ARRHYTHMIAS IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER CORONARY SHUNTING AND INTRAOPERATIVE HEMOLYSIS

Abstract

Background. Cardiopulmonary bypass surgery in patients with coronary artery disease can lead to the development of different complications in the postoperative period. Objective. To establish the relationship between intraoperative hemolysis (IOH) and the development of arrhythmias in patients with coronary artery disease after cardiopulmonary bypass surgery. Material and methods. According to the degree of IOH, the patients were divided into 3 groups based on free Hb level: group 1 – ≤0.1 g/l; group 2 – > 0.1 g/l and <0.5 g/ l; group 3 – ≥0.5g/l. We used electrocardiography and 24-hour ECG monitoring to assess the patients. The frequency of arrhythmias in the studied groups of patients with cardiopulmonary bypass surgery and different levels of IOH in the perioperative (during the operation and the first day after it) and early postoperative period (up to 1 month) was analyzed. Results. Arrhythmias were observed in 2.3% of patients of the 1st group, in 11.9% of patients of the 2nd group and in 52.6% of patients of the 3rd group. Associations between free Hb in plasma at the end of cardiopulmonary bypass surgery and arrhythmias (Rs = 0.70, p<0.001) were noted. Conclusions. The relationship between the development of arrhythmias in the postoperative period of coronary artery bypass surgery and the degree of intraoperative hemolysis was established.

Keywords

• coronary shunting
• hemolysis
• arrhythmias