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Association of Aortic Cross-Clamping Time with Systemic Immune Inflammation and Systemic Inflammatory Response

Duygu Durmaz1, Sedat Gündöner1, Hayrettin Tekümit1

  • 1Bandirma Onyedi Eylül University Department of Cardiothoracic and Vascular Surgery Balıkesir Turkiye Department of Cardiothoracic and Vascular Surgery, Bandirma Onyedi Eylül University, Balıkesir, Turkiye.

Brazilian Journal of Cardiovascular Surgery
|September 17, 2025
PubMed

Insights

Prolonged aortic cross-clamping in coronary artery bypass grafting intensifies the inflammatory response. Higher systemic immune inflammation index and systemic inflammatory response index indicate increased inflammation post-surgery.

Area of Science:

  • Cardiovascular Surgery
  • Immunology
  • Inflammation Research

Background:

  • Cardiac surgery, particularly coronary artery bypass grafting (CABG), involves aortic cross-clamping.
  • Prolonged aortic cross-clamping is suspected to exacerbate systemic inflammation post-surgery.
  • Evaluating inflammatory markers is crucial for understanding surgical outcomes.

Purpose of the Study:

  • To investigate the impact of aortic cross-clamping duration on inflammatory indices.
  • To assess the relationship between cross-clamp time and systemic inflammatory response index (SIRI) and systemic immune inflammation index (SIII) in isolated CABG patients.

Main Methods:

  • Retrospective analysis of 155 patients undergoing first-time isolated CABG.
  • Patients divided into two groups based on median cross-clamping time (≤ 64 minutes vs. > 64 minutes).
  • Collection of demographic, hematologic, and biochemical data; calculation of SIRI and SIII.

Main Results:

  • Mean cross-clamping times were 53 minutes (Group I) and 78 minutes (Group II).
  • Both SIRI and SIII increased postoperatively in all patients.
  • Group II (longer cross-clamp time) showed significantly higher postoperative SIRI and SIII levels.
  • A weak positive correlation was found between cross-clamp duration and postoperative SIRI.

Conclusions:

  • Extended aortic cross-clamping duration is linked to a heightened postoperative inflammatory response.
  • SIRI and SIII can potentially serve as valuable biomarkers for systemic inflammation after CABG.
  • Optimizing cross-clamp time may help mitigate postoperative inflammation.
Abstract

Keywords:
BiomarkersConstrictionCoronary Artery BypassInflammationLymphocytesNeutrophilsSystemic Inflammatory Response Syndrome.

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