Introduction:The Neurological injury is an important complication after CABG. There is considerable evidence that early postoperative cognitive dysfunction is related to a combination of three factors often associated with CPB: (micro) embolism, hypoperfusion, and the systemic inflammatory response. Intraoperative formation of gaseous emboli and aggregated platelets, atherosclerotic debris, hypoperfusion, hypotension, hyperthermia, hyperglycaemia, surgical trauma, blood loss, Anaesthetic agents, arrhythmia and transfusion all enhance the risk of cognitive dysfunction.There are two types of Neurological injury, Type-I includes stroke, transient ischemic attack and coma and the incidence is approximately 3 to 6 percent. Type-II injury is more subtle and includes impairment of cognitive functions. These defects associated with attention, concentration, short term memory, fine motor function and speed of the mental response. The incidence of neurocognitive impairment after cardiac surgery varies from 20% to 80%. 1 Based on prospective studies, however it is apparent that the incidence of subtle postoperative neurologic and neuropsychological abnormalities is much higher, closer to 50 percent in the first week after cardiac surgery. 2 These apparent high rate of subtle neurologic impairment detected prospectively are in sharp contrast to the considerably lower incidence of stroke after cardiac surgery, reported as 1-5 percent, in several large retrospective series from different centers. 3 There are several reasons for these apparent differences in the reported incidences the timing, thoroughness and the reproducibility of the neurologic examinations, as well as the incorporation of the preoperative assessment for comparison, all determine the sensitivity and Evaluation of Neurocognitive Dysfunction afterCoronary Artery Bypass Surgery p = 0.002 and 25.93 ± 3.11 vs. 26.63 ± 2.50, p = 0.023 respectively

Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenital heart diseases undergoing cardiac surgery. Methods: This was a retrospective study conducted between January 2013 and June 2019. 49 consecutive patients with Down’s syndrome with congenital heart disease admitted in pediatric cardiac surgery unit at National Institute of Cardiovascular Diseases (NICVD). Patients were followed up postoperatively for in-hospital outcome. Results: Among 49 patients the heart lesion ranked in incidence as follows- VSD 24(48.97%), AV canal defect 12(24.48%), TOF 6(12.24%), PDA 6(12.24%) and ASD 1(2.04%). Pulmonary hypertension was found in 63.25% patients. Moderate pulmonary hypertension was most common, found in 18(38.66%) patients. Severe and mild pulmonary hypertension was found in 10(32.38%) and 3(9.67%) patients respectively. All the patients had undergone surgical correction. The postoperative period was complicated in 44.89% of patients. The most frequent complication was pulmonary infection 20.40%, Wound infection 6.12% and low output syndrome 6.12% were the next. One patient had postoperative heart block, needed permanent pace maker implantation. In-hospital mortality was 12.24%. Conclusion: Patients with Down’s syndrome with congenital heart disease undergoing surgical correction had an acceptable postoperative morbidities and mortality. Cardiovasc. j. 2020; 13(1): 35-39

Background: Obesity is supposed to be a risk factor for patients undergoing coronary artery bypass surgery (CABG) increasing risk of in-hospital mortality and postoperative morbidity. So, this study was conducted to evaluate the outcome of CABG in obese patients in Bangladesh.Methods: This prospective clinical trial was undertaken in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2015 to December 2016. A total of 60 consecutive patients were selected for CABG operation and their outcome measured against pre-set variables. Body mass index (BMI) 25kg/m2was considered as cut off value between obese and non-obese patients.Results: Mortality after CABG surgery was 9.5% in obese group and 10.3% in non-obese group (p= 0.976) showing no significant difference but average hospital stay was more in obese group (10.2 + 25 days) than non-obese group (8.3 +3.7 days), p=0.489. Sternal would infection (50.0% &8.69%) and conduit harvest site infection (35.7% &4.34%) is also more in obese group but not significant statistically (p= 0.064 & 0.084 respectively).Conclusion: Patients with a BMI higher than normal are not at greater risk of in-hospital mortality after CABG. But obese patients should be more cared in post operative period for sternal and conduit harvest site infection as infection is more in obese patients.Cardiovasc. j. 2018; 10(2): 150-157

Background: Arterial hypertension is one of the leading modifiable risk factor in coronary artery disease patients who underwent coronary artery bypass grafting (CABG) with the major impact on clinical outcome in these patients. This study was done to evaluate the effect of arterial hypertension on postoperative mortality and morbidity after off-pump CABG.Methods: 200 patients with mean age of 52 ± 6 years, (182 male/18 female) undergoing off pump CABG were divided equally into two groups, 100 patients with hypertension (Group A) and 100 patients without hypertension (Group B). Postoperative mortality and morbidities (Wound infection, AMI, TIA, Stroke) up to 6 months were recorded in the 2 groups.Results: In comparison with the normotensive patients, hypertensive patients had a higher mortality rate (Group A 10% and Group B 2%, p value-<0.05) and increased frequency of myocardial infarction (Group A 12 % and Group B 3%, p value - <0.05). There was also increased rate of infection in hypertensive patients (Group A 13 % and Group B 4%, p value - <0.05). We found that hypertensive patients developed post-operative cerebrovascular complications like TIA (Group A 8 % and Group B 1%, p value - <0.05) and stroke (Group A 11 % and Group B 2%, p value - <0.05) more frequently than normotensive patients. Post-operative ventilator support and duration of hospital stay were almost similar in both groups.Conclusions: Among CABG patients, those with a history of hypertension have an increased frequency of post-operative complications and increased mortality.Cardiovasc. j. 2017; 10(1): 13-16

Introduction:Postoperative arrhythmias are common complication after cardiac surgery. Incidence of postoperative AF varies between 10%-40% during the first postoperative week. 1 AF is the most common supraventricular arrhythmia following cardiac surgery. It ranges from 28%-54% of patients. 2 Incidence of atrialarrhythmia including AF after open heart surgery is between 20% and 50%. 3 20% to 40% of patients have AF after coronary artery bypass operation. 4 These variations in the incidence of AF depend on the patient population studied, type ofcardiac surgery, the definition of the arrhythmia and the duration of observation period. 5,6 After CABGthe etiology of AF is unknown, but may due to -unprotected ischemia, multi-