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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
Redo Surgery in Mitral Valve Diseases

Authors: Walla Luay Al-Falluji --- Wisam Al-Obaidy --- Ammar Naif
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 4 Pages: 896 -903
Publisher: Babylon University جامعة بابل

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Abstract

This is a retrospective study of a total 70 patients underwent redo mitral valve surgery from 2010 to 2015 in Ibn Al-Bitar Cardiac Center at Baghdad. The objectives of this research are to discuss the outcome of redo surgery in mitral valve, assesses the causes of death for surgery in patients underwent a mitral valve redo surgery, and evaluation of the late outcomes after mitral valve surgery especially after open and closed valvotomy. The gender of our patients is 64% females and 36% males; the middle old age of the suffers at the redo surgery time was 39.6 years (ranged from 13-65 years). Previous mitral surgery was closed mitral commissurotomy (CMC) in 30 patients (42%), mitral valve replacement (MVR) in 20 patients (29%), opened commissurotomy of miral valve in 12 suffers (19%) while repair of mitral valve in 8 suffers (10%). Re-operative surgery included mitral valve replacement with mechanical valves St. Jude type in all suffers . The mean time to redo surgery was 15 years run between 6 months – 35 years. Surgical indication were valve restenosis after open type of commisurotomy & closed type of commisurotomy in 40 patients were restenosis of valve surface area of prosthesis in 10 patients, mitral regurgitation in 8 patients, infected endocarditis in 6 suffers and paravalvular leak in 6 suffers. An operative mortality was 14% (10 patients). We now have proven in this be trained that mitral valve reoperations can be done with a suitable death rate at surgery that compares nicely with results in other studies.


Article
Functional Performance For Patients Post Heart's Valves Replacement at Cardiac Surgery Centers in Baghdad City
الأداء الوظيفي للمرضى بعد استبدال صمامات القلب في مراكزجراحة القلب في مدينة بغداد

Authors: Halima Y. Kadhum حليمة كاظم --- Jabbar J. Atiea جبار عطية
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2018 Volume: 31 Issue: 2 Pages: 91-102
Publisher: Baghdad University جامعة بغداد

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Abstract

AbstractObjectives: The study is carried out to assess functional performance for heart's valve replacement patients and find out relationship with sociodemographic data and clinical data Methodology: Descriptive design is carried out at cardiac surgery centers in Baghdad ; Ibn -Al Betar Specialized for cardiac surgery center and Al-Iraqi center for cardiac disease. its initiation from December28the 2013 to September 1st 2014,A non- probability (purposive) sample of 50 adults patients are attended cardiac surgery centers at Baghdad city and who have heart valves replacement. The data collection through development of questionnaire which is composed from three parts(socio demographic data, clinical information, functional performance) after validity and reliability , validity has been determined through (15) experts and reliability has been determined through pilot study, The data are descriptive statistical and analysis through application of descriptive and inferential statistical methods.Results: The result of the study has revealed that level of Functional Performance for the patients post heart's valve replacement were(80%) moderate and (20%)low majority of the study samples (92%)have regular up take of the anticoagulation drugs and majority of the samples(92%) have mechanical valve implementation ,The results of the study represent a significant statistical correlation between the level of Functional Performance for patients post heart's valve replacement group and the age p=0.042* , level education p=0.008*, socio economic status p=0.004*, ejection fraction p=0.044* ,follow up of the patients p=0.042* , regular up take of the anticoagulation drugs p=0.004*, mechanical valve used p=0.05*, duration post operation p=0.044*Recommendations : The study recommended to using biologic valve (tissue valve) for elderly patient instead mechanical valve when valve replacement to reduce complication anticoagulation drugs and enhance survival post operation, establishing Psychological consultation to copy the patients with emotional and social impact which results from the operation, an education program should be designed to increase patients education about self-care and increase satisfaction with care ,use education and training programs (regular lectures for nursing staff) to improving the expertise and knowledge of nurses to play an essential role in fostering patients care and prevent valve infection.

الخلاصه : الهدف : أجريت الدراسه لتقيم ألاداء الوظيفي للمرضى بعد تبديل الصمامات القلبيه ولأيجاد العلاقه بين ألاداء الوظيفي والمعلومات الديموغرافيه والمعلومات الطبية.المنهجية: اجريت دراسه وصفيه في مراكز جراحة القلب في مدينة بغداد (مركز ابن البيطار التخصصي لجراحه القلب ومركز العراق التخصصي لأمراض القلب)وللمدة من 28 كانون الاول 2013 لغاية 1 ايلول 2014حيث اختيرت عينه غير احتماليه (غرضيه) من 50 مريض بالغ يراجعون مراكز جراحة القلب في مدينة بغداد تم تبديل الصمام القلبي لهم,جمعت البيانات من خلال استبانه مكونه من ثلاثة اجزاء (بيانات ديموغرافيه ,وبيانات طبيه ,مقياس الاداء الوظيفي )بعد ثبوتها ,حيث حددت المصداقيه من خلال 15 خبير والثبوتيه من خلال دراسه مصغرة حيث حللت البيانات احصائيا وصفيا من خلال تطبيق الأجراءات الوصفيه والأستنتاجيه.النتائج : اظهرت نتائج الدراسه بأن مستوى ألأداء الوظيفي للمرضى (80%)متوسط و(20%) منخفض وان معظم عينة الدراسه (92%)هم منتظمون في تناول علاج مانع التخثر ومعظم العينه(92%) تم تبديل لهم صمام ميكانيكي وأظهرت الدراسة علاقه معنوية بين ألاداء الوظيفي للمرضى وبين العمر p=0.042*و مستوى التعليم p=0.008**والحالة الاقتصاديه* p=0.004*وقوة ضخ القلب p=0.044*واللتزام بلمتابعه للمريض0.042* p=واللتزام بأخذ العلاج بصورة منتظمه p=0.004*والصمام الميكانيكيp=0.05* وللمده بعد العمليه p=0.044*التوصيات :أوصت الدراسه باستخدام لصمام النسيجي بدلأ من الميكانيكي لمرضى كبار السن لتقليل المضاعفات الناتجة من اسنخدام ادويه مانعة التخثروتحسين المعيشة بعد العملية,ستشاريه نفسيه تساعد المرضى على التغلب على المشاكل النفسية والاجتماعية الناتجة من العملية,تصميم برنامج تثقيفي للمرضى لغرض زيادةعناية لمريض لنفسة وزيادة القناعة بالعناية العلاجية ,استخدام برامج تثقيفية وتدريبية للملاكات التمريضية لتحسين الخبرة والمعرفةلديهم للعب دور اكبرفي الخدمة العلاجبه المقدمة للمريض ومنع اصابة لصمام بلعدوى الانتقالية


Article
Mitral Valve Surgery in Ibn Albitar Center for Cardiac Surgery from 2004 to 2018

Authors: Walla Luay Al_Fallujia --- Talat Rifat Rahmanb --- Ammar Naif Qassimc
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2019 Volume: 27 Issue: 4 Pages: 8-19
Publisher: Babylon University جامعة بابل

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Abstract

Discuss the outcome of the mitral valve surgery in Ibn Al Bitar Center for cardiac surgery from 2004 to 2018 with 2250 patients ,Assesses the factors of risk for surgical mortality in those who perform surgery for mitral valve and Improve that the out come of mitral valve replacement much better than other types of mitarl valve surgery.The type of this research is a retrospective of a total 2250 patients who performed mitral valve surgery from 2004 to 2018 in Ibn Al Bitar Center for cardiac surgery (Baghdad /Iraq). The mitral valve surgery was mitral valve replacement 82.5% , closed mitral commissurotom 7.1%, open mitral commissurotomy 4.9% and redomitral valve surgery 5.5% . There are only 22 patients die and the causes of the death were Hemorrhage and cardiac temponad in 9 patients (40%), infective endocarditis in 6 patients (27.2%), heart failure in 4 patients (18.1%) , and thromboembolism in 3 patients (13.6%). This study showed that Mitral valve surgery will be performed with a suitable operative mortality that compares favourably with leads to different printed series and future survival for bicuspid valve replacement square measure wonderful additionally to it the incidence to reoperation were considerably less than closed and open commissurotomy,so the bicuspid valve replacement is that the best style of bicuspid valve surgery.

تبحث هذه الدراسة في كفاءة العمليات الجراحية الخاصة بأمراض الصمام الإكليلي التي أجريت ل 2250 مريض في مركز أبن البيطار لجراحة القلب في بغداد/ العراق للفترة من 2004 و لغاية 2018 و التي تشمل عمليات تبديل و توسيع وتصليح واعادة جراحة الصمام الاكليلي .حيث تم بحث هذه العمليات عن طريق متابعة المرضى خلال فترة ما قبل العملية بواسطة الفحوصات السريرية و المختبرية و أثناء وفترة ما بعد العملية بواسطة المضاعفات ألآنية و المستقبلية و ما لها من أثار سلبية على المرضى ولقد كانت النتائج في نهاية البحث واضحة جدا في أثبات كفاءة عملية تبديل الصمام الإكليلي بأخر صناعي و اعتبارها العملية الأكثر نجاح في جراحة الصمام الإكليلي لما لها من نتائج جيدة على المدى البعيد بالنسبة للمريض مع انخفاض كبير لاحتمالية تعرض المريض لإعادة جراحة الصمام الإكليلي في المستقبل عند المقارنة مع انواع الجراحة الاخرى.

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