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

Abstract

Objectives: In this study, we tested the hypothesis that
pulmonary artery venting would decrease the incidence of
atrial fibrillation after coronary artery bypass surgery.
Methods: 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.
Results: 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%.
Conclusions: 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.