Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta
Abstract Objectives Aortic pathologies often present with elevated inflammatory biomarkers due to the nature of the disease. Open aortic surgery causes significant trauma to the body due to often mandatory ischemic periods, long cardiopulmonary bypass times and polytransfusion. We aim to determine p...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02672-4 |
| _version_ | 1797199198977785856 |
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| author | Martin T Yates Alexander Smith Alina A Mistirian Carola M Bigogno Michelle Lee Ana Lopez-Marco |
| author_facet | Martin T Yates Alexander Smith Alina A Mistirian Carola M Bigogno Michelle Lee Ana Lopez-Marco |
| author_sort | Martin T Yates |
| collection | DOAJ |
| description | Abstract Objectives Aortic pathologies often present with elevated inflammatory biomarkers due to the nature of the disease. Open aortic surgery causes significant trauma to the body due to often mandatory ischemic periods, long cardiopulmonary bypass times and polytransfusion. We aim to determine postoperative trends on inflammation biomarkers for different aortic pathologies and type of surgery in different segments of the aorta. Methods Retrospective review of prospectively collected data of 193 consecutive patients who underwent aortic surgery in our centre between 2017 and 2021, grouped according to the type of aortic intervention: (1) Type A aortic dissection (AD) repair with ascending aorta/hemiarch replacement, (2) Aortic root replacement (ARR), (3) Aortic arch + Frozen elephant trunk (FET), (4) Descending thoracic aorta (DTA)/Thoraco-Abdominal aortic repair (TAA). Primary outcomes were daily values of white blood cells (WBC) and C-Reactive Protein (CRP) during the first 15 postoperative days. Results All groups had a similar inflammatory peak in the first 2–4 days (WBC 12-15 × 109 c/L). AD and FET groups show similar trends with WBC and CRP peaks on days 2 and 10. The ARR group didn’t experience the 2nd peak as most patients were already discharged. DTA/TAA patients experienced a more prolonged inflammatory response, reaching a plateau by day 5–10. AD group shows the highest WBC levels and the DTA/TAAA group the highest CRP levels. CRP levels remain elevated (100–200 mg/L) in all groups after 15 postoperative days. Conclusions Inflammatory biomarkers show different postoperative trends depending on the clinical presentation and complexity of the aortic procedure performed. Further understanding of the inflammatory response to different aortic pathologies and surgical procedures will permit reduction on the liberal use of antibiotics that this cohort of patients are usually exposed to. An earlier version of the data included in this manuscript was presented as Oral Abstract in the UK Society of Cardiothoracic Surgery Annual meeting in 2021 |
| first_indexed | 2024-04-24T07:11:57Z |
| format | Article |
| id | doaj.art-7a885ae6db3d4ac2958b8aeb14beebf2 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-24T07:11:57Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-7a885ae6db3d4ac2958b8aeb14beebf22024-04-21T11:29:56ZengBMCJournal of Cardiothoracic Surgery1749-80902024-04-011911710.1186/s13019-024-02672-4Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aortaMartin T Yates0Alexander Smith1Alina A Mistirian2Carola M Bigogno3Michelle Lee4Ana Lopez-Marco5Department of Cardiothoracic Surgery, St Bartholomew’s HospitalDepartment of Cardiothoracic Surgery, St Bartholomew’s HospitalDepartment of Cardiothoracic Surgery, St Bartholomew’s HospitalWilliam Harvey Institute, Queen Mary UniversityDepartment of Cardiothoracic Surgery, St Bartholomew’s HospitalDepartment of Cardiothoracic Surgery, St Bartholomew’s HospitalAbstract Objectives Aortic pathologies often present with elevated inflammatory biomarkers due to the nature of the disease. Open aortic surgery causes significant trauma to the body due to often mandatory ischemic periods, long cardiopulmonary bypass times and polytransfusion. We aim to determine postoperative trends on inflammation biomarkers for different aortic pathologies and type of surgery in different segments of the aorta. Methods Retrospective review of prospectively collected data of 193 consecutive patients who underwent aortic surgery in our centre between 2017 and 2021, grouped according to the type of aortic intervention: (1) Type A aortic dissection (AD) repair with ascending aorta/hemiarch replacement, (2) Aortic root replacement (ARR), (3) Aortic arch + Frozen elephant trunk (FET), (4) Descending thoracic aorta (DTA)/Thoraco-Abdominal aortic repair (TAA). Primary outcomes were daily values of white blood cells (WBC) and C-Reactive Protein (CRP) during the first 15 postoperative days. Results All groups had a similar inflammatory peak in the first 2–4 days (WBC 12-15 × 109 c/L). AD and FET groups show similar trends with WBC and CRP peaks on days 2 and 10. The ARR group didn’t experience the 2nd peak as most patients were already discharged. DTA/TAA patients experienced a more prolonged inflammatory response, reaching a plateau by day 5–10. AD group shows the highest WBC levels and the DTA/TAAA group the highest CRP levels. CRP levels remain elevated (100–200 mg/L) in all groups after 15 postoperative days. Conclusions Inflammatory biomarkers show different postoperative trends depending on the clinical presentation and complexity of the aortic procedure performed. Further understanding of the inflammatory response to different aortic pathologies and surgical procedures will permit reduction on the liberal use of antibiotics that this cohort of patients are usually exposed to. An earlier version of the data included in this manuscript was presented as Oral Abstract in the UK Society of Cardiothoracic Surgery Annual meeting in 2021https://doi.org/10.1186/s13019-024-02672-4Aortic surgeryInflammationPerioperative management |
| spellingShingle | Martin T Yates Alexander Smith Alina A Mistirian Carola M Bigogno Michelle Lee Ana Lopez-Marco Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta Journal of Cardiothoracic Surgery Aortic surgery Inflammation Perioperative management |
| title | Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta |
| title_full | Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta |
| title_fullStr | Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta |
| title_full_unstemmed | Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta |
| title_short | Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta |
| title_sort | inflammation in aortic surgery postoperative evolution of biomarkers according pathologies and segments of the aorta |
| topic | Aortic surgery Inflammation Perioperative management |
| url | https://doi.org/10.1186/s13019-024-02672-4 |
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