Objective: To determine the incidence and predictor of postoperative wound infection in patients underwent coronary artery bypass grafting (CPB). Methods:This was a prospective comparative study of 577 patients who underwent cardiac surgery with (CPB) was conducted at cardiac surgery department of Punjab Institute of cardiology, Lahore from 1st March 2012 to 31st March 2017. Consecutive patients undergoing elective and isolated CABG, both genders age ≥20 years, with normal ejection fraction were included in the study Results: Out of 577 patients of which 166(87.83%) were male while 23(12.16%) were female. The mean age of the patient was 53.23 ± 8.43. Incidence of post-operative wound infection in patients underwent coronary artery bypass grafting (CPB) was 73(12.65%). Common co morbid conditions were hypertension 50%, diabetes mellitus (43.5%), smoking (31.1%), hyperlipidemia (20.3%), prior of stoke (12.2%), Prior Surgery (6.8%) and prior renal failure (4.1%), mean CPB time (61.69 ± 32.27), ICU stay 976.03 ± 31.93), mean Cross clamp time(25.27 ± 19.17mg/dl) and Hospital stay (10.16 ± 5.6 day) were more in WI group. Themortality was found to be high in WI group (23.3%). Logistic regression showed that significantly predicted of the post-operative WI were elder age,diabetes mellitus, smoking, family history of IHD, hyperlipidemia, cardiopulmonary bypass time, ICU stay, hospital stay. Conclusion:We can conclude that wound infected patients are at significantly greater risk of incidence, morbidity and mortality after cardiac surgery.

Background: Anemia is a common risk factor for cardiovascular disease. The impact of preoperative anaemia is unclear in cardiac surgery. Preoperative anaemia affects early findings in patients undergoing cardiac surgery. Aim and Objective: The main objective of current research was to investigate the impact of preoperative anaemia on early outcomes in heart surgery patients. Material and Methods: A prospective randomized clinical research was undertaken after obtaining written informed consent from patients for cardiac surgery at the PIC, Lahore between Apr 2020 and Feb 2021. A total of 120 individuals between the ages of 20 and 60 were chosen for the research. Preoperative anaemia was described as Hb levels of <13 g/dl for males and <12 g/dl in female patients undergoing cardiac surgery. Results: Total 120 patients were enrolled and stratified into two groups (60 patients each) with average age 5 ± 5.75 years. Early outcomes after surgery such as postoperative stroke (6.67 % versus 1.6 %), AF (37 % versus32 %), and duration of hospital stay > 7 days (50 % vs 41.67 %) were found to be different between anaemic and normal Hb groups. Conclusion: Preoperative anaemia can be increased risk of morbidity and mortality in patients after surgery. Low preoperative Hb found as advanced risk factor for death, renal impairment, stroke, AF and long hospital stay in our research. Keywords: Anemia, CABG, AF, MI, IABP, CPB

Aim: To compare conventional ultrafiltration (CUF) with zero-balanced ultrafiltration (Z-BUF) in the patients having valvular heart surgery. Methods: This cross-sectional mono-centered retrospective study was designed. The data of total 471 patients were reviewed during March 2018 to February 2020, only 98 patients fitted in the inclusion criteria and were divided into two groups with 47(47.95%) patients received CUF, while 51 (52.04%) patients were administered with Z-BUF at the Department of Cardiovascular Surgery, King Edward Medical University, Lahore, Pakistan. Statistical analysis was done using SPSS version 25. The early postoperative clinical outcomes included, renal function as primary outcome and hemodynamics stability of the patients as secondary outcome. Results: Renal functions in terms of serum creatinine (1.1 vs. 1.3mg/dL; P < 0.010) and creatinine clearance ratio (81.51vs. 67.3mL/min; P < 0.01) were improved in the patients having Z-BUF compared with CUF. Urine output was almost double in the Z-BUF cohort compared with the CUF. The hemofiltration technique had no impact on the secondary outcomes as amount of the blood loss and number of patients required blood transfusion were similar (P > 0.05) in our cohort. Conclusion: Z-BUF appeared to be better hemofiltration method than CUF during CPB when assessed in terms of renal protection without hemodynamic status in patients undergoing valvular heart surgeries in our population. Keywords: Cardiopulmonary bypass, Ultrafiltration, Renal injury, Hemoglobin, Blood transfusion

Background: Care of heart patients especially after coronary artery bypass graft (CABG) surgery can be difficult to manage especially in postoperative phase due to decreased cardiac output. Inotropes used to increase cardiac output during the peri or postoperative may cause harmful effects. Mechanical circulatory support devices, such as an intra-aortic balloon pump can be beneficial in such patients. Objective: To compare early outcomes of Intra-Aortic Balloon Pump (IABP) in Patients Undergoing Coronary Artery Bypass Grafting (CABG) Surgery Methods: Systematic random samples of 134 patients were registered from the department of cardiac surgery of Punjab Institute of Cardiology (PIC), Lahore undergone open heart surgery from December 2019 to May 2020. High-risk patients with hemodynamically stable undergoing scheduled CABG were included. The patients were divided into two groups. All information including gender and age were obtained using a structured questionnaire. Death and other complications were compared between two groups. Data was entered and analyzed using SPSS. Statistical test like chi- square and Independent t-tests were applied to obtain the required results and percentages. Results: Total 134 patients enrolled and equally divided into two groups. Group A (with IABP) have mean age was 47.58± 2.0 compared with Group B (without IABP) mean age 48.43± 4.31.There were 79(63.2%) males and 46(36.8%) were females enrolled. Hypertension, diabetes mellitus, smoking, Prior CVA, recent AMI and congestive heart failure remained statistically insignificant as p-value > 0.05. The duration of IABP, respiratory failure, renal dysfunction and length of ICU stay showed statistically significant p-value < 0.05. Reoperation for bleeding, acute AMI, pneumonia, stroke, wound infection and surgical mortality are statistically insignificant as pvalue > 0.05. Conclusion: In high-risk patients of coronary artery bypass graft, early implantation of an intra-aortic balloon pump improves the outcomes by reducing ICU stay and death; increased post-insertion creatinine levels have been proven to be an indication of approaching mortality. Keywords: Intra-aortic balloon pump, Coronary artery bypass graft, Creatinine levels, Low Cardiac Output Syndrome