Open AccessAtrial Fibrillation, Blood Loss, and Transfusion in Patients With Left Ventricular Dysfunction
Author(s) -
Omar A. Jarral,
Srdjan Saso,
Leanne Harling,
Roberto Casula,
Thanos Athanasiou
Publication year - 2012
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0b013e31825cb055
Subject(s) - medicine , atrial fibrillation , cardiology , cardiopulmonary bypass , odds ratio , incidence (geometry) , blood transfusion , off pump coronary artery bypass , hemostasis , artery , anesthesia , confidence interval , physics , bypass grafting , optics
Despite advancements in surgical technique, intensive care methods and pharmaceutical prophylaxis atrial fibrillation (AF) after on-pump coronary artery bypass remains common. Transfusion, blood loss, and cardiopulmonary bypass (CPB) have been identified as risk factors for AF and adverse outcomes such as early mortality. This study examines outcomes in patients with left ventricular dysfunction after revascularization with and without CPB. A systematic literature review identified 22 studies including 7,454 patients. Meta-analysis through subgroup analysis of the highest-quality studies revealed that the off-pump coronary artery bypass (OPCAB) technique is associated with a significantly lower incidence of blood loss, transfusion requirement, reoperation for bleeding, and length of stay. There was also a reduction in the incidence of AF in the OPCAB group but this was not statistically significant (odds ratio = 0.77, 95% confidence interval 0.58-1.02, p = 0.07). The results strengthen research suggesting that CPB has a damaging effect on hemostasis and subsequent transfusion requirements in this patient group. More research is required to assess the association between OPCAB and AF in patients with ventricular dysfunction.