Publications by authors named "Jamshid Bagheri"

16 Publications

  • Page 1 of 1

Isolated tricuspid valve surgery; long-term outcomes based on Tehran Heart Center data bank report.

J Cardiothorac Surg 2021 Feb 23;16(1):19. Epub 2021 Feb 23.

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Given that isolated tricuspid valve (TV) repair or replacement is performed relatively rarely, we sought to evaluate the rate of long-term mortality and readmission following this surgery.

Methods: The current study was conducted in Tehran Heart Center on patients who underwent isolated TV repair or replacement between 2010 and 2018. Totally, 197 patients (repair = 150 vs replacement = 47) were included in our study and were then followed right after surgery for a median of 8 years to assess the incidence of postoperative events, readmission, and all-cause mortality.

Results: The final analysis was conducted on 197 patients at a mean age of 44.4 ± 13.8 years. Most of the patients were female (56.9%). Ejection fraction, TAPSE, and right ventricular function improved in both groups after TV surgery. Length of stay in the intensive care unit per hour and hospitalization per day were higher in the replacement group and compared to the repair group (158.34 vs. 55.11 and 18.21 vs. 9.34, respectively). In-hospital mortality occurred in 20 patients, of whom 15 had TV replacement. Readmission occurred in five (2.5%) patients,all were in the repair group.

Conclusions: The result of this single-center study showed that TV replacement is associated with a higher rate of postoperative events and all-cause mortality compared to TV repair. Whereas, repair group had a higher rate of readmission. Therefore, the overwhelming tendency is toward repair; nonetheless, no hesitation is permissible if a replacement is adjudged to confer a better outcome for the patient.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13019-021-01394-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903743PMC
February 2021

The association of statins for secondary prevention with progression to diabetes in patients with prediabetic state after coronary artery bypass graft surgery: A retrospective cohort study.

J Diabetes Complications 2020 Dec 24;34(12):107713. Epub 2020 Aug 24.

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Aim: Despite proven benefits of statins for secondary prevention of coronary artery diseases, their diabetogenic effect is still controversial. We aimed to examine the occurrence of type 2 diabetes mellitus (T2DM) in prediabetic patients after coronary artery bypass grafting (CABG).

Methods: The retrospective cohort population comprised of post-CABG patients who were prediabetic at the time of surgery and were taking statins. Patients were categorized into the high- and low-intensity statin regimens according to the commonly used dose during the follow-up. Moreover, we calculated the cumulative dose (milligrams*days) by taking into account that patients were on different doses of statins during different periods of time. We observed patients for occurrence of T2DM or major adverse cardiovascular events (MACE) as a composite of death, myocardial infarction, cerebrovascular accident, and hospitalization for unstable angina or heart failure.

Results: We studied 819 patients for a median of 37.8 months after CABG. T2DM occurred in 8.1% (n = 66). The rate of T2DM development was not different between the high- and low-intensity groups (P = 0.715) and also according to the cumulative dose (P = 0.962). Furthermore, we found no association (P = 0.938) even after adjustment for confounders including age, sex, body mass index, alcohol use, history of hypertension and hyperlipidemia, and family history of T2DM. Moreover, high- rather than low-intensity statin regimen was correlated with a lower occurrence of MACE (P = 0.027), even after adjustment for confounders (P = 0.015).

Conclusions: In prediabetic post-CABG patients, treatment with statins was not associated with the development of T2DM and reduced occurrence of MACE after 37 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jdiacomp.2020.107713DOI Listing
December 2020

Early respiratory outcomes following cardiac surgery in patients with COVID-19.

J Card Surg 2020 Oct 13;35(10):2479-2485. Epub 2020 Aug 13.

Department of Disease Control, Tehran Heart Center, Tehran, Iran.

Background: Both coronavirus disease (COVID-19) and cardiac surgery have a negative impact on pulmonary function. This study aimed to determine the postoperative respiratory outcomes of patients with COVID-19 who underwent cardiac surgery.

Methods: In this retrospective study, we reviewed and analyzed the patient characteristics and clinical data of 25 asymptomatic patients with COVID-19 who underwent urgent or emergency cardiac surgery at Tehran Heart Center Hospital, Iran, between 29 February and 10 April 2020.

Results: The mean age, EuroSCORE, and body mass index were 57.3 ± 15.1 years, 6.65 ± 1.29, and 25.7 ± 3.7 kg/m , respectively. Four patients underwent off-pump cardiac surgery and 21 underwent on-pump cardiac surgery with a median cardiopulmonary bypass time of 85 minutes (interquartile range (IQR, 50-147). The overall mortality rate and the length of stay in the intensive care unit (ICU) were higher compared to those of a propensity-matched group of patients who underwent cardiac surgery in the pre-COVID era. The median intubation time was 13 hours (IQR, 9.5-18), which was comparable to that of pre-COVID cardiac surgery patients. The readmission rate to the ICU was 16%. In this ICU readmitted group, the mean oxygen index, FiO , and mortality rate were higher and the PaO /FiO ratio was lower than those of the nonreadmitted patients.

Conclusions: Although early respiratory outcomes of asymptomatic COVID-19 patients who underwent early cardiac surgery appeared to be satisfactory, compared to the propensity-scored matched non-COVID group, the postoperative outcomes were worse, especially in the ICU readmitted patients. We suggest postponing cardiac operations unless the patient requires emergency surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocs.14915DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436810PMC
October 2020

Effect of persistent opium consumption after surgery on the long-term outcomes of surgical revascularisation.

Eur J Prev Cardiol 2020 Dec 16;27(18):1996-2003. Epub 2020 Jul 16.

Department of Cardiac Surgery, Tehran University of Medical Sciences, Iran.

Background: A wrong traditional belief persists among people that opium consumption beneficially affects cardiovascular disease and its risk factors. However, no evidence exists regarding the effect of opium consumption or cessation on the long-term risk of major adverse cardio-cerebrovascular events after coronary artery bypass grafting. We therefore aimed to evaluate the effect of persistent opium consumption after surgery on the long-term outcomes of coronary artery bypass grafting.

Methods: The study population consisted of 28,691 patients (20,924 men, mean age 60.9 years), who underwent coronary artery bypass grafting between 2007 and 2016 at our centre. The patients were stratified into three groups according to the status of opium consumption: never opium consumers ( = 23,619), persistent postoperative opium consumers ( = 3636) and enduring postoperative opium withdrawal ( = 1436). Study endpoints were 5-year mortality and 5-year major adverse cardio-cerebrovascular events, comprising all-cause mortality, acute coronary syndrome, cerebrovascular accident and revascularisation.

Results: After surgery, 3636 patients continued opium consumption, while 1436 patients persistently avoided opium use. The multivariable survival analysis demonstrated that persistent post-coronary artery bypass grafting opium consumption increased 5-year mortality and 5-year major adverse cardio-cerebrovascular events by 28% (hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.06-1.54;  = 0.009) and 25% (HR 1.25, 95% CI 1.13-1.40;  < 0.0001), respectively. It also increased the 5-year risk of acute coronary syndrome by 34% (sub-distribution HR 1.34, 95% CI 1.16-1.55;  < 0.0001).

Conclusions: The present data suggest that persistent post-coronary artery bypass grafting opium consumption may significantly increase mortality, major adverse cardio-cerebrovascular events and acute coronary syndrome in the long term. Future studies are needed to confirm our findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2047487320932010DOI Listing
December 2020

Smoking Cessation After Surgery and Midterm Outcomes of Surgical Revascularization.

Ann Thorac Surg 2020 06 7;109(6):1874-1879. Epub 2019 Nov 7.

Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Although multiple studies have reported the devastating effect of cigarette smoking (CS) on short-term outcomes of patients who underwent coronary artery bypass grafting surgery (CABG), its effect on long-term outcomes is still questionable. We aimed to evaluate the long-term outcomes of CS cessation after CABG surgery.

Methods: This retrospective cohort study included all patients who underwent isolated CABG at our center between 2007 and 2016 and were cigarette smokers either just before or at the time of surgery. Patients were stratified into those who continued CS and those who were persistently CS abstinent after CABG. The endpoints of the study were 5-year mortality and 5-year major adverse cardiovascular and cerebrovascular events.

Results: Of 28,945 patients who underwent isolated CABG, 9173 current cigarette smokers (93.5% men; mean age, 58.6 years) met our selection criteria and were included in the final analysis. Of these 3302 patients (40.0%) continued CS after surgery and 5688 patients were persistently abstinent. Multivariable survival analysis demonstrated that CS cessation after CABG, adjusted for major coronary risk factors, could reduce the 5-year mortality by 35% (hazard ratio, 0.65; 95% confidence interval, 0.54-0.77; P < .001) and 5-year major adverse cardiovascular and cerebrovascular events by 18% (hazard ratio, 0.82; 95% confidence interval, 0.74-0.92; P = .001).

Conclusions: Our study shows that CS abstinence after CABG significantly reduces long-term mortality and number of major adverse events. As a result, patients who smoke should be encouraged to participate in CS cessation programs after CABG surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.athoracsur.2019.09.045DOI Listing
June 2020

Comparison of the effect of 80 vs 40 mg atorvastatin in patients with isolated coronary artery bypass graft surgery: A randomized clinical trial.

J Card Surg 2019 Aug 18;34(8):670-675. Epub 2019 Jun 18.

Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: Atorvastatin can decrease cardiac injury after coronary artery bypass graft (CABG) surgery. We compared the effects of 80 and 40  mg of atorvastatin per day on the levels of cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) after an isolated CABG.

Methods: This randomized single-blind parallel clinical trial enrolled 125 patients (mean age = 60.59 ± 8.37 years) who were candidates for elective isolated CABG at the Tehran Heart Center between May 2017 and December 2017. Patients were randomly allocated into two groups to receive either 80 mg (n = 62) or 40 mg of atorvastatin (n = 63) per day, 5 days before surgery. The levels of cTnT and CK-MB, used as myocardial injury markers, were measured at baseline and then at 8 and 24 hours after CABG.

Results: The levels of CK-MB and cTnT at baseline and at 8 and 24 hours following CABG were not significantly different between the two groups. Our repeated measures analysis of variance showed that the levels of CK-MB and cTnT increased significantly over time (P <  .001). No significant interaction was observed between time and the atorvastatin dosage on the levels of either CK-MB (P =  .159) or cTnT (P =  .646). In addition, the between-group effects were not significant for CK-MB (P =  .632) and cTnT (P =  .126).

Conclusion: The higher dose of atorvastatin (80 mg) did not exert a more protective effect than the standard dose of atorvastatin (40 mg) after CABG surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jocs.14100DOI Listing
August 2019

Post-Myocardial Infarction Ventricular Septal Defect in the Wall of a Basal Ventricular Aneurysm.

J Tehran Heart Cent 2018 Jan;13(1):38-39

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037629PMC
January 2018

Cross-linking gold nanoparticles aggregation method based on localised surface plasmon resonance for quantitative detection of miR-155.

IET Nanobiotechnol 2018 Jun;12(4):453-458

Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.

MiR-155 plays a critical role in the formation of cancers and other diseases. In this study, the authors aimed to design and fabricate a biosensor based on cross-linking gold nanoparticles (AuNPs) aggregation for the detection and quantification of miR-155. Also, they intended to compare this method with SYBR Green real-time polymerase chain reaction (PCR). Primers for real-time PCR, and two thiolated capture probes for biosensor, complementary with miR-155, were designed. Citrate capped AuNPs (18.7 ± 3.6 nm) were synthesised and thiolated capture probes immobilised to AuNPs. The various concentrations of synthetic miR-155 were measured by this biosensor and real-time PCR method. Colorimetric changes were studied, and the calibration curves were plotted. Results showed the detection limit of 10 nM for the fabricated biosensor and real-time PCR. Also, eye detection using colour showed the weaker detection limit (1 µM), for this biosensor. MiR-133b as the non-complementary target could not cause a change in both colour and UV-visible spectrum. The increase in hydrodynamic diameter and negative zeta potential of AuNPs after the addition of probes verified the biosensor accurately fabricated. This fabricated biosensor could detect miR-155 simpler and faster than previous methods.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1049/iet-nbt.2017.0174DOI Listing
June 2018

Serum Levels of miR-155, miR-326, and miR-133b as Early Diagnostic Biomarkers for the Detection of Human Acute Heart Allograft Rejection in Comparison with Serum Cardiac Troponin T.

Heart Surg Forum 2018 03 12;21(2):E101-E107. Epub 2018 Mar 12.

Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran Heart Center, Tehran, Iran.

Background: Acute heart allograft rejection occurs as a result of antibody-mediated rejection that presents during the first month after transplantation. Finding a non-invasive biomarker is essential for diagnosis of heart allograft rejection. In this research, we intended to compare expression levels of several microRNAs across cardiac troponin T levels between rejected patients (who died before one month following transplantation), non-rejected patients (who survived for at least one month after transplantation), and non-transplanted patients (CABG surgery patients).

Methods: Serum levels of miR-155, miR-326, and miR-133b were evaluated by the q-RT-PCR method. Furthermore, cardiac troponin T levels were measured by a highly sensitive electrochemiluminescence assay. Finally, the data were analyzed by independent sample t-test using SPSS 21® computer software. Results: It was observed that miR-326 and miR-155 expression levels increased after 24h and 72h of surgery in rejected patients compared with the two other groups, but these increases were not statistically significant. Moreover, the decrease in miR-133b expression level was non-significant after transplantation in the rejected group compared with the non-rejected group. However, cTnT levels in rejected patients increased significantly compared with the other groups (P < .05). After ROC curve analysis, the cTnT marker with the most area under the curve (AUC = 1.00, 95% confidence interval, 1.00 to 1.00; P = .006), had the best discriminatory power, and among microRNAs, miR-326 had the largest area under curve (AUC = 0.81), and consequently the highest discriminatory power.

Conclusions: We demonstrated that troponin T can be a more efficient biomarker than miRNAs for early prediction of human death caused by acute heart rejection, and the ROC curves analysis verified this finding.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1532/hsf.1887DOI Listing
March 2018

Early Outcomes of Coronary Endarterectomy in Patients Undergoing Coronary Artery Bypass Surgery.

Heart Surg Forum 2016 Apr 4;19(2):E059-63. Epub 2016 Apr 4.

Cardiac Surgery and Transplantation Research Center, Tehran University of Medical Sciences, Tehran.

Background: Coronary endarterectomy (CE) is performed as an adjunct to coronary artery bypass surgery (CABG); however, the efficacy of this technique is still controversial. We aimed to evaluate the impact of CE combined with CABG when compared with isolated CABG.

Methods: Patients who underwent CABG between July 2007 and June 2014 were included. 70 of 2452 patients (2.8%) underwent CE in addition to CABG. Early results were compared with isolated CABG and predictors of adverse outcome were measured in stepwise multivariate logistic regression analyses.

Results: The incidence of comorbidities including prior myocardial infarction, diabetes mellitus, and three-vessel coronary disease in CE patients was higher; however, mortality (4.3% versus control 3.6%; P = .762) and postoperative complications were not significantly increased in this group of patients (except supraventricular arrhythmia). Although age greater than 70 years, impaired ejection fraction, intraoperative intraaortic balloon pump, and prolonged cardiopulmonary bypass time were important predictors of adverse outcomes, CE was not associated with increased mortality or postoperative morbidities.

Conclusion: Despite the higher risk profile of patients who underwent CE, this technique was not identified as an independent risk factor for adverse postoperative outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1532/hsf.1352DOI Listing
April 2016

Predictors of blood transfusion in patients undergoing coronary artery bypass grafting surgery.

Int Cardiovasc Res J 2013 Mar 15;7(1):25-8. Epub 2013 Mar 15.

Cardiac Surgery and Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.

Objectives: The aim of this retrospective study is to identify intraoperative patient's characteristics predicting the need for blood transfusion during CABG in our local cardiac surgical service.

Methods: This study included 1835 consecutive patients, 1311 males and 524 females with mean age 58.8±9.9 years, undergoing coronary artery bypass grafting. Risk factors detected by univariate study were entered in a multivariate logistic regression model of the relationship between preoperative variables and blood transfusion.

Results: Blood transfusion was used in 435 patients (29.9%). Univariate analysis identified hemoglobin, smoking, hypertension, sex, diabetes, BMI and use of cardiopulmonary bypass (CPB) as significant predictors. Multivariate analysis revealed hemoglobin (OR: 0.8; CI: 0.74-0.86; P<0.001), CPB use (OR: 12.2; CI: 8.2-18.1; P<0.001) and female gender (OR: 2.29; CI:1.72-3.04; P<0.001) as independent risk factors for blood transfusion.

Conclusions: The predictors of RBC transfusion after isolated CABG were performing CPB, preoperative hemoglobin and female gender. These factors can be used as a clinical tool to preserve blood bank resources without increasing patient's risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987423PMC
March 2013

Dose impaired relaxation of left ventricle affect early outcomes in CABG patients?

Acta Med Iran 2010 May-Jun;48(3):164-7

Department of Cardiovascular Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Although systolic dysfunction is revealed as a prognostic factor in cardiac surgery, the role of diastolic dysfunction as a predictive factor is less evaluated. In this retrospective study from 872 patients that underwent isolated coronary artery bypass graft (Jan 2008-Feb 2009), 388 patients had normal left ventricular ejection fraction (>50%). These are divided in two groups, Group 1: 361 patients without diastolic dysfunction (impaired relaxation) and Group 2: 27 patients with diastolic dysfunction (impaired relaxation). Mean age in group 1 was 57.72 year and in group 2 was 61.16 year (P = 0.07). Risk factors such as diabetes mellitus, hypertention and dyslipidemia were similar. Although overall complication rate was higher in group 2 (11.1% vs. 2.8% P value 0.05), but when each complication was studied individually no significant statistical difference was found. Also no significant statistical difference was found in mortality (2.2% in group 1 vs 7.4% in group 2 P = 0.1). In conclusion, from clinical standpoint diastolic dysfunction can be an important factor in assessing surgical outcome in patients whom underwent coronary artery bypass grafting.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2011

Echo rejection score: new echocardiographic approach to diagnosis of heart transplant rejection.

Eur J Cardiothorac Surg 2010 Aug 30;38(2):176-80. Epub 2010 Mar 30.

Shariati General Hospital, Tehran, Iran.

Objective: The gold standard test in the diagnosis of heart transplant rejection is right ventricular (RV) myocardial biopsy, which is an invasive, time-consuming, expensive method. In an effort to find a reliable method to minimise the sequential use of myocardial biopsy, we assessed the main echocardiographic indices for the detection of allograft rejection.

Materials And Methods: Fifty myocardial specimens were examined in this prospective study, which assessed the prominent echocardiographic parameters propounded by previous studies as indicators of rejection. Prior to biopsy, all the patients underwent preoperative transthoracic echocardiography. The accuracy of the echocardiographic indices was compared with that of myocardial biopsy indices as the gold standard. At three myocardial segments, namely, RV base, interventricular septal (Sep) base and lateral left ventricular (Lat) base, peak systolic strain (RV-S, Lat-S and Sep-S) was measured. In addition, time to systole (TS) was measured at the same three segments, yielding the three variables of RV-TS, Sep-TS and Lat-TS.

Results: Our logistic regression model revealed that the four factors of Lat-S (%), Sep-TS (ms), posterior wall thickness (PWT; mm) and left ventricular mass index (LVMI; g m(-2)) could denote heart transplant rejection. We devised a new index, the echo rejection score, using the following formula: [(PWT+LVMI)-(Lat-S+Sep-TS)]. This new formula has an area under a curve of 0.932 and a cut-off point of 0; it yields a sensitivity of 100.0%, specificity of 71.0%, positive predictive value of 67.9% and a negative predictive value of 100.0%. If the echo rejection score is >0, there is a 67.9% possibility that a cardiac transplant patient is presenting with allograft rejection, while a score < or =0 denotes a 100% improbability of rejection.

Conclusion: Our proposed method for screening patients at risk of acute cardiac rejection with echo rejection score showed a good sensitivity in detection of graft rejection. However, further study is required to determine if it can be used as an adjunct to the myocardial biopsy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejcts.2009.12.045DOI Listing
August 2010

The association between Chlamydia pneumoniae DNA in arherosclerotic plaque and major risk factors in patients undergoing coronary artery bypass grafting.

Kardiol Pol 2009 Sep;67(9):981-6

Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background And Aim: This study was conducted to investigate the prevalence of Chlamydia pneumoniae pathogen inside the atherosclerotic plaque of patients undergoing CABG by using PCR assay and to determine whether there is any association between the presence of bacteria in atherosclerotic lesions and classical coronary risk factors.

Methods: In a cross-sectional study, 102 patients (20 to 79 years old; 73.5% male) undergoing CABG were evaluated in terms of major coronary risk factors and the presence of Chlamydia pneumoniae.

Results: Chlamydia pneumoniae was found in 23.4% of coronary plaque specimens. Of these, two patients had no risk factor and the rest of the patients had 1 to 3 risk factors. Patients with positive PCR were more likely to have hypercholesterolaemia (p = 0.009) and low HDL levels (p = 0.000) in comparison with the PCR-negative group. There were no statistical differences for other risk factors.

Conclusion: Our results imply the synergic contribution of Chlamydia pneumoniae DNA and known dyslipidaemia to the development of atherosclerotic lesions in patients undergoing CABG.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2009

Heart transplantation in iran; a comprehensive single-center review of 15-year performance.

Arch Iran Med 2009 Mar;12(2):111-5

Department of Cardiac Surgery, Shariati Hospital,Tehran University of Medical Sciences, Tehran, Iran.

Background: Heart transplantation in Iran was first performed in July 1993. Since then, Shariati Hospital, affiliated to Tehran University of Medical Sciences, has been representing the most active center of cardiac transplantation in Iran and one of the major sites in the Middle East. This is a comprehensive review of our 15-year practice registry to make a scheme of our record and achievements.

Methods: Clinical data on all consecutive transplanted patients from the Department of Cardiac Surgery, Shariati Hospital, Tehran, Iran over the last 15 years were reviewed. Descriptive and analytical statistics were extracted in regard to recipients, donors, surgical characteristics, and current status of the patients on follow-up.

Results: Totally, 90 patients were transplanted since 1993; 11, 32, and 47 in three five-year periods, respectively. The mean age of the recipients was 29.30+/-13.17 years. Motor-vehicle accident was the main cause of brain death of donors (48.8%). The most common indication for surgery was idiopathic dilated cardiomyopathy (75.5%).The mean survival rate has been 6.66+/-0.87 years. One-year and five-year survivals had a rising trend through the five-year periods. Acute allograft rejection and infection were the two major events complicating our transplants.

Conclusion: This study shows that despite a vast variety of obstacles, we have passed the primitive milestones. The number of transplants is increasing at a higher rate in recent years, and patients' survival rates and outcomes seem to be improving.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2009

Transient bilateral cortical visual loss after coronary artery bypass grafting in a normotensive risk-free patient.

Heart Surg Forum 2008 ;11(4):E248-51

Department of Cardiac Surgery, Shariati General Hospital, Medical Sciences University of Tehran, Tehran, Iran.

Background: Postoperative blindness has been mentioned as a rare complication of heart surgery. The majority of reported cases are caused by retinal artery occlusion or ischemic optic neuropathy. We report a case of transient visual loss due to cortical ischemia after coronary artery bypass grafting (CABG).

Case Report: A 52-year-old nondiabetic man developed complete bilateral visual loss immediately after CABG. He had been normotensive throughout the operation. An ophthalmologic exam detected no causative ocular damage. The results of a Doppler study of the carotid, vertebral, and ophthalmic arteries were completely normal, and an echocardiography examination showed no left ventricular clot. Magnetic resonance imaging of the brain, however, showed several ischemic plaques in watershed areas and a small subacute infarct in the occipital lobe. Recovery began on postoperative day 4, and the patient's vision was restored in 6 months.

Conclusion: Although most cases of visual loss after open heart surgery have been caused by injuries to the peripheral optic system, cortical blindness may occur following open heart surgery in the absence of any preexisting risk factor. Fortunately, the course of recovery is promising one, as it was for our patient.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1532/HSF98.20081014DOI Listing
April 2009