Introduction: The cardiopulmonary bypass may have multiple systemic effects on the body organs as liver. This prospective study was planned to explore further the incidence and significance of this change. Methods: Two hundred patients with coronary artery bypass grafting (CABG), were randomly selected for the study. Total and indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase were measured preoperatively and at 24, 48 and 72 hours, following coronary artery bypass grafting. Postoperative value of the liver function tests with respect to hypothermia or hypotension were compared by one way analysis of variance for repeated measure and compared with t test. Patient’s characteristics with bilirubin value (≤1.5 mg or >1.5 mg) were compared with t test. Results: A significant increase of total bilirubin, aspartate aminotransferase, and alkaline phosphatase were noted in the third postoperative day. Significant relation was seen between hypotension and alkaline phosphatase, and aspartate aminotransferase change but hypothermia had not affected alanine aminotransferase, total bilirubin and indirect bilirubin change. Pump time, alanine aminotransferase in third postoperative day and direct bilirubin in first and second day of postoperative period had significant relation with pre and post-operative bilirubin change. Conclusion: Transient but not permanent alterations of hepatic enzymes after coronary artery bypass grafting presumably attributed to the decreased hepatic flow, hypoxia, or pump-induced inflammation.

Background:Atrial fibrillation (AF) is a frequent and serious complication of coronary artery bypass graft (CABG) surgery.Methods:We undertook a retrospective review of the records of patients undergoing CABG at Imam Ali Hospital between February 1, 2003 and February 1, 2006. The patients were divided in two groups, ie, Group A (AF) and Group B (no AF). The association between the occurrence of AF following CABG and other variables was compared with respect to continuous or categorical variables by t-test and χ2-test.Results:Multivariate logistic regression analysis of potentially predictive factors in univariate analysis showed that opium use, type of operation, and crossclamp time were predictors of AF following CABG.Conclusion:This study identifies some new predictors of postoperative AF, control of which could lead to a lower incidence of AF and reduced morbidity, mortality, and resource utilization for patients undergoing cardiac surgery.

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Cardiac involvement is seen in 0.5-2% of patients with hydatid disease, and involvement of the interventricular septum (IVS) is even rarer. We report surgical treatment of a large cardiac hydatid cyst in the IVS. A 55-year-old woman presented with dyspnea and bradycardia. Transthoracic echocardiography revealed a large cyst in the mid to apical part of the IVS. The patient was placed on cardiopulmonary bypass. Through an incision to bulging part of cyst into right atrium, and without opening adjacent cardiac chambers, we aspirated the entire contents of the cyst, removed its germinative membrane, and washed the cavity with 96% alcoholic solution. The patient recovered uneventfully. She had begun taking albendazole 5 days preoperatively, and this therapy was continued for 12 weeks postoperatively. A permanent pace maker was implanted because she was dependent on temporary pace maker and after 1 year follow-up, complete heart block had not recovered to normal conduction rhythm.

Background and aimThere is some controversy about survival of coronary endarterectomy (CE) patients, so the current study aims to compare short and long term survival of patients undergoing off pump coronary artery bypass graft (OPCAB) with and without coronary endarterectomy.Patients and methodswe performed a retrospective analysis of data on patients undergoing OPCAB and CE between 2011 and 2012. Preoperative, perioperative and postoperative data collected from data bank. Follow-up information was obtained from telephone contact mean time 37.13 ± 23.82 months after surgery. Early and late outcomes were compared by univariate and Kaplan-Meier analysis.ResultOPCAB was performed in 474 patients, which 69 of them had a CE. The mean long term survival was similar between OPCAB (56.28 ± 0.61) and OPCAB + CE (55.54 ± 1.3) groups (p = 0.66). Multiple Cox regression shows that age, gender, BMI, EF and angina were significant predictors of mortality. Patients undergoing CE have a long term intensive care unit (ICU) stay (51.31 ± 5.59 vs 37.23 ± 0.88, P = 0.015) and blood transfusion was higher in CE group (650.62 ± 110 vs. 324.71 ± 22, P = 0.001).ConclusionThe current study demonstrates that results of CE are acceptable with respect to short and long -term survival. Patients undergoing CE required long term ICU stay and higher blood transfusion.