Surgical Treatment for Stand-Alone Atrial Fibrillation in North America

Publication date: Available online 17 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Niv Ad, Sari D. Holmes, Harold G. Roberts, J. Scott Rankin, Vinay BadhwarAbstractBackgroundSurgical treatment of symptomatic atrial fibrillation (AF) has been performed for three decades. We reviewed trends and outcomes of surgical ablation (SA) for stand-alone AF using the Society of Thoracic Surgeons Adult Cardiac Surgical Database (STS-ACSD).MethodsThe STS-ACSD was reviewed from 2011-2017 (N=7,187) for trends. Contemporary data from 2014-2017 (N=3,893) were used to compare three subgroups: off-pump (n=3,252), on-pump (n=491), and patients with incision conversion or conversion from off-pump to on-pump (n=150). Propensity score matching was conducted to balance groups.ResultsAnnual growth of stand-alone SA was 7%. Median age was 64 (57–70) years (30% female). Overall 30-day mortality was 0.8% and perioperative stroke incidence was 0.8%. Most SA procedures were off-pump (84%), with 12% greater odds for off-pump per year (OR=1.12, P
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Abstract BACKGROUND: Surgical treatment of symptomatic atrial fibrillation (AF) has been performed for three decades. We reviewed trends and outcomes of surgical ablation (SA) for stand-alone AF using the Society of Thoracic Surgeons Adult Cardiac Surgical Database (STS-ACSD). METHODS: The STS-ACSD was reviewed from 2011-2017 (N=7,187) for trends. Contemporary data from 2014-2017 (N=3,893) were used to compare three subgroups: off-pump (n=3,252), on-pump (n=491), and patients with incision conversion or conversion from off-pump to on-pump (n=150). Propensity score matching was conducted to balance groups. ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Steroids suppress the inflammatory response to cardiopulmonary bypass, but the impact on death at 30 days, myocardial infarction or injury, stroke, renal failure, respiratory failure, new atrial fibrillation, transfusion requirement, infection, and length of intensive care unit (ICU) and hospital stays are uncertain.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
AbstractPurpose of ReviewStroke prevention is the cornerstone of atrial fibrillation (AF) management and the anticoagulation decision is currently based on CHA2DS2-VASc risk score. We discuss several novel risk factors besides those included in CHA2DS2-VASc score and alternative models for stroke prediction.Recent FindingsSeveral clinical markers including obstructive sleep apnea and renal failure, laboratory markers like brain natriuretic peptide, imaging criteria including left atrial appendage morphology, spontaneous echo contrast, and coronary artery calcium score may predict stroke in AF patients. Addition of African ...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
ConclusionOff ‐pump coronary artery bypass grafting proved a safe and effective procedure, with low postoperative atrial fibrillation occurrence, for myocardial revascularization. Chronic renal insufficiency and the use of venous‐origin graft solely proved to be independent predictor factors for PAOF.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusion: Intracranial artery calcification is common in patients with ischemic cerebrovascular disease and the intracranial carotid artery is most frequently affected. Intracranial arterial calcifications might be associated with imaging markers of SVD and are highly correlated with WMHs, lacunes, and CMBs. Quantification of calcification on CT provides additional information on the pathophysiology of SVD. Intracranial arterial calcification could act as a potential marker of SVD. Introduction Atherosclerosis is a systemic vascular process that is considered a major cause of cerebrovascular and cardiovascular di...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Despite improvements in perioperative and operative care, postoperative atrial fibrillation (POAF) is still found in approximately 15% to 60% of cardiac surgical patients.1 The potential clinical impact on patients is dependent on mainly their clinical status and can include heart failure, acute renal failure, stroke or thromboembolism, anticoagulation-related complications, and even death. This is particularly true because a significant proportion of patients with aortic stenosis have diastolic dysfunction and rely on the atrial contraction to maintain adequate cardiac output.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
Authors: Filip G, Bryndza MA, Konstanty-Kalandyk J, Piatek J, Wegrzyn P, Ceranowicz P, Brzezinski M, Lakkireddy D, Kapelak B, Bartuś K Abstract Introduction: Aortic valve replacement (AVR) is the gold standard in treating symptomatic aortic valve defects. To improve the healing process and limit the trauma, the minimally invasive approach was introduced. Aim: To compare the peri- and post-operative results of aortic valve replacement performed via conventional full sternotomy (con-AVR) and of AVR performed via partial upper sternotomy (mini-AVR). Material and methods: The total study population was divided into...
Source: Polish Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research
Authors: Plasek J, Taborsky M Abstract Atrial fibrillation is the most common arrhythmia and as such, it has become a significant public health issue due to its impact on patient morbidity and mortality. The prevalence of atrial fibrillation (AF) almost doubled in the last decade, being currently 2% in unselected patient populations. Its occurrence varies with age (present in almost 20% of octogenarians) and concomitant diseases. The most prevalent concomitant diseases are hypertension, diabetes, heart failure, renal failure, and cognitive decline. Cognitive decline or stroke may be actually the first manifestation...
Source: Biomedical Papers of the Medical Faculty of the Univ Palacky Olomouc Czech Repub - Category: Biomedical Science Tags: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Source Type: research
CONCLUSIONS: Our results suggest that compared to CABG, HCR is associated with a lower risk of postoperative blood transfusion and infection, as well as a shorter ICU stay and hospital stay. HCR was also associated with a higher risk of long-term TVR. PMID: 30504516 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
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