CABG 手术后的心房颤动。100 例患者的经验

S. Kuçi, A. Ibrahimi, Marsela Goga, Fation Hamiti, E. Bejko, Stavri Llazo, J. Burimi, Esmerilda Bulku
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引用次数: 0

摘要

导言:心房颤动(房颤)是心脏手术最常见的并发症,10%-40% 的患者会出现这种情况。术后房颤(POAF)是指无房颤病史的患者在心脏手术后四周内新发的房颤。虽然 POAF 可能是一过性的,不会造成任何后果,但它可能会导致严重的并发症,增加术后的死亡率和发病率。风险因素可能与患者、术中和术后有关。本研究旨在估算接受 CABG 合并瓣膜置换术或未接受 CABG 合并瓣膜置换术的患者发生房颤的频率。识别易患心律失常的患者将有助于锁定那些最有可能从预防性治疗中获益的患者。 材料和方法:本研究是一项前瞻性研究,对象是 2022 年 2 月至 4 月期间在地拉那 "特蕾莎修女 "大学医院中心接受择期 CABG 手术并出现 POAF 的 100 名患者,平均年龄为 66 ± 13 岁,其中 30% 为女性。结果:16名患者(16%)在心脏手术后中位 3.7 天(第 2-7 天)出现术后房颤。94%(15 例)的 POAF 仅发生在 CABG 手术中,6%(1 例)发生在联合介入手术(AVR et CABG)中。结论:心房颤动是最常见的并发症:房颤是 CABG 术后最常见的并发症。心房颤动的发生与介入类型(仅 CABG 或联合瓣膜置换术)、接受旁路移植的血管数量或血管类型无关。电解失衡应在接受 CABG 患者的术后过程中进行评估。
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Atrial Fibrillation following CABG Surgery. Our Experience with 100 Patients
Introduction: Atrial fibrillation (AF) is the most common complication of cardiac surgery, occurring in 10-40% of patients. Postoperative AF (POAF) refers to new-onset AF in a patient without a history of AF that occurs within the first four weeks after cardiac surgery. While POAF can be transient and without consequences, it may lead to severe complications, increasing mortality and morbidity in the postoperative period. Risk factors can be patient-related, intraoperative, and postoperative. This study aimed to estimate the frequency of AF in patients after CABG combined with valvular replacement or not. Identification of patients vulnerable to arrhythmia will allow targeting of those most likely to benefit from prophylactic therapy.  Material and Methods: The presented study is a prospective study of 100 patients undergoing elective CABG from February to April 2022 with a mean age of 66 ± 13 years, 30% women, undergoing CABG at the University Hospital Centre “Mother Teresa” Tirana, that developed POAF. Results: Postoperative atrial fibrillation occurred in sixteen patients (16%) at a median of 3.7 days after cardiac surgery (2nd – 7th day). 94% (15) of POAF occurred in CABG only, and 6% (1) in the combined intervention (AVR et CABG). Conclusion: AF is the most common complication after CABG. The occurrence is not dependent on the type of intervention (only CABG or combined with valve replacement), the number of vessels that underwent bypass grafting, or the type of vessel. Electrolytic imbalance should be assessed during the postoperative course of patients who undergo CABG.  
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