BACKGROUND: Major aortic surgery results in significant haemodynamic and oxidative stress to the myocardium. Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences. AIM: The aim of this study was to investigate the occurrence of myocardial injury during conventional and endovascular abdominal aortic aneurysm repair using measurement of the myocardial-specific protein, cardiac troponin T. Interleukin-6 was also measured in both groups and haemodynamic responses to surgery assessed. METHODS: Nine consecutive patients undergoing conventional infra-renal aortic aneurysm surgery were compared with 13 patients who underwent EVAR. Patients were allocated on the basis of aneurysm morphology and suitability for endovascular repair. RESULTS: Patients undergoing open repair had significantly more haemodynamic disturbance than those having endovascular repair (mean arterial pressure at 5 min following unclamping or balloon deflation: open (69.6 + 3.3 mmHg); endovascular (86 + 4.4 mmHg), P < 0.05 vs. pre-op). Troponin T levels at 48 h post-operatively were higher in patients who underwent open repair (open 0.164 + 0.1 ng/ml; endovascular 0.008 + 0.0005 ng/ml, P < 0.04). Significantly more patients in the open repair group had troponin T levels > 0.1 ng/l when compared with the endovascular group (P < 0.01, chi (2) test) CONCLUSION: Endovascular aortic surgery produces significantly less myocardial injury than the open technique of aortic aneurysm repair.
BACKGROUND: Major aortic surgery results in significant haemodynamic and oxidative stress to the myocardium. Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences. AIM: The aim of this study was to investigate the occurrence of myocardial injury during conventional and endovascular abdominal aortic aneurysm repair using measurement of the myocardial-specific protein, cardiac troponin T. Interleukin-6 was also measured in both groups and haemodynamic responses to surgery assessed. METHODS: Nine consecutive patients undergoing conventional infra-renal aortic aneurysm surgery were compared with 13 patients who underwent EVAR. Patients were allocated on the basis of aneurysm morphology and suitability for endovascular repair. RESULTS:Patients undergoing open repair had significantly more haemodynamic disturbance than those having endovascular repair (mean arterial pressure at 5 min following unclamping or balloon deflation: open (69.6 + 3.3 mmHg); endovascular (86 + 4.4 mmHg), P < 0.05 vs. pre-op). Troponin T levels at 48 h post-operatively were higher in patients who underwent open repair (open 0.164 + 0.1 ng/ml; endovascular 0.008 + 0.0005 ng/ml, P < 0.04). Significantly more patients in the open repair group had troponin T levels > 0.1 ng/l when compared with the endovascular group (P < 0.01, chi (2) test) CONCLUSION: Endovascular aortic surgery produces significantly less myocardial injury than the open technique of aortic aneurysm repair.
Authors: Monique Prinssen; Eric L G Verhoeven; Jaap Buth; Philippe W M Cuypers; Marc R H M van Sambeek; Ron Balm; Erik Buskens; Diederick E Grobbee; Jan D Blankensteijn Journal: N Engl J Med Date: 2004-10-14 Impact factor: 91.245
Authors: I Syk; J Brunkwall; K Ivancev; B Lindblad; A Montgomery; E Wellander; J Wisniewski; B Risberg Journal: Eur J Vasc Endovasc Surg Date: 1998-05 Impact factor: 7.069
Authors: Toru Takahashi; Atsushi Kato; Sergejs Berdnikovs; Whitney W Stevens; Lydia A Suh; James E Norton; Roderick G Carter; Kathleen E Harris; Anju T Peters; Kathryn E Hulse; Leslie C Grammer; Kevin C Welch; Stephanie Shintani-Smith; Bruce K Tan; David B Conley; Robert C Kern; Bruce S Bochner; Robert P Schleimer Journal: J Allergy Clin Immunol Date: 2017-02-24 Impact factor: 10.793