Shahriar Moinuddin | Bangabandhu Sheikh Mujib Medical University (original) (raw)

Papers by Shahriar Moinuddin

Research paper thumbnail of Evaluation of Neurocognitive Dysfunction after Coronary Artery Bypass Surgery

Cardiovascular Journal, 2018

Objective: The Neurological injury is an important complication after coronary artery bypass surg... more Objective: The Neurological injury is an important complication after coronary artery bypass surgery (CABG). The incidence of neurocognitive impairment after cardiac surgery varies from 20% to 80%. In this study we tried to analyze this difference of neurologic dysfunction between On-pump CABG and Off-pump CABG (OPCAB).Methods:This is a case control study done in National Institute of Cardiovascular Disease (NICVD), Dhaka during the period of July 2012 to June 2014. Sixty Patients with Ischemic heart disease were the study population. Group- A includes 30 patients underwent on pump CABG, Group-B 30 patients underwent OPCAB. All the patients of both the groups were followed up to 2 month’s postoperatively to find out any neurological and neurocognitive dysfunctionby observing motor function, sensory function,Mini Mantel state (MMS) Examination, orientation, memory, attention and calculation, recall and language test.Results: Neurocognitive dysfunction in the early postoperative perio...

Research paper thumbnail of Severe mitral stenosis with giant LA with LA thrombus - A case report

Bangladesh Heart Journal, 2018

Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. T... more Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the leftright shunt with cardiac insufficiency. In this paper, we presented a case study of severe mitral stenosis with giant LA with LA thrombus in a 42 years old female patient. The patient underwent successful mitral valve replacement and removal of LA thrombus and discharged from the hospital with advice. Bangladesh Heart Journal 2018; 33(2) : 141-144

Research paper thumbnail of Preoperative Aspirin Use and Outcomes in Off-pump Coronary Artery Bypass Grafting Surgery

Bangladesh Heart Journal, 2018

Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at bl... more Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery. Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study. Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB. Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.

Research paper thumbnail of The effect of local application of tranexamic acid to reduce blood loss after off pump coronary artery bypass grafting (CABG)

Journal of cardiothoracic surgery, Jan 16, 2015

The effect of local application of tranexamic acid to reduce blood loss after off pump coronary a... more The effect of local application of tranexamic acid to reduce blood loss after off pump coronary artery bypass grafting (CABG).

Research paper thumbnail of Atrial fibrillation after coronary artery bypass graft surgery

American Heart Journal, 2000

Research paper thumbnail of Case Report Patient with D transposition of Great Arteries Operated by Senning Procedure: A Case Report

The atrial switch operation, the Mustard or Senning operation, for the transposition of the great... more The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries (TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation Senning procedure for 5 months old child with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).

Research paper thumbnail of Use of Pericardial Patch Conduit in Bidirectional Glenn Shunt: An Innovative Technique

Cardiovascular Journal

Bidirectional Glenn Shunt is a palliative procedure in single ventricle or hypoplastic right vent... more Bidirectional Glenn Shunt is a palliative procedure in single ventricle or hypoplastic right ventricle, tricuspid atresia and pulmonary stenosis complex where definitive repair is not feasible as well as a intermediate step of Fontan procedure. It is done by anastomosing superior venacava with right pulmonary artery or conduit can be used. We were forced to do the anastomosis between superior venacava and left pulmonary artery using a conduit as anatomy wasn’t favorable. Due to unavailability of any recognized conduits we used autologous pericardium and created a conduit with it to carry out anastomosis. Post-operative results were satisfactory. Cardiovasc. j. 2020; 13(1): 92-94

Research paper thumbnail of Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience

Cardiovascular Journal

Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenit... more 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 fr...

Research paper thumbnail of Patient with D transposition of Great Arteries Operated by Senning Procedure: A Case Report

Journal of Current and Advance Medical Research

The atrial switch operation, the Mustard or Senning operation, for the transposition of the great... more The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries (TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation Senning procedure for 5 months old child with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).Journal of Current and Advance Medical Research 2017;4(1):31-33

Research paper thumbnail of Administration of Magnesium and its Association with Prevention of Ventricular Arrhythmias Following Cardiopulmonary Bypass in Open Heart Surgery

Cardiovascular Journal

Background: The development of cardiac arrhythmias following open- heart surgery is fairly common... more Background: The development of cardiac arrhythmias following open- heart surgery is fairly common. Hypomagnesemia appear to be a significant element in the genesis of postoperative ventricular arrhythmias. Purpose of this study is to evaluate the effects of postoperative use of magnesium following cardiopulmonary bypass and minimize the risk of dreadful ventricular arrhythmia.Methods: Total 80 (Eighty) patients were enrolled for this study divided in 2 groups, Group A (n=40): patients who were given Magnesium Sulphate and Group B (n=40): patients who were not given Magnesium. Monitoring of the patient in ICU was done for incidence of ventricular arrhythmias.Results: From this study the incidence of postoperative ventricular arrhythmia was less in the magnesium treated group than the control group. Mean serum magnesium concentration decreased to subnormal value, immediately after surgery in both magnesium-treated and untreated groups.Conclusions: Routine intravenous magnesium adminis...

Research paper thumbnail of Effect of Arterial Hypertension on Postoperative Mortality and Morbidity after Off-pump CABG Surgery

Cardiovascular Journal

Background: Arterial hypertension is one of the leading modifiable risk factor in coronary artery... more 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 infect...

Research paper thumbnail of Effect of Topical Administration of Tranexamic Acid in Reducing Post-Operative Bleeding after Off-Pump Coronary Artery Bypass Surgery-A Single Center Experience

Cardiovascular Journal

Background: This study was designed to assess the role of topically applied tranexamic acid in pe... more Background: This study was designed to assess the role of topically applied tranexamic acid in pericardial cavity in reducing post operative bleeding.Methods: This study is a non-randomized, double blinded, clinical trial, conducted in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases from January 2014 to December 2015 among the patients admitted for off pump coronary artery bypass (OPCAB) surgery. A total of 60 patients were recruited for the study and they were divided in two groups- 30 patients in tranexamic acid group (Group I) and 30 patients in placebo group (Group II). On completion of the grafting, before closure of the sternum tranexamic acid (2.5 g/25 ml) or placebo (25 ml of saline) diluted in 100 ml of warm saline (37 °C) was instilled into the pericardial cavity including the mediastinal tissues and left for 5 minutes. Total mediastinal bleeding and packed red cell transfusion were estimated in the postoperative period in both groups.Resul...

Research paper thumbnail of Evaluation of Body Mass Index as a Factor of Outcome in Coronary Artery Bypass Surgery

Cardiovascular Journal

Background: Obesity is supposed to be a risk factor for patients undergoing coronary artery bypas... more 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 harv...

Research paper thumbnail of Transaxillary Surgical Ligation of Patent Ductus Arteriosus in Paediatric Group of Patient

Patent ductus arteriosus is one of the most common congenital heart defects accounting for 5-10% ... more Patent ductus arteriosus is one of the most common congenital heart defects accounting for 5-10% of all congenital heart diseases with left to right shunt and reported incidence in term neonate only 1:2000 life birth. 1 Due to its haemodynamic consequences and curative result of closure, various methods for closure have been introduced. Indomethacin still been used specially in neonates as a medical methods initiates cessation of shunt. 2 Percutaneous transcatheter ductal closure has taken most of PDA cases away from surgical intervention. Recent success of video assisted thoracoscopic clipping or ligation has added a new alternate for closure. 3 However conventional surgical ligation is the ultimate request when other methods fail to achieve cessation of the shunt. Conventional posterolateral thoracotomy incision is still used but it is less cosmetic and more painful and produce bad scar. The current study is designed to assess the outcome of the transaxillary approach in surgical ligation of patent ductus arteriosus. Methods: Between January, 2015 to May, 2018 total 46 patients underwent transaxillary surgical ligation of PDA in National Institute of cardiovascular diseases, Dhaka, Bangladesh. There were 18 male(39%) and 28 female (61%).Their age range from 5 months to 10 years months (mean 39.2±24.7months) and body weight ranges from 4.5 kg to 32 kg (mean 16.05±6.63 kg). All patients had undergone elective operation. The studied patients had pre and post operative clinical assessment, routine laboratory investigation, chest X-ray, ECG and Echocardiography. Operative technique: All patients underwent operation after they had been anesthetized and intubated. A radial or femoral arterial line was used to continuously

Research paper thumbnail of Evaluation of Neurocognitive Dysfunction after Coronary Artery Bypass Surgery

Cardiovascular Journal, 2018

Objective: The Neurological injury is an important complication after coronary artery bypass surg... more Objective: The Neurological injury is an important complication after coronary artery bypass surgery (CABG). The incidence of neurocognitive impairment after cardiac surgery varies from 20% to 80%. In this study we tried to analyze this difference of neurologic dysfunction between On-pump CABG and Off-pump CABG (OPCAB).Methods:This is a case control study done in National Institute of Cardiovascular Disease (NICVD), Dhaka during the period of July 2012 to June 2014. Sixty Patients with Ischemic heart disease were the study population. Group- A includes 30 patients underwent on pump CABG, Group-B 30 patients underwent OPCAB. All the patients of both the groups were followed up to 2 month’s postoperatively to find out any neurological and neurocognitive dysfunctionby observing motor function, sensory function,Mini Mantel state (MMS) Examination, orientation, memory, attention and calculation, recall and language test.Results: Neurocognitive dysfunction in the early postoperative perio...

Research paper thumbnail of Severe mitral stenosis with giant LA with LA thrombus - A case report

Bangladesh Heart Journal, 2018

Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. T... more Excess dilatation of the left atrium >60 mm is known in the literature as a gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the leftright shunt with cardiac insufficiency. In this paper, we presented a case study of severe mitral stenosis with giant LA with LA thrombus in a 42 years old female patient. The patient underwent successful mitral valve replacement and removal of LA thrombus and discharged from the hospital with advice. Bangladesh Heart Journal 2018; 33(2) : 141-144

Research paper thumbnail of Preoperative Aspirin Use and Outcomes in Off-pump Coronary Artery Bypass Grafting Surgery

Bangladesh Heart Journal, 2018

Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at bl... more Introduction: Aspirin, the most widely used platelet function inhibitor extremely effective at blocking the production of thromboxane in platelets, rendering the platelets incapable of functioning normally, and thus preventing thrombosis. The practice of empirically discontinuing aspirin preoperatively should be abandoned because evidence strongly supports continued use of aspirin in patients for secondary prevention of CAD, CVD, or PVD when undergoing surgery. Methods and Materials: This Observational study was conducted at Department of Cardiac Surgery, NICVD, Dhaka, who underwent off pump CABG (OPCAB), divided in two groups, Group A: 24 patients who stopped and Group B: 24 patients who are continuing aspirin throughout the perioperative period. Post operative blood loss, requirement of blood transfusion, post-operative MI, ICU stay, Total hospital stay (days) and early post-operative complication (Stroke, New arrhythmia in ECG, 30 days mortality) were recorded and included in the study. Results: The key finding of the present study is that preoperatively continued aspirin use was not associated with increased risk of post-operative blood loss, blood transfusion requirements and need for re exploration after OPCAB. Conclusions: Preoperative aspirin therapy should be continued till off-pump CABG without interruption.

Research paper thumbnail of The effect of local application of tranexamic acid to reduce blood loss after off pump coronary artery bypass grafting (CABG)

Journal of cardiothoracic surgery, Jan 16, 2015

The effect of local application of tranexamic acid to reduce blood loss after off pump coronary a... more The effect of local application of tranexamic acid to reduce blood loss after off pump coronary artery bypass grafting (CABG).

Research paper thumbnail of Atrial fibrillation after coronary artery bypass graft surgery

American Heart Journal, 2000

Research paper thumbnail of Case Report Patient with D transposition of Great Arteries Operated by Senning Procedure: A Case Report

The atrial switch operation, the Mustard or Senning operation, for the transposition of the great... more The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries (TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation Senning procedure for 5 months old child with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).

Research paper thumbnail of Use of Pericardial Patch Conduit in Bidirectional Glenn Shunt: An Innovative Technique

Cardiovascular Journal

Bidirectional Glenn Shunt is a palliative procedure in single ventricle or hypoplastic right vent... more Bidirectional Glenn Shunt is a palliative procedure in single ventricle or hypoplastic right ventricle, tricuspid atresia and pulmonary stenosis complex where definitive repair is not feasible as well as a intermediate step of Fontan procedure. It is done by anastomosing superior venacava with right pulmonary artery or conduit can be used. We were forced to do the anastomosis between superior venacava and left pulmonary artery using a conduit as anatomy wasn’t favorable. Due to unavailability of any recognized conduits we used autologous pericardium and created a conduit with it to carry out anastomosis. Post-operative results were satisfactory. Cardiovasc. j. 2020; 13(1): 92-94

Research paper thumbnail of Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience

Cardiovascular Journal

Background: Our objective was to analyze the outcome of patients of Down’s syndrome with congenit... more 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 fr...

Research paper thumbnail of Patient with D transposition of Great Arteries Operated by Senning Procedure: A Case Report

Journal of Current and Advance Medical Research

The atrial switch operation, the Mustard or Senning operation, for the transposition of the great... more The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries (TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation Senning procedure for 5 months old child with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).Journal of Current and Advance Medical Research 2017;4(1):31-33

Research paper thumbnail of Administration of Magnesium and its Association with Prevention of Ventricular Arrhythmias Following Cardiopulmonary Bypass in Open Heart Surgery

Cardiovascular Journal

Background: The development of cardiac arrhythmias following open- heart surgery is fairly common... more Background: The development of cardiac arrhythmias following open- heart surgery is fairly common. Hypomagnesemia appear to be a significant element in the genesis of postoperative ventricular arrhythmias. Purpose of this study is to evaluate the effects of postoperative use of magnesium following cardiopulmonary bypass and minimize the risk of dreadful ventricular arrhythmia.Methods: Total 80 (Eighty) patients were enrolled for this study divided in 2 groups, Group A (n=40): patients who were given Magnesium Sulphate and Group B (n=40): patients who were not given Magnesium. Monitoring of the patient in ICU was done for incidence of ventricular arrhythmias.Results: From this study the incidence of postoperative ventricular arrhythmia was less in the magnesium treated group than the control group. Mean serum magnesium concentration decreased to subnormal value, immediately after surgery in both magnesium-treated and untreated groups.Conclusions: Routine intravenous magnesium adminis...

Research paper thumbnail of Effect of Arterial Hypertension on Postoperative Mortality and Morbidity after Off-pump CABG Surgery

Cardiovascular Journal

Background: Arterial hypertension is one of the leading modifiable risk factor in coronary artery... more 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 infect...

Research paper thumbnail of Effect of Topical Administration of Tranexamic Acid in Reducing Post-Operative Bleeding after Off-Pump Coronary Artery Bypass Surgery-A Single Center Experience

Cardiovascular Journal

Background: This study was designed to assess the role of topically applied tranexamic acid in pe... more Background: This study was designed to assess the role of topically applied tranexamic acid in pericardial cavity in reducing post operative bleeding.Methods: This study is a non-randomized, double blinded, clinical trial, conducted in the Department of Cardiac Surgery, National Institute of Cardiovascular Diseases from January 2014 to December 2015 among the patients admitted for off pump coronary artery bypass (OPCAB) surgery. A total of 60 patients were recruited for the study and they were divided in two groups- 30 patients in tranexamic acid group (Group I) and 30 patients in placebo group (Group II). On completion of the grafting, before closure of the sternum tranexamic acid (2.5 g/25 ml) or placebo (25 ml of saline) diluted in 100 ml of warm saline (37 °C) was instilled into the pericardial cavity including the mediastinal tissues and left for 5 minutes. Total mediastinal bleeding and packed red cell transfusion were estimated in the postoperative period in both groups.Resul...

Research paper thumbnail of Evaluation of Body Mass Index as a Factor of Outcome in Coronary Artery Bypass Surgery

Cardiovascular Journal

Background: Obesity is supposed to be a risk factor for patients undergoing coronary artery bypas... more 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 harv...

Research paper thumbnail of Transaxillary Surgical Ligation of Patent Ductus Arteriosus in Paediatric Group of Patient

Patent ductus arteriosus is one of the most common congenital heart defects accounting for 5-10% ... more Patent ductus arteriosus is one of the most common congenital heart defects accounting for 5-10% of all congenital heart diseases with left to right shunt and reported incidence in term neonate only 1:2000 life birth. 1 Due to its haemodynamic consequences and curative result of closure, various methods for closure have been introduced. Indomethacin still been used specially in neonates as a medical methods initiates cessation of shunt. 2 Percutaneous transcatheter ductal closure has taken most of PDA cases away from surgical intervention. Recent success of video assisted thoracoscopic clipping or ligation has added a new alternate for closure. 3 However conventional surgical ligation is the ultimate request when other methods fail to achieve cessation of the shunt. Conventional posterolateral thoracotomy incision is still used but it is less cosmetic and more painful and produce bad scar. The current study is designed to assess the outcome of the transaxillary approach in surgical ligation of patent ductus arteriosus. Methods: Between January, 2015 to May, 2018 total 46 patients underwent transaxillary surgical ligation of PDA in National Institute of cardiovascular diseases, Dhaka, Bangladesh. There were 18 male(39%) and 28 female (61%).Their age range from 5 months to 10 years months (mean 39.2±24.7months) and body weight ranges from 4.5 kg to 32 kg (mean 16.05±6.63 kg). All patients had undergone elective operation. The studied patients had pre and post operative clinical assessment, routine laboratory investigation, chest X-ray, ECG and Echocardiography. Operative technique: All patients underwent operation after they had been anesthetized and intubated. A radial or femoral arterial line was used to continuously