Thoracic and Cardiovascular Surgeon最新文献

{"title":"Surgical Aortic Valve Replacement in Patients Above the Guideline-endorsed Age Cut-off: Reasons for Surgery and Clinical Outcomes.","authors":"Johannes Petersen, Harun Sarwari, Till Demal, Oliver Bhadra, Simon Pecha, Hermann Reichenspurner, Andreas Schaefer","doi":"10.1055/a-2724-5108","DOIUrl":"10.1055/a-2724-5108","url":null,"abstract":"<p><strong>Objectives: </strong>The 2017 and 2021 ESC/EACTS guidelines for the management of valvular heart disease recommend transcatheter aortic valve implantation (TAVI) as a treatment option for severe symptomatic aortic valve stenosis (AS) in patients ≥75 years of age. However, surgical aortic valve replacement (SAVR) remains a viable option for elderly patients, particularly in specific anatomical or clinical subsets. The objective of this study was to analyze indications for SAVR and postoperative outcomes in patients ≥75 years of age.</p><p><strong>Methods: </strong>Heart team protocols were reviewed to determine indications for SAVR. The adjudication of acute procedural and early clinical outcomes was conducted in accordance with the standardized VARC-3 definitions. Furthermore, cardiovascular mortality and rate of aortic valve re-intervention were assessed at latest follow-up with a median duration of 5.5 years (1.9-7.1 years).</p><p><strong>Results: </strong>A total of 43 patients ≥75 years of age (51% male) underwent isolated SAVR at our center between 2017 and 2022. STS/EuroSCORE II was 1.7 ± 0.6%/1.7 ± 0.4%. The age distribution of patients was as follows: 75 to 76 years in 32.5% (14/43), 77 to 79 years in 46.5% (20/43), and 80 to 83 years in 21% (9/43) of patients. Indications for SAVR included low operative risk according to STS (1.6 ± 0.3%) and EuroSCORE II (1.4 ± 0.3%) in 51.2% (22/43), unicuspid/bicuspid aortic valve in 21% (9/43), patient preference in 13.9% (6/43), large aortic annulus in 9.3% (4/43), and massive calcification of the left ventricular outflow tract in 4.6% (2/43) of patients. Mean aortic cross clamp and cardiopulmonary bypass times were 67.1 ± 18.2 minutes and 98.6 ± 25.1 minutes. All-cause 30-day mortality was 0% (0/43). Technical success, device success, and early safety were 100% (43/43), 100% (43/43), and 81.4% (35/43). Bleeding complications and the need for permanent pacemaker implantation (PPM) were observed in 9.3% (4/43) and 4.6% (2/43) of patients. Mean ICU and hospital stay were 2.9 ± 2.1 days and 12.5 ± 3.6 days. Post-procedural echocardiography demonstrated absence of paravalvular leakage (PVL) in all but one patient, who exhibited moderate PVL. The mean transvalvular pressure gradient was 11.4 ± 4.5 mmHg. Latest follow-up was at median 5.5 years (1.9-7.1 years). Aortic valve re-intervention at follow-up was 2.3% (1/43) and cardiovascular mortality was 4.6% (2/43).</p><p><strong>Conclusion: </strong>In the current era, SAVR is rarely performed in patients ≥75 years of age. Despite the highly selective nature of the patient cohort studied, the results are excellent, with a 30-day mortality of 0% and a low cardiovascular mortality at 5 years. SAVR should still be considered a valid option in elderly patients, evaluated by a heart team, which considers each patient's unique clinical, anatomic, and procedural characteristics.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"384-389"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolisation of Contraceptive Implants to the Pulmonary Arterial System: A Series of Three Cases from a Tertiary Thoracic Surgery Unit.","authors":"Theo Hughes, Leo Gundle, Micayla Pather, Sara Khademi, Sophia Chan, Shuya Chen, Rebecca Weedle, Andrea Bille, Leanne Ashrafian, John Pilling","doi":"10.1055/a-2687-1182","DOIUrl":"10.1055/a-2687-1182","url":null,"abstract":"<p><strong>Abstract: </strong>Contraceptive implants are widely used for long-acting reversible contraception (LARC) due to their high efficacy and convenience. However, complications including migration and, rarely, embolisation to the pulmonary arterial system have been reported. This case series presents three cases of contraceptive implant embolisation to the pulmonary arterial system, managed at a tertiary thoracic surgery unit between 2021 and 2024. Different surgical management was performed in all three cases influenced by factors including: length of time since possible embolisation, implant location, and suspected degree of endothelialisation. The cases highlight challenges in surgical management of embolized contraceptive implants, focusing on arteriotomy and anatomical resection approaches. The importance of prompt diagnosis, multidisciplinary decision-making, and necessity for further research to establish guidelines for the management of embolized contraceptive implants is exemplified. Suppliers should be aware of this rare complication and consider methods to prevent its occurrence.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"410-413"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally Thoracoscopic Ablation for Atrial Fibrillation: All-Box Clamping.","authors":"Nicolas Doll, Antonia Doll, Geza Horvath, Gerold Mönnig, Christian Pott, Thorsten Hanke, Taoufik Ouarrak, Jochen Senges, Mahmoud Wehbe","doi":"10.1055/a-2625-9617","DOIUrl":"10.1055/a-2625-9617","url":null,"abstract":"<p><strong>Background: </strong>Epicardial surgical ablation is an effective strategy to treat non-paroxysmal forms of atrial fibrillation. Current thoracoscopic epicardial surgical strategies are complex, and are therefore often avoided. With slight modifications to the thoracoscopic maze procedure, totally thoracoscopic all-box clamping may facilitate the performance of epicardial thoracoscopic ablation, while maintaining good results.</p><p><strong>Methods: </strong>Between December 2023 and December 2024, 42 patients underwent thoracoscopic all-box clamping at a single center. All-box clamping uses commercially available bipolar radiofrequency clamps for isolation of the ipsilateral pulmonary veins and posterior left atrial wall through right and then left-sided thoracoscopic access. The left atrial appendage is occluded using a clip device, and the ligament of Marshall is transected. Assessment of a bidirectional block confirmed electrical isolation. Data from the CASE-AF registry were analyzed retrospectively. Short-term results pertaining to efficacy and safety are provided.</p><p><strong>Results: </strong>All-box clamping was successfully offered to all patients by three surgeons. There were no reported major or minor complications. The median hospital stay was 6 days (interquartile range 5-6). At discharge, a sinus rhythm was observed in 92.9%, and in 76.1% of patients off any class I/III antiarrhythmic drugs.</p><p><strong>Conclusion: </strong>Surgical ablation with a modified thoracoscopic technique is safe and feasible for the treatment of atrial fibrillation.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"390-395"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Replica-Based Upsizing for Epic Supra Aortic Bioprosthesis.","authors":"Hristo Kirov, Murat Mukharyamov, Angelique Runkel, Tulio Caldonazo, Torsten Doenst","doi":"10.1055/a-2695-2575","DOIUrl":"10.1055/a-2695-2575","url":null,"abstract":"<p><strong>Background: </strong>Different techniques allow implantation of biological aortic valve prostheses larger than associated with classic annulus sizing. We described a replica-based technique (upsizing) before that utilizes the patient's root anatomy. We here evaluate the safety and efficacy of upsizing compared with standard sizing using the Epic Supra bioprosthesis.</p><p><strong>Methods: </strong>We assessed 958 patients undergoing aortic valve replacement with the Epic Supra bioprosthesis between 2010 and 2023. Upsizing was defined as implantation of a prosthesis larger than the measured annular size without enlarging the annulus. We assessed hemodynamic and standard outcome parameters. Mean follow-up was 44.5 ± 31.2 months. Propensity score matching was used to adjust for baseline differences.</p><p><strong>Results: </strong>Patient anatomy allowed upsizing in 62% of patients. Demographics and outcomes (perioperative mortality, reoperation, bleeding, and pacemaker implantation) were comparable between the matched groups. Immediate postoperative and long-term pressure gradients were consistently and significantly lower in the upsizing groups across all annular sizes (upsizing vs. control: 23 mm; 12.9 ± 8.2 vs. 14.0 ± 5.6 mm Hg, <i>p</i> = 0.029; 25 mm; 10.8 ± 4.0 vs. 13.0 ± 4.4 mm Hg, <i>p</i> < 0.001; 27 mm; 10.8 ± 4.0 vs. 13.0 ± 4.4 mm Hg, <i>p</i> < 0.001). Differences persisted at long-term follow-up but were less pronounced for the 25-mm annular size and greatest in the 27-mm group (8.5 ± 4.5 vs. 12.5 ± 5.5 mm Hg; <i>p</i> < 0.001). Long-term survival was numerically higher in the upsizing groups with statistical significance in annular size 25 mm.</p><p><strong>Conclusion: </strong>Implanting a larger Epic Supra prosthesis than classically recommended (\"upsizing\") is safe and associated with improved immediate- and long-term hemodynamics without increasing pacemaker, perioperative, or long-term mortality risks.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"362-368"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Repair of Pectus Arcuatum.","authors":"Tunc Lacin, Nezih Onur Ermerak, Haktan Uygar Onen, Aleyna Gultekin Aridas","doi":"10.1055/a-2642-1738","DOIUrl":"10.1055/a-2642-1738","url":null,"abstract":"<p><strong>Background: </strong>Pectus arcuatum, a very rare variant (chondromanubrial) of the carinatum chest wall deformity, occurs due to premature fusion of the sternal ossification centers causing obliteration of the manubrio-sternal joint. Typically, patients undergo surgical repair for cosmetic purposes. This study reviews the clinical experience using titanium plate systems for surgical repair of pectus arcuatum.</p><p><strong>Methods: </strong>The records of our prospective Chest Wall Deformities Clinical Database since September 2018 include 27 pectus arcuatum patients. The patients aged 17 and older were evaluated for corrective surgery (<i>n</i> = 24, 16 male, 8 female, mean age: 24.9 years). The hybrid surgical technique included wedge osteotomy of the most protruded part of the sternum, excision of the associated costochondral junctions followed by placement of two parallel titanium plates to secure the sternum, and insertion of an excavatum bar (<i>n</i> = 7) if there is a significant depression at the sternal body. Follow-up outpatient visits were every 3 to 6 months.</p><p><strong>Results: </strong>All of the patients tolerated the surgery very well. The mean length of the surgery was 118 minutes. The mean hospital length of stay was 5.6 days. One patient experienced pericardial and right pleural effusion 2 weeks after surgery, which was resolved by anti-inflammatory treatment. The mean time to return to daily activity was 12 days. The mean follow-up was 42 months. All patients indicated the postoperative results as very good or excellent.</p><p><strong>Conclusion: </strong>Repair of arcuatum deformity can be performed in adults with low morbidity, short hospital stay, and satisfactory cosmetic results even in complex cases.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"420-429"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Exploring Factors Influencing Medical Students' Interest in Cardiac Surgery in Africa.","authors":"Samuel Ghislain Junior Fodop, Victor Oluwafemi Femi-Lawal, Achanga BillSmith Anyinkeng, Achumbom Haggai Akumbom, Asogwa Chukwuebuka, Edward Majani, Emmanuel Chileshe Phiri, Abuelgasim Mohamed, Marwah SaedAli Emhemed, Adenuga Favour Demilade, Kabelo Paile, Sheriffdeen Adebowale Lawal, Michelle van der Heiden, Clarence Pingpoh","doi":"10.1055/a-2724-5166","DOIUrl":"10.1055/a-2724-5166","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality worldwide, with Sub-Saharan Africa (SSA) facing a severe shortage of cardiac surgeons (0.12 per million people) and limited access to cardiac surgical care. This study explores the career aspirations of African medical students and examines the factors influencing their interest in pursuing various career paths and cardiac surgery in particular.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 807 medical students from various African medical schools. Data were collected using a validated online questionnaire available in English, French, and Arabic. Sociodemographic characteristics, career aspirations, specialty preferences, and factors influencing career choices were analyzed using descriptive and bivariate statistical methods.</p><p><strong>Results: </strong>The mean age of participants was 22.79 ± 2.99 years, with a nearly equal gender distribution (51.2% male, 48.8% female). Surgery was the most preferred specialty (34.3%), cardiac surgery was chosen by 11.8% of participants, and 0.5% chose cardiothoracic surgery. The inclusion of cardiac surgery in the curriculum (<i>p</i> = 0.046) and exposure to cardiac patients (<i>p</i> = 0.034) positively influenced career interest. However, the presence of functional cardiac surgery units in teaching hospitals was negatively associated with pursuing the specialty (<i>p</i> = 0.032). Additionally, hospital-based exposure to cardiac surgery significantly reduced interest in cardiac surgery (<i>p</i> < 0.001) as specialty choice. A majority (71.4%) intended to pursue postgraduate studies abroad, citing limited local opportunities.</p><p><strong>Conclusion: </strong>The level of interest in cardiac surgery among African medical students highlights the need for targeted interventions, including curriculum reforms, improved training environments, and structured mentorship programs to translate this interest into cardiac surgical workforce. Strengthening local postgraduate training capacity and addressing systemic barriers are crucial steps in building a sustainable cardiac surgery workforce in Africa, ultimately helping to reduce the burden of cardiovascular diseases across the continent.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"414-419"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Computed Tomography is Associated with Reduced In-Hospital Complications in Aortic Valve Surgery.","authors":"Liliane Zillner, Julian Heidtmann, Markus Mach, Richard Nolz, Christian Loewe, Alfred Kocher, Daniel Zimpfer, Martin Andreas","doi":"10.1055/a-2708-3100","DOIUrl":"10.1055/a-2708-3100","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of preoperative full aortic computed tomography (CT) to reduce complications during surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong>A single-center retrospective study examined all SAVR procedures from 2013 to 2015, comparing outcomes between surgeries planned with CT and those without. The study assessed how CT imaging adapted surgical methods, including cannulation and the possibility of switching from SAVR to interventional therapy. The analysis primarily focused on the occurrence of in-hospital complications.</p><p><strong>Results: </strong>Out of 359 patients analyzed, those who received presurgical CT (<i>n</i> = 305, complications = 53; 17%; EuroSCORE = 1.8) had fewer in-hospital complications compared with the non-CT group (<i>n</i> = 54, complications = 17; 32%; EuroSCORE = 1.8), with a statistically significant difference (<i>p</i> = 0.016). Patients in the CT group had a 15% absolute risk reduction and a number needed to treat of 7 to avoid one in-hospital complication.</p><p><strong>Conclusion: </strong>CT is associated with reduced in-hospital complications in SAVR patients and could enhance patient outcomes when used in preoperative planning. This supports the recommendation for incorporating CT into routine preoperative assessment to enable personalized surgical strategies, potentially including a shift to transcatheter treatments when indicated.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"369-377"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: Totally Thoracoscopic Ablation for Atrial Fibrillation: All-Box Clamping.","authors":"Qi Tong, Ahmad Umar, Yongjun Qian","doi":"10.1055/a-2695-2624","DOIUrl":"10.1055/a-2695-2624","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"396"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Total Arterial Bypass Grafting via Left Mini-Thoracotomy in Obese Patients.","authors":"Ibrahim Gadelkarim, Rakan Shaqu, Jagdip Kang, Waseem Zakhary, Alexey Dashkevich, Jörg Ender, Sussane de Waha, Michael Borger, Alexander Verevkin","doi":"10.1055/a-2668-4842","DOIUrl":"10.1055/a-2668-4842","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive cardiac surgery total arterial coronary artery bypass grafting (MICS-CABG) has emerged as an alternative to conventional coronary artery bypass grafting (CABG). Its safety and efficacy in obese patients remain a concern due to technical challenges. The current study compares early and long-term outcomes of MICS-CABG in obese and non-obese patients.</p><p><strong>Methods: </strong>Between January 2015 and December 2023, 279 patients underwent off-pump MICS-CABG at our center. Obesity was defined as body mass index ≥30 (kg/m²). The primary endpoint was 30-day survival. Secondary endpoints were survival and freedom from major adverse cardiac and cerebrovascular events (MACCE) at 5 years.</p><p><strong>Results: </strong>Of all 279 patients, 56 (20.1%) were classified as obese and 223 (79.9%) as non-obese. Obese patients had a higher EuroSCORE II (2.06 ± 1.53 vs. 1.63 ± 0.94, <i>p</i> = 0.008) and a higher prevalence of comorbidities including diabetes mellitus (<i>p</i> < 0.001) and pulmonary hypertension (<i>p</i> = 0.03). The incidence of postoperative complications including repeat thoracotomy for bleeding (<i>p</i> = 0.18), low cardiac output syndrome (<i>p</i> = 0.70), or wound infection (<i>p</i> = 0.38) did not differ between obese and non-obese patients. There were no deaths or myocardial infarctions within 30 days in obese patients (0% vs. 0.5%, <i>p</i> = 0.95; 0% vs. 2.7%, <i>p</i> = 0.47). Long-term outcome at 5 years, including survival (91.9% vs. 92.4%, <i>p</i> = 0.99) and freedom from MACCE (83.3% vs. 84.6%, <i>p</i> = 0.63), showed no difference between the two groups.</p><p><strong>Conclusion: </strong>MICS-CABG can be performed safely and efficaciously in select obese patients by specialized coronary surgeons at high-volume cardiac centers.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"355-360"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Atrial Fibrillation after Aortic Valve Replacement: An Isolated Episode?","authors":"Laura Varela Barca, Nieves De Antonio Antón, Hugo Auquilla Luzuriaga, Esperanza Gomez Alonso, Maria Roldan Martinez, Emilio Monguió Santín, Fernando Alfonso Manterola, Guillermo Reyes Copa","doi":"10.1055/a-2722-4150","DOIUrl":"10.1055/a-2722-4150","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative atrial fibrillation (POAF) is a frequent entity after cardiac surgery. However, its potential relationship with adverse outcomes and permanent arrhythmias remains uncertain. We sought to assess the relationship between the occurrence of atrial fibrillation (AF) in the postoperative period and its long-term recurrence.</p><p><strong>Methods: </strong>Patients who underwent aortic valve replacement (AVR) with a biological prosthesis between 2005 and 2023 were analyzed at our center. The incidence of atrial fibrillation in the postoperative period and the factors associated with its occurrence, as well as its long-term recurrence and related risk factors, were analyzed.</p><p><strong>Results: </strong>The incidence of POAF was 22%. Postoperative renal insufficiency (<i>p</i> < 0.001) and chronic obstructive pulmonary disease (COPD) (<i>p</i> = 0.047) were identified as risk factors. During long-term clinical follow-up (mean 6.5 ± 4.5 years), 20.4% of patients without any previous arrhythmia episodes developed AF, whereas the incidence was 40.4% in those with atrial fibrillation in the postoperative period (Hazard Ratio [HR] = 2.18 [1.33-3.56]; <i>p</i> = 0.002). AF during follow-up was independently associated with age (HR = 1.05), COPD (HR = 3.22), and POAF (HR = 1.9). In addition, there was an apparent association between permanent AF during follow-up and long-term mortality, which approached statistical significance (HR = 1.4 [95% CI: 0.9-1.8]; <i>p</i> = 0.06).</p><p><strong>Conclusion: </strong>POAF is a frequent complication following AVR and is significantly associated with an increased risk of developing permanent AF during long-term follow-up. Multivariate analysis identified renal insufficiency and COPD as independent predictors of POAF, while age and COPD were independently associated with long-term AF. Additionally, there was a trend toward an association between permanent AF and increased long-term mortality.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"378-383"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}