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Heart Lung. 2019 May 27. pii: S0147-9563(18)30633-2. doi: 10.1016/j.hrtlng.2019.05.014. [Epub ahead of print]

The association of preoperative atrial fibrillation with post-cardiopulmonary bypass hyperfibrinolysis in rheumatic valvular heart disease patients.

Author information

1
Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
2
Department of Cardiac Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
3
Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China. Electronic address: drliujingjie@163.com.

Abstract

OBJECTIVE:

The purpose of this study was to assess the fibrinolytic status after cardiopulmonary bypass in rheumatic valvular heart disease patients, and detect the associated factors of post-cardiopulmonary bypass hyperfibrinolysis.

METHODS:

According to the fibrinolytic status after cardiopulmonary bypass, 203 rheumatic valvular heart disease patients were divided into two groups: hyperfibrinolysis group (H group, n = 78) and non-hyperfibrinolysis group (NH group, n = 125). The demographic characteristics, operative variables, and postoperative follow-ups were compared between these two groups.

RESULTS:

The incidence of hyperfibrinolysis was 38.4% after cardiopulmonary bypass. Patients in the H group had a significant higher incidence of preoperative atrial fibrillation than patients in the NH group (92.3% vs. 55.2%, P < 0.01). Furthermore, postoperative daily drainage (655.3 ± 131.5 ml vs. 535.4 ± 161.4 ml, P < 0.01), transfusion volume of fresh frozen plasma (621.8 ± 220.2 ml vs. 455.2 ± 208.5 ml, P < 0.01), and red blood cells (5.9 ± 2.2 u vs. 4.7 ± 2.8 u, P < 0.01) was greater in the H group than in the NH group. Moreover, the logistic regression analysis revealed that preoperative atrial fibrillation was associated with post-cardiopulmonary bypass hyperfibrinolysis (OR = 19.691, 95% CI = 6.849-56.612; P < 0.05).

CONCLUSION:

Preoperative artial fibrillation is associated with post-cardiopulmonary bypass hyperfibrinolysis in rheumatic valvular heart disease patients.

KEYWORDS:

Atrial fibrillation; Cardiopulmonary bypass; Hyperfibrinolysis; Rheumatic valvular heart disease

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