1. Beating Heart Surgery
Punjab Institute of Cardiology, Lahore

2. Early Phase Experience in Coronary Artery Surgery at Punjab Institute of Cardiology, Lahore
Dr. Abdul Ghaffar;
FCPS (Cardiac Surgery)
Assistant Professor of Cardiac Surgery,
Consultant Cardiac Surgery,
Punjab Institute of Cardiology, Lahore.

3. Duration Case Distribution February , 2003  October, 2006
Total Cases=797
Coronary Artery Bypass Graft (CABG)=482
Valvular Heart Surgery =176
Congentital Cardiac lesions =139

4. Risk Factors Distribution
Coronary Artery Bypass Grafting
Age Distribution = Years ( 56y)
Sex Distribution
Male = 372(77.6%), Female = 110(22.4%)
Risk Factors Distribution
Diabetes Mallitus =156 Cases(32.4%)
Hypertension =239(49.85%)
Smoking = 94 (19.5%)
Hyperlipidiamia (Obesity) = 238 (49.83%)

5. Extent of Disease Ejection Fraction (EF%) CLOT in LV Cavity = 7 (1.5%)
Single vessel disease =8(1.66%)
Two vessel disease =104(21.57%)
Tripple vessel disease = 370 (76.76%)
Ejection Fraction (EF%)
Poor EF = 24 (4.98%)
Low EF = 76 (15.76%)
Moderate to normal EF above 30% = 382 (79.25%)
CLOT in LV Cavity = 7 (1.5%)

6. Per Operative Techniques
Blood Cardioplegia =7 (1.45%)
Intermittent Fibrillatory arrest = 377 (78.21%)
Beating Heart Surgery = 98 (20.33%)

7. IMA Harvesting

9. Beating Heart Surgery Technique

10. Number of Grafts Cardioplegia 1-3 ( 2.3)
Intermittent Fibrillatory arrest 2-6 (3.7)
Beating Heart Surgery (3.6)

11. Grafts Used LIMA =479 (99.38%) SVG=In (Addition to LIMA)
Blood Used =(354)Cases
Number of Blood Bags used= 1-6 (1.9)

12. ICU Stay Cardioplegia 1 - 3 ( 1.7) Days
Intermittent Fibrillatory arrest 1- 5 (1.4) Days
Beating Heart Surgery (1.3) Days

13. Institutional Stay (Post Op)
Cardioplegia (9) Days
Intermittent Fibrillatory arrest (7.9)Days
Beating Heart Surgery (6.7) Days

14. Post OP Complications Reopening = 7 (1.45%) Woond Infection:-
Superifical = 23 (4.77%)
Deep = 8 (1.66%)
Central Nervous System :
CVA = 2 (0.41%)
Gastro- Intertimal & Biliary
Mild = 21 (4.36%)
Severe = 01 (0.20%)
Renal = 18 (3.73%)

15. Mortalities (seven Days Post OP in Hospital)
Total = 3 (0.62%)
1st Case =ICU- Post Operative
2nd Case = Renal shutdown (7th Post Op Day)
3rd Case =Hepatic/ Renal Shut down (5th Post Op Days)

16. INFERENCES Beating Heart Surgery Reproducible result Learning Curve
Safe
Cost effective

17. Thanks