Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute Endoscopic versus open radial artery harvesting used in coronary artery

Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptibleto contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman, Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.

Hermitian Geometry of Twistor Spaces

In the present thesis we investigate the almost Hermitian geometry of the twistor spaces of oriented Riemannian 4-manifolds. Holomorphic and orthogonal bisectional curvatures have been intensively explored on K ̈hler manifolds and a lot of important results have been obtained in this case. a But in the non-K ̈hler case these curvatures are not very well studied and it seems a that the main reason for that is the lack of interesting examples. The first part of the thesis is devoted to the study of the curvature properties of Atiyah-Hitchin- Singer and Eells-Salamon almost Hermitian structures. This is used to provide some interesting examples of almost Hermitian 6-manifolds of constant or strictly positive holomorphic, Hermitian and orthogonal bisectional curvatures. In the second part of the thesis we determine the Gray-Hervella classes of the so-called compatible almost Hermitian structures on the twistor spaces, recently in- troduced by G. Deschamps . The interest in determining these classes is motivated by the fact that the Gray-Hervella classification is a very useful tool in studying almost complex manifolds. Our results in this direction generalize the well known integrabil- ity theorems by Atiyah-Hitchin-Singer, Eells-Salamon and Deschamps and show that there is a close relation between the properties of the spectrum of the anti-self-dual Weyl tensor of an almost K ̈hler 4-manifold and the almost Hermitian geometry of a its twistor space.