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Q. CARETTA, C. A. MERCANTI, D. DE NARDO, F. CHIAROTTI, G. SCIBILIA, A. REALE, B. MARINO, Ventricular conduction defects and atrial fibrillation after coronary artery bypass grafting. Multivariate analysis of preoperative, intraoperative and postoperative variables, European Heart Journal, Volume 12, Issue 10, September 1991, Pages 1107–1111, https://doi.org/10.1093/oxfordjournals.eurheartj.a059845
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Abstract
Preoperative, intraoperative and postoperative variables, which might play a role in the development of ventricular conduction defects (VCD) and atrial fibrillation (AF) following coronary artery bypass grafting (CABG), were evaluated in 236 consecutive patients. VCD and AF developed postoperatively in 15·5% of patients. 4·5% had VCD (subgroup A), 11·0% had AF (subgroup B). In 84·5 of patients VCD and AF did not occur (subgroup C). Univariate analysis showed statistically significant differenes between subgroups A and C with respect to.. left main sign stenoses and number of diseased vessels. Bypass pump time and aortic cross-clamp time were significantly longer in subgroup B. Multivariate analysis showed a significantly greater incidence of left main disease and of right coronary artery occlusion associated with significant stenosis of the proximal left anterior descending artery in subgroup A. In subgroup B, the duration of aortic cross-clamp time was signficantly higher.
Ischaemic injury, with increasing duration of cardioplegic arrest, seems to play a key role in the development of AF. Nonhomogeneous cardioplegic delivery to critical areas of myocardium, and particularly to the specialized conducting system, may cause VCD after CABG.
- aorta
- atrial fibrillation
- myocardium
- ischemia
- coronary artery bypass surgery
- anterior descending branch of left coronary artery
- right coronary artery
- cardiac conduction system disorders
- constriction, pathologic
- heart ventricle
- intraoperative care
- preoperative care
- bypass
- vocal cord dysfunction
- left main coronary artery disease
- univariate analysis