ABSTRACT Introduction: Many etiological factors affect the occurrence of atrial fibrillation after coronary artery bypass grafting. In this study, the relationship between cardiopulmonary bypass and cross-clamping times and the development of postoperative atrial fibrillation was examined. Methods: All patients who underwent isolated coronary artery bypass grafting with the same surgical team in our clinic between September 2018 and December 2019 were prospectively included in the study, and their perioperative data were recorded. Results: One hundred and three patients who met the specified criteria were included in the study. The median age was 62 (interquartile range: 54-71) years, and 82 (79.6%) were male. The patients were divided into two groups: those who developed atrial fibrillation and those who did not. Atrial fibrillation developed in 25 of 103 patients (24.3%). All patients underwent isolated coronary artery bypass grafting under standard cardiopulmonary bypass. The median duration of cardiopulmonary bypass was 72 (interquartile range: 63-97) minutes in those with atrial fibrillation and 82 (61-98) minutes in those without it, and there was no statistical difference (P=0.717). The median cross-clamping time was 40 (32.5-48) minutes in those with atrial fibrillation and 39.5 (30-46) minutes in those without it. Statistically, the relationship between cross-clamping time and atrial fibrillation was not significant (P=0.625). Conclusion: Our study found no significant relationship between cardiopulmonary bypass and cross-clamping times and the incidence of postoperative atrial fibrillation. However, we believe that there is a need for large-scale and multicenter clinical studies on the subject.

ABSTRACT Introduction: Many etiological factors affect the occurrence of atrial fibrillation after coronary artery bypass grafting. In this study, the relationship between cardiopulmonary bypass and cross-clamping times and the development of postoperative atrial fibrillation was examined. Methods: All patients who underwent isolated coronary artery bypass grafting with the same surgical team in our clinic between September 2018 and December 2019 were prospectively included in the study, and their perioperative data were recorded. Results: One hundred and three patients who met the specified criteria were included in the study. The median age was 62 (interquartile range: 54-71) years, and 82 (79.6%) were male. The patients were divided into two groups: those who developed atrial fibrillation and those who did not. Atrial fibrillation developed in 25 of 103 patients (24.3%). All patients underwent isolated coronary artery bypass grafting under standard cardiopulmonary bypass. The median duration of cardiopulmonary bypass was 72 (interquartile range: 63-97) minutes in those with atrial fibrillation and 82 (61-98) minutes in those without it, and there was no statistical difference (P=0.717). The median cross-clamping time was 40 (32.5-48) minutes in those with atrial fibrillation and 39.5 (30-46) minutes in those without it. Statistically, the relationship between cross-clamping time and atrial fibrillation was not significant (P=0.625). Conclusion: Our study found no significant relationship between cardiopulmonary bypass and cross-clamping times and the incidence of postoperative atrial fibrillation. However, we believe that there is a need for large-scale and multicenter clinical studies on the subject.

RESUMO OBJETIVO: O objetivo do estudo é investigar patologias cardíacas e extracardíacas em pacientes operados por oclusão arterial aguda. MÉTODOS: Entre março de 2010 e março de 2018, um total de 120 pacientes submetidos a tratamento cirúrgico para oclusão arterial aguda foram incluídos neste estudo retrospectivo. RESULTADOS: Dos pacientes incluídos, 84 (70%) e 27 (22.5%) apresentavam, respectivamente, patologias cardíacas e extracardíacas. Em 9 (7.5%) dos casos, nenhuma cause para a oclusão arterial foi encontrada. Fibrilação atrial isolada foi encontrada em 39 (32.5%) pacientes. Fibrilação atrial e valvopatias cardíacas foram detectadas em 45 pacientes (37.5%). Entre aqueles com valvopatias cardíacas, 9 (7.5%) tinham estenose mitral isolada, 21 (17. 5%) tinham estenose mitral moderada a avançada com regurgitação tricúspide, 9 (7. 5%) tinham 2°-3° de regurgitação mitral com 3o regurgitação tricúspide, 3 (2. 5%) tinham estenose mitral moderada, 3°-4° regurgitação tricúspide e 2°-3° estenose aórtica, e 3 (2.5%) tinham 3o mitral, 1°- 2° regurgitação tricúspide moderada, estenose aórtica moderada calcificada e doença coronariana. Entre os 27 pacientes com patologia extracardíaca, 21 (22.5%) tinham doença arterial periférica, 3 (2,5%) tinham aneurisma da aorta abdominal, e 3 (2.5%) tinham Doença de Behçet. CONCLUSÃO: Patologias cardíacas e extracardíacas devem ser consideradas em pacientes com oclusão arterial aguda. Assim, patologias detectadas podem ser tratadas e o desenvolvimento de trombos periféricos adicionais pode ser evitado.

SUMMARY OBJECTIVE: We aimed to investigate cardiac and extra-cardiac pathologies in patients who were operated for acute arterial occlusion. METHODS: Between March 2010 and March 2018, a total of 120 patients who underwent surgical treatment for acute arterial occlusion were included in this retrospective study. RESULTS: 84 (70%) and 27 (22. 5%) of the patients had cardiac and extra-cardiac pathologies, respectively. In 9 (7. 5%) of the cases, no reason for arterial occlusion could be found. Pure atrial fibrillation was found in 39 (32. 5%) patients. Atrial fibrillation and cardiac valvular pathologies were detected in 45 patients (37. 5%). Among those with a cardiac valvular pathology, 9 patients (7. 5%) had pure mitral stenosis, 21 patients (17. 5%) had moderate to advanced mitral stenosis with tricuspid regurgitation, 9 patients (7. 5%) had 20-30 mitral regurgitation with 30 tricuspid regurgitation, 3 patients (2. 5%) had moderate mitral stenosis, 30-40 tricuspid regurgitation and 20-30 aortic stenosis, and 3 patients (2. 5%) had 30 mitral regurgitation, 10- 20 tricuspid regurgitation, calcific moderate aortic stenosis, and coronary artery disease. Among those 27 patients with an extra-cardiac pathology, 21 patients (22. 5%) had peripheral artery disease, 3 patients (2.5%) had an abdominal aortic aneurysm, and 3 patients (2. 5%) had Behçet's Disease. CONCLUSION: Cardiac and extra-cardiac pathologies should be kept in mind in patients with acute arterial occlusion. Thus, detected pathologies could be treated, and the development of additional peripheral emboli could be prevented.