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ADVANCES IN SURGICAL MANAGEMENTADVANCES IN SURGICAL MANAGEMENTOFOF
CORONARY ARTERY DISEASE (CAD)CORONARY ARTERY DISEASE (CAD)
Dr. Assem BALAWI, MDDr. Assem BALAWI, MD
Cardiac and Thoracic SurgeonCardiac and Thoracic Surgeon
Private HospitalsPrivate Hospitals -- AmmanAmman
French Board - Paris LyonMobile : 962+ 79 555 8572
Full Profile Here
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
Coronary artery disease ( CAD ) is the first killing disease in theCoronary artery disease ( CAD ) is the first killing disease in themodern era.modern era.
Surgeons offer a good variety of recent methods to help patientsSurgeons offer a good variety of recent methods to help patientswho couldnt be treated medically :who couldnt be treated medically :
1.1. (CABG) Coronary artery bypass graft on pump .(CABG) Coronary artery bypass graft on pump .
2.2. (CABG) Coronary artery bypass graft off pump ( beating heart ).(CABG) Coronary artery bypass graft off pump ( beating heart ).
3.3. TransTrans--Myocardial Revascularization (TMR) by laser.Myocardial Revascularization (TMR) by laser.
4.4. Surgical reduction of myocardial mass ( DOR and Batista operations ) inSurgical reduction of myocardial mass ( DOR and Batista operations ) inischemic cardiomyopathy.ischemic cardiomyopathy.
5.5. Heart transplantation in end stage heart failure patients.Heart transplantation in end stage heart failure patients.
6.6. Robotic Cardiac SurgeryRobotic Cardiac Surgery
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1.1. (CABG)(CABG)
Coronary artery bypass graftCoronary artery bypass graft
on pump .on pump .
ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
The Heart-lung machine we use ( On pump technique )
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ADVANCES IN SURGICAL tttADVANCES IN SURGICAL ttt
OF CADOF CAD
Where we take our grafts?
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
Surgical approach
Sternotomy Thoracotomy Thoracoscopy
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Technique of suturing
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
1.1. (CABG) Coronary artery bypass graft on pump .(CABG) Coronary artery bypass graft on pump .Types of grafts we frequently use.Types of grafts we frequently use.
Vein graft only Vein graft + LIMA Vein graft + RIMA
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22 .. (CABG)(CABG)
off pump techniqueoff pump techniqueBeating Heart surgery.Beating Heart surgery.
ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
22 . (CABG) off pump technique,. (CABG) off pump technique,
Beating Heart surgery.Beating Heart surgery.
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
We stabilise only the site of anastomosis by stabilisers :We stabilise only the site of anastomosis by stabilisers :
CompressionStabilisers
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
Suction Stabilisers ( Octipus )
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
22 .(CABG) Coronary artery bypass graft off pump ..(CABG) Coronary artery bypass graft off pump .
We use the same types of grafts and we do the sameWe use the same types of grafts and we do the sameanastomosis as on pump when possible i.e :anastomosis as on pump when possible i.e :
Vein graft only Vein graft + LIMA Vein graft + RIMA
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3 .Trans3 .Trans--MyocardialMyocardial
RevascularizationRevascularization(TMR) by laser.(TMR) by laser.
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3 .Trans3 .Trans--Myocardial Revascularization (TMR) by laser.Myocardial Revascularization (TMR) by laser.
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
44 . Surgical reduction of. Surgical reduction ofmyocardial mass ( DORmyocardial mass ( DORand Batista operations )and Batista operations )
in ischemicin ischemic
cardiomyopathy.cardiomyopathy.
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
4 . Surgical reduction of myocardial mass4 . Surgical reduction of myocardial mass
( DOR operation ) in ischemic cardiomyopathy.( DOR operation ) in ischemic cardiomyopathy.
1 2 3
4 5 6
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
4 . Surgical reduction of myocardial mass4 . Surgical reduction of myocardial mass
( Batista operation ) in ischemic cardiomyopathy.( Batista operation ) in ischemic cardiomyopathy.
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55 . Heart. Heart
transplantation intransplantation inend stage heartend stage heart
failure.failure.
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55 . Heart transplantation in end stage heart failure.. Heart transplantation in end stage heart failure.
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66 . Robotic Cardiac Surgery. Robotic Cardiac Surgery
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ADVANCES IN SURGICAL tttADVANCES IN SURGICAL ttt
OF CADOF CAD
66 . Robotic Cardiac Surgery. Robotic Cardiac Surgery
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Cardiac Surgery is well advanced but still we have a lot to doto improve ourselves and our instruments
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ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD
Dr. Assem BALAWI, MDDr. Assem BALAWI, MD
Cardiac and Thoracic SurgeonCardiac and Thoracic Surgeon
Private HospitalsPrivate Hospitals -- AmmanAmman
French Board - Paris LyonMobile : 962+ 79 555 8572
Full Profile Here
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