Introduction Rhythm problems are the most observed complications following coronary artery bypass grafting (CABG), the most common being postoperative atrial fibrillation (PoAF), with an incidence reaching 50% of the patients. In this study, we aimed to investigate the predictive importance of prognostic nutritional index (PNI) and visceral adiposity index (VAI) in predicting PoAF, which occurs after CABG accompanied by cardiopulmonary bypass. Methods Patients who underwent isolated CABG with cardiopulmonary bypass between June 15 and October 15, 2019, were prospectively included in the study. Patients who did not develop in-hospital PoAF were identified as Group 1, and those who did constituted Group 2. Results PoAF developed in 55 (27.6%) patients (Group 2). The mean age of the 144 patients included in Group 1 and 55 patients in Group 2 were 56.9±8.7 and 64.3±10.2 years, respectively ( P <0.001). In multivariate analysis Model 1, age (odds ratio [OR]: 1.084, confidence interval [CI]: 1.010-1.176, P =0.009), chronic obstructive pulmonary disease (OR: 0.798, CI: 0.664-0.928, P =0.048), and PNI (OR: 1.052, CI: 1.015-1.379, P =0.011) were determined as independent predictors for PoAF. In Model 2, age (OR: 1.078, CI: 1.008-1.194, P =0.012), lymphocyte counts (OR: 0.412, CI: 0.374-0.778, P =0.032), and VAI (OR: 1.516, CI: 1.314-2.154, P <0.001) were determined as independent predictors for PoAF. Conclusion In this study, we determined that low PNI, a simply calculable and cheap parameter, along with high VAI were risk factors for PoAF.

Objectives Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. Methods Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. Results A total of 255 patients were included in the study. Those who did not develop PoAF were included in Group 1 (N = 196, mean age = 58.9 ± 9.4 years), and those who did were included in Group 2 (n = 59, mean age = 61.1 ± 12 years). There were no statistically significant differences between the two groups in terms of age, gender, presence of hypertension and hyperlipidemia. Rates of chronic obstructive pulmonary disease and previous percutaneous coronary interventions, waist circumference, waist to height ratio and HATCH score values were significantly higher in Group 2 compared to Group 1 ( p values: 0.019, 0.034, 0.001, <0.001, <0.001, respectively). In multivariate analysis, WHR (Odds ratio: 1.068, Confidence interval: 1.032–1.105, p < 0.001) and HATCH score (Odds ratio: 2.590, Confidence interval: 1.850–3.625, p < 0.001) were independent predictors of PoAF. Conclusions With this current prospective study, we showed that calculating WHR and HATCH score in the preoperative period can help us predict PoAF.

The heart remained a mystery for many years and was considered surgically untouchable. With the use of extracorporeal circulation, there has been a revolution in this area. Due to its mechanical components and interactions with blood, cardiopulmonary bypass (CPB) can cause significant changes in the body. Factors such as contact between artificial materials and blood, continuous flow, hemodilution, hypothermia and anticoagulation affect all organs during CPB, and may result in various complications. The minimally invasive extracorporeal circulation (MiECC) system was developed to minimize the contact of blood with air and foreign surfaces during conventional CPB. In addition, the biocompatibility of the components that make up the MiECC circuits increased, which reduced the inflammatory response. The absence of a venous reservoir and shorter lines allow the prime volume to be used to decrease, which also reduces the damage to the blood elements, and consequently, the need for blood transfusion. The MiECC system also has its downsides, the most important one being the difficulty in removing the air that can enter through the venous line, the impairment of the pump function, and embolization. During the use of these systems, perfusion safety and communication with the whole team must be at the highest level. In line with this information, the use of these systems can become standard in cardiac surgery with new technological additions.

Amaç: Aortik diseksiyon günümüzde hala önemli bir mortalite ve morbidite nedenidir. Tip A aort diseksiyonu nedeniyle ameliyat edilen hastalarda birçok faktör cerrahi sonuçları etkilemektedir. Bu faktörlerin yeterince belirlenmesi tedavinin başarılı olmasına etki edecektir. Yöntemler: Kliniğimizde Ocak 2006-Aralık 2016 yılları arasında Tip A aort diseksiyonu tanısı ile opere edilen 140 hastanın preoperatif, intraoperatif, ve postoperatif verileri, hasta dosyaları ve hastane bilgi yönetim sistem kayıtlarından retrospektif olarak araştırıldı. Gruplar arası niceliksel parametreler Student t veya Mann-Whitney U testleri ile, niteliksel veriler ise Ki-Kare testi ile karşılaştırıldı. Mortalite olan hastalarda perfüzyon süreleri uzun, inotrop ihtiyacı fazla, yoğun bakım yatış süreleri istatiksel olarak anlamlı derecede yüksekti (p<0.05). RSP yapılan grupta yoğun bakımda kalış süreleri ve mortalite, ASP uygulanan hastalara göre anlamlı oranda yüksekti (sırası ile p=0.02, p=0.04). Sonuç: Tip A aortik diseksiyonlarda mortalite üzerine etki eden faktörlerin daha büyük hasta serilerinde ortaya konulması ve bu faktörlere yönelik tedbirlerin alınması mortalite ve morbiditenin azaltılmasında etkili olabilir.