Does Pulmonary Artery Venting Decrease the Incidence of Postoperative Atrial Fibrillation after Conventional Aortocoronary Bypass Surgery?

Abstract

In this study, we tested the hypothesis that pulmonary artery venting would decrease the incidence of atrial fibrillation after coronary artery bypass surgery. This prospective study included 301 patients who underwent complete myocardial revascularization with cardiopulmonary bypass in our department during a 2-year period. The patients were randomly divided into 2 groups: group I included 151 patients who underwent aortic root venting and group II included 150 patients who underwent pulmonary arterial venting for decompression of the left heart. Pre-, peri-, and postoperative risk factors for atrial fibrillation were assessed in both groups. The mean age was similar in the 2 groups. The mean number of anastomoses was significantly higher in group I (2.8 ± 0.8) than in group II (2.4 ± 0.8) (P = 0.001). The mean cross-clamp time was 42.7 ± 17.4 minutes in group I and 54.1 ± 23.8 minutes in group II (P = 0.001). The mean cardiopulmonary bypass time was 66.4 ± 46.1 minutes in group I and 77.4 ± 28.6 minutes in group II (P = 0.08). The incidence of atrial fibrillation was 14.5% (n = 21) in group I and 6.5% (n = 10) in group II (P = 0.02). Multivariate regression analysis showed that pulmonary artery venting decreased the postoperative incidence of atrial fibrillation by 17.6%. Pulmonary arterial venting may be used as an alternative to aortic root venting during on-pump coronary bypass surgery, especially in patients at high risk of postoperative atrial fibrillation.