Kalp Cerrahisi Yapılan Hastalarda Erken Dönemde Gelişen Postperikardiyotomi Sendromu ve Atriyal Fibrilasyon Arasındaki İlişki

Abstract

Giriş: Postoperatif atriyal fibrilasyon (POAF) ve postperikardiyotomi sendromu (PPS) kalp cerrahisinin sık görülen komplikasyonları arasında yer alır. POAF ve PPS uzamış yatış süreleri, yüksek morbidite ve mortalite oranları ve yüksek sağlık bakım maliyetleri ile ilişkili bulunmuştur. Her iki komplikasyonun da patogenezinde inflamasyon suçlanmakla birlikte, PPS ve POAF arasındaki ilişki açıklığa kavuşmamıştır. Bu çalışmanın amacı koroner baypas yapılan hastalarda, erken dönemde gelişen PPS ve POAF arasındaki ilişkiyi incelemektir.

Hastalar ve Yöntem: Kliniğimizde kardiyopulmoner baypas altında koroner baypas operasyonu yapılmış olan hastaların kayıtları retrospektif olarak incelendi. Takibinde POAF gelişmiş olan ardışık 60 hasta çalışmaya dahil edildi. Takiplerinde POAF gelişmeyen koroner baypas cerrahisi yapılmış ardışık 142 hasta kontrol grubuna dahil edildi.

Bulgular: POAF gelişen hastalarda, POAF gelişmeyen hastalarla karşılaştırıldığında erken PPS gelişme sıklığı anlamlı olarak daha yüksek bulunmuştur (%61.7 vs %45.8, p= 0.04 ). Lojistik regresyon analizinde, POAF gelişen hastalarda erken PPS gelişme riskinin daha fazla olduğu saptandı (Odds oranı  1.9, %95 güven aralığı 1.03-3.5, p= 0.04).

Sonuç: Çalışmamızda, izole koroner baypas ameliyatı yapılmış ve POAF gelişen hastalarda, erken PPS gelişim riskinin POAF gelişmeyen hastalarla karşılaştırıldığında daha fazla olduğu saptandı. POAF gelişen hastalar, erken PPS gelişimi açısından yakından takip edilmelidir.

Keywords

• Postperikardiyotomi sendromu,postoperatif atriyal fibrilasyon,koroner baypas

Relationship Between Early Post-Pericardiotomy Syndrome and Atrial Fibrillation After Cardiac Surgery

Abstract

Introduction: Post-operative atrial fibrillation (POAF) and post-pericardiotomy syndrome (PPS) are common complications of cardiac surgery. Both PPS and POAF are associated with increased morbidity, mortality, costs and length of stay after cardiac surgery. Inflammation is involved in the pathogenesis of both PPS and POAF; however, the relationship between PPS and POAF remains unclear. The aim of this study was to examine the relationship between early PPS and POAF in patients who underwent cardiac surgery.

Patients and Methods: Records of patients who underwent on-pump coronary artery bypass graft (CABG) surgery were retrospectively reviewed. A total of 60 consecutive patients who were diagnosed with POAF were included in the study, while 142 consecutive patients who were not diagnosed with POAF were included as controls.

Results: An early PPS development was significantly higher in patients with POAF than in patients without POAF (61.7% vs 45.8%, p= 0.04). Logistic regression analysis demonstrated that patients with POAF had 1.9-times increased risk for developing early PPS (OR, 1.9; 95% CI, 1.03-3.5; p= 0.04).

Conclusion: This study showed that POAF was associated with an increased incidence of early PPS in patients who underwent isolated CABG surgery. Therefore, patients with POAF should be closely monitored for the occurrence of early PPS.

Keywords

• Post-pericardiotomy syndrome,post-operative atrial fibrillation,coronary artery bypass graft surgery

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