Cardiothoracic Intensive Care Unit (ICU):
Introduction
Cardiothoracic Intensive Care Unit
was opened in 2007 and untill September 2012, this unit continued its work although
it was not at full level activity because of changes occurring on that time;
since November 2012, this hospital provided full-time services to patients,
actively. In December 2017, this unit was transferred to the specialized Razi
Hospital and it has continued his work. Cardiac surgerydepartment located in Razi Hospital and Educational and Research
Center has a space of 375 square meters with two operating rooms, 6 ICU beds
for adults and children, it has skilled staffs including 2 cardiothoracicsurgeons, cardiac
anesthesiologist, nurses, operating room technician, perfusionist,
anesthetic technician who are providing services 24 hours a day in adults and
children's cardiac surgeryand
vascular surgery department.
Different
types of surgery:
-
Embolectomy:
In the case of acute embolism,
which leads to chronical elevation
of pulmonary artery pressure, pulmonary
endarterectomy is effective toreducepulmonary artery pressure. In the case of
acute ambolism, emergency removing clot from artery pressure will be effective.
These type of operations are performed in Shahid Rajaee Cardiovascular Center.
-
Coronary
Artery Bypass:
Coronary artery bypass
is a surgical procedure in which a blocked heart vessel or more than one
vessels that flow blood to the heart are bypassed;similar arteries or
veins from other parts of
the bodyare taken to reroute the
blood supply around a blocked artery. The
blood vessels from other parts of body used as an alternative are as follow: The greatsaphenous vein in leg, blood vessel
in chest or blood, radial artery in patient's arm. In fact,
these grafts should be attached to a place passing the narrowed coronary artery
and then oxygenated blood will flow in it. In fact, this operation aims to get
the patient to the normal life, having no pain and it is a precaution against
unexpected events including myocardial infarction.
-
Congenital
Heart Defect:
It is possible to discover this
type of illness during the birth or when the patient is infant or a child or a
teenager or maybe later than that. There is the possibility of having congenital heart defect without any signs and symptoms, and
considering the severity of the illness in the first step and its development
in time, the appearance of signs and symptoms may result at any time. Symptoms
such as shortness of breath, reduced exercise tolerance are some examples. These
illnesses are diagnosed by cardiologist examination, using chest radiography,
electrocardiogram, echocardiogram and angiography.
In minor illnesses, treatment is not needed, observing the patient by a
cardiologist is the only necessary action to be done and in acute illnesses,
treatment by the use of medication and surgeries such as anomalous
coronary artery repair, are needed. Surgeons in this center are unique
in performing some types of surgeries; procedures include aortic valve,ascending
aorta, and aortic arch surgeries.
More than everyday heart surgery schedule, a cardiovascular surgeonis always present in the hospital for
emergency aortic surgeries and he/she is responsible for them.
-
AorticAneurysm:
Since some cardiologists work in
this hospital, all types of surgeries on aortic valve and peripheral vascular
surgeries are operated by their cooperation. These surgeries, specially
descending aorta surgery is performed by a team
including thecardiovascular surgeon, thoracic
surgeons, and thevascular surgeon. Diagnosis, treatment and follow-up treatment
procedures for these patients are possible 24 hours a day, using different
devices such as echocardiogram, transesophagealechocardiography, CT scanner, angiography and MRI.
-
Heart Valve
Repair or Replacement:
Heart valves performance is vital
to flow blood in a one-way track and they are opened and closed by every heart
beats. Changes in pressure on the back or in front of the valve allows the
valves to be opened in one side and in appropriate time, then they are closed
firmly to prevent backward flow of blood.
-
Replacement
of Heart Valve Surgery:
There are two common problems in
heart valves that need surgery:
-
Narrowing
of the valve in the heart:
In
narrowing of the mitral valve, valve flaps are not opened properly and just a
little amount of blood is flowed through the valve. Stenosis
is when valve flaps are thick, hard or stick together. Valve surgery is
performed to open a narrowed valve or to replace it with a new one
-
Valve
Regurgitation:
Regurgitation is a condition in which valves are not working properly. In this
case, the valve is not moving properly in the right direction forward, so blood
leaks backward. A surgery is needed on valve in case of narrowing or the valve
should be replaced.
Repairing and replacement of heart
valves includes valve reconstruction
to make it work properly. Replacing the valve means that the valve is removed
and replaced by a biological tissue valve (made from animals or human tissues)
or a mechanical valve (made of plastic, carbon or metal).
Installed
Equipment in this Ward:
Cardiothoracic Intensive Care Unit
has special equipment including:
-
Full-option
monitoring system
-
840
Drager Ventilators
-
Echocardiogram
capable of doing TEE, TTE Echo-tests
-
intra-aortic balloon pump (IABP)
-
portable radiology
equipment privately used in this ward
-
arterial-blood gas (ABG) analyzer or Gasometry
device used as a diagnostic tool
-
doing dialysis in ICU;
haemodialysis
and CRRT in critical conditions
-
a trolley equipped fully
and an electroshock device
There
is a ward called "Pediatric ICU" which is completely the same as
adult ICU.
Each bed has a range of equipment
including: syringe pump, serum pump, central suction device, blood warmer,
foldable beds that can change patient's body position, nebulizer device,
ventilator, heart monitoring system, infusion pumps (IMS); hospital air beds,
special multi-fold beds that can change patient's body position, nebulizer
system, equipment needed for resuscitation. All beds in ICU are connected to
the central monitoring system and the beds are separated from each other by an
anti-bacterial curtain. There is an isolation room which is equipped with all
medical devices according to hospital standards. Power system in ICU is
connected to central UPS system of the hospital, so in case of power outage in
the city, all devices and equipment work without stopping. There is a CCTV
system in this ward for patients to see their family or friends, because “Visiting is forbidden”. So, if the patient has a
stable condition, after 48 hours, he/she will be transferred to the Intermediate
Care Unit After Cardiac Surgery. Therefore, the number of patients is
changeable based on the number of surgeries, the number of patients that have
stable condition and lack of patients in acute condition.