Toggle Main Menu Toggle Search

Open Access padlockePrints

Myocardial injury in major aortic surgery

Lookup NU author(s): Dr Christoph Berwanger, Professor Gerard Stansby

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

PURPOSE: The purpose of this study was to examine the effects of major aortic surgery and its associated oxidative stress and injury on the myocardium. METHODS: Plasma from 27 patients who underwent thoracoabdominal aortic aneurysm (TAAA) repair and 17 patients who underwent infrarenal aortic aneurysm (AAA) repair was collected at incision, aortic crossclamping, and reperfusion and 1, 8, and 24 hours thereafter. Samples were assayed for the myocardial specific protein troponin-T, total antioxidant status, and lipid hydroperoxides. RESULTS: Ten patients experienced cardiac dysfunction in the first 24 hours after surgery (eight patients in the TAAA group and two patients in the AAA group). Immediately after reperfusion, total antioxidant status levels dropped in all patients with TAAA and with AAA; this was more marked in patients with TAAA, leading to a significant difference between the two groups at this time point and for up to 1 hour thereafter (P <.01). Patients with TAAA showed a sharp rise in lipid hydroperoxide levels immediately after reperfusion, and levels were significantly higher than in patients with AAA (P =.0007). In patients with AAA, no significant change in troponin-T was observed throughout the study period; whereas in patients with TAAA, levels were significantly elevated at 8 and 24 hours after reperfusion (P <.01). Troponin-T levels significantly correlated with total antioxidant status (r = -0.5) and lipid hydroperoxides (r = 0.78) but not with systolic blood pressure. CONCLUSION: Supracoeliac aortic crossclamping is associated with a significant release of the myocardial injury marker troponin-T. This seems to correlate with the severity of oxidative rather than hemodynamic stresses. Ameliorating oxidative injury during TAAA surgery may therefore have a cardioprotective effect.


Publication metadata

Author(s): Hafez HM, Berwanger CS, McColl A, Richmond W, Wolfe JH, Mansfield AO, Stansby G

Publication type: Article

Publication status: Published

Journal: Journal of Vascular Surgery

Year: 2000

Volume: 31

Issue: 4

Pages: 742-750

ISSN (print): 0741-5214

ISSN (electronic): 1097-6809

Publisher: Mosby, Inc.

URL: http://dx.doi.org/10.1067/mva.2000.102325

DOI: 10.1067/mva.2000.102325

Notes: 0741-5214 Journal Article


Altmetrics

Altmetrics provided by Altmetric


Actions

Find at Newcastle University icon    Link to this publication


Share