Posterior pericardiotomy to prevent new-onset atrial fibrillation after coronary artery bypass grafting: a systematic review and meta-analysis of 10 randomized controlled trials
| Autor: | Ya-Xiong Li, Lei Pu, Yun-Long Zhu, Xu Cui, Hua Li, Yuan-Feng Ma, Tao Xiong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty RD1-811 Pleural effusion Coronary artery bypass grafting Pericardial effusion Pericardial Effusion law.invention Postoperative Complications Anesthesiology law Atrial Fibrillation Cardiopulmonary bypass medicine Humans RD78.3-87.3 Coronary Artery Bypass Randomized Controlled Trials as Topic business.industry Atrial fibrillation General Medicine medicine.disease Intensive care unit Postoperative atrial fibrillation Cardiac surgery Surgery Cardiothoracic surgery Pericardiectomy Tamponade Posterior pericardiotomy Cardiology and Cardiovascular Medicine business Research Article |
| Zdroj: | Journal of Cardiothoracic Surgery Journal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-15 (2021) |
| ISSN: | 1749-8090 |
| DOI: | 10.1186/s13019-021-01611-x |
| Popis: | Background Atrial fibrillation (AF) is associated with adverse events after cardiac surgery. Multiple studies have reported that posterior pericardiotomy (PP) may be effective for preventing AF after coronary artery bypass grafting (CABG), but some conflicting results have been reported and the quality of evidence from previous meta-analyses has been limited. The present study aimed to systematically evaluate the safety and efficacy of PP for preventing AF after CABG in adults. Methods We conducted a quantitative meta-analysis of randomized controlled trials (RCTs) published before May 31, 2021. The primary outcome was AF after CABG under cardiopulmonary bypass. Secondary outcomes included early pericardial effusion, late pericardial effusion, pericardial tamponade, pleural effusion, length of hospital stay, length of intensive care unit (ICU) stay, pulmonary complications, intra-aortic balloon pump use, revision surgery for bleeding, and mortality. Results Ten RCTs with 1829 patients (910 in the PP group and 919 in the control group) were included in the current meta-analysis. The incidence of AF was 10.3% (94/910) in the PP group and 25.7% (236/919) in the control group. A random-effects model indicated that incidence of AF after CABG significantly lower in the PP group than in the control group (risk ratio = 0.45, 95% confidence interval 0.29–0.64, P P P P P P P = 0.66), pulmonary complications (RR = 0.99, 95% CI 0.71–1.39, P = 0.97), revision surgery for bleeding (RR = 0.84, 95% CI 0.43–1.63, P = 0.60), use of IABP (RR = 1, 95% CI 0.61–1.65, P = 1.0), or death (RR = 0.45, 95% CI 0.07–3.03, P = 0.41) were observed between the PP and control groups. Conclusions PP may be a safe, effective, and economical method for preventing AF after CABG in adult patients. |
| Databáze: | OpenAIRE |
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