ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ ПОСЛЕ ОПЕРАЦИЙ АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ НА РАБОТАЮЩЕМ СЕРДЦЕ

Introduction. One of the most frequent complications arising after standard coronary artery bypass grafting surgery is the occurrence of atrial fibrillation. This complication, occurring at different times in the postoperative period, leads to varying degrees of severity of hemodynamic disturbances, lengthening the hospital period and the increasing of overall cost of the treatment for the patient in particular and for the health care system as a whole. Material and methods. In the Department of Cardiac Surgery of the Republican Specialized Scientific and Practical Medical Center for Cardiology for the period 2015–2017 420 operations of off-pump were performed. Out of this number of patients, 26 patients (6.2 % of the total) who were operated on at different periods of the postoperative period had an episode of atrial fibrillation (AF). In order to identify preoperative and / or intraoperative risk factors for AF, all patients were divided into 2 groups: Group I – 26 (6.2 %) patients with AF episode in the postoperative period and Group II – 394 (93.8 %) patients without rhythm disturbances in the postoperative period. Results. It was revealed that patients of I group were on the average 7 years older than patients of II group, with large sizes of LA (44.8 against 37.7 mm), with a higher functional class of angina (53.9 % against 39.1 %), with higher share of persons with ACS (19.2 % versus 8.9 %) and a higher risk of operational intervention, calculated by the risk-stratification EuroSCORE (4.63 % versus 3.83 %). Additional risk factors were the longer operation time (288 versus 228 minutes), larger blood loss and a larger volume of plasmo-and hemotransfusions. Also, longer respiratory support (7.8 hours versus 5.6 hours) was a risk factor for AF in the post-op period. Conclusion. Further accumulation of clinical material is needed to clarify and specify pre-operative risk factors.