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Does totally endoscopic access for off-pump cardiac surgery influence the incidence of postoperative atrial fibrillation in coronary artery bypass grafting? A preliminary report.
Cardiovasc Eng. 2006 Sep; 6(3):118-21.CE

Abstract

BACKGROUND

The occurrence rate of atrial fibrillation (AF) after coronary artery bypass grafting, quoted in the literature, is wide ranging from 5% to over 40%. It is speculated that, off-pump coronary artery bypass grafting (OPCAB) and also minimally invasive cardiac surgery reduces the incidence of postoperative AF due to reduced trauma, ischemia, and inflammation. Current data, however, do not clearly answer the question, whether the incidence of postoperative AF is reduced in using minimally invasive techniques, ideally resulting in the combination of both small access and off-pump surgery. The aim of this study was to evaluate the incidence of postoperative AF in patients undergoing totally endoscopic off-pump coronary artery bypass grafting (TECAB).

METHODS

A retrospective analysis of 72 patients undergoing myocardial revascularization was performed. Early postoperative incidence of AF was compared between three groups of patients: 24 after conventional coronary artery bypass grafting (CABG), 24 after OPCAB, and 24 after totally endoscopic off-pump CABG. Clinical profile of the patients, including factors having potential influence on postoperative AF was matched for groups.

RESULTS

Postoperative AF occurred in 25% of the patients in the CABG group, in 16% of the patients in the OPCAB group, and in 16% of the patients in the TECAB group. This difference has no statistical significance. Risk factors and incidence of postoperative complications were comparable in all groups excepting the number of distal anastomoses. There was a statistical significance between CABG group and TECAB group.

CONCLUSION

Avoiding cardiopulmonary bypass and minimizing surgical trauma did not reduce the incidence of postoperative AF in this patient collective. It remains an attractive hypothesis that postoperative AF is reduced by off-pump myocardial revascularisation and minimizing surgical trauma but more robust data are required.

Authors+Show Affiliations

Department of Thoracic and Cardiovascular Surgery, J. W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. M.Scherer@em.uni-frankfurt.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16967324

Citation

Scherer, Mirela, et al. "Does Totally Endoscopic Access for Off-pump Cardiac Surgery Influence the Incidence of Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting? a Preliminary Report." Cardiovascular Engineering (Dordrecht, Netherlands), vol. 6, no. 3, 2006, pp. 118-21.
Scherer M, Sirat AS, Dogan S, et al. Does totally endoscopic access for off-pump cardiac surgery influence the incidence of postoperative atrial fibrillation in coronary artery bypass grafting? A preliminary report. Cardiovasc Eng. 2006;6(3):118-21.
Scherer, M., Sirat, A. S., Dogan, S., Aybek, T., Moritz, A., & Wimmer-Greinecker, G. (2006). Does totally endoscopic access for off-pump cardiac surgery influence the incidence of postoperative atrial fibrillation in coronary artery bypass grafting? A preliminary report. Cardiovascular Engineering (Dordrecht, Netherlands), 6(3), 118-21.
Scherer M, et al. Does Totally Endoscopic Access for Off-pump Cardiac Surgery Influence the Incidence of Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting? a Preliminary Report. Cardiovasc Eng. 2006;6(3):118-21. PubMed PMID: 16967324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does totally endoscopic access for off-pump cardiac surgery influence the incidence of postoperative atrial fibrillation in coronary artery bypass grafting? A preliminary report. AU - Scherer,Mirela, AU - Sirat,Abdul Sami, AU - Dogan,Selami, AU - Aybek,Tayfun, AU - Moritz,A, AU - Wimmer-Greinecker,G, PY - 2006/9/13/pubmed PY - 2007/4/25/medline PY - 2006/9/13/entrez SP - 118 EP - 21 JF - Cardiovascular engineering (Dordrecht, Netherlands) JO - Cardiovasc Eng VL - 6 IS - 3 N2 - BACKGROUND: The occurrence rate of atrial fibrillation (AF) after coronary artery bypass grafting, quoted in the literature, is wide ranging from 5% to over 40%. It is speculated that, off-pump coronary artery bypass grafting (OPCAB) and also minimally invasive cardiac surgery reduces the incidence of postoperative AF due to reduced trauma, ischemia, and inflammation. Current data, however, do not clearly answer the question, whether the incidence of postoperative AF is reduced in using minimally invasive techniques, ideally resulting in the combination of both small access and off-pump surgery. The aim of this study was to evaluate the incidence of postoperative AF in patients undergoing totally endoscopic off-pump coronary artery bypass grafting (TECAB). METHODS: A retrospective analysis of 72 patients undergoing myocardial revascularization was performed. Early postoperative incidence of AF was compared between three groups of patients: 24 after conventional coronary artery bypass grafting (CABG), 24 after OPCAB, and 24 after totally endoscopic off-pump CABG. Clinical profile of the patients, including factors having potential influence on postoperative AF was matched for groups. RESULTS: Postoperative AF occurred in 25% of the patients in the CABG group, in 16% of the patients in the OPCAB group, and in 16% of the patients in the TECAB group. This difference has no statistical significance. Risk factors and incidence of postoperative complications were comparable in all groups excepting the number of distal anastomoses. There was a statistical significance between CABG group and TECAB group. CONCLUSION: Avoiding cardiopulmonary bypass and minimizing surgical trauma did not reduce the incidence of postoperative AF in this patient collective. It remains an attractive hypothesis that postoperative AF is reduced by off-pump myocardial revascularisation and minimizing surgical trauma but more robust data are required. SN - 1567-8822 UR - https://www.unboundmedicine.com/medline/citation/16967324/Does_totally_endoscopic_access_for_off_pump_cardiac_surgery_influence_the_incidence_of_postoperative_atrial_fibrillation_in_coronary_artery_bypass_grafting_A_preliminary_report_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16967324.ui DB - PRIME DP - Unbound Medicine ER -