Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary artery disease

1. Cardiac Surgery Dr. S. Krishna Kishor M.S., DNB, FIACS
Consultant Cardiothoracic Surgeon
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2. Introduction
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April 2013
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55 cases till date
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CABG,
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Valve replacements
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Surgery for congenital heart disease
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Lung surgery
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3. Sternotomy
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4. Pericardiotomy
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5. Pursetrings
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6. Heart lung machine
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7. Arterial cannulation
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8. Cannulation
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9. Venous Cannulation
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10. Oxygenator
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11. Arterial filter
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12. Isolation
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13. Surface cooling
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14. Complications of CPB
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Cognitive disorders
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Haemodilution
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Platelet activation & aggregation
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Immune mediated reactions
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Air and particulate emboli
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Micro infarcts
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Stroke
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Renal dysfunction
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Resp. dysfunction
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Hypothyroidism, Hyperglycaemia …..
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15. Mitral valve
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16. MVR
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30 yrs female
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Class III dyspnoea
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PND
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Echo – Severe Mitral stenosis, MVA 0.7
cmsq, Moderate MR, Mild PAH
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Chest X-ray – Mitralised LHB,
Cardiomegaly
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ECG – LAE, AF
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17. MV excision
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18. Excised MV
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19. MV sutures
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20. Mitral prosthesis
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21. Valve Seated
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22. AVR
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22 yrs male
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Dyspnoea class III
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Fever on and off ? Endocarditis
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LVF
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Optimised Medically
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Taken up for AVR
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Echo – Dilated LV, EF 38%, Normal MV,
Severe AR, Mild PAH
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23. AVR
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24. Aortic valve sutures
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25. Annular sutures
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26. Prosthetic valve
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27. Valve seated
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28. CABG
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63 yrs Male
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Angina and dyspnoea Class II
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Recent IWMI
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Echo – IW,septum hypokinetic, EF 40%
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CAG – TVD
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29. IMA harvest
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30. IMA
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31. SVG harvest
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32. LIMA anastamosis
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33. OM graft
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34. Inferior wall graft
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35. Proximal anastamosis
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36. OPCAB
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37. Endoscopic Vein Harvest
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38. SVG by EVH

39. Harvested Vein

40. EVH

41. Closure

42. Closure

43. Complications
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Infection
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Endocarditis
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Embolism
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Renal dysfunction
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Stroke
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Pulmonary complications
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44. Our Results
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Wound infection Nil
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Prolonged ventilation Nil
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Sepsis / Neurological events Nil
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Prolonged Hospital Stay Nil
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Mortality One
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45. ACC guidelines
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46. 6 ‘C’ from acc
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Communication
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Co-operation
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Coordination
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Cognition
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Conflict resolution
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Coaching
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47. Future
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Total arterial grafting with composite
grafts
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Minimally invasive procedures
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Surgery for heart failure
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ECMO
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48. www.heartconsult.in
Thank you for your patience !