Incidence Of Postoperative Atrial Fibrillation In Minimal Invasive Approach for Mitral Valve Surgery
Lizeth Dayana Saldaña Morales, Alberto Alejandro Quintero Gómez, Natally Vanegas, Juan Camilo Rendón Isaza, Juan Santiago Jaramillo Isaza.
Clinica Cardio VID, Medellin, Colombia.
OBJECTIVE: Atrial fibrillation after cardiac surgery still a common complication in valvular patients. In our institution, the minimal invasive approach is the standar choice for valve surgery. Our objective was to determine the incidence of postoperative atrial fibrillation with this surgical approach.
METHODS: Observational, descriptive and retrospective study, from January 2013 to November 2015, including patients with a minimally invasive mitral valve approach who presented postoperative atrial fibrillation, excluding patients with a history of arrhythmias, previous cardiac surgeries, active infective endocarditis, and emergency situation.
RESULTS: A total of 166 patients with a minimally invasive mitral valve approach, 53% (88/166) replacements and 47% (78/166) repairs. 87 patients with no history of arrhythmias, 23% (20/87) had postoperative atrial fibrillation, 55% (11/20) were women. The average age was 60 years (±SD 11.08), 70% (14/20) over 60 years. The mean BMI was 24. The comorbidities were Arterial Hypertension 55% (11/20), smoking 40% (8/20), dyslipidemia 25% (5/20) hypothyroidism 25% (5/20). Were medicated in the preoperative period, 35% (7/20) with beta blockers, 30% (6/20) statins, 25% (5/20) ARA II and 5% (1/20) ACE inhibitors. The mean time of aortic cross clamping were 99.6 minutes (±SD 41.5) and perfusion 141.8 minutes (±SD 61.7). The median in ICU and hospital stay were 2.5 days (1-20) and 8 days (4-34). No reintervention due to bleeding, 1 only re-entry for other medical isssues. There was no mortality at 30 days.
CONCLUSIONS: Minimally invasive approach for isolated cardiac valvular surgery did not increase the incidence of postoperative atrial fibrillation.
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