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Transthoracic device closure lowers risk of postoperative arrhythmia

29 Sep 2017
Contamination of heater-cooler devices puts patients who undergo open-heart surgery at high risk

Transthoracic device closure (TTDC) seems to reduce the postoperative risk of arrhythmia and is not associated with the risk of other complications, according to a new meta-analysis.

Pooled data from 23 studies (n=4,626) that focused on success rate showed that TTDC resulted in significantly lower rate compared to conventional open-heart surgery (COHS; relative risk [RR], 0.97; 95 percent CI, 0.96 to 0.99; p<0.0001) and case-controls (odds ratio [OR], 0.23; 0.12 to 0.43; p<0.00001).

In terms of intraoperative complications, the case-controls studies showed that TTDC and COHS had comparable rates of intraoperative arrhythmias (OR, 1.18; 0.52 to 2.67; p=0.68). In contrast, cohort studies showed that TTDC significantly decreased the risk of the complication compared with COHS (RR, 0.48; 0.25 to 0.92; p=0.03).

Pooled data from cohort studies also revealed no significant difference in the rates of intraoperative aortic valve insufficiency (RR, 0.89; 0.08 to 9.61; p=0.92) and of residual shunts (RR, 3.39; 0.39 to 4.83; p=0.24) between COHS and TTDC. In case-controlled studies, TTDC had a higher risk of intraoperative residual shunts (OR, 6.98; 1.17 to 41.61 to p=0.03).

Pooled data from four randomized controlled trials found that the risk of postoperative complications was significantly lower for TTDC than COHS (RR, 0.20; 0.13 to 0.32; p<0.00001). The same trend was observed when data from five cohort studies were pooled (RR, 0.50; 0.35 to 0.70; p<0.0001).

In comparison, case-control studies found no significant difference in the risk of postoperative complications (OR, 0.87; 0.42 to 1.79; p=0.71).

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Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.