Myocardial Revascularization by Left Ventricular Assisted Beating Heart Is Associated With Reduced Systemic Inflammatory Response

Autor: Giancarlo Brando, Paolo Stassano, Luigi Di Tommaso, Giuseppe Ambrosio, Severino Iesu, Mario Monaco, Paolo Pepino, Salvatore Buonpane, Giuseppe Di Benedetto
Rok vydání: 2009
Předmět:
Male
Pulmonary and Respiratory Medicine
Inotrope
medicine.medical_treatment
Coronary Artery Bypass
Off-Pump
Coronary Disease
Inflammation
Revascularization
Risk Assessment
Statistics
Nonparametric
Proinflammatory cytokine
law.invention
Leukocyte Count
Extracorporeal Membrane Oxygenation
Postoperative Complications
law
Myocardial Revascularization
Cardiopulmonary bypass
Humans
Medicine
Aged
Probability
Analysis of Variance
Cardiopulmonary Bypass
biology
Interleukin-6
Tumor Necrosis Factor-alpha
business.industry
Extracorporeal circulation
C-reactive protein
Middle Aged
Radiography
C-Reactive Protein
Treatment Outcome
Elective Surgical Procedures
Anesthesia
Circulatory system
biology.protein
Cytokines
Female
Surgery
Inflammation Mediators
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: The Annals of Thoracic Surgery. 87:46-52
ISSN: 0003-4975
DOI: 10.1016/j.athoracsur.2008.07.098
Popis: Background The present study was designed to investigate whether use of left ventricular assisted technique (LVA) in beating-heart myocardial revascularization would exert less impact on patients' inflammatory response, as compared with minimal extracorporeal circulation (MECC). Methods Seventy-three consecutive high-risk patients undergoing myocardial revascularization were randomly assigned either to LVA (group A) or to MECC (group B). Monocyte count and plasma concentration of C-reactive protein, inflammatory cytokines interleukin-1β, interleukin-6, and tumor necrosis factor-α, and polymorphonuclear elastase were measured at baseline and at various time points postoperatively. Results Preoperative clinical and demographic data did not differ between the two groups. The two groups also were similar with respect to mortality, number of grafts performed, duration of extracorporeal circulation, and need for inotropes. However, LVA was associated with significantly less inflammatory response postoperatively compared with MECC, as indicated by a significant difference in interleukin-6 ( p = 0.002), C-reactive protein ( p = 0.002), monocyte percentage ( p = 0.006), tumor necrosis factor-α ( p = 0.002), and polymorphonuclear elastase ( p = 0.001). Conclusions High-risk patients undergoing beating-heart myocardial revascularization with LVA show reduced inflammatory response compared with patients treated with the MECC.
Databáze: OpenAIRE
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