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Cardiac Surgery in Octogenarians and Beyond: Single Center Experience

Open Journal of Thoracic Surgery 2013年第2期3卷 51-56页

作者： Reda E. al-Refaie Hashem aliter Ricardo Gallo ali Youssef mushabab al-murayeh Edwin Ravikumar Department of Cardiac Surgery and Car- diology Armed Forces Hospitals Southern Region Khamis Mushayt KSA Department of Cardiothoracic Surgery Mansoura University Hospitals Mansoura Egypt

Background: Increasing numbers of octogenarians and improvements in surgical techniques and postoperative care have resulted in increasing cardiac operations in this age. The aim is to analyze our experience of cardiac surgery on octogenarians and beyond concerning postoperative morbidities and mortality. Methods: 67 octogenarians and nonagenarians underwent open heart surgery in our hospital between 2001 to 2009 were retrospectively reviewed. Data included baseline preoperative status, intraoperative and perioperative course, and immediate outcomes. Results: The mean age was 86.22 ± 6.1 years. 86.6% patients were males. Symptoms were dyspnea;Class II in 13.4%, Class III in 55.2%, Class IV in 31.4% patients;angina in 82.1%, and CHF in 25.4% patients. The mean EF was 37.8% ± 10. Risk factors include smoking in 52.2%, DM in 37.3%, hypertension in 28.4%, obesity in 25.4%, previous MI in 22.4%, COPD in 17.9%, renal insufficiency in 11.9%, pulmonary hypertension in 7.5%, PVD in 6%, and cerebrovascular disease in 3% patients. The procedures were isolated CABG in 73%, AVR in 9%, MVR in 6%, CABG/valve in 9%, and MVR and AVR in 3% patients. Complications were 18%. It included renal impairment in 18%, arrhythmias in 14.9%, bleeding in 6%, prolonged ventilation in 13.4%, CHF in 4.5%, gastrointestinal bleeding in 4.5%, wound infection in 7.5%, and cerebrovascular accident in 3%. Hospital mortality was 9% patients. Conclusions: Cardiac surgery can be performed safely with acceptable hospital morbidity and mortality in octogenarians and beyond. Early referral and proper selection of patients are mandatory to improve immediate postoperative survival.

关键词： Coronary Artery Bypass Graft Valve Octogenarians Nonagenarian

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Inter-ethnic marriages and severity of coronary artery disease:A multicenter study of Arabian Gulf States

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World Journal of Cardiology 2017年第4期9卷 371-377页

作者： Amin Daoulah Salem al-kaabi Amir Lotfi mushabab al-murayeh S ali Nasseri Waleed Ahmed Salah N al-Otaibi Mohamed N alama Osama E Elkhateeb Amy J Plotkin Majed M Malak Khalid alshali Mohamed Hamzi Saleh al Khunein Mohammed Abufayyah alawi A alsheikh-ali Cardiovascular Department King Faisal Specialist Hospital and Research Center Cardiology Department Zayed Military Hospital Division of Cardiology Baystate Medical CenterTufts University School of Medicine Cardiovascular Department Armed Forces Hospital Southern Region Politecnico di Torino Internal Medicine Department King Faisal Specialist Hospital and Research Center Cardiac Anesthesiology King Faisal Specialist Hospital AND Research Center Cardiology Department King Abdul Aziz University Hospital Cardiology Department King Abdullah Medical City in Holy Capital Department of Pathology Johns Hopkin University Internal Medicine Department King Abdul Aziz University Hospital Anesthesia Department Prince Sultan Military Medical City College of Medicine Mohammed Bin Rashid University of Medicine and Health Sciences Institute of Cardiac Sciences Sheikh Khalifa Medical City

AIM To assess the association of inter-ethnic vs intra-ethnic marriage with severity of coronary artery disease(CAD) in men undergoing *** We conducted a prospective multicenter,multi-ethnic,cross sectional observational study at five hospitals in Saudi Arabia and the United Arab Emirates,in which we used logistic regression analysis with and without adjustment for baseline differences. RESULTS Data were collected for 1068 enrolled patients undergoing coronary angiography for clinical indications during the period of April 1^(st),2013 to March 30^(th),2014. Ethnicities of spouses were available only for male patients. Of those enrolled,687 were married men and constituted the cohort for the present analysis. Intra-ethnic marriages were reported in 70% and inter-ethnic marriages in 30%. After adjusting for baseline differences,interethnic marriage was associated with lower odds of having significant CAD [adjusted odds ratio 0.52(95%CI:0.33,0.81)] or multi-vessel disease(MVD) [adjusted odds ratio 0.57(95%CI:0.37,0.86)]. The adjusted association with left main disease showed a similar trend,but was not statistically significant [adjusted odds ratio 0.74(95%CI:0.41,1.32)]. The association between interethnic marriage and the presence of significant CAD and MVD was not modified by number of concurrent wives(P interaction > 0.05 for both).CONCLUSION Among married men undergoing coronary angiography,inter-ethnic,as compared to intra-ethnic,marriage is associated with lower odds of significant CAD and MVD.

关键词： Arabian Gulf Inter-ethnic marriage Coronary artery disease Cardiac epidemiology Coronary angiography

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