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Comparison of serum troponin I and plasma lactate concentrations in arrested versus beating-heart aortic valve
1Department for Cardiovascular Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia. primoz.trunk@mf.uni-lj.si
Background And Aim Of The Study:
The study aim was to monitor serum troponin and plasma lactate concentrations in conventional aortic valve replacement compared to a beating-heart technique, perfused via the coronary sinus.
Methods:
In this prospective, non-randomized study, which was conducted between 2003 and 2009, a total of 35 patients was allocated to two groups, based on the method of myocardial protection. The groups did not differ significantly in terms of preoperative parameters. Levels of lactate were measured in all 35 patients, and of troponin I in 20 patients, in consecutive samples during and after surgery.
Results:
There was no in-hospital mortality and no serious complications among patients. The cardiopulmonary bypass and aortic cross-clamp times were each significantly shorter and lactate and troponin I concentrations higher, in the beating-heart group. No perioperative myocardial infarction was observed.
Conclusion:
Although good clinical results were observed in patients operated when using the beating-heart technique with retrograde coronary sinus perfusion, postoperative serum levels of troponin I were higher than in patients operated on using a conventional technique. Although troponin I is considered a prognostic factor for postoperative mortality, this parameter applies only to selected patients rather than for widespread use.
