A literature review: pre-/post-operative atrial fibrillation for thoracic aortic aneurysm procedures

Abstract

Atrial fibrillation (AF) is among the most frequent cardiac surgical arrhythmias documented. The global AF prevalence is estimated at over 33 million cases, with estimates ranging up to 6.1 million cases in the United States. Among cardiac surgical patients, the risk factors for new-onset post-operative AF (POAF) include Caucasian race with increased prevalence documented in older men. Due to trends of earlier thoracic aortic aneurysm (TAA) detection and treatment, it is timely to review the AF association with adverse TAA clinical outcomes. Towards this goal, a comprehensive PubMed literature review was performed. For this initial Medline literature search, the MeSH search strategy included “thoracic aortic aneurysm” and “atrial fibrillation”. Based on the pertinent articles identified, the limited literature available for preoperative TAA AF and the predictors of POAF following TAA procedures were reviewed. Given only a handful of publications addressing these pre-/post-operative AF topics were identified using this very broad initial search approach, a knowledge chasm exists–as very little is known about TAA patients with pre-operative or new-onset post-operative AF. Given the paucity of evidence-based information available, clinically relevant TAA-specific research questions have been raised to guide future TAA AF-related investigations.

Editorial review: guidance for future atrial fibrillation research

“…In spite of the high prevalence of these mental illnesses, the impact of mental illness as a preoperative comorbidity for cardiac surgical procedures has not been well studied. Addressing this "knowledge chasm", Kolba and her team examined preoperative mental illness diagnoses and the association of mental illness with post-procedural new-onset atrial fibrillation for both aortic valve replacement [AVR] procedures including surgical aortic valve replacements [SAVR] procedures and transcatheter aortic valve replacements [TAVR] procedures [20] . Given the inherently higher post-procedural risk for adverse events, they also evaluated the impact of preoperative mental illness on repeat AVR procedures including repeat SAVR [r-SAVR] and valve-in-value TAVR [viv-TAVR] procedures.…”