Background and Objectives: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, associated with increased morbidity and prolonged hospital stays. Oxidative stress has been implicated in POAF pathogenesis, with malondialdehyde (MDA), a marker of lipid peroxidation, proposed as a potential biomarker. However, conflicting evidence exists regarding its predictive value. This study aimed to assess the association between serum MDA levels and POAF incidence in patients undergoing cardiac surgery. Materials and Methods: This prospective observational study included 99 consecutive patients undergoing elective on-pump cardiac surgery. Patients with preoperative atrial fibrillation, chronic kidney disease requiring dialysis, or emergency surgery were excluded. Blood samples for MDA measurement were collected at six perioperative time points: preoperatively, intraoperatively after aortic clamp release, and at 8, 24, 48, and 72 h postoperatively. Patients were monitored for new-onset POAF during the first three postoperative days. Statistical analyses included independent samples t-tests, Mann–Whitney U-tests, and Fisher’s exact tests, with significance set at p < 0.05. Results: POAF occurred in 33 (33%) patients. Patients who developed POAF were significantly older (p = 0.017) and had higher EuroSCORE II values (p = 0.019). No significant differences were observed in serum MDA concentrations between POAF and non-POAF patients at any measured time point. The incidence of POAF was higher in patients undergoing valvular surgery (p = 0.014). Conclusions: Serum MDA levels were not associated with POAF development, suggesting that lipid peroxidation alone may not play a central role in POAF pathogenesis. These findings challenge the predictive value of MDA for POAF risk stratification. Future research should explore alternative oxidative stress markers and their potential therapeutic implications in POAF prevention.

Aim: This study aims to identify independent risk factors associated with postoperative respiratory complications (PRC) in patients undergoing coronary artery bypass surgery (CABG). Methods: A retrospective cohort study was conducted on 98 patients (82 male, 16 female) who underwent CABG at the Cardiovascular Surgery Clinic, University Hospital Tuzla. The incidence of PRC and potential risk factors were analyzed. Univariate analysis was performed to assess associations, followed by multivariable logistic regression to adjust for confounding factors. Independent risk factors were identified, including diabetes mellitus, smoking, hypertension, gender, and preoperative oxygen saturation <94%. Results: PRC were observed in 48 patients (48.97%). Preoperative factors significantly associated with PRC included diabetes mellitus, smoking, hypertension, and low preoperative oxygen saturation. Intraoperative and postoperative factors, such as prolonged surgery duration (>180 min), mechanical ventilation >120 min, and blood transfusion exceeding 500 ml/24 h, were also identified as risk factors. Multivariable logistic regression confirmed that prolonged surgery duration, extended respiratory support, and transfusions >500 ml/24 h were independent predictors of PRC. Conclusion: This study highlights the importance of perioperative risk stratification in preventing PRC. Reducing prolonged mechanical ventilation and minimizing unnecessary transfusions may improve postoperative outcomes. Further studies with larger cohorts are needed to refine risk prediction models and optimize perioperative management strategies.

Aim To determine the prevalence of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and its effect on 6-month cardiovascular outcomes. MethodsThis prospective study included 40 patients diagnosed with LMCAD, in the period from 2017 to 2018. The patients with LMCAD and low or intermediate SYNTAX score were randomized to PCI with zotarolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization. Results Among 40 patients without atrial fibrillation on presentation, NOAF developed 3.1±1.3 days during hospitalization in three CABG treated patients, and one PCI treated patient. One patient that was CABG treated developed NOAF after two months. Patients with versus patients without NOAF had a significantly longer duration of hospitalization, probably because they were discharged on anticoagulant therapy. Myocardial infarction was presented in one CABG treated patient after 3 months, and also in one PCI treated patient after 4 months. One patient died 2 months after the operation, and one developed stroke 5 months after the CABG operation. Conclusion The NOAF was common after CABG, but extremely rare after PCI, and it occurred almost exclusively following CABG. There was a clear statistical tendency for all-cause death, cardiovascular death and stroke at 6-month follow-up period.

Background: The upper mini sternotomy Bentall (mini-Bentall) procedure may result in less trauma and earlier recovery compared with the usual full sternotomy Bentall procedure (Usual Bentall-DeBono procedure). Objective: This study evaluates the efficacy and safety of mini sternotomy aortic root surgery (MSARS), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs. Methods: The upper mini sternotomy (UMS) approach was performed in ten patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSARS markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy. Results: The median postoperative length of stay was seven days for MSARS versus 11 days for traditional sternotomy, with ICU stays of 27 hours and 105 hours, respectively. Our study also highlights the cost-effectiveness of MSARS, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSARS is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency. Conclusion: Mini sternotomy aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy, marking a significant advancement in the field of cardiac surgery.