Register
Forgot your password?

The incidence and possible predictors of atrial fibrillation in adult patients in the early postoperative period after Ozaki surgery

Authors: Makarova N.V., Durmanov S.S., Batrakov P.А., Bazylev V.V.

Company: Federal Center for Cardiovascular Surgery, Penza, Russian Federation

For correspondence:  Sign in or register.

Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2022-16-4-508-519

For citation: Makarova N.V., Durmanov S.S., Batrakov P.А., Bazylev V.V. The incidence and possible predictors of atrial fibrillation in adult patients in the early postoperative period after Ozaki surgery. Creative Cardiology. 2022; 16 (4): 508–19 (in Russ.). DOI: 10.24022/1997-3187-2022-16-4-508-519

Received / Accepted:  14.08.2022 / 29.11.2022

Keywords: aortic valve defects Ozaki operation atrial fibrillation early postoperative period

Full text:  

 

Abstract

Objective. To study the incidence and determine possible predictors of atrial fibrillation (AF) in the early postoperative period after Ozaki surgery in adult patients.

Material and methods. The study included 256 patients after successful aortic valve replacement using the Ozaki method with/without prosthetics of the ascending aorta. The inclusion criterion is sinus rhythm on admission. The duration of follow-up was limited to the period of inpatient treatment and amounted to 13.1 ± 4.6 days.

Results. In 70 (27.3%) patients AF was registered, of which 55 (21.5%) for the first time. The median time of onset was 3.0 [2.0–4.0] days. In order to identify possible predictors of the development of AF in the early postoperative period, a univariate logistic regression analysis was performed, which included clinical, demographic, instrumental, laboratory, and perioperative characteristics. Statistically significant values were obtained for the following parameters: age (p = 0.020), coronary artery disease (p = 0.027), history of AF (p = 0.003), interatrial blockade on baseline ECG (p = 0.035), anterior-posterior dimension of the left atrium (p = 0.041), posterior wall thickness of the left ventricle (p = 0.047), time of cardiopulmonary bypass (p = 0.019), time of myocardial ischemia (p = 0.020), risk of intervention according to the EuroSCORE II scale (p = 0.001). The method of multivariate logistic regression revealed the only independent predictor of postoperative AF – the history of AF (OR 3.389; 95% CI 1.091–10.531; p = 0.035).

Conclusion. The incidence of AF in the early postoperative period after the Ozaki operation with/without prosthetics of the ascending aorta was 27.3% (70 patients). The only predictor of the development of AF was an indication of AF in the anamnesis. A history of AF increased the risk of developing AF after Ozaki surgery more than three times.

References

  1. Lung B., Baron G., Butchart E.G., Delahaye F., GohlkeBärwolf C., Levang O.W. et al. A prospective survey of patients with valvular heart disease in Europe: the euro heart survey on valvular heart disease. Eur. Heart J. 2003; 24 (13): 1231–43. DOI: 10.1016/s0195-668x(03)00201-x
  2. Dilawar I., Putra M.A., Makdinata W., Billy M., Paat R.K. Autologous pericardium for adult and elderly patients undergoing aortic valve replacement: a systematic review. Cir. Cardiovasc. 2022; 29 (1): 25–30. DOI: 10.1016/j.circv.2021.07.002
  3. Askadinov M.N., Kadyraliev B.K., Kucherenko S.V., Musaev O.G., Arutyunyan V.B. Prostheting of the valves of the aortal valve using the autopericard by processing with glutary aldehyde as an alternative approach to treating aortal valve stenosis. Bulletin of Pirogov National Medical and Surgical Center. 2020; 15 (3–2): 10–4 (in Russ.). DOI: 10.25881/BPNMSC.2020.47.11.002
  4. Greenberg J.W., Lancaster T.S., Schuessler R.B., Melby S.J. Postoperative atrial fibrillation following cardiac surgery: a persistent complication. Eur. J. Cardiothorac. Surg. 2017; 52 (4): 665–72. DOI: 10.1093/ejcts/ezx039
  5. Ibrahim K.S., Kheirallah K., Mayyas F., Waqfi N., Al-Zoubi N., Wagner D.V. Atrial fibrillation after rheumatic heart valve surgery: incidence, predictors, and outcomes. Thorac. Cardiovasc. Surg. 2022; 2. DOI: 10.1055/s-0041-1740985
  6. Sokolskaya M.A., Shvartz V.A., Ispiryan A.Yu., Petrosyan A.D., Paskhalov I.D., Abgaryan A.A. et al. Predictors of postoperative atrial fibrillation after aortic valve replacement in patients with aortic insufficiency. Annaly Aritmologii. 2020; 17 (4): 220–31 (in Russ.). DOI: 10.15275/annaritmol.2020.4.1
  7. Iliescu A.C., Salaru D.L., Achitei I., Grecu M., Floria M., Tinica G. Postoperative atrial fibrillation prediction following isolated surgical aortic valve replacement. Anatol. J. Cardiol. 2018; 19 (6): 394–400. DOI: 10.14744/AnatolJCardiol.2018.70745
  8. Ozaki S., Kawase I., Yamashita H., Uchida S., Nozawa Y., Takatoh M., Hagiwara S. A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium. J. Thorac. Cardiovasc. Surg. 2014; 147 (1): 301–6. DOI: 10.1016/j.jtcvs.2012.11.012
  9. Arakelyan M.G., Bockeria L.A., Vasilieva E.Yu., Golitsyn S.P., Golukhova E.Z., Gorev M.V. et al. 2020 Clinical guidelines for Atrial fibrillation and atrial flutter. Russian Journal of Cardiology. 2021; 26 (7): 4594 (in Russ.). DOI: 10.15829/1560-4071-2021-4594
  10. Makarova N.V., Durmanov S.S., Bazylev V.V. Interatrial block: there is an occasion to reflect. Annaly Aritmologii. 2018; 15 (2): 112–22 (in Russ.). DOI: 10.15275/annaritmol.2018.2.6
  11. Sá M.P.B.O., Perazzo Á.M., Zhigalov K., Komarov R., Kadyraliev B., Enginoev S. et al. Аortic valve neocuspidization with glutaraldehyde-treated autologous pericardium (Ozaki procedure) – a promising surgical technique. Braz. J. Cardiovasc. Surg. 2019; 34 (5): 610–4. DOI: 10.21470/1678- 9741-2019-0304
  12. Koechlin L., Eckstein F.S. Аortic valve neocuspidization using autologous pericardium (Ozaki procedure): an alternative to aortic valve replacement in adult cardiac surgery? Curr. Anesthesiol. Rep. 2021; 11: 318–25. DOI: 10.1007/s40140-021-00454-5
  13. Bazylev V.V., Kobzev E.E., Babukov R.M., Rosseykin E.V. Ozaki procedure in the case of a small aortic annulus – is this new solution to the old problem? Russian Journal of Thoracic and Cardiovascular Surgery. 2018; 60 (3): 217–25 (in Russ.). DOI: 10.24022/0236-2791-2018-60-3-217-225
  14. Ozaki S., Kawase I., Yamashita H., Uchida S., Nozawa Y., Matsuyama T. et al. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact. Cardiovasc. Thorac Surg. 2011; 12 (4): 550–3. DOI: 10.1510/icvts.2010.253682
  15. Reuthebuch O., Koechlin L., Schurr U., Grapow M., Fassl J., Eckstein F.S. Aortic valve replacement using autologous pericardium: single centre experience with the Ozaki technique. Swiss Med. Wkly. 2018; 148: w14591. DOI: 10.4414/smw.2018.14591
  16. Rosseikin E.V., Kobzev E.E., Bazylev V.V. Minimally invasive Ozaki technique. Angiology and Vascular Surgery. 2019; 25 (3): 142–8 (in Russ). DOI: 10.33529/ANGIO2019319
  17. Pivatto Júnior F., Teixeira Filho G.F., Sant’anna J.R., Py P.M., Prates P.R., Nesralla I.A., Kalil R.A. Advanced age and incidence of atrial fibrillation in the postoperative period of aortic valve replacement. Rev. Bras. Cir. Cardiovasc. 2014; 29 (1): 45–50. DOI: 10.5935/1678-9741.20140010
  18. Ionova V.V., Semenovsky M.L. Аtrial fibrillation or flutter in the early postoperative period after ascending aorta and/or aortic valve replacement: risk factors, treatment, preventive maintenance. Russian Journal of Transplantology and Artificial Organs. 2010; 12 (3): 36–40 (in Russ.). DOI: 10.15825/1995-1191-2010-3-36-40
  19. Silva R.G., Lima G.G., Guerra N., Bigolin A.V., Petersen L.C. Risk index proposal to predict atrial fibrillation after cardiac surgery. Rev. Bras. Cir. Cardiovasc. 2010; 25 (2): 183–9. DOI: 10.1590/s0102-76382010000200009
  20. Valle F.H., Costa A.R., Pereira E.M., Santos E.Z., Pivatto Júnior F., Bender L.P. et al. Morbidity and mortality in patients aged over 75 years undergoing surgery for aortic valve replacement. Arq. Bras. Cardiol. 2010; 94 (6): 720–5. DOI: 10.1590/s0066- 782x2010005000052
  21. Fraga~o-Marques M., Saraiva F., Oliveira J., Lourenc, o A.P., Leite-Moreira A., Falca~o-Pires I. De novo atrial fibrillation following aortic valve replacement surgery is associated with decreased creatinine clearance and increased C-reactive protein levels: PS025. Porto Biomed. J. 2017; 2 (5): 189. DOI: 10.1016/j.pbj.2017.07.034
  22. Popylkova O.V., Durmanov S.S., Voevodin A.B., Bazylev V.V. Assessment of the frequency and possible risk factors for paroxysmal atrial fibrillation in the early postoperative period after transapical implantation of the MedLab-CT valve. Journal of Arrhythmology. 2020; 27 (4): 5–11 (in Russ.). DOI: 10.35336/VA-2020-4-5-11
  23. Banach M., Goch A., Misztal M., Rysz J., Jaszewski R., Goch J.H. Predictors of paroxysmal atrial fibrillation in patients undergoing aortic valve replacement. J. Thorac. Cardiovasc. Surg. 2007; 134 (6): 1569–76. DOI: 10.1016/j.jtcvs.2007.08.032
  24. Skopin I.I., Golukhova E.Z., Iskandaryan Sh.R. Early postoperative predictors of atrial fibrillations after prosthetic repair of the aortic valve. Russian Journal of Thoracic and Cardiovascular Surgery. 2005; 5: 7–11 (in Russ.).
  25. Burrage P.S., Low Y.H., Campbell N.G., O’Brien B. New-onset atrial fibrillation in adult patients after cardiac surgery. Curr. Anesthesiol. Rep. 2019; 9 (2): 174–93. DOI: 10.1007/s40140-019- 00321-4

About Authors

  • Natal’ya V. Makarova, Cardiovascular Surgeon; ORCID
  • Sergey S. Durmanov, Cand. Med. Sci., Head of Department, Cardiovascular Surgeon; ORCID
  • Pavel A. Batrakov, Сardiovascular Surgeon; ORCID
  • Vladlen V. Bazylev, Dr. Med. Sci., Professor, Chief Physician, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Sort by