Publications by authors named "Daniel J Lauritzen"

3 Publications

  • Page 1 of 1

Long-term neurodevelopmental effects of intraoperative blood pressure during surgical closure of a septal defect in infancy or early childhood.

Cardiol Young 2021 Apr 12:1-7. Epub 2021 Apr 12.

Department of Anesthesiology, Centre of Head and Orthopaedics, Copenhagen University Hospital, Copenhagen, Denmark.

Background: Many children born with congenital heart defects are faced with cognitive deficits and psychological challenges later in life. The mechanisms behind are suggested to be multifactorial and are explained as an interplay between innate and modifiable risk factors. The aim was to assess whether there is a relationship between mean arterial pressure during surgery of a septal defect in infancy or early childhood and intelligence quotient scores in adulthood.

Methods: In a retrospective study, patients were included if they underwent surgical closure of a ventricular septal defect or an atrial septal defect in childhood between 1988 and 2002. Every patient completed an intelligence assessment upon inclusion, 14-27 years after surgery, using the Wechsler Adult Intelligence Scale Version IV.

Results: A total of 58 patients met the eligibility criteria and were included in the analyses. No statistically significant correlation was found between blood pressure during cardiopulmonary bypass and intelligence quotient scores in adulthood (r = 0.138; 95% CI-0.133-0.389). Although amongst patients with mean arterial pressure < 40 mmHg during cardiopulmonary bypass, intelligence quotient scores were significantly lower (91.4; 95% CI 86.9-95.9) compared to those with mean arterial pressure > 40 mmHg (99.8; 95% CI 94.7-104.9).

Conclusions: Mean arterial pressure during surgery of ventricular septal defects or atrial septal defects in childhood does not correlate linearly with intelligence quotient scores in adulthood. Although there may exist a specific cut-off value at which low blood pressure becomes harmful. Larger studies are warranted in order to confirm this, as it holds the potential of partly relieving CHD patients of their cognitive deficits.
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http://dx.doi.org/10.1017/S1047951121001414DOI Listing
April 2021

Left atrial mechanical contraction in discontinuation of anticoagulants after surgical ablation of atrial fibrillation: A response letter.

J Card Surg 2021 Mar 29;36(3):1173. Epub 2021 Jan 29.

Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus N, Denmark.

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http://dx.doi.org/10.1111/jocs.15379DOI Listing
March 2021

Discontinuation of anticoagulants after successful surgical ablation of atrial fibrillation.

J Card Surg 2020 Sep 27;35(9):2216-2223. Epub 2020 Jul 27.

Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.

Background: The decision of whether to continue oral anticoagulation therapy (OAT) after successful surgical ablation of atrial fibrillation is challenging, and current guidelines provide no specific recommendations on whether or not it is safe to terminate OAT. Therefore, the aim of this study was to assess long-term outcomes in patients who either did or did not, receive OAT after surgical ablation of atrial fibrillation.

Methods: In a prospective follow-up study, patients were included if surgical ablation of atrial fibrillation concomitantly with other cardiac surgery was done, between 2004 and 2018 at Aarhus University Hospital, Denmark. After 12 months, OAT was discontinued if: (a) sinus rhythm was documented by electrocardiogram, (b) atrial fibrillation was absent on 5-day Holter monitoring, (c) CHADS score ≤2, and (d) no other indications for OAT were present. Follow-up was ended in April 2019.

Results: A total of 560 patients underwent surgical ablation of which 436 patients reached the baseline at 12 months; 286 patients received OAT, and 150 had OAT discontinued. Survival analysis revealed no differences between the two groups (P = .723). Mean survival time in the group receiving OAT was 5.3 ± 3.3 years, compared to 5.1 ± 3.0 years in the group where OAT was discontinued (P = .784). There was no difference in major adverse cardiac and cerebrovascular events between the two groups (P = .846).

Conclusion: Discontinuation of OAT is safe in patients with a CHADS score ≤2 following successful surgical ablation and left atrial appendage occlusion. This conclusion needs to be confirmed in randomized trials.
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http://dx.doi.org/10.1111/jocs.14719DOI Listing
September 2020