinic of Kartal Koşuyolu High Specialization Training and Research Hospital. Sociodemographic-clinical data form, Beck depression inventory, standardized mini-mental test, State-Trait Anxiety Inventory (STAI TX I-II), and Zarit Burden Interview (ZBI) were applied to the parents. Results: The rate of interventional birth was higher in the palliative surgery group whereas there was no difference between the palliative surgery and corrective repair groups in terms of age, gender, birth weights, and presence of additional diseases (p= 0.001). There was no difference between maternal education levels and pregnancy duration. This difference was not significant even though the mean age of the mothers in the corrective repair group was higher compared to the palliative surgery group. The mean STAI-S scores of the palliative surgery group (state anxiety) were lower than the corrective repair group, and the STAI-T scores of the palliative surgery group (trait anxiety) were higher. The ZBI scores were significantly higher in the palliative surgery group (p= 0.03). Conclusion: Congenital heart diseases and surgical interventions, as a result, are a major source of distress for affected families. Mothers are mainly affected by this situation. Changes in the mental status of the caregiver may have serious adverse effects on the operated child at every stage of the disease. Caregiving in parents is perceived as a burden and increased anxiety leads to different psychiatric clinical manifestations. Therefore, it is recommended that parents of children who have undergone congenital cardiac surgery receive routine psychiatric support from the early stages of the disease.

Post-operative Respiratory Distress Due to Laryngeal Granuloma and Subglottic Stenosis in a Patient Undergoing Open Heart Surgery

Post-operative Respiratory Distress Due to Laryngeal Granuloma and Subglottic Stenosis in a Patient Undergoing Open Heart Surgery

Respiratory Fitness and Mental Health in Patients Who Had Undergoing Open Heart Surgery: A Preliminary Observational Study

Respiratory Fitness and Mental Health in Patients Who Had Undergoing Open Heart Surgery: A Preliminary Observational Study

Vitamin D Deficiency and Its Response to Supplementation as “Stoss Therapy” in Children with Cyanotic Congenital Heart Disease Undergoing Open Heart Surgery

Abstract Background Data from many studies suggest that patients with congenital heart disease are vitamin D (vitD) deficient. Following cardiac surgery as a result of intraoperative institution of cardiopulmonary bypass (CPB), serum vitD levels become even low. This may affect postoperative convalescence in terms of mechanical ventilation, inotropic support, infection, and so forth. Objective We intended to study the prevalence of vitD deficiency pre and post cardiac surgery and the effect of vitD supplementation (stoss therapy) on postoperative convalescence of the children with tetralogy of Fallot (TOF) undergoing intracardiac repair (ICR). Methodology In this randomized controlled trial (RCT), 60 children younger than 18 years with TOF and serum vitD levels &lt; 20ng/dL were randomized into two groups. The study group received vitD supplementation as “stoss therapy” at 10,000 units/kg body weight. All these children underwent ICR with CPB. Demographic data, preoperative, intraoperative, and postoperative variables were compared between the study and the control groups. Results Prevalence of severe vitD deficiency was 93.1%. When compared with the control group, study group showed higher serum vitD levels in the immediate preoperative period (p = 0.001), postoperative period following CPB (p = 0.012), and on the first postoperative day (p = 0.003). No statistically significant difference was observed in postoperative mechanical ventilation (p = 0.35), intensive care unit (ICU) stay (p = 0.15), and inotropic duration (p = 0.19). Conclusion Children with TOF are highly deficient of vitD, its level falls further after CPB, and supplementing vitD preoperatively does not influence postoperative recovery pattern. Supplementation of vitD as “stoss therapy” was useful in raising the serum levels before and after cardiac surgery.