Abstract Purpose The aim of this study was to evaluate the impact of preoperative red blood cell distribution width (RDW) values on the risk of post-operative new-onset atrial fibrillation (PNAF) during hospitalization following cardiac valve replacement surgery. Materials and methods The clinical data of 148 patients with preoperative sinus rhythm who underwent cardiac valve replacement surgery at The First Affiliated Hospital of Anhui Medical University from September 2017 to June 2018 were retrospectively analysed. Univariate and multivariate logistic regression analyses were used to determine the relationship between preoperative RDW values and the development of PNAF. Results Forty-nine of the 148 patients (33.1%) developed PNAF. The median preoperative RDW was 13.1 (12.6–17.2), while the median RDW value was significantly higher in patients with PNAF than in those without PNAF [14.1 (13.2–15.0) vs. 12.9 (12.4–13.5), p < 0.001]. Multivariate logistic regression analysis showed that preoperative RDW values were significantly correlated with the occurrence of PNAF (odds ratio: 1.940, 95% confidence interval: 1.377–2.731, p < 0.001). Conclusions Preoperative RDW is an independent risk factor for PNAF during hospitalization following cardiac valve replacement surgery. This finding suggests that preoperative RDW measurement may be used to stratify the risk for PNAF development in patients undergoing cardiac surgery.

This paper describes a case of a patient with situs inversus totalis (SIT) and dextrocardia in which robotic atrial septal defect (ASD) repair was successfully performed in a beating heart.

OBJECTIVE:We conducted a meta-analysis to evaluate the effects of prophylactic perioperative dexmedetomidine administration on postoperative junctional ectopic tachycardia (JET) and acute kidney injury (AKI) in pediatric patients having undergone cardiac surgery.DESIGN:This systematic review was registered with PROSPERO (CRD42017083880). Databases including PubMed, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials (RCTs) and observational cohort studies from its inception to March 2018. Two reviewers independently screened literature, extracted data, and assessed the quality of included studies using the Jadad scale and Newcastle-Ottawa score. Meta-analysis was then conducted by RevMan 5.3 and Stata 12.0 software. P value < .05 was considered significant.RESULTS:A total of nine eligible studies (5 RCTs and 4 observational studies) comprising 1851 patients were selected for the final analysis. The results of meta-analysis showed that dexmedetomidine significantly reduced the incidence of postoperative JET (OR =0.35, 95% CI: 0.22 to 0.53, P < .00001), but there was no significant difference between groups in AKI (OR =0.44, 95% CI: 0.19 to 1.04, P = .06) and all-cause mortality (OR =0.87, 95% CI: 0.35 to 2.14, P = .77).CONCLUSIONS:The administration of perioperative dexmedetomidine effectively prevents JET in pediatric patients undergoing cardiac surgery but has no significant effect on postoperative renal function. However, the quality of evidence for these findings is low; thus, future larger scale randomized studies are needed to verify the real clinical effects of dexmedetomidine prophylaxis in pediatric patients.