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Published on: March 26, 2018
Myocardial injury in major aortic surgery
H M Hafez1, C S Berwanger, A McColl
1Academic Surgical and Regional Vascular Unit, Division of Surgery and Anaesthetics, Imperial College Medical School at St Mary's Hospital, UK.
Journal of Vascular Surgery
|February 7, 2001
Summary
Major aortic surgery, especially thoracoabdominal aortic aneurysm (TAAA) repair, causes cardiac injury. Oxidative stress, indicated by lower antioxidant status and higher lipid hydroperoxides, correlates with myocardial damage (troponin-T release) after TAAA surgery.
Area of Science:
- Cardiovascular Surgery
- Oxidative Stress Research
- Myocardial Injury Biomarkers
Background:
- Major aortic aneurysm repair involves significant surgical stress.
- Oxidative stress and its impact on the myocardium during these procedures are not fully understood.
Purpose of the Study:
- To investigate the effects of major aortic surgery on myocardial injury.
- To assess the role of oxidative stress in myocardial damage following aortic aneurysm repair.
Main Methods:
- Plasma samples collected from patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair (n=27) and infrarenal aortic aneurysm (AAA) repair (n=17).
- Measurements included troponin-T, total antioxidant status, and lipid hydroperoxides at multiple time points.
- Cardiac dysfunction was monitored post-surgery.
Main Results:
- Cardiac dysfunction occurred in 10 patients post-surgery, predominantly in the TAAA group.
- Total antioxidant status decreased significantly post-reperfusion, more so in TAAA patients.
- Lipid hydroperoxide levels rose sharply post-reperfusion in TAAA patients.
- Troponin-T levels elevated significantly 8 and 24 hours after reperfusion in TAAA patients, correlating with oxidative stress markers.
Conclusions:
- Supracoeliac aortic crossclamping is linked to troponin-T release, indicating myocardial injury.
- The observed myocardial injury correlates more with oxidative stress than hemodynamic changes.
- Targeting oxidative injury during TAAA surgery could offer cardioprotection.
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