Reduced inflammatory response by transcatheter,as compared to surgical aortic valve replacement |
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| Authors: | Karoline K. H. Fiane Gry Dahle Bjørn Bendz Per Steinar Halvorsen Michael Abdelnoor Tom Eirik Mollnes |
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| Affiliation: | 1. The Intervention Centre, Oslo University Hospital, Oslo, Norway;2. Faculty of Medicine, Oslo University, Oslo, Norway;3. Faculty of Medicine, Oslo University, Oslo, Norway;4. Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway;5. Department of Cardiology, Oslo University Hospital, Oslo, Norway;6. Department of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway;7. Department of Immunology, Oslo University Hospital, and K.G. Jebsen IRC, University of Oslo, Oslo, Norway;8. Research Laboratory, Nordland Hospital, Bod?, and K.G. Jebsen TREC, University of Troms?, Bod?, Norway;9. Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway |
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| Abstract: | Objectives. The inflammatory response to on-pump cardiac surgery is well known. Systemic inflammatory response syndrome after transcatheter valve implantation (TAVI) has been reported. The objective of this study was to study the inflammatory response during TAVI, and compare with the response during surgical aortic valve replacement. Methods. Eighteen patients undergoing transcatheter implantation, either by a transfemoral (n?=?9) or transaortal (n?=?9) approach were compared with eighteen patients admitted for surgical replacement. Blood samples per- and postoperatively were analysed for C3bc, terminal complement complex, myeloperoxidase, macrophage inflammatory protein-1β, monocyte chemo-attractant peptide-1, eotaxin, IL-6 and troponin-T. All markers were measured at defined time points and the areas under the curve were compared. Results. Activation of complement, granulocytes, monocytes and eosinophils were significantly lower in the transcatheter group as compared to the surgical group (<0.01). There was no difference in generation of troponin T and IL-6. A small difference in complement activation was observed between the transfemoral and transaortal placement of TAVI. There was no significant difference in clinical outcomes between the TAVI and surgical groups. Discussion. Activation and release of inflammatory markers was significantly less during with TAVI as compared to SAVR, particularly for markers associated with extracorporeal circulation. TAVI and SAVR generated the same degree of IL-6 and troponin T, indicating that the burden on the myocardial tissue was the same.Clinical Trials: Gov ID: NCT03074838 Unique protocol ID: 2012/7919 |
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| Keywords: | Transcatheter aortic valve implantation aortic valve replacement aortic stenosis inflammation systemic inflammatory response syndrome |
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