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2020, Number 3

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Rev Cubana Cardiol Cir Cardiovasc 2020; 26 (3)

Post-surgical atrial fibrillation in valve surgery

Gómez NK, Hechavarría PS, Pérez LH, Arazoza HA, Nápoles SI

Language: Spanish
References: 35
Page: 1-8
PDF size: 248.73 Kb.


ABSTRACT

Introduction: Post-surgical Atrial fibrillation (PSAT) is associated to higher morbidity, early and long-term mortality, and a significative delay in hospital discharge. Objective: The objective of this study was to describe PSAF behavior and outcome after valve surgery in La Havana Cardiovascular Institute. Methods: The present work is an observational, analytic and retrospective study since November 2010 - 2018. It included 139 patients with post-surgical Atrial fibrillation diagnosis. Results: The PSAF rate was 18.24%. The mean age was 46.9 ± 13.43 years. Rheumatic etiology had a higher prevalence (76.97 %). Pulmonary hypertension was frequently reported (26.61%). Mitral valve replacement (69,78%) was the most used surgical approach. Multi-organ dysfunction was the principal cause of death (31.8%). Most frequent complications before surgery were renal dysfunction and low output heart failure (46.04%). Conclusion: The risk of death in a valve surgery was higher in patients who developed PSAF; more likely if they were overweight, had worsen functional class or decreased left ventricular ejection fraction. Anoxic cardiac arrest over 120 minutes and extracorporeal circulation time over 150 minutes were also risk factors for PSAF.


REFERENCES

  1. GO AS, Hylek EM, Phillips KA,Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atril fibrillation in adults: national implication for rythm management and stroke prevention AnTicoagulation and Risk factors in Atrial Fibrillation (ATRIA) Study. JAMA, 2001; 285: 2370-2375 Medline.

  2. Gambarte AJ. Génesis de la Fibrillación auricular. Potenciales mecanismos involucrados. Rev Fed Arg Cardiol 2004; 33: 364-375.

  3. Lewis T: The mechanism and graphic registration of the heartbeat. London, Shaw & Sons 1925. Moro C, Hernández-Madrid A. Fibrilación auricular: ¿estamos ante una epidemia? RevEspCardiol. 2009; 62:10-4.

  4. Levy S, Maarek M, Coumel P, Guize L, Lekieffre J, MedvedowskyJl, et al. Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study: the College of French Cardiologists. Circulation. 1999;99:3028-35.

  5. Brugada R, Tapscott T, Czernuszewicz GZ, et al. Identification of a genetic locus for Fibrilación auricular milial atrial fibrillation. N Engl J Med. 2007;336:905-11.

  6. Prystowsky EN, Katz AM. Atrial fibrillation. En: Textbook of Cardiovascular Medicine. Philadelphia: Lippincott-Raven; 2008. p. 1661.

  7. Allessie M, Boyden P, Camm J, et al. Pathophysiology and Prevention of Atrial Fibrillation. Circulation. 2001;103:769-777.

  8. Friberg L, Hammar N, Rosenqvist M. Stroke in paroxysmal atrial fibrillation: report from the Stockholm Cohort of Atrial Fibrillation. Eur Heart J. 2010; 31:967-75.

  9. Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the cardiovascular health study). Am J Cardiol. 1994;74:236-41.

  10. Kannel WB, Benjamin EJ. Epidemiology of atrial fibrillation. Med Clin North Am. 2008;92:17.

  11. Schnabel RB, Yin X, Gona P, Larson MG, BeiserAS, McManus DD, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. The Lancet. 2015; 386(9989):154-62.

  12. Shirzad M, Karimi A, Tazik M, Aramin H, Ahmadi SH, Davoodi S, et al. Determinants of postoperative atrial fibrillation and associated resource utilization in cardiac surgery. Rev EspCardiol. 2010; 63:1054-60.

  13. Alqahtani AA. Atrial fibrillation post cardiac surgery trends toward management. Heart views. 2010; 11(2):57.

  14. Bramer S, van Straten AH, Soliman Hamad MA, van den Broek KC, Maessen JG, Berreklouw E. New-onset postoperative atrial fibrillation predicts late mortality after mitral valve surgery. Ann ThoracicSurg. 2011; 92:2091-6.

  15. Thorén E, Hellgren L, Granath F, Hörte LG, Ståhle E. Postoperative atrial fibrillation predicts cause-specific late mortality after coronary surgery. Scand Cardiovasc J. 2014; 48:71-8.

  16. George I, Yerebakan H, Kalesan B, Nazif T, Kodali S, Smith CR, Williams MR. Age alone should not preclude surgery: contemporary outcomes after aortic valve replacement in nonagenarians. J Thorac Cardiovasc Surg. 2014 Oct; 148(4):1360-1369.e1. doi: 10.1016/j.jtcvs.2014.01.015.

  17. Rahimtoola SH, Durairaj A, Mehra A et al. Current evaluation and management of patients with mitral stenosis. Circulation 106:1183, 2002.

  18. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37:2893-2962.

  19. Rodríguez Rosales E, de Arazoza Hernández A, Vázquez Castro, Aldama Pérez LI, Valdés Dupeyrón O. Fibrilación auricular posoperatoria. Enunciación de un concepto. MÉD.UIS. 2014;27(2):109-112.

  20. Hogue CW Jr, Creswell LL, Gutterman DD, Fleisher LA; American College of Chest Physicians. Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:9-16.

  21. Murad, H. Complicações da circulação extracorpórea. Módulo Teórico 1. Sociedade brasileira de Circulação Extracorpórea. Rio de Janeiro, 2010.

  22. Westaby, S. Organ dysfunction after cardiopulmonary bypass. A systemic inflammatory reaction initiated by the extracorporeal circuit. Intensive Care Medicine 2007; 13: 89.

  23. Song Wan, M.D., LeClerk, J.L., Vincent, J.L. Cytokine responses to cardiopulmonary bypass: lessons learned from cardiac transplantation. Annals of Thoracic Surgery 1997; 63: 269.

  24. New York Heart Association Guidelines: In Barash, P G; Cullen, F; Stoelting, R K: Handbook of clinical anesthesia. Second Edition. J.B. Lippincott, 1993: 290-291.

  25. Molteni M, Polo Friz H, Primitz L, Marano G, Boracchi P, Cimminiello C. The definition of valvular and non-valvular atrial fibrillation: results of a physicians’ survey. Europace. 2014;16:1720–5.

  26. Tsang W, Freed BH, Lang RM: Three-dimensional anatomy of the aortic and mitral valves. In Otto CM, Bonow RO, editors: Valvular Heart Disease: A Companion to Braunwald’s Heart Disease, 4th ed., Philadelphia, 2013, Saunders, pp 14-29.

  27. Bharti S, Lev M. Histology of the normal and diseased atrium. En: Fall RH, Podrid PJ, editores. Atrial Fibrillation: Mechanism and Management. New York: Raven Press; 2017. p. 15-39

  28. Aime-Sempe C, Folliguet T, Rucker-Martin C, et al. Myocardial cell death in fibrillating and dilated human right atria. J Am CollCardiol. 2016;34:1577-86

  29. Banach M, Rysz J, Drozdz J, Okonski P, Misztal M, Barylski M, et al. Risk factors of atrial fibrillation following coronary artery bypass grafting. A preliminary report. Circulation Journal 2016; 70: 438-41.

  30. McKeown P. Introduction. American College of Chest Physisians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest 2005; 128: 6S-8S.

  31. Pandit SV, Anumonwo J, Jalife J. Atrial Fibrillation Susceptibility in Obesity. Circulation research. 2016; 118:1468-71.

  32. Fukui A, Takahashi N, Nakada C, Masaki T, Kume O, Shinohara T, et al. Role of leptin signaling in the pathogenesis of angiotensin II mediated atrial fibrosis and fibrillation. Circ Arrhythm Electrophysiol. 2013; 6:402-9.

  33. Goudis CA, Korantzopoulos P, Ntalas IV, Kallergis EM, Ketikoglou DG. Obesity and atrial fibrillation: a comprehensive review of the pathophysiological mechanisms and links. J Cardiol. 2015; 66:361-9.

  34. Fleckenstein A, Frey M: Consequences of uncontrolled calcium entry and its prevention with calcium antagonists. EurHeart J 1983; 4 (Supl 2): 43-50.

  35. Vázquez Castro, F: Congreso Europeo de Cardiología 2017. 29 AGO 09 Día a día en IntraMed.




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