Abstract
The primary aim of our work is to determine the incidence of atrial fibrillation following cardiac surgery in adults with congenital heart disease. Secondary aims include identifying risk factors predictive of developing earlypostoperative atrial fibrillation and morbidities associated with earlypostoperative atrial fibrillation. Retrospective analysis. Single center, quaternary care children's hospital. This review included patients at least 18years of age with known congenital heart disease who underwent cardiac surgery requiring a median sternotomy at our congenital heart center from January 1, 2012 to December 31, 2016. None. The primary outcome was earlypostoperative atrial fibrillation. Secondary outcomes included preoperative comorbidities, preoperative echocardiographic findings, operative details, and postoperative morbidities, such length of stay, reintubation,stroke, and death. The incidence of early postoperative atrial fibrillation was 21%. Those who developed early postoperative atrial fibrillation were older (50years vs 38years, P=<.001), had a history of atrial fibrillation prior to surgery, had preoperative pulmonary hypertension,and had longer cardiopulmonary bypass times (103minutes vs 84minutes, P=.025) when compared to those who did not develop postoperative atrial fibrillation. Multivariate analysis identified age greater than 60, preoperative pulmonary hypertension, mitral valve intervention,and the need for postoperative inotropic support as being independent predictors of postoperative atrial fibrillation. Those who developed postoperative atrial fibrillationremained in the hospital longer (9days vs 7days, P=<.001). Atrial fibrillation is a common complication following cardiac surgery in adults with congenital heart disease. Age, preoperative comorbidities, type of surgical intervention,and the need for perioperative inotropic infusions may predict the risk of atrial fibrillation in this unique patient population.
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