Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Dikshya Joshi, Sidhartha Pradhan, Rabindra Timala, Navin C. Gautam, Raamesh Koirala, Jyotindra Sharma
Shahid Gangalal National Heart Centre, Bansbari, Nepal
Scientific Tracks Abstracts: J Clin Exp Cardiolog
Background: Changes in lifestyle in Nepalese population has led to significant increase in the number of Coronary artery disease(CAD). Left main coronary artery disease (LMCAD) which occurs in 4-10% is associated with higher mortality in patients undergoing coronary artery bypass grafting (CABG). We sought to review our experience with CABG in LMCAD population at our centre. Methods: Hospital records of all consecutive patients who underwent CABG between April 2014 and August 2017 were evaluated in this retrospective study. Data regarding demographic profile, risk factors for CAD, functional class, left ventricular ejection fraction (LVEF), use of intra-aortic balloon pump (IABP), complications, ICU stay, duration of mechanical ventilation and mortality were assessed. Results: A total of 1206 patients had undergone CABG for CAD. Among them, 145(12%) patients had LMCAD and were included in the analysis. Mean age was 58.8�±9 years, and 119(82%) were males. Mean Euroscore was 6.2�±8.3. Mean number of vessels grafted were 3.2�±0.9. IABP was used in 39(26.9%) before induction, as an assistance for weaning in 5(3.4%), and as rescue in 2(1.4%). Overall mortality was 7(4.8%). Follow up was available for 70 patients with a mean duration of 27�±2.2 months. Most of the patients are in CCS class I (80%). One patient required re-do CABG for graft occlusion 6 months after surgery. Conclusion: The prevalence of LMCAD, in this study, is higher compared to the available prevalence data of CAD in general Nepalese population. Requirement for reintervention, however, remains low at intermediate follow-up.
Dikshya Joshi is currently working at Shahid Gangalal National Heart Centre, the busiest and Comprehensive cardiac Centre of Nepal. She is the first female cardiac surgeon of the country and has almost 10 years of experience in both adult and congenital cardiac surgery. She has extensive Experience in treating Rheumatic Heart Disease and has presented papers and articles both in national and international platforms. Her research works have received various awards and recognition. Evidence of her expert status among her peers also includes membership on the editorial board of the “Annual Report” publication of her Center. She is passionately interested in the new advances and researches to achieve excellence in quality cardiac care in Nepal. She has a particular interest in Minimally Invasive Cardiac Surgery, and, her current focus is in the introduction of this program at her Centre which will unquestionably make a difference minimizing the cumulative trauma of surgery to younger patients undergoing valve surgeries for Rheumatic Heart Disease.
Email:joshidixa@hotmail.com