Atrial fibrillation and minimally invasive coronary artery bypass grafting: Risk factor analysis
Atrial fibrillation (AF) is a frequent arrhythmia after conventional coronary artery bypass grafting. With the advent of minimally invasive technique for left internal mammary artery‐left anterior descending coronary artery (LIMA‐LAD) grafting, we analyzed the incidence and the risk factors of posto...
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| description | Atrial fibrillation (AF) is a frequent arrhythmia after conventional coronary artery bypass grafting. With the advent of minimally invasive technique for left internal mammary artery‐left anterior descending coronary artery (LIMA‐LAD) grafting, we analyzed the incidence and the risk factors of postoperative AF in this patient population. This prospective study involves all patients undergoing isolated LIMA‐LAD grafting with minimally invasive technique between January 1994 and June 2000. Twenty‐four possible risk factors for postoperative AF were entered into univariate and multivariate logistic regression analyses. Postoperative AF occurred in 21 of the 90 patients (23.3%) analyzed. Double‐ or triple‐vessel disease was present in 12/90 patients (13.3%). On univariate analysis, right coronary artery disease (p |
| doi_str_mv | 10.1007/s00268-001-0296-9 |
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Résumé
La fibrillation auriculaire (FA) est une forme d’arythmie fréquente après pontage coronarien conventionnel. A l’heure du prélèvement mini‐invasif de l’artère mammaire interne gauche, nous avons analysé l’incidence et les facteurs de risque de FA après pontage antérieur gauche. Cette étude prospective a inclus tous les patients ayant eu un by‐pass de l’artère antérieure gauche avec prélèvement mini‐invasif de l’artère mammaire interne gauche entre jan 1994 et juin 2000. Vingtquatre facteurs de risque possibles de FA ont été rentrés dans une analyse par régression logistique uni‐ et multivariée. La FA a été constatée chez 21 des 90 patients (23.3%) analysés. La maladie intéressait deux ou trois vaisseaux chez 12/90 patients (13.3%). En analyse univariée les facteurs de risque étaient la maladie coronaire droite (p<0.01), l’âge (p=0.01) et le diabète (p=0.04). En analyse multivariée, seule la maladie intéressant l’artère coronaire gauche a été retrouvée (p=0.02). Dans cette population de patients, l’incidence de FA après pontage coronarien avec prélèvement mini‐invasif est comprise dans la fourchette des valeurs rapportées pour la chirurgie conventionnelle. La maladie coronaire droite est un facteur prédictif indépendant et ceci peut être en rapport avec le fait que dans cette population, l’artère coronaire droite n’a pas été revascularisée au moment de l’acte chirurgical. Pour cette même raison, ce facteur de risque pourrait avoir un rôle plus important en chirurgie thoracique non‐cardiaque.
Resumen
La fibrilación auricular (AF) es la arritmia que aparece con más frecuencia tras el “by pass” aorto‐coronario convencional. Al incrementarse las técnicas mínimamente invasivas utilizando como injertos la arteria mamaria interna izquierda—la arteria descendente anterior izquierda, hemos analizado la incidencia y los riesgos de AF en esta población de pacientes tratados con dichas técnicas. Este estudio prospectivo comprende a todos aquellos pacientes a los que con técnicas mínimamente invasivas se injertó una vez aislada, la arteria mamaria interna izquierda—arteria descendente anterior izquierda. La casuística incluye a todos los pacientes así intervenidos entre enero de 1994 y junio de 2000. Mediante un análisis de regresión logística uni y multivariante se estudiaron 24 posibles factores de riesgo capaces de originar una fibrilación auricular (AF) postoperatoria. De los 90 pacientes analizados, 21 (23.3%) desarrollaron una AF postoperatoria. Afectación doble o triple de los vasos se registró en 12/90 pacientes (13.3%). Los factores de riesgo revelados en un análisis univariante fueron: enfermedad de la arteria coronaria derecha (p<0.01), edad (p=0.01) y diabetes (p=0.04). En el análisis multivariante solo la afectación de la arteria coronaria derecha reveló ser un factor de riesgo significativo (p=0.02). En pacientes intervenidos con técnicas mínimamente invasivas la incidencia de la AF postoperatoria es similar a la observada en cirugía convencional de “by‐pass” aortocoronario. Sólo la afectación de la arteria coronaria derecha constituyó un factor pronóstico independiente. Este hecho podría referirse a que en los pacientes de la población estudiada, la lesión de la coronaria derecha no fue revascularizada durante el tratamiento quirúrgico. Este mismo factor de riesgo puede aplicarse a la cirugía torácica no cardiaca.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-001-0296-9</identifier><identifier>PMID: 12053211</identifier><identifier>CODEN: WJSUDI</identifier><language>eng</language><publisher>New York: Springer‐Verlag</publisher><subject>Aged ; Arrhythmia ; Atrial Fibrillation ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Biological and medical sciences ; Bypass ; Cardiac arrhythmia ; Cardiovascular disease ; Coronary Artery Bypass ; Coronary Artery Bypass - adverse effects ; Coronary Artery Bypass Grafting ; Coronary artery disease ; Coronary Artery Disease - complications ; Coronary Artery Disease - surgery ; Coronary vessels ; Diabetes ; Diabetes mellitus ; Factor analysis ; Female ; Fibrillation ; Grafting ; Heart diseases ; Heart surgery ; Humans ; Left Anterior Descend ; Left Internal Mammary Artery ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Multivariate Analysis ; Patients ; Population studies ; Prospective Studies ; Regression analysis ; Risk analysis ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Thoracic surgery ; Thorax ; Treatment Outcome ; Vein & artery diseases</subject><ispartof>World journal of surgery, 2002-06, Vol.26 (6), p.639-642</ispartof><rights>2002 International Society of Surgery</rights><rights>2002 INIST-CNRS</rights><rights>Copyright Springer-Verlag 2002</rights><rights>Société Internationale de Chirurgie 2002.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5489-cd1ec7595fb9614f85b05e7f09c19c49ea73cf679b2ecc12d7d5de25599872e83</citedby><cites>FETCH-LOGICAL-c5489-cd1ec7595fb9614f85b05e7f09c19c49ea73cf679b2ecc12d7d5de25599872e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1007%2Fs00268-001-0296-9$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1007%2Fs00268-001-0296-9$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13973088$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12053211$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mueller, Xavier M.</creatorcontrib><creatorcontrib>Tevaearai, Hendrik T.</creatorcontrib><creatorcontrib>Ruchat, Patrick</creatorcontrib><creatorcontrib>Stumpe, Frank</creatorcontrib><creatorcontrib>von Segesser, Ludwig K.</creatorcontrib><title>Atrial fibrillation and minimally invasive coronary artery bypass grafting: Risk factor analysis</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><description>Atrial fibrillation (AF) is a frequent arrhythmia after conventional coronary artery bypass grafting. With the advent of minimally invasive technique for left internal mammary artery‐left anterior descending coronary artery (LIMA‐LAD) grafting, we analyzed the incidence and the risk factors of postoperative AF in this patient population. This prospective study involves all patients undergoing isolated LIMA‐LAD grafting with minimally invasive technique between January 1994 and June 2000. Twenty‐four possible risk factors for postoperative AF were entered into univariate and multivariate logistic regression analyses. Postoperative AF occurred in 21 of the 90 patients (23.3%) analyzed. Double‐ or triple‐vessel disease was present in 12/90 patients (13.3%). On univariate analysis, right coronary artery disease (p<0.01), age (p=0.01), and diabetes (p=0.04) were found to be risk factors for AF. On multivariate analysis, right coronary artery disease was identified as the sole significant risk factor (p=0.02). In this patient population, the incidence of AF after minimally invasive coronary artery bypass is in the range of that reported for conventional coronary artery bypass grafting. Right coronary artery disease was found to be an independent predictor, and this may be related to the fact that in this patient population the diseased right coronary artery was not revascularized at the time of the surgical procedure. For the same reason, this risk factor may find a broader application to noncardiac thoracic surgery.
Résumé
La fibrillation auriculaire (FA) est une forme d’arythmie fréquente après pontage coronarien conventionnel. A l’heure du prélèvement mini‐invasif de l’artère mammaire interne gauche, nous avons analysé l’incidence et les facteurs de risque de FA après pontage antérieur gauche. Cette étude prospective a inclus tous les patients ayant eu un by‐pass de l’artère antérieure gauche avec prélèvement mini‐invasif de l’artère mammaire interne gauche entre jan 1994 et juin 2000. Vingtquatre facteurs de risque possibles de FA ont été rentrés dans une analyse par régression logistique uni‐ et multivariée. La FA a été constatée chez 21 des 90 patients (23.3%) analysés. La maladie intéressait deux ou trois vaisseaux chez 12/90 patients (13.3%). En analyse univariée les facteurs de risque étaient la maladie coronaire droite (p<0.01), l’âge (p=0.01) et le diabète (p=0.04). En analyse multivariée, seule la maladie intéressant l’artère coronaire gauche a été retrouvée (p=0.02). Dans cette population de patients, l’incidence de FA après pontage coronarien avec prélèvement mini‐invasif est comprise dans la fourchette des valeurs rapportées pour la chirurgie conventionnelle. La maladie coronaire droite est un facteur prédictif indépendant et ceci peut être en rapport avec le fait que dans cette population, l’artère coronaire droite n’a pas été revascularisée au moment de l’acte chirurgical. Pour cette même raison, ce facteur de risque pourrait avoir un rôle plus important en chirurgie thoracique non‐cardiaque.
Resumen
La fibrilación auricular (AF) es la arritmia que aparece con más frecuencia tras el “by pass” aorto‐coronario convencional. Al incrementarse las técnicas mínimamente invasivas utilizando como injertos la arteria mamaria interna izquierda—la arteria descendente anterior izquierda, hemos analizado la incidencia y los riesgos de AF en esta población de pacientes tratados con dichas técnicas. Este estudio prospectivo comprende a todos aquellos pacientes a los que con técnicas mínimamente invasivas se injertó una vez aislada, la arteria mamaria interna izquierda—arteria descendente anterior izquierda. La casuística incluye a todos los pacientes así intervenidos entre enero de 1994 y junio de 2000. Mediante un análisis de regresión logística uni y multivariante se estudiaron 24 posibles factores de riesgo capaces de originar una fibrilación auricular (AF) postoperatoria. De los 90 pacientes analizados, 21 (23.3%) desarrollaron una AF postoperatoria. Afectación doble o triple de los vasos se registró en 12/90 pacientes (13.3%). Los factores de riesgo revelados en un análisis univariante fueron: enfermedad de la arteria coronaria derecha (p<0.01), edad (p=0.01) y diabetes (p=0.04). En el análisis multivariante solo la afectación de la arteria coronaria derecha reveló ser un factor de riesgo significativo (p=0.02). En pacientes intervenidos con técnicas mínimamente invasivas la incidencia de la AF postoperatoria es similar a la observada en cirugía convencional de “by‐pass” aortocoronario. Sólo la afectación de la arteria coronaria derecha constituyó un factor pronóstico independiente. Este hecho podría referirse a que en los pacientes de la población estudiada, la lesión de la coronaria derecha no fue revascularizada durante el tratamiento quirúrgico. Este mismo factor de riesgo puede aplicarse a la cirugía torácica no cardiaca.</description><subject>Aged</subject><subject>Arrhythmia</subject><subject>Atrial Fibrillation</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Biological and medical sciences</subject><subject>Bypass</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Bypass Grafting</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Factor analysis</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Grafting</subject><subject>Heart diseases</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Left Anterior Descend</subject><subject>Left Internal Mammary Artery</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Population studies</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Thoracic surgery</subject><subject>Thorax</subject><subject>Treatment Outcome</subject><subject>Vein & artery diseases</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkV1rFTEQhoMo9rT6A7yRoOjd6kw-NkmvLKV-URCs4mXMZpOSumf3mOyp7L83x3OgIIhXE16eeTMzLyFPEF4hgHpdAFirGwBsgJm2MffICgVnDeOM3ycr4K2ob-RH5LiUm8qpFtqH5AgZSM4QV-T72ZyTG2hMXU7D4OY0jdSNPV2nMa3dMCw0jbeupNtA_ZSn0eWFujyHWrpl40qh19nFOY3Xp_RzKj9odH6ecvVww1JSeUQeRDeU8PhQT8jXtxdfzt83l5_efTg_u2y8FNo0vsfglTQydqZFEbXsQAYVwXg0XpjgFPexVaZjwXtkveplH5iUxmjFguYn5OXed5Onn9tQZrtOxYe60himbbEKNYCQbQWf_wXeTNtcpy2WKa0EgkBZqWf_pNAYgaixQriHfJ5KySHaTa5Hy4tFsLuE7D4hWy9vdwlZU3ueHoy33Tr0dx2HSCrw4gC44t0Qsxt9KnccN4qD3i38Zs_9SkNY_v-z_fbx6uqPWLWdZPhvy3eqvQ</recordid><startdate>200206</startdate><enddate>200206</enddate><creator>Mueller, Xavier M.</creator><creator>Tevaearai, Hendrik T.</creator><creator>Ruchat, Patrick</creator><creator>Stumpe, Frank</creator><creator>von Segesser, Ludwig K.</creator><general>Springer‐Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200206</creationdate><title>Atrial fibrillation and minimally invasive coronary artery bypass grafting: Risk factor analysis</title><author>Mueller, Xavier M. ; Tevaearai, Hendrik T. ; Ruchat, Patrick ; Stumpe, Frank ; von Segesser, Ludwig K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5489-cd1ec7595fb9614f85b05e7f09c19c49ea73cf679b2ecc12d7d5de25599872e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Aged</topic><topic>Arrhythmia</topic><topic>Atrial Fibrillation</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>Biological and medical sciences</topic><topic>Bypass</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Bypass Grafting</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Factor analysis</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Grafting</topic><topic>Heart diseases</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Left Anterior Descend</topic><topic>Left Internal Mammary Artery</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - adverse effects</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Population studies</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Thoracic surgery</topic><topic>Thorax</topic><topic>Treatment Outcome</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mueller, Xavier M.</creatorcontrib><creatorcontrib>Tevaearai, Hendrik T.</creatorcontrib><creatorcontrib>Ruchat, Patrick</creatorcontrib><creatorcontrib>Stumpe, Frank</creatorcontrib><creatorcontrib>von Segesser, Ludwig K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mueller, Xavier M.</au><au>Tevaearai, Hendrik T.</au><au>Ruchat, Patrick</au><au>Stumpe, Frank</au><au>von Segesser, Ludwig K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial fibrillation and minimally invasive coronary artery bypass grafting: Risk factor analysis</atitle><jtitle>World journal of surgery</jtitle><addtitle>World J Surg</addtitle><date>2002-06</date><risdate>2002</risdate><volume>26</volume><issue>6</issue><spage>639</spage><epage>642</epage><pages>639-642</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><coden>WJSUDI</coden><abstract>Atrial fibrillation (AF) is a frequent arrhythmia after conventional coronary artery bypass grafting. With the advent of minimally invasive technique for left internal mammary artery‐left anterior descending coronary artery (LIMA‐LAD) grafting, we analyzed the incidence and the risk factors of postoperative AF in this patient population. This prospective study involves all patients undergoing isolated LIMA‐LAD grafting with minimally invasive technique between January 1994 and June 2000. Twenty‐four possible risk factors for postoperative AF were entered into univariate and multivariate logistic regression analyses. Postoperative AF occurred in 21 of the 90 patients (23.3%) analyzed. Double‐ or triple‐vessel disease was present in 12/90 patients (13.3%). On univariate analysis, right coronary artery disease (p<0.01), age (p=0.01), and diabetes (p=0.04) were found to be risk factors for AF. On multivariate analysis, right coronary artery disease was identified as the sole significant risk factor (p=0.02). In this patient population, the incidence of AF after minimally invasive coronary artery bypass is in the range of that reported for conventional coronary artery bypass grafting. Right coronary artery disease was found to be an independent predictor, and this may be related to the fact that in this patient population the diseased right coronary artery was not revascularized at the time of the surgical procedure. For the same reason, this risk factor may find a broader application to noncardiac thoracic surgery.
Résumé
La fibrillation auriculaire (FA) est une forme d’arythmie fréquente après pontage coronarien conventionnel. A l’heure du prélèvement mini‐invasif de l’artère mammaire interne gauche, nous avons analysé l’incidence et les facteurs de risque de FA après pontage antérieur gauche. Cette étude prospective a inclus tous les patients ayant eu un by‐pass de l’artère antérieure gauche avec prélèvement mini‐invasif de l’artère mammaire interne gauche entre jan 1994 et juin 2000. Vingtquatre facteurs de risque possibles de FA ont été rentrés dans une analyse par régression logistique uni‐ et multivariée. La FA a été constatée chez 21 des 90 patients (23.3%) analysés. La maladie intéressait deux ou trois vaisseaux chez 12/90 patients (13.3%). En analyse univariée les facteurs de risque étaient la maladie coronaire droite (p<0.01), l’âge (p=0.01) et le diabète (p=0.04). En analyse multivariée, seule la maladie intéressant l’artère coronaire gauche a été retrouvée (p=0.02). Dans cette population de patients, l’incidence de FA après pontage coronarien avec prélèvement mini‐invasif est comprise dans la fourchette des valeurs rapportées pour la chirurgie conventionnelle. La maladie coronaire droite est un facteur prédictif indépendant et ceci peut être en rapport avec le fait que dans cette population, l’artère coronaire droite n’a pas été revascularisée au moment de l’acte chirurgical. Pour cette même raison, ce facteur de risque pourrait avoir un rôle plus important en chirurgie thoracique non‐cardiaque.
Resumen
La fibrilación auricular (AF) es la arritmia que aparece con más frecuencia tras el “by pass” aorto‐coronario convencional. Al incrementarse las técnicas mínimamente invasivas utilizando como injertos la arteria mamaria interna izquierda—la arteria descendente anterior izquierda, hemos analizado la incidencia y los riesgos de AF en esta población de pacientes tratados con dichas técnicas. Este estudio prospectivo comprende a todos aquellos pacientes a los que con técnicas mínimamente invasivas se injertó una vez aislada, la arteria mamaria interna izquierda—arteria descendente anterior izquierda. La casuística incluye a todos los pacientes así intervenidos entre enero de 1994 y junio de 2000. Mediante un análisis de regresión logística uni y multivariante se estudiaron 24 posibles factores de riesgo capaces de originar una fibrilación auricular (AF) postoperatoria. De los 90 pacientes analizados, 21 (23.3%) desarrollaron una AF postoperatoria. Afectación doble o triple de los vasos se registró en 12/90 pacientes (13.3%). Los factores de riesgo revelados en un análisis univariante fueron: enfermedad de la arteria coronaria derecha (p<0.01), edad (p=0.01) y diabetes (p=0.04). En el análisis multivariante solo la afectación de la arteria coronaria derecha reveló ser un factor de riesgo significativo (p=0.02). En pacientes intervenidos con técnicas mínimamente invasivas la incidencia de la AF postoperatoria es similar a la observada en cirugía convencional de “by‐pass” aortocoronario. Sólo la afectación de la arteria coronaria derecha constituyó un factor pronóstico independiente. Este hecho podría referirse a que en los pacientes de la población estudiada, la lesión de la coronaria derecha no fue revascularizada durante el tratamiento quirúrgico. Este mismo factor de riesgo puede aplicarse a la cirugía torácica no cardiaca.</abstract><cop>New York</cop><pub>Springer‐Verlag</pub><pmid>12053211</pmid><doi>10.1007/s00268-001-0296-9</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0364-2313 |
| ispartof | World journal of surgery, 2002-06, Vol.26 (6), p.639-642 |
| issn | 0364-2313 1432-2323 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71800456 |
| source | Wiley Online Library - AutoHoldings Journals; MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Arrhythmia Atrial Fibrillation Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Biological and medical sciences Bypass Cardiac arrhythmia Cardiovascular disease Coronary Artery Bypass Coronary Artery Bypass - adverse effects Coronary Artery Bypass Grafting Coronary artery disease Coronary Artery Disease - complications Coronary Artery Disease - surgery Coronary vessels Diabetes Diabetes mellitus Factor analysis Female Fibrillation Grafting Heart diseases Heart surgery Humans Left Anterior Descend Left Internal Mammary Artery Logistic Models Male Medical sciences Middle Aged Minimally Invasive Surgical Procedures - adverse effects Multivariate Analysis Patients Population studies Prospective Studies Regression analysis Risk analysis Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Thoracic surgery Thorax Treatment Outcome Vein & artery diseases |
| title | Atrial fibrillation and minimally invasive coronary artery bypass grafting: Risk factor analysis |
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