BackgroundAbout 40–50% of patients undergoing coronary artery bypass graft (CABG) surgery have diabetes. The prevalence of impaired glucose tolerance (IGT) is also high in this group, however, incidence of new diabetes following CABG surgery is unknown. Objectives: To determine incidence of new diabetes and the impact on ICU and hospital stay in patients undergoing CABG surgery in India, we performed a registry-based study.MethodsProspectively collected data among consecutive adult cardiac surgical patients who underwent CABG surgery at a single hospital were analyzed. Descriptive statistics are reported.ResultsWe recruited 1559 consecutive patients (men 1355, women 204) and analyzed data among 933 non-diabetic patients. Patients with known diabetes (n = 626, 40%) were excluded. 57 (6.1%) of the 933 non-diabetic patients developed persistently high glucose levels at discharge with incidence rate of 61 + 5/1000. Patients who developed diabetes had similar age and body mass index vs those who did not, but had greater preoperative IGT (44.6 vs 13.7%) and more time-period in intensive care unit (102.0 + 75 vs 80.2 + 29 hours) as well as in hospital (11.7 + 5.7 vs 9.6 + 2.4 days) (p < 0.001).ConclusionIn a significant proportion of non-diabetic patients diabetes is unmasked after CABG. This is more likely in those with impaired glucose tolerance and prolonged period in intensive care and hospital.
A 63-year-old diabetic and hypertensive lady presented in New York Heart Association class III–IV dyspnea on exertion. Echocardiography showed a large mass attached to the anterior mitral leaflet and the base of the interatrial septum. After removal of the mass and excision of the anterior and posterior mitral leaflets, a bioprosthetic valve was deployed. The postoperative course was uneventful. Histopathology showed that the tumor was a high-grade rhabdomyosarcoma. Although it is a highly lethal tumor, surgical removal was indicated to relieve dyspnea, clarify the diagnosis, and improve short-term survival. Our patient survived for 8 months after surgical excision.
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