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Article
Renal Impairment After Valvular Heart Surgery in Adult

Author: Wadhah A. Mahbuba
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 4 Pages: 347-350
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Cardiac surgery can either induce acute renal failure or improve GFR by improving the cardiac performance. Acute renal shutdown (urine output <0.5ml/kg/hr.) is an uncommon but fatal complication which occurs in cases of insufficient cardiac function and may be accompanied with multi-organ failure. Acute renal failure (ARF) after open heart valve surgery occurs in about 8% of adult cardiac surgical patients with some preoperative renal impairment and in about 3-4% of patients with normal preoperative renal function test. This study was done to determine the frequency of acute renal shutdown after valvular open heart surgery and to detect any suggestive risk factors.METHODS:90 patients undergoing valve replacement (mitral and/ or aortic) were prospectively evaluated in three time periods: before, 24 hours after surgery and 48 hours after surgery. The association between preoperative, intra-operative and postoperative variables and the development of ARF was assessed thoroughly.RESULTS:Of the 90 consecutive patients 3 (3.49%) patients developed acute renal failure (serum creatinine>2.5 mg/dl) and 16 (18.6%) patients developed acute renal dysfunction (serum creatinine 1.6-2.4 mg/dl). The risk factors that were noted in the development of ARF were age, raised preoperative blood urea and creatinine, low cardiac output state, diabetes mellitus, oligurea, total cross clamp time total CPB time, and significant hypotension during the procedure or during intensive care unit (ICU) stay. Mortality rate for established ARF was extremely poor (50 %).CONCLUSION:Avoidance of this dangerous outcome looks better than trying to treat once it is fully established.


Article
Cardiac injuries Revision of local experience

Author: Wadhah A. Mahbuba F.I.B.M.S (CTVS)*
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2010 Volume: 13 Issue: 1 Pages: 50-59
Publisher: University of Kufa جامعة الكوفة

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Abstract

AbstractBackground: The sequel of cardiac injuries varies from benign to catastrophic ends. In United state, traumatic injuries still the fifth cause of death (1). It has been observed that in the prehospital period, 20% of traumatic deaths are due to cardiac-related injuries (2). Over the last twenty years, the quick and right transportation of patients and early application of advanced life support have enabled more of injured people who were previously non-survived to arrive the hospital in a terminal shock state. The level of suspicion and early identification of the cardiac injury is quite important. Reliable detection, however is challenging, as there are still no diagnostic criteria for penetrating cardiac injury (3). The following review presents an evidencebased approach to the evaluation and management of the patient who presents with thoracic injury that may involve a cardiac injury. Patients and methods: Sixteen patients suffering from thoracic trauma and penetrating injury to the heart were retrospectively evaluated regarding the time of presentation state of presentation and the management that were done. The relation of prehospital and hospital variation and the faith of the victims was assessed thoroughly. Results: Of the 16 patients 4 (25%) were presented in a stable condition and 6 (37.5%) were in shock state, while 6 (37.5%) in terminal stage. The left ventricle was the injured part in 8 (50%), while right ventricle, left atrium, right atrium, and multiple site were 3 (18.75%), 2 (12.5%), 2 (12.5%) and 1 (6.25%) respectively. The pulmonary injuries is the most associated injured organ 13 (81.25%), with overall mortality of 6 (37.5%). Conclusions: Early transportation, early surgical intervention, and the site of inj


Article
Fontan's Iraqi experience
ستجراح فونتان في القلب

Author: Wadhah A. Mahbuba (M.B.Ch.B ,F.I.B.M.S ) Cardiothoracic surgeon*
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2008 Volume: 11 Issue: 2 Pages: 58-67
Publisher: University of Kufa جامعة الكوفة

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Abstract

Complex congenital heart disease, Fontan procedure, Glenn procedure, Single ventricle, Fontan circulation.

دراسه يناقش بها ماطراء على عملية فونتان منذ الأفكار الأولى عام 1940 وأنتهاءا بأخر التطوراتمع دراسة باثر رجعي لاجراء عمليات فونتان في العراق ومناقشة النتائج والمشاكل والتعقيدات اثناء وما بعد اجراءها كما تمت مقارنتها مع النتائج الاخرى في العالم ومناقشة اسباب الاختلافات والخروج بتوصيات ورؤى مستقبلية لواقع عمليات القلب المفتوح في العراق للمرضى المصابين بتشوهات قلبية خلقية معقدة ومدى امكانية النهوض بالواقع الصحي في سبيل الوصول الى مستوى مقارب للمراكز العالمية.

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