CAD _ Dr. Assem BALAWI_ Medics Index Member 4thJan 2011

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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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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    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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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    3 .Trans3 .Trans--MyocardialMyocardial

    RevascularizationRevascularization(TMR) by laser.(TMR) by laser.

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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    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

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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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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    55 . Heart. Heart

    transplantation intransplantation inend stage heartend stage heart

    failure.failure.

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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    55 . Heart transplantation in end stage heart failure.. Heart transplantation in end stage heart failure.

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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    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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    ADVANCES IN SURGICAL ttt OF CADADVANCES IN SURGICAL ttt OF CAD

    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