Impact of Right Atrial Appendage Ligation vs. Repair on Serum Atrial Natriuretic Peptide, Brain Natriuretic Peptide, and Atrial Fibrillation following Coronary Artery Bypass Grafting.

Objective: In this study, we aimed to compare the levels of serum atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) with ligation and primary repair of right atrial appendage after venous decannulation procedure in isolated coronary artery bypass grafting (CABG) and their relationship with postoperative atrial fibrillation (POAF).

Methods: In this prospective randomized study, 38 patients who underwent isolated CABG in Haydarpasa Training Hospital between March 2015 and November 2015 were included. Patients were divided into two groups whose atrial appendage were ligated (group A) or primary repaired (group B) after right atrial appendage decannulation. Both groups were evaluated in terms of perioperative serum ANP/BNP levels and POAF incidence. ANP/BNP levels were measured by taking blood samples through the central venous catheter on the preoperative day and postoperative days 1 and 3.

Results: While six POAF incidents were observed in group A, there were none in group B. There was no statistical difference between the groups (P > 0.05) in the evaluation of ANP/BNP levels. POAF rate in group A was statistically significantly higher than in group B (P < 0.05).

Conclusion: No significant difference in perioperative ANP/BNP levels was observed between the two groups. Also, no correlation between ANP/BNP levels and POAF were detected. Development of POAF significantly increased in group A. Therefore, we advocate that the prevalence of atrial fibrillation might be reduced in patients who had undergone right atrial repair with primary repair method.