Retrospective Analysis of Bypass-Related Complications at Iran's Cardiovascular Surgical Centers

Document Type : Original Article

Authors

1 Department of Anesthesiology, Lung Diseases Research Center, School of Medicine, Mashhad University of Medical Science , Mashhad, Iran.

2 Department of Cardiac Surgery, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.

3 Department of Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

4 Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran Univesity of Medical Siences , Tehran, Iran.

7 Department of Perfusion Technology, Faculty of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.

8 Department of Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: In addition to the well-known benefits of cardiopulmonary bypass (CPB), there are also certain possible risks, some of which are avoidable and some of which are accidental. In addition to CPB, potentially life-threatening consequences include human error and mechanical disruptions. The purpose of this study is to conduct a retrospective analysis of CPB accidents in Iranian cardiovascular surgery departments.
Methods: This study included 151 Iranian perfusionists who were evaluated using a questionnaire created by the researchers. The questionnaire recorded all participants' demographic information as well as their experiences with human errors (e.g., perfusionist fatigue and drowsiness; errors in CPB circuit arrangement; and so on) and mechanical disturbances (cooling-warming circuit, oxygenator failure, electrical disruption, and so on). SPSS Version 16 was used to analyze all of the data.
Result: 1) venous obstruction and improper venous return had the highest recurrence rate of 89.4%, 2) Removing the venous cannula and venting the venous path 86.8%, 3) 79.5% were unable to raise (ACT) more than 400. Most significant injuries were caused by clots or thrombi during CPB (2.6%), 2) failure of the oxygenator (2.6%). Most deaths were caused by an air embolism (5.29).




Conclusions: Although the occurrence of human errors and mechanical disturbances cannot be predicted, they can be mitigated by the sharing of accidents and mistakes.

Keywords

References

  1. Mirhosseini SJ, Forouzannia SK, Sayegh AH, Sanatkar M. Effect of Prophylactic Low Dose of Methylprednisolone on Postoperative New Atrial Fibrillation and Early Complications in Patients with Severe LV Dysfunction Undergoing Elective Off-Pump Coronary Arte. Acta Medica Iranica. 2011:288-92.
  2. Sharkawy MN, Dastan I. A scoping review of health economic evaluation in the World Health Organization Eastern Mediterranean region. Expert Review of Pharmacoeconomics & Outcomes Research. 2021 Sep 3;21(5):877-84.
  3. Terranova N, Venkatakrishnan K, Benincosa LJ. Application of machine learning in translational medicine: current status and future opportunities. The AAPS Journal. 2021 Jul;23(4):1-0.
  4. Amin R, Alaparthi GK, Samuel SR, Bairapareddy KC, Raghavan H, Vaishali K. Effects of three pulmonary ventilation regimes in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Scientific Reports. 2021 Mar 24;11(1):1-3.
  5. Abolahrari-Shirazi S, Emami F, Rojhani-Shirazi Z, Janati M, Razeghi M. The Effects of Coronary Artery Bypass Grafting on Postural Balance. Journal of Rehabilitation Sciences & Research. 2022 Mar 1;9(1):42-6.
  6. Toreyhi H, Asgari S, Khalili D, Pishgahi M, Azizi F, Hadaegh F. Sudden cardiac death among Iranian population: a two decades follow-up of Tehran lipid and glucose study. Scientific reports. 2021 Aug 3;11(1):1-0.
  7. Mousa TM, Liu D, Cornish KG, Zucker IH. Exercise training enhances baroreflex sensitivity by an angiotensin II-dependent mechanism in chronic heart failure. Journal of applied physiology. 2008 Mar;104(3):616-24.
  8. Mir Mohammad Sadeghi M, Cardiopulmonary bypass, Key points in heart surgery and icu, Tymourzadeh,1th ed, Esfehan,1394.
  9. Groenenberg I, Weerwind PW, Everts PA, Maessen JG. Dutch perfusion incident survey. Perfusion. 2010 Sep;25(5):329-36.
  10. Willcox TW. Guest Editorial: D’où Venons-nous/Que Somes Nous/Où Allons Nous? Accidents Are Inevitable. The journal of extra-corporeal technology. 2012 Mar;44(1):P2.
  11. Erickson SM, Wolcott J, Corrigan JM, Aspden P, editors. Patient safety: achieving a new standard for care.
  12. Jenkins OF, Morris R, Simpson JM. Australasian perfusion incident survey. Perfusion. 1997 Sep;12(5):279-88.
  13. Charrière JM, Pélissié J, Verd C, Léger P, Pouard P, de Riberolles C, Menestret P, Hittinger MC, Longrois D. Survey: retrospective survey of monitoring/safety devices and incidents of cardiopulmonary bypass for cardiac surgery in France. The Journal of Extra-corporeal Technology. 2007 Sep;39(3):142-157.
  14. Willcox TW, Baker RA. Incident Reporting in Perfusion: current Perceptions on PIRS-2. The journal of extra-corporeal technology. 2020 Mar;52(1):7.
Journal of Cardio-Thoracic Medicine
Volume 10, Issue 4
December 2022
Pages 1078-1088

Files

Share

How to cite

Statistics