Open Heart Surgery in a Newly Established Cardiovascular Department: A Retrospective Evaluation of the First 450 Cases

Introduction: The Department of Cardiovascular Surgery at the Sisli Hamidiye Etfal Training and Research Hospital was founded in 2014, and the first open heart surgery was performed on November 19, 2014. We aim to evaluate the results of the first 450 open heart surgeries retrospectively. Patients and Methods: Records of the first 450 consecutive open heart surgeries performed between November 2014 and October 2019 were retrospectively evaluated. All patients were treated with acetylsalicylic acid (100 mg/day) up to the preoperative day, and those who had acute coronary syndrome were continued to be treated with clopidogrel (75 mg/day). In all cases, the surgeries were performed through median sternotomy. The standard cardiopulmonary bypass technique was used in all patients who underwent coronary artery bypass grafting (CABG). Antegrade blood cardioplegia was given at 20-minute intervals to achieve a diastolic arrest of cardiac activity. In patients who underwent CABG, proximal anastomoses were performed under a side clamp, and sometimes, with single clamp technique depending on the patient characteristics. Results: The mean age of the patients was 58.7 years. The most common comorbidity seen in the patients was hypertension (62.9%). Other comorbid diseases observed in the patients were diabetes mellitus (43.6%), hyperlipidemia (28.0%), chronic obstructive pulmonary disease (24.9%), peripheral arterial disease (13.1%), and chronic renal dysfunction (4.7%). In-hospital death occurred in 33 of 450 patients with a mortality rate of 7.3%. Conclusion: Open heart surgeries can be performed with reasonable and successful mortality rates in our center.