Short summary

Despite the advancement of surgical aortic valve replacement (SAVR) and perioperative care, postoperative complications remain frequent, leading to substantial increases in mortality, morbidity, and costs. Atrial fibrillation (AF) being the most common postoperative complication occurs in 17% to 50%. Post operative atrial fibrillation is a manifestation of different factors including inflammation. We therefor plan to investigate statins and the implications for postoperative AF.

Rationale

Several attempts have been made to predict POAF and thereby to administrate a prophylactic regime to the patients most at risk, but so far, no study has found a reliable multivariable risk prediction model, where only advancing age and male sex are consistent findings.

Although, beta-blockers, amiodarone and perhaps statins demonstrate potential prophylactic effect on prevention of POAF, it is still not recommended as standard because of inconsistent data. The majority of studies pharmacological prophylaxis of POAF are based on patients undergoing coronary artery bypass grafting (CABG), and it is recommended to proceed with caution with other cardiac procedures (i.e. aortic valve replacement). This is especially essential for amiodarone, as patients having aortic valve procedures are more prone to developing AV block, in which amiodarone has shown to increase the risk of torsade de points. The focus of this study is to investigate statins and the implications for postoperative AF.

Description of the cohort

Patients undergoing elective solitary SAVR with bioprosthesis.

Collaborating researchers and departments

Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark