DEPARTMENT OF CARDIAC SURGERY

Dr. Aftab Younas

MBBS, FRCSEd.
Associate Professor and Chief of Cardiac Surgery ,
King Edward Medical University/Mayo Hospital                                                               

Dr. Aftab Younas

The department of Cardiac Surgery in Mayo Hospital and KEMU was started in the late nineteen-sixties with Dr. Aslam Cheema as its pioneer head. It was the first department in any medical institution in the Punjab to perform open heart surgery. It was also the first to perform surgery for congenital heart disease, cardiac valve replacements and then coronary bypass operations.
At present, The Department is being headed by Dr Aftab Yunus, Associate Professor. He is a graduate of Rawalpindi Medical College and did his FRCSEd in 1998. Since then he has been trained in Cardiac Surgery at Punjab Institute of Cardiology Lahore, Bristol Royal Infirmary UK and King Khalid University Hospital Riyadh. He was appointed as Assistant Professor in December 2004 and then Associate Professor in October 2007.
Dr. Yunus was appointed Chairman and Head of Department in March 2011. His interest in teaching and training of residents, students and preparing them as academic Clinical Scientists in the field of cardiac surgery has widened the horizon of Department nationally and internationally, attracting post graduate students from Nepal and Bangladesh.
His motivation in research and innovation has lead department to new level. After appointment as Chairman, under his leadership, in 2012 alone more than 10 research papers were published in different journals. This area was laid back for last 8 years, which took excellent turnover by his constant effort and academic dedication.
His areas of expertise include coronary revascularisation, valve repairs and replacements and septal defect closures. On the average 250 to 300 open heart procedures are carried out in the department annually. The latest innovations in cardiac surgery including off pump coronary artery bypass especially total arterial revascularisation and blood less cardiac surgery are being practiced in the department.

Cardiac Surgery is located in the main block of Mayo Hospital and is also called the “thandee ward” or the cold ward since it was the first fully air conditioned ward in Mayo Hospital.
Faculty list:
Dr. Aftab Yunus, Associate Professor                    MBBS, FRCSEd

Adnan Haider, Lecturer                                             M.Phil ( Physiology)

POST GRADUATE PROGRAMS:

1. Master of Surgery (MS). A new research based curriculum for the Master of Surgery program was developed. The first student is now eligible for the examination. The purpose is to prepare a cadre of academic surgeons trained in clinical and research methodologies who can form the nucleus of future training programme.
2. Fellowship of the College of Physicians and Surgeons in Cardiac Surgery (FCPS). The department provides clinical attachment for physicians preparing for the FCPS cardiac surgery examinations.

UNDER GRADUATE PROGRAMS:

1. The department provides clinical rotation for MBBS students as well as a series of didactic lectures.
2. Bachelor in Cardiac Perfusion Technology B.Sc (Hons). A new 4 years bachelor program in Cardiac Perfusion to train young perfusionist in the field of cardiac surgery.

ANCILLIARY STAFF:

The department also provides clinical rotations for students of the School of Physiotherapy and trains them in basic aspects of cardiac care and resuscitation.


RESEARCH PROJECTS:

Different clinical research projects are underway. These include:

1. Prevalence of Hepatitis B and C in the Cardiac Surgical population, analysis of risk in surgery and effect on long term survival. This is of great importance since many patients referred for cardiac surgery have viral markers for these forms of hepatitis. No information is available in the literature if this increases operative mortality and morbidity or has impact on long term survival especially in patients requiring life time anti-coagulation. This is an ongoing study and interim results will be publishes when an adequate cohort is available.
2. Total Arterial Revascularisation, use of right internal mammary artery and radial artery and get a CT-angiogram done after one year, five years and ten years to access for patency and compare it with saphenous vein grafts. The effect of spasm of radial artery in the immediate postoperative period is being studied.
3. Prosthetic Aortic Valve Replacement, a comparison of pre-operative gradients with immediate post-operative gradients and delayed gradients across the valve. This is an echo based study and will attempt to correlate the clinical status of patients with valve gradients as measured by echo-cardiography in the post-operative period.
4. Mitral Valve Repair in Patients with Mitral Regurgitation. Majority of patients requiring valve surgery are suffering from Rheumatic Heart Disease (RHD). The purpose of this study is to identify that subset of patients who develop mitral regurgitation for non RHD causes and are amenable to repair. It is important to identify this subset since repair avoids problems with long term anti-coagulation and improves survival.
5. Blood Less cardiac Surgery. Attempt is being made to develop methods to decrease the use of donor blood consumption in cardiac surgery. Considering the present status of infective hepatitis transmitted by blood transfusions, and the difficulty in acquiring adequate supply of blood, this study will help in delineating those patients where surgery can be safely performed without the need for blood transfusions.
Funding is being sought to develop the infrastructure for creating an environment where clinical research can be carried out as a part of the normal training process. New technology like intra operative TEE, portable TTE, Cell savers is also being asked for. Furthermore, full time research staff will also be acquired.
An attempt is being made to develop a first rate clinical department that provides appropriate care for the patients while at the same time presents an academic environment conducive to clinical research and in time basic research. Emphasis is going to be on preparing a new cadre of academic surgeons who can form the nucleus of future training and education in the field of cardiac care

CARDIAC SURGERY IN PROGRESS