Abstract Journal Cardiothoracic Surgery

Abstract

Journal Cardiothoracic Surgery CS001 MID-TERM RESULTS OF SURGICAL ABLATION FOR LONGSTANDING PERSISTENT ATRIAL FIBRILLATION: LEFT ATRIAL VERSUS BI-ATRIAL ABLATION PARADORN JETWANNA, PATTARALANYAPORN YUWAPONGPIPAT AND KORAKOT WICHITSA-NGUAN JETWANNA Suratthani Hospital, Suratthani, Thailand Purpose: To assess the results of left atrial and biatrial ablations with cardiac operations. Method: Between April 2011 and January 2014, 54 patients with persistent atrial fibrillation (AF) underwent modified maze procedures in 2 different techniques. Radiofrequency ablation devices were used with the open-heart operations. Left atrial plus right isthmus ablations were performed for 27 patients, while 25 patients had biatrial ablation. The preoperative, intraoperative and postoperative results of both were compared. Results: There were three in-hospital deaths (5.6%), including one in the left atrial group (3.7%) and two in the biatrial group (8 %) (p= 0.51). Only one in-hospital death in the bi-atrial group was due to the operation. In the left atrial group, there were one patient who needed a pacemaker and two patients who developed an atrial flutter postoperatively. The mean followup time was 45 months for the left atrial group and 49 months for the biatrial group. Freedom from AF/atrial flutter in biatrial vs atrial groups when compared was 96.0% to 69.2%, respectively, with p= 0.008 after the operation; 95.0% vs 60.9%, with p = 0.008 at 1 year; 77.8% vs 43.8 %, with p = 0.042 at 2 years, 6 months; and 71.4% vs 50.0%, with p = 0.47 at 4 years. Conclusion: Biatrial and left atrial ablations produced comparable hospital mortality rates, but left atrial ablation has a higher rate of postoperative atrial flutter. Biatrial ablation is more effective than left atrial ablation in the restoration of sinus rhythm after an operation. CS002 AUSTRALIAN SINGLE CENTRE OUTCOME OF TYPE A AORTIC DISSECTION REPAIRS SPANNING 10 YEARS JOSE NADAL AND FABIANO VIANA Royal Adelaide Hospital, SA Purpose: Type A Aortic Dissection is a devastating condition that carries a high mortality if not managed emergently, estimated to be at 50% at 48 hours if left untreated. We describe our experience as a high volume centre managing acute type A dissections in South Australia, and our patient outcomes over the last 10 years. Methodology: A retrospective analysis of patient data has been performed, noting the preoperative, intraoperative, and postoperative course of each case. Patient data has been obtained from hospital case records, the hospital operation tracking system (ORMIS), and the hospital patient tracking application (OACIS) with patient follow up via phone call. Results: A total of 68 Acute Type A Dissections were surgically managed over the period from 2008 to 2017. Half of these cases presented in the last three years. The average age at presentation was 62.29 years, with 43 (63.24%) males and 25 (36.76%) females. The most common presenting complaint was chest pain (69.18%) followed by collapse (10.29%) and hemiparesis (7.35%). We report an overall 30-day mortality rate of 16%, with a five-year survival rate of 68.96% (29 cases). Conclusions: Despite the aging population noted in our cohort, overall mortality is lower than the quoted 30 day mortality rate by the International Registry of Acute Aortic Dissection which can be as high as 25%. An increase in cases has also been noted. This calls for a collaboration with other high volume centres to come up with a larger dataset for further evaluation and risk stratification. CS003 PREDICTORS AND SEQUELAE OF POST-CARDIAC SURGERY CARDIAC ARREST MOSTAFA ALWAN, JOHN BROOKES, MANISH MATHEW, BRENDAN INGRAM AND JULIAN SMITH