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This study investigates how POAF may be mitigated by epicardial placement of aseptically processed human placental membrane allografts (HPMAs) before pericardial closure in CABG surgery. This study was conducted as a pilot feasibility study to collect preliminary for a forthcoming multi-center randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective observational study of patients undergoing CABG surgery excluded patients with pre-operative heart failure, chronic kidney disease, or a history of atrial fibrillation. The \u201ctreatment\u201d group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924) had three HPMAs placed epicardially following cardiopulmonary bypass decannulation but before partial pericardial approximation and chest closure. The only difference in clinical protocol for the control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954) was that they did not receive HPMA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HPMA-treated patients saw a significant, greater than four-fold reduction in POAF incidence compared to controls (35.2\u20138.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0136). Univariate analysis demonstrated that HPMA treatment was associated with an 83% reduction in POAF (OR\u2009=\u20090.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0248). Multivariable analysis yielded similar results (OR\u2009=\u20090.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0156) after controlling for other covariates. Overall length of stay (LOS) between groups was similar, but ICU LOS trended lower with HPMA treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0677). Post-operative inotrope and vasopressor requirements were similar among groups. There was no new-onset post-operative heart failure, stroke, or death reported up to thirty days in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Epicardial HPMA placement can be a simple intervention at the end of CABG surgery that may provide a new approach to reduce post-operative atrial fibrillation by modulating local inflammation, possibly reducing ICU and hospital stay, and ultimately improving patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-024-02822-8","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T05:01:38Z","timestamp":1717218098000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Epicardial placement of human placental membrane allografts in coronary artery bypass graft surgery is associated with reduced postoperative atrial fibrillation: a pilot study for a future multi-center randomized controlled trial"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2607-5555","authenticated-orcid":false,"given":"Zain","family":"Khalpey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-5856","authenticated-orcid":false,"given":"Ujjawal","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Hitscherich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Aslam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelia","family":"Chnari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"key":"2822_CR1","doi-asserted-by":"crossref","unstructured":"Heron M, Deaths. 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Full informed consent for the surgical procedures as well as anonymized inclusion into this study was obtained for all patients. No patient-identifiable information is contained within this work. All methods of this study were conducted following the relevant guidelines and regulations for working with human subjects. The HPMAs used in this study (MTF AmnioBand\u00ae Matrix, MTF Biologics, Edison, NJ) are aseptically processed amnion and chorion tissue forms regulated for use as a Human Cellular and Tissue-Based Product (HCT\/P) under FDA 21 CFR 1271 and Sect.\u00a0361 of the Public Health Service (PHS) Act when labelled and promoted for use in wound treatment and management as a protective covering for internal or external soft tissue defects including acute, chronic, and surgically created wounds.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All patients were appropriately consented for retrospective outcome analysis and inclusion in this subsequent publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"ZK serves as a consultant for MTF Biologics. PH, EC, and ML are employed by MTF Biologics. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be a potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"315"}}