Transcript Mitral Replacement : 5 cases.

KING ABDULAZIZ UNIVERSITY
HOSPITAL
CARDIAC SURGERY UNIT
Dr. Khalid Al-Ibrahim
Dr. Khalid Medhat
Dr. Hussein Jabbad
Dr. Ragab Shehata
STARTED
th
28
From
Feb. 2006
once weekly
Till may 2006 then
twice weekly
Total No. : 53cases
Coronary artery bypass graft
CABG
( 35cases )
- Age : 45 – 69 years
Mean age : 52.5 years
- No of graft : 1- 5 grafts
Mean No. : 3.4 grafts
Valve replacement
( 15 cases )
- Aortic Replacement : 2cases.
- Mitral Replacement : 5 cases.
- Aortic+mitral : 2 case.
Mitral+tricuspid 2 cases
Mitral repair
3 cases
- Combined (Valve Rep + CABG ) : One case
Rheumatic aortic valves
Normal aortic valve
Different types of prosthetic valve
Valve replacement
- Age 13 - 43 years old
Mean 31.7 years
Total No. of valves 11 valves
- Tissue : 5 valves
- Mechanical: 6 valves
- Rings : One ring for tricuspid valve repair
3 mitral

Other cases
Ascending aortic aneurysm in a
marfan
Ruptured interventricular septum
Operative field in cardiac surgery
Operating room for cardiac surgery
Noncardiac cases
: PDA surgical ligation (7).
: Pacemaker insertion.
: Oesophageal enteric cyst excision.
: AAA repair ( 2 ).
: PA banding.
: Fem-Pop bypass graft .
PACEMAKER INSERTION IN 30 DAYS OLD INFANT
PRE OP.
POST OP.
TERATOMA EXCSTION IN 17 Y OLD GIRL
C-T chest of 17 ys old girl showing Teratoma
CXR of 50 years old female 
SVC Aneurysm
C-T chest of the same patient
C-T chest of 31 y old female with enteric
cyst of the esophagus
RESULTS
One case postoperative mortality
Successes rate 98 %
Mortality rate
2%
MORBIDITY
( 1 ) Perioperative MI:- 4 cases
- ↑ cardiac enzyme & troponin
- S-T changes
- New Q wave
- New left bundle block
3 cases
4 cases
2 cases
2 cases
(2) Postoperative bleeding
( Re-exploration)
( No Patients need re-exploration).
Avarage
Avarage
Avarage
Avarage
total drain
blood given
ffp given
plat. Given
: 370 ml
: 2 unit
: 3 unit
: 2 unit
(3) Post operative Arrhythmia
- Atrial fibrillation : 3 cases, all regained SR
- Heart block
: No cases
- PVCs
: 2 cases
- Bigeminy
: one case
- V. T( NS )
: one case
- V. F
: No case
(4) Wound infection
- Superficial wound infection in 5 cases,
With frequent dressing healed within one
week.
- One case of deep leg wound infection.
- No cases of Deep sternal wound infection
- No cases of mediastinitis
(5) Low cardiac output
Occurs in 3 cases:- - 2 cases Need IABP.
- One case Need LVAD.
(6) Postoperative DVT
One case P/ CABG developed DVT in
unusual site, axillary & brachial veins,
(predisposed by central line insertion)
- Readmitted to hospital and treated medically,
- Improved and discharged.
Successful case of ascending aortic
aneurysm repair




A 43 y old Indonesian man
12cm asc aortic aneurysm
Congestive heart failure
Renal and liver impairment
Ruptured interventricular septum
65 years male post acute anterior M.I. 
Cardiogenic shock requiring I.A.B.P

+Inotropes
Emergency open heart 
Transventricular 
incision
Pericardial patch repair

Teflon sheet enforced ventricular closure
- ICU stay : 2 – 6 days
Mean 3 days
- Hospital stay: 7 – 23 days
Mean 11 days
Follow up
All patients are followed up regularly in out patient
clinic
FUTURE OF CARDIAC SURGERY
IN KAUH
1- Increase the OR days up to 3 days weekly
2- Plan to sit Cardiac surgery for pediatrics
3- Private cases
4-Expand cardiology
5- Haematology clinic for valve patients
THANK YOU