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Postoperative atrial fibrillation

Elizabeth M Colwell, Carlos O Encarnacion, Lisa E Rein, Aniko Szabo, George Haasler, Mario Gasparri, William Tisol, David Johnstone
BACKGROUND: There have been numerous studies regarding atrial fibrillation (AF) associated with cardiac and pulmonary surgery; however, studies looking at esophagectomy and atrial fibrillation are sparse. The goal of this study was to review our institution's atrial fibrillation rate following esophagectomy in order to better define the incidence and predisposing factors in this patient population. METHODS: A retrospective chart review of all patients undergoing esophagectomy with transcervical endoscopic mobilization of the esophagus (TEEM) at the Medical College of Wisconsin and Affiliated Hospitals from July 2009 through December 2012...
June 19, 2018: Journal of Cardiothoracic Surgery
Robert B Hawkins, J Hunter Mehaffey, Matthew M Mullen, Wiley L Nifong, W Randolph Chitwood, Marc R Katz, Mohammed A Quader, Andy C Kiser, Alan M Speir, Gorav Ailawadi
OBJECTIVES: Institutional studies suggest robotic mitral surgery may be associated with superior outcomes. The objective of this study was to compare the outcomes of robotic, minimally invasive (mini), and conventional mitral surgery. METHODS: A total of 2300 patients undergoing non-emergent isolated mitral valve operations from 2011 to 2016 were extracted from a regional Society of Thoracic Surgeons database. Patients were stratified by approach: robotic (n=372), mini (n=576) and conventional sternotomy (n=1352)...
June 18, 2018: Heart: Official Journal of the British Cardiac Society
Arash Salemi, Andrea De Micheli, Abdullah Aftab, Adham Elmously, Regis Chang, S Chiu Wong, Berhane M Worku
OBJECTIVES: Left atrial appendage thrombus (LAT) was an exclusion criterion in the seminal transcatheter aortic valve replacement (TAVR) trials; however, such patients do undergo TAVR in the 'real-world' setting. This study sought to analyse outcomes after TAVR in patients with LAT or spontaneous echo contrast (SEC). METHODS: All patients undergoing TAVR at our institution between March 2009 and December 2014 were prospectively analysed. The presence of LAT or SEC was determined via a retrospective chart review...
June 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Syed Saleem Mujtaba, Simon M Ledingham, Asif Raza Shah, Thasee Pillay, Stephan Schueler, Stephen Clark
OBJECTIVE: The aim of this retrospective study was to compare early postoperative outcomes after aortic valve replacement (AVR) with sutureless bioprostheses and conventional stented bioprostheses implanted through median sternotomy. METHODS: From January 2011 to December 2016, 763 patients underwent aortic valve replacement with bioprostheses; of these, 139 received a Perceval S sutureless valve (Group A) and 624 received a Perimount Magna Ease valve (Group B)...
March 2018: Brazilian Journal of Cardiovascular Surgery
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
A 77 year old male underwent elective bioprosthetic aortic valve replacement (23mm Carpentier-Edwards Perimount MagnaEase) for severe aortic stenosis. His pre-discharge transthoracic echocardiogram (TTE) was normal. He presented 9 days after surgery with dyspnoea and fever. He was in sinus rhythm. Blood cultures were taken and he was commenced on empirical antibiotics for possible infective endocarditis (subsequently all negative). Repeat TTE showed a well-seated prosthesis without regurgitation but elevated gradients (peak / mean gradients 49 / 22 mmHg respectively)...
June 12, 2018: Echo Research and Practice
Hannan Dalyanoglu, Arash Mehdiani, Jan Philipp Minol, Nihat Firat Sipahi, Hug Aubin, Udo Boeken, Alfred Müller, Hisaki Makimoto, Artur Lichtenberg, Bernhard Korbmacher
Postoperative, new-onset atrial fibrillation (POAF) is one of the most common complications after cardiosurgical procedures. Vernakalant has been reported to be effective in the conversion of POAF. The aim of this study was to evaluate the efficacy and safety of vernakalant for atrial fibrillation after cardiac operations, and to investigate predictors for the success of vernakalant treatment. Patients and Methods: Post-cardiac surgery patients with new-onset of atrial fibrillation (AF) were consecutively enrolled in this study...
May 25, 2018: Heart Surgery Forum
Alev Kılıcgedik, Abdulrahman Naser, Ahmet Seyfeddin Gurbuz, Seyhmus Kulahcioglu, Ruken Bengi Bakal, Tuba Unkun, Fatih Yilmaz, Gokhan Kahveci, Cevat Kirma
BACKGROUND: The use of the CHA2DS2-VASc scoring system and red cell distribution width (RDW) as post-op Atrial Fibrillation (POAF) predictors may be promising for the identification of patients that are at a higher risk of POAF. METHODS: A total of 358 patients (57 patients with POAF, and 301 patients with non-POAF ) with sinus rhythm undergoing a coronary artery bypass graft (CABG) operation were included in the study retrospectively. Preoperative RDW levels and electrocardiograms with sinus rhythm were recorded...
May 16, 2018: Heart Surgery Forum
Louise Y Sun, Amy M Chung, Michael E Farkouh, Sean van Diepen, Jesse Weinberger, Michael Bourke, Marc Ruel
BACKGROUND: Stroke is a leading cause of morbidity, mortality, and disability in patients undergoing cardiac surgery. Identifying modifiable perioperative stroke risk factors may lead to improved patient outcomes. The association between the severity and duration of intraoperative hypotension and postoperative stroke in patients undergoing cardiac surgery was evaluated. METHODS: A retrospective cohort study was conducted of adult patients who underwent cardiac surgery requiring cardiopulmonary bypass at a tertiary center between November 1, 2009, and March 31, 2015...
June 8, 2018: Anesthesiology
James N Tsoporis, Anastasia Fazio, Ioannis K Rizos, Shehla Izhar, Gerald Proteau, Vasileos Salpeas, Angelos Rigopoulos, Eleftarios Sakadakis, Ioannis K Toumpoulis, Thomas G Parker
Atrial fibrillation (AF) following on-pump coronary artery bypass grafting (CABG) is a common condition associated with increased morbidity and mortality. We investigated the possibility that miRs may play a contributory role in postoperative AF and associated apoptosis. A total of 42 patients (31 males and 11 females, mean age 65.0 ± 1.3 years) with sinus rhythm and without a history of AF were prospectively enrolled. We examined the levels of the muscle-specific miRs 1 and 133A and markers of apoptosis including TUNEL staining, caspase-3 activation, Bcl2 and Bax mRNAs in right atrial appendage (RAA) biopsies and blood plasma taken before aortic cross-clamping and after reperfusion...
June 7, 2018: Journal of Molecular and Cellular Cardiology
James L Cox, Niv Ad, Andrei Churyla, S Chris Malaisrie, Duc Thinh Pham, Jane Kruse, Olga Kislitsina, Patrick M McCarthy
BACKGROUND: There is concern that the right atrial lesions of the Maze procedure lead to more permanent pacemakers postoperatively and that they provide little therapeutic advantage over left atrial lesions alone. METHODS: A discussion of the pertinent anatomy related to atrial fibrillation and the performance of the Maze procedure, the potential ways that the specialized conduction system could theoretically be damaged by the procedure, non-procedure-related causes for increased postoperative pacemaker requirements, and the basis for the efficacy of the right atrial lesions of the Maze procedure are presented...
June 5, 2018: Annals of Thoracic Surgery
Ming Ann Sim, Weiling Liu, Sophia T H Chew, Lian Kah Ti
INTRODUCTION: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery associated with increased morbidity and mortality. Although sustained hyperglycemia is a known risk factor of AF and poor ICU outcomes, emerging in-vitro studies reveal acute glycemic fluctuations to be an additional independent predictor of AF. The effect of acute glycemic fluctuations on the incidence of POAF in the clinical setting remains unclear. We aim to investigate the effect of the magnitude of acute perioperative glycemic fluctuations on the incidence of POAF in a multi-ethnic Southeast-Asian population...
2018: PloS One
Katarzyna Kotfis, Aleksandra Szylińska, Mariusz Listewnik, Marta Strzelbicka, Mirosław Brykczyński, Iwona Rotter, Maciej Żukowski
Introduction: Postoperative delirium is a common complication of cardiac surgery associated with increased mortality, morbidity, and long-term cognitive dysfunction. The aim of this study was to identify incidence and risk factors of delirium in elderly (≥65 years) and very elderly (≥80 years) patients undergoing major cardiac surgery. Materials and methods: We performed a retrospective cohort analysis of prospectively collected data from a register of the cardiac surgery department of a tertiary referral university hospital between 2014 and 2016...
2018: Clinical Interventions in Aging
Michael Kosasih, Aubrey A Almeida, Julian A Smith
BACKGROUND: Sutureless aortic valve replacement (SU-AVR) offers an alternative to traditional aortic valve replacement (AVR) and is becoming widely performed in many hospitals. The aim of the current study was to evaluate the early experience in SU-AVR with the Perceval S bioprosthesis at Monash Medical Centre. METHODS: Fifty-two patients who underwent SU-AVR were retrospectively analysed (mean age: 74.8±6.5years). Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30days after surgery, re-admissions and longer term echocardiographic data were collected from the relevant hospital databases...
May 18, 2018: Heart, Lung & Circulation
Alina Cristina Iliescu, Delia Lidia Salaru, Ionut Achitei, Mihaela Grecu, Mariana Floria, Grigore Tinica
OBJECTIVE: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, with increased risk of stroke and high mortality. Our aim was to identify patients at risk and to design a model that could predict POAF. METHODS: In this single center study, we evaluated 1191 patients requiring isolated surgical aortic valve replacement between January 2000 and June 2014. The patients were followed during the early postoperative period until discharge...
June 2018: Anatolian Journal of Cardiology
Caineng Wu, Wuhua Ma, Qingyun Cen, Qingxiang Cai, Jiyong Wang, Ying Cao
BACKGROUND: Postoperative supraventricular arrhythmias are common in patients after thoracoscopic lobectomy. Inadequate pain control has long been recognised as a significant risk factor for arrhythmias. The performance of ultrasound-guided (USG) thoracic paravertebral block (PVB) is increasing as an ideal technique for postoperative analgesia. OBJECTIVE: We conducted this study to evaluate whether a single-shot USG thoracic PVB would result in fewer postoperative supraventricular tachycardias (SVT) than intercostal nerve blocks (ICNBs) after thoracoscopic pulmonary resection...
May 29, 2018: European Journal of Anaesthesiology
Jimmy T Efird, Charulata Jindal, Andy C Kiser, Shahab A Akhter, Patricia B Crane, Alan P Kypson, Aaron L Sverdlov, Stephen W Davies, Linda C Kindell, Ethan J Anderson
Background Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass graft (CABG) surgery. This arrhythmia occurs more frequently among patients who receive perioperative inotropic therapy (PINOT). Administration of nitrates with antiplatelet agents reduces the conversion rate of cyclic guanosine monophosphate to guanosine monophosphate. This process is associated with increased concentrations of free radicals, catecholamines, and blood plasma volume. We hypothesized that patients undergoing CABG surgery who receive PINOT may be more susceptible to POAF when nitrates are administered with antiplatelet agents...
January 1, 2018: Journal of International Medical Research
Ali H Hachem, Joseph E Marine, Housam A Tahboub, Sana Kamdar, Shaffi Kanjwal, Ronak Soni, Khalil Kanjwal
Background: Pulmonary vein isolation is commonly performed using radiofrequency energy with cryoablation gaining acceptance. We performed a meta-analysis of randomized controlled trials which compared radiofrequency versus cryoablation for patients with atrial fibrillation. Methods: A systematic search strategy identified both published and unpublished articles from inception to November 10, 2016, in multiple databases. The primary outcomes for this meta-analysis were long-term freedom from atrial fibrillation at 12-month follow-up and overall postoperative complication rates...
2018: Cardiology Research and Practice
Robert B Hawkins, J Hunter Mehaffey, Abra Guo, Eric J Charles, Alan M Speir, Jeffrey B Rich, Mohammed A Quader, Gorav Ailawadi, Leora T Yarboro
BACKGROUND: Postoperative atrial fibrillation (POAF) is a known risk factor for morbidity and mortality after cardiac surgery but has not been investigated in the left ventricular assist device (LVAD) population. We hypothesize that POAF will increase morbidity and resource utilization after LVAD placement. METHODS: Records were extracted for all patients in a regional database who underwent continuous-flow LVAD placement (n = 1064, 2009-2017). Patients without a history of atrial fibrillation (n = 689) were stratified by POAF for univariate analysis...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
Amy M O'Connor, Andrew H Smith, Kim Crum, Todd L Edwards, Prince J Kannankeril
BACKGROUND: Atrial tachycardia (AT) after infant congenital heart disease (CHD) surgery is associated with increased mortality. Polymorphisms in PITX2 (rs2200733) and IL6 (rs1800795) are associated with postoperative atrial fibrillation in adults but have not been studied in CHD. The objective was to test the hypothesis that clinical factors and variants in PITX2 and IL6 are associated with postoperative AT in infants with CHD. METHODS: Infants (<1 year of age) undergoing CHD surgery between September 2007 and May 2016 were included...
April 30, 2018: American Heart Journal
Xiaoxi Yao, Bernard J Gersh, David R Holmes, Rowlens M Melduni, Daniel O Johnsrud, Lindsey R Sangaralingham, Nilay D Shah, Peter A Noseworthy
Importance: Surgical occlusion of the left atrial appendage (LAAO) may be performed during concurrent cardiac surgery. However, few data exist on the association of LAAO with long-term risk of stroke, and some evidence suggests that this procedure may be associated with subsequent development of atrial fibrillation (AF). Objective: To evaluate the association of surgical LAAO performed during cardiac surgery with risk of stroke, mortality, and development of subsequent AF...
May 22, 2018: JAMA: the Journal of the American Medical Association
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