Technical Approach Determines Inflammatory Response after Surgical and Transcatheter Aortic Valve Replacement

• Published in: PloS one 2015-11, Vol.10 (11), p.e0143089-e0143089
• Main Authors: Erdoes, Gabor, Lippuner, Christoph, Kocsis, Istvan, Schiff, Marcel, Stucki, Monika, Carrel, Thierry, Windecker, Stephan, Eberle, Balthasar, Stueber, Frank, Book, Malte
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Anesthesiology; Antibiotics; Aorta; Aortic valve; Aortic valve stenosis; Atherosclerosis; Biomarkers; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Cardiology; Cardiovascular disease; Care and treatment; Coronary vessels; Cytokines; Cytokines - blood; Diabetes; Diagnosis; Emergency procedures; Female; Heart surgery; Heart valve replacement; Histocompatibility antigen HLA; HLA-DR Antigens - metabolism; Hospitals; Humans; Immune system; Immunosuppressive agents; Implantation; Inflammation; Inflammation - blood; Inflammation - etiology; Inflammation - pathology; Inflammatory response; Interleukin; Interleukin 10; Interleukin 6; Interleukin 8; Invasiveness; L-Selectin; Leukocyte Count; Leukocytes; Male; Medicine; Mortality; Pain; Patients; Rheumatic heart disease; Risk factors; Solubility; Stenosis; Studies; Surgeons; Surgery; Thoracic surgery; Transcatheter Aortic Valve Replacement - adverse effects; Transcatheter Aortic Valve Replacement - methods
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0143089

To investigate the periprocedural inflammatory response in patients with isolated aortic valve stenosis undergoing surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) with different technical approaches. Patients were prospectively allocated to one of the following treatments: SAVR using conventional extracorporeal circulation (CECC, n = 47) or minimized extracorporeal circulation (MECC, n = 15), or TAVI using either transapical (TA, n = 15) or transfemoral (TF, n = 24) access. Exclusion criteria included infection, pre-procedural immunosuppressive or antibiotic drug therapy and emergency indications. We investigated interleukin (IL)-6, IL-8, IL-10, human leukocyte antigen (HLA-DR), white blood cell count, high-sensitivity C-reactive protein (hs-CRP) and soluble L-selectin (sCD62L) levels before the procedure and at 4, 24, and 48 h after aortic valve replacement. Data are presented for group interaction (p-values for inter-group comparison) as determined by the Greenhouse-Geisser correction. SAVR on CECC was associated with the highest levels of IL-8 and hs-CRP (p