Search In this Thesis
   Search In this Thesis  
العنوان
Early Outcome of Complete versus Incomplete Revascularization in Patients with Multi Vessels Disease Undergoing Coronary Artery Bypass Grafting \
المؤلف
Elshafey, Akram Ahmed Mahmoud.
هيئة الاعداد
باحث / أكرم أحمد محمود الشافعى
مشرف / محسن محمد عبد الكريم
مشرف / ياسر محمود النحاس
مشرف / تامر شحات هيكل
تاريخ النشر
2019.
عدد الصفحات
141 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض القلب والطب القلب والأوعية الدموية
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - جراحة القلب والصدر
الفهرس
Only 14 pages are availabe for public view

from 141

from 141

Abstract

Coronary artery disease (CAD) remains the leading cause of mortality worldwide. Myocardial revascularization procedures continue to represent important treatment options for patients with acute and chronic coronary artery disease (CAD). Among patients with multi-vessel coronary artery disease, CR may be the optimal revascularization strategy.
This study was performed at Cardiac Surgery Department, Shibin El-Kom Teaching Hospital to evaluate the impact of incomplete coronary surgical revascularization on patients with multi-vessels coronary heart disease in comparison to patients with complete coronary revascularization on early outcomes.
This study included 60 patients admitted with coronary artery disease to Cardiac Surgery Department, Shibin El-Kom Teaching Hospital.
All Patients were subjected to full history taking, complete medical examination and thorough laboratory and radiological investigations.
1. Personal history including: name, age, sex and special habits.
2. Medical history including: hypertension, DM, COPD, CHF, CVS, dyslipidemia, history of coronary artery disease and previous PCI.
3. Drug history was also considered specially use of anti platelets, anticoagulant, inotropes and ant ischemic drugs.
4. Thorough clinical examination.
5. Laboratory investigations include: CBC, RFT, LFT, coagulation profile, cardiac enzymes and troponin.
6. Electro Cardiogram (ECG).
7. Chest X-Ray.
8. Trans thoracic Echocardiography.
9. Coronary angiography.
In our study there were no significant difference in the mean of age between both groups, more IR patients were with DM, HTN and 10% presented with STEMI.
Patients with complete revascularization had a higher incidence of a normal preoperative electrocardiogram than patients with incomplete revascularization (n=16 (53.3%), n=10 (33.3) respectively) and there was improvement of left ventricular ejection fraction in patients underwent complete revascularization.
This study found that there was a highly significance difference (P <0.001) between two groups regarding cross lamp time which was shorter in group B than A.
This study showed that 6 patients in-group B developed MI shortly after revascularization in comparison with group A in which there was no patient developed it.
The results of our study found that significant difference in survival rate between group A and group B and about 10 patients of the studied groups died during hospitalization with a higher hospital mortality among women in both groups.
In fact, hospital and late survival were comparable for IR and CR patients. This finding implies that one should be cautious about interpreting the increased risk of morbidity and mortality from IR. We believe that adverse effects of IR are probably due to the preoperative condition of the patient rather than IR itself.