The impact of socio-demographic factors on health-related quality of life after coronary artery bypass surgery.

OBJECTIVES: To achieve a beneficial impact on long-term outcome after coronary artery bypass grafting (CABG), the goal of the present study was the early identification of patients at risk of impaired postoperative health-related quality of life (HRQoL), particularly evaluating the significance of socio-demographic variables. METHODS: In this prospective, single-centre cohort study of patients having an isolated CABG (January 2004-December 2014), preoperative socio-demographic (preSOC) and preoperative medical variables as well as 6-month follow-up data including the Nottingham Health Profile were analysed in 3,237 patients. RESULTS: All preSOC (gender, age, marriage and employment) and follow-up (chest pain, dyspnoea) variables proved to have significant influence on HRQoL (P < 0.001), male patients below 60 years being particularly impaired. The effects of marriage and employment on HRQoL are modulated by age and gender. The significance of the predictors of reduced HRQoL differs between the 6 Nottingham Health Profile domains. Multivariable regression analyses revealed explained proportions of variance amounting to 7% for preSOC and 4% for preoperative medical variables. CONCLUSIONS: The identification of patients at risk of impaired postoperative HRQoL is decisive for providing additional support. This study reveals that the assessment of 4 preoperative socio-demographic characteristics (age, gender, marriage, employment) is more predictive of HRQoL after CABG than are multiple medical variables.

Single Atrium and Miscarriages.

Background A single atrium is a very rare heart condition, in which the inter atrial septum is missing. These congenital heart defects usually are surgically corrected after birth. Case Presentation We present a successful surgical repair of a single atrium (SA) in a 27-year-old woman, who has a complete missing of the atrial septum, without coexisting valvular pathology. The SA diameter was 9.97 × 6.18 cm and the Systemic blood flow/pulmonary blood flow (Qp/Qs) was 4.1 due to the single atrium. Surgical correction consisted of creating a new atrial septum, using a double-velor patch. At first- and second-year follow up, the patient was in a very good condition and without any symptoms present. We consider that the diagnoses of single atrium, especially in child bearing women, should be done in appropriate time, to avoid miscarriages, preterm births and other complications associated. Conclusion There are many case reports that show good surgical repair of single atrium and without late complications. In our case, we have obtained a very good surgical repair, without AV bundle damage and no residual shunt demonstrated on intraoperative transesophageal echocardiography.