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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2003 December;44(6):713-7

language: English

The role of posterior pericardiotomy on the incidence of atrial fibrillation after coronary revascularization

Arbatli H. 1, Demirsoy E. 1, Aytekin S. 2, Rizaoglu E. 2, Unal M. 1, Yagan N. 1, Sonmez B. 1

1 Depart­ment of Car­di­o­vas­cular Sur­gery, Kadir Has Uni­ver­sity, Flor­ence Night­in­gale Hos­pital, ­Istanbul, ­Turkey
2 Depart­ment of Car­di­ology Kadir Has Uni­ver­sity, Flor­ence Night­in­gale Hos­pital, ­Istanbul, ­Turkey

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Aim. Per­i­car­dial effu­sion and ­atrial fib­ril­la­tion (AF) are two ­common com­pli­ca­tions in cor­o­nary revas­cu­lar­iza­tion sur­gery. The aim of ­this ­study was to eval­uate the effi­ciency of pos­te­rior per­i­car­di­otomy in per­i­car­dial effu­sion and AF.
­Methods. ­This ran­dom­ized pros­pec­tive ­study ­includes 113 ­patients who under­went iso­lated ­CABG pro­ce­dure ­between May 2000 and ­December 2000 in our hos­pital. Pos­te­rior per­i­car­di­otomy inci­sion was ­done in ­Group I (n=54). ­Group II con­sti­tuted the con­trol ­group (n=59). Post­op­er­a­tive per­i­car­dial effu­sion was ­assessed by ech­o­car­di­og­raphy and ­rhythm ­follow-up was ­done by the ­same car­di­ol­o­gist.
­Results. ­There was no sig­nif­i­cant dif­fer­ence ­between ­study ­group and the con­trol ­group con­sid­ering the ­chest ­drainage (940.18±367.96 vs 894.92±360.65; p=0.507). The ­number of ­patients ­with remark­able intra­per­icar­dial effu­sion (>50 ml) was sig­nif­i­cantly ­lower in the pos­te­rior per­i­car­di­otomy ­group (25.93% vs 47.45%, p=0.020). The inci­dence of post­op­er­a­tive AF was no dif­ferent ­between the pos­te­rior per­i­car­di­otomy ­group and the con­trol ­group (12.96% vs 20.34%; p=0.32). In ­both ­groups, the inci­dence of AF was sig­nif­i­cantly ­higher in ­patients ­with ­mild or mod­erate per­i­car­dial effu­sion (29%), com­pared to ­patients ­with no or min­imal per­i­car­dial effu­sion (10%), (p=0.017).
Con­clu­sion. Pos­te­rior per­i­car­di­otomy sig­nif­i­cantly ­reduces the per­i­car­dial effu­sion in cor­o­nary ­bypass pro­ce­dure post­op­er­a­tively. ­Patients ­with per­i­car­dial effu­sion ­were sub­jected to AF ­more fre­quently.

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