The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation
Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Christian Erbel,1 Christian A Gleissner,1 Fabrice F Darche,1 Dierk Thomas,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital...
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doaj-d4932f8ecefb49b3aebb8a4a6cd90b812020-11-24T21:43:09ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2017-03-01Volume 1328729731758The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantationRivinius RHelmschrott MRuhparwar AErbel CGleissner CADarche FFThomas DBruckner TKatus HADoesch AORasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Christian Erbel,1 Christian A Gleissner,1 Fabrice F Darche,1 Dierk Thomas,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Purpose: Early posttransplant atrial fibrillation (AF) has been associated with worse clinical outcomes after heart transplantation (HTX). The type of surgical technique may constitute a relevant risk factor for AF. Patients and methods: This retrospective single-center study included 530 adult patients. Patients were stratified by surgical technique (biatrial, bicaval, or total orthotopic HTX) and early posttransplant heart rhythm (AF or sinus rhythm). Univariate and multivariate analyses were performed to evaluate risk factors for AF. Results: A total of 161 patients received biatrial HTX (30.4%), 115 bicaval HTX (21.7%), and 254 total orthotopic HTX (47.9%). Sixty-one of 530 patients developed early posttransplant AF (11.5%). Patients with AF showed a statistically inferior 5-year survival compared to those with sinus rhythm (P<0.0001). Total orthotopic HTX had the lowest rate of AF (total orthotopic HTX [6.3%], bicaval HTX [14.8%], biatrial HTX [17.4%], P=0.0012). Multivariate analysis showed pretransplant valvular heart disease (P=0.0372), posttransplant enlarged left atrium (P=0.0066), posttransplant mitral regurgitation (P=0.0370), and non-total orthotopic HTX (P=0.0112) as risk factors for AF. Conclusion: Early posttransplant AF was associated with increased mortality (P<0.0001). Total orthotopic HTX showed the lowest rate of AF compared to biatrial or bicaval HTX (P=0.0012). Keywords: atrial fibrillation, biatrial heart transplantation, bicaval heart transplantation, mortality, surgical technique, total orthotopic heart transplantationhttps://www.dovepress.com/the-influence-of-surgical-technique-on-early-posttransplant-atrial-fib-peer-reviewed-article-TCRMAtrial fibrillationbiatrial heart transplantationbicaval heart transplantationmortalitysurgical techniquetotal orthotopic heart transplantation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rivinius R Helmschrott M Ruhparwar A Erbel C Gleissner CA Darche FF Thomas D Bruckner T Katus HA Doesch AO |
spellingShingle |
Rivinius R Helmschrott M Ruhparwar A Erbel C Gleissner CA Darche FF Thomas D Bruckner T Katus HA Doesch AO The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation Therapeutics and Clinical Risk Management Atrial fibrillation biatrial heart transplantation bicaval heart transplantation mortality surgical technique total orthotopic heart transplantation |
author_facet |
Rivinius R Helmschrott M Ruhparwar A Erbel C Gleissner CA Darche FF Thomas D Bruckner T Katus HA Doesch AO |
author_sort |
Rivinius R |
title |
The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
title_short |
The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
title_full |
The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
title_fullStr |
The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
title_full_unstemmed |
The influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
title_sort |
influence of surgical technique on early posttransplant atrial fibrillation — comparison of biatrial, bicaval, and total orthotopic heart transplantation |
publisher |
Dove Medical Press |
series |
Therapeutics and Clinical Risk Management |
issn |
1178-203X |
publishDate |
2017-03-01 |
description |
Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Christian Erbel,1 Christian A Gleissner,1 Fabrice F Darche,1 Dierk Thomas,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Purpose: Early posttransplant atrial fibrillation (AF) has been associated with worse clinical outcomes after heart transplantation (HTX). The type of surgical technique may constitute a relevant risk factor for AF. Patients and methods: This retrospective single-center study included 530 adult patients. Patients were stratified by surgical technique (biatrial, bicaval, or total orthotopic HTX) and early posttransplant heart rhythm (AF or sinus rhythm). Univariate and multivariate analyses were performed to evaluate risk factors for AF. Results: A total of 161 patients received biatrial HTX (30.4%), 115 bicaval HTX (21.7%), and 254 total orthotopic HTX (47.9%). Sixty-one of 530 patients developed early posttransplant AF (11.5%). Patients with AF showed a statistically inferior 5-year survival compared to those with sinus rhythm (P<0.0001). Total orthotopic HTX had the lowest rate of AF (total orthotopic HTX [6.3%], bicaval HTX [14.8%], biatrial HTX [17.4%], P=0.0012). Multivariate analysis showed pretransplant valvular heart disease (P=0.0372), posttransplant enlarged left atrium (P=0.0066), posttransplant mitral regurgitation (P=0.0370), and non-total orthotopic HTX (P=0.0112) as risk factors for AF. Conclusion: Early posttransplant AF was associated with increased mortality (P<0.0001). Total orthotopic HTX showed the lowest rate of AF compared to biatrial or bicaval HTX (P=0.0012). Keywords: atrial fibrillation, biatrial heart transplantation, bicaval heart transplantation, mortality, surgical technique, total orthotopic heart transplantation |
topic |
Atrial fibrillation biatrial heart transplantation bicaval heart transplantation mortality surgical technique total orthotopic heart transplantation |
url |
https://www.dovepress.com/the-influence-of-surgical-technique-on-early-posttransplant-atrial-fib-peer-reviewed-article-TCRM |
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