Physical outcome and its determinants of patients undergoing coronary artery bypass graft (cabg) and valvular surgeries in JIPMER, puducherry

Introduction: Cardiovascular diseases (CVDs) have become the most important cause of non - communicable disease deaths.According to WHO statistics, cardiovascular diseases are the most common cause of deaths in the world.In every open heart surgery, there is the risk of complications specific to the disease and surgery being performed, in addition to the general risks related to surgery and anesthesia. Both CABG & valvular surgeries are performed to improve functional capability and quality of life. Aim: To assess the physical outcome and its determinants of patients undergoing Coronary artery bypass graft and valvular surgeries. Methods: In this prospective observational study, 40 patients who underwent coronary artery bypass graft or valvular surgery were selected through consecutive sampling method from August 2018 to February 2018. The tools used for data collection were numerical rating scale to assess postoperative pain, performance check list for using incentive spirometry and subject data sheet. Results: The complications observed in CABG group were bleeding 2 (11.8%) and re-exploration 1 (5.9%), cognitive impairment 2 (11.8%) and graft site infection 1 (2.5%). Major complications observed in valve group were bleeding 3 (13%) and re-exploration 2 (8.7%), atrial fibrillation (52.2%), acute kidney injury 1 (4.3%), pericardial effusion 1 (4.3%). There was an improvement in NYHA functional class postoperatively where 88.5% of participants were in NYHA grade I. The determinants of outcome of CABG surgery were age more than 65 years (p < 0.017), NYHA grade II & III (p < 0.052), triple vessel disease (p<0.033), and high BMI (p<0.46). The determinants of outcome after valve surgery include female gender (0.008), NYHA grade III & IV (p < 0.026), mitral valve replacement (p<0.054), and history of previous cardiac operation (p<0.001). Conclusion: Coronary artery bypass graft and valve surgeries improve the quality of life in patients with coronary artery disease and valvular heart disease.