The Effects of the Usage of Blood and Blood Products in Open Heart Surgery Patients and the Risk of Postoperative Atrial Fibrillation Development

Abstract

Background: The current study explains the relationship between blood and blood-products that are used during surgery and AF. Material and Methods: A total of 260 patients who underwent elective isolated coronary artery bypass grafting (CABG) between January 2015 and March 2017 were included in the study, retrospectively. The study subjects were divided into two groups; patients whom we used blood products during surgery (Group I) and patients whom we didn't use blood products during surgery (Group II). In Group I there were 140 patients (54 female, 86 male), in Group 2 there were 120 patients (45 female, 75 male). AF rates, perioperative and postoperative blood usage rates and preoperative demographic characteristics were recorded and studied in both groups. Results: AF developed in 95 (36%) of 260 patients who underwent isolated coronary bypass surgery. AF developed in 64 (45%) patients in group I and 31 (25%) in group II. The incidence of AF was found to be statistically significantly lower in the group which we the blood products weren't used (p> 0,05). There was no significant difference between the groups in terms of smoking habits, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM) and hypertension (HT). The mean age was 63.2 +/- 9.2 years in Group I and 60.5 +/- 8.3 years in Group II. Aortic cross clamping (ACK) duration in patients with cardiopulmonary bypass was 65.2 +/- 33.1 minutes in Group I, In the Group 2 mean duration was 59.7 +/- 25.4 minutes (p < 0,05). The mean number of distal anastomoses was 3.1 +/- 2.3 in Group I and 3.5 +/- 2.7 in Group II (p < 0,05). 1 bag of blood and blood products were given to 75 patients (53.5%), 2 bags to 38 patients (27.1%) and 3 bags were given to 27 patients (19.2%). The mean duration of hospitalization in intensive care unit was 3.2 +/- 1.6 days in Group I and 2.1 +/- 1.1 days in Group II. No mortal cases within the first month were included in the study. Conclusion: The incidence of AF was significantly lower in coronary bypass operations without the usage of blood and blood products during and after the operation. We conclude that limiting the usage of blood and blood products will result in a significant reduction in the incidence of AF.