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Heart Surg Forum. 2010 Oct;13(5):E311-6. doi: 10.1532/HSF98.20091184.

Pericardial reconstruction using an extracellular matrix implant correlates with reduced risk of postoperative atrial fibrillation in coronary artery bypass surgery patients.

Author information

1
University of California Davis Medical Center, 2221 Stockton Blvd., Sacramento, CA 95817, USA. douglas.boyd@ucdmc.ucdavis.edu

Abstract

BACKGROUND:

Postoperative atrial fibrillation (AF) is a significant complication following open heart surgery, with potentially serious clinical and economic implications. To assess the effect of a novel procedure, pericardial reconstruction using a porcine-derived extracellular matrix (ECM) implant, on the risk of postoperative AF after primary isolated coronary artery bypass grafting (CABG), we performed a retrospective comparison of the incidence of postoperative AF in patients who underwent this procedure versus an untreated control group.

METHODS:

We performed a retrospective comparison of the incidence of postoperative AF in 111 patients who underwent a pericardial reconstruction procedure with the CorMatrix ECM for Pericardial Closure (CorMatrix Cardiovascular, Atlanta, GA, USA) following primary isolated CABG, versus a control group of 111 patients who did not undergo pericardial reconstruction.

RESULTS:

Postoperative AF occurred in 43 of 111 control patients (39%; lower control limit [LCL], 30%; upper control limit [UCL], 49%) but in only 20 of 111 treated patients (18%; LCL, 11%; UCL, 27%). This result represents a 54% reduction in relative risk in the treatment group (P < .001). There was a small but statistically insignificant decrease in the hospital length of stay for the treated patients. The 2 treatment groups exhibited similar postoperative complication profiles.

CONCLUSIONS:

In this retrospective study, pericardial reconstruction with the ECM implant contributed directly to a statistically significant and clinically meaningful reduction in the rate of postoperative AF in patients undergoing primary isolated CABG. A prospective multicenter randomized trial has been planned to further test this approach.

PMID:
20961831
DOI:
10.1532/HSF98.20091184
[Indexed for MEDLINE]

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