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KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting

Year 2017, Volume: 7 Issue: 4, 29 - 35, 13.12.2017

Abstract

ÖZET

Amaç: İzole koroner arter baypas greftleme (KABG) sonrası atriyal fibrilasyon (AF) gelişimi stroke, ekstremite

iskemisi, pulmoner emboli gibi birçok morbidite ve mortalitesi yüksek komplikasyonu beraberinde

getiren, hastanede kalış süresini ve maliyeti arttıran bir komplikasyondur. KABG uygulanan hastaların

%20-40’ında ve en sık 2. ve 4. günler arasında gerçekleşmektedir. Fizyopatolojinin tam olarak ortaya

konulamaması, morbidite ve mortalitede etkin bir azalma sağlanamaması nedeniyle halen güncelliğini

korumaktadır.

Gereç ve Yöntem: Bu çalışmada 01 Ocak 2011 ile 31 Aralık 2011 tarihleri arasında izole KABG uygulanan

197 hastayı geriye dönük olarak inceledik. Postoperatif AF gelişimine etki edebileceğini düşündüğümüz

parametreleri preoperatif, intraoperatif ve postoperatif olarak 3 grupta sınıflayarak elde ettiğimiz verileri

istatistiksel olarak analiz ettik.

Bulgular: Hasta yaşı, sol atriyum çapı, perkütan koroner girişim öyküsü, sağ koroner arter distal anastomozu

bulunması, intraoperatif pozitif inotropik destek tedavisi, sol internal meme arteri grefti, drenaj

miktarı ve yoğun bakım ünitesinde kalma süresi parametrelerini postoperatif AF gelişimi açısından

istatistiksel olarak anlamlı bulduk. TG seviyeleri AF grubunda, sinüs ritmi grubuna oranla daha düşük

düzeydeydi.

Sonuç: KABG sonrası AF gelişimine etki eden çok sayıda parametre mevcuttur. Bu değerlerin doğru olarak

tanımlanması ve alınacak önlemler ile postoperatif AF gelişiminin azaltılması mortalite ve morbiditenin

azalmasına önemli katkılar sağlayacaktır.

Anahtar Sözcu¨kler: Atriyal fibrilasyon; Koroner arter baypas; Greft; Atriyum


ABSTRACT

Objectives: Postoperative atrial fibrillation following isolated coronary artery bypass grafting has major

complications like stroke, pulmonary embolism, extremity ischemia leading long hospital stay and

increased cost of hospitalization. Postoperative atrial fibrillation is seen 20-40% of patients undergoing

isolated coronary artery bypass grafting and most frequently between the postoperative second and

fourth days. It is still a current subject due to lack of understranding the physiopathologic mechanisms,

inadequate decrease in the mortality and morbidity.

Material and Methods: In this study, 197 patients who underwent isolated coronary artery baypass

grafting between 1st January and 31st December in 2011 were analysed retrospectively. We have

classified the factors, possible to effect postoperative atrial fibrillation, in three groups, as preoperative,

intraoperative and postoperative factors, and analysed the data in statistics.

Results: Preoperative age, left atrium diameter, history of percutaneous coronary intervention,

occurrence of the distal anastomosis of right coronary artery, the use of intraoperative positive inotropic

agents and left internal mammarian artery as an arterial graft, postoperative bleeding, the lenght of

hospital stay were meaningful statistically. Triglyceride levels were lower in atrial fibrillation group.

Conclusion:Consequently, there are many parameters effecting postoperative atrial fibrillation

development. Understanding the mechanisms and having reasonable precautions will help in decreasing

the morbidity and morrtality.

Keywords: Atrial fibrillation; Coronary artery bypass; Graft; Atrium

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, andpredictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516–21. 2. Zýpes DP. Specific arrhythmias: Diagnosis and treatment. In: Braunwald E, ed. Heart Disease. A Ttextbook of Cardiovascular medicine. Philadelphia: WB Saunders Company, 1992:682. 3. Hogue CW Jr, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanism, and treatment. Ann Thorac Surg 2000;69:300-6. 4. Habibollahi P, Jam SH, Vahdati SS, Baghi HM, Amiri H. Amiodaron in atrial fibrillation: post coronary artery bypass graft.World J Emerg Med. 2016;7(4):250-254. 5. Lewicki L, Siebert J, Rogowski J.Atrial fibrillation following offpump versus on-pump coronary artery bypass grafting: Incidence and risk factors.Cardiol J. 2016 Sep 26. doi: 10.5603/CJ.a2016.0066. 6. Zaman A, Archbold A, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery. Circulation 2000; 101: 1403-8. 7. Aranki F, Shaw D, Adams D, et al. Predictors of atrial fibrillation after coronary artery surgery. Chin Med J (Engl) 2002; 115(2): 232-4. 8. Place D, Peragallo A, Carroll R, et al. Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2002;16(2): 144-8. 9. Luo W, Huaibin W, Wenjun Z, Jie T, Xiaokang O, et al.Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old.Heart Surg Forum. 2017 Feb 28;20(1):E038-E042. doi: 10.1532/hsf.1583.
Year 2017, Volume: 7 Issue: 4, 29 - 35, 13.12.2017

Abstract

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, andpredictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516–21. 2. Zýpes DP. Specific arrhythmias: Diagnosis and treatment. In: Braunwald E, ed. Heart Disease. A Ttextbook of Cardiovascular medicine. Philadelphia: WB Saunders Company, 1992:682. 3. Hogue CW Jr, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanism, and treatment. Ann Thorac Surg 2000;69:300-6. 4. Habibollahi P, Jam SH, Vahdati SS, Baghi HM, Amiri H. Amiodaron in atrial fibrillation: post coronary artery bypass graft.World J Emerg Med. 2016;7(4):250-254. 5. Lewicki L, Siebert J, Rogowski J.Atrial fibrillation following offpump versus on-pump coronary artery bypass grafting: Incidence and risk factors.Cardiol J. 2016 Sep 26. doi: 10.5603/CJ.a2016.0066. 6. Zaman A, Archbold A, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery. Circulation 2000; 101: 1403-8. 7. Aranki F, Shaw D, Adams D, et al. Predictors of atrial fibrillation after coronary artery surgery. Chin Med J (Engl) 2002; 115(2): 232-4. 8. Place D, Peragallo A, Carroll R, et al. Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2002;16(2): 144-8. 9. Luo W, Huaibin W, Wenjun Z, Jie T, Xiaokang O, et al.Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old.Heart Surg Forum. 2017 Feb 28;20(1):E038-E042. doi: 10.1532/hsf.1583.
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Details

Journal Section Original Research
Authors

Kıvanç Atılgan

Ertan Demirdaş This is me

Celalettin Günay This is me

Publication Date December 13, 2017
Published in Issue Year 2017 Volume: 7 Issue: 4

Cite

APA Atılgan, K., Demirdaş, E., & Günay, C. (2017). KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting. Bozok Tıp Dergisi, 7(4), 29-35.
AMA Atılgan K, Demirdaş E, Günay C. KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting. Bozok Tıp Dergisi. December 2017;7(4):29-35.
Chicago Atılgan, Kıvanç, Ertan Demirdaş, and Celalettin Günay. “KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting”. Bozok Tıp Dergisi 7, no. 4 (December 2017): 29-35.
EndNote Atılgan K, Demirdaş E, Günay C (December 1, 2017) KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting. Bozok Tıp Dergisi 7 4 29–35.
IEEE K. Atılgan, E. Demirdaş, and C. Günay, “KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting”, Bozok Tıp Dergisi, vol. 7, no. 4, pp. 29–35, 2017.
ISNAD Atılgan, Kıvanç et al. “KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting”. Bozok Tıp Dergisi 7/4 (December 2017), 29-35.
JAMA Atılgan K, Demirdaş E, Günay C. KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting. Bozok Tıp Dergisi. 2017;7:29–35.
MLA Atılgan, Kıvanç et al. “KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting”. Bozok Tıp Dergisi, vol. 7, no. 4, 2017, pp. 29-35.
Vancouver Atılgan K, Demirdaş E, Günay C. KORONER ARTER CERRAHİSİ SONRASI GÖRÜLEN ATRİYAL FİBRİLASYON GELİŞİMİNE ETKİ EDEN FAKTÖRLER Factors Effecting Postoperative Atrial Fibrillation Development Following Coronary Artery Bypass Grafting. Bozok Tıp Dergisi. 2017;7(4):29-35.
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