Background: Elderly patients and those with multiple concomitant disorders are nowadays qualified for cardiac surgery procedures, which is related to higher incidence of the postoperative complications. Aim: The aim of this study was a retrospective analysis of the perioperative factors potentially contributing to occurrence of cardiac incidents after cardiac surgery procedures. Methods: Data of 552 patients of the cardiac surgery clinic were collected and analyzed. Data concerning medical history, previous treatment, laboratory results, additional tests results, operation and hospitalization period were examined. Results: In the study population of 552 patients, cardiac complications were observed in 49.5% of them. Among cardiac complications, the most frequent were supraventricular tachycardia (30.1%) and atrial fibrillation (27.4%). Postoperative bradycardia occurred in 5.25% patients, half of whom required temporary cardiac pacing. Conclusions: The risk of incidence of cardiac complications after cardiac surgery procedures depends mostly on patient’s age, EuroSCORE Logistic (ESL) score, left ventricular ejection fraction, myocardial hypertrophy, presence of paroxysmal AF and coincidence of nephrological complications. The necessity of performing more than one heart defibrillation after removing aortic cross-clamp favors early postoperative bradycardia. Considering the outcomes of this study, continuing reperfusion at least until 1/3 of the aortic cross-clamp time brings no additional benefits to the patients.

Hypertrophic cardiomyopathy (HCM) is the most prevalent genetic cardiac disease while apical hypertrophic cardiomyopathy (apHCM) is a rare subset of HCM. The significance of this case report is to present apHCM, its chronological course, and its association with left ventricular aneurysm, thrombosis, and cardiac arrest. We present the case of a 56-year-old female with a past medical history of apHCM who was admitted for substernal chest pain, developed a ventricular storm (VT), and subsequently suffered cardiac arrest; resuscitation of spontaneous circulation (ROSC) was eventually achieved after 10 minutes. It was initially thought that her arrhythmia and hemodynamic decompensation were purely secondary to cocaine use at a party six hours prior to her presentation. During hospitalization, cardiac magnetic resonance imaging demonstrated a severe apHCM apical aneurysm, thrombosis, and a re-entrant circuit as a likely cause of this patient’s decompensation and eventual cardiac arrest. After several days of hemodynamic stability and decreased dependence on intravenous antiarrhythmic medication infusions, she was extubated and transitioned to oral amiodarone and beta-blocker therapy with the implantation of a cardioverter-defibrillator (ICD). In this case, we analyze the continuum of apHCM, a rare subset of HCM once thought to be benign but with the emergence of complications, including aneurysm, thrombus formation, resistant ventricular tachycardia, and cardiac arrest. Recognition and management of apHCM with medical and/or surgical intervention are therefore critical to prevent the aforementioned sequela.