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Acute phase proteins and inflammatory factors: the peri-operative changes in on-pump versus off-pump cardiac surgery

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objectives

Off-pump cardiac bypass grafting (OPCABG) has reduced in numbers as some studies suggest no clinical benefit and greater technical difficulty compared to on-pump operations. We examined the inflammatory changes due to extracorporeal circulation and compared the outcomes of patients undergoing OPCABG, on-pump CABG and single cardiac valve replacement with mechanical one.

Methods

Sixty-six elective patients who had severe coronary vessel disease requiring coronary artery bypass were allocated to two groups. The 1st group underwent OPCAB and the other one on-pump coronary artery bypass. A third group of 33 patients presented with single valve disease and underwent mechanical valve replacement were included in our study. Pre- and postoperative serum levels of 15 markers of acute phase inflammatory response were analysed. Postoperative complications were also recorded.

Results

Both on-pump and off-pump coronary bypass techniques provoked biochemical and enzymatic alterations, with more systemic inflammations which correlate with more complications and worse outcome in the on-pump group. Mechanical valve implantation also provoked more systemic inflammation, possibly due to foreign bodies in the systemic circulation.

Conclusion

Our results suggest that off-pump bypass induce a lesser inflammatory response and have better outcomes to on-pump bypass and valve replacement operations.

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Acknowledgments

Our acknowledgments are to the staff of the Immunopathology Laboratory of Onassis Cardiac Surgery Centre of Athens, Greece for their unselfish help.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Clydebank, 2/1, 35 Polwarth Street, Hyndland, Glasgow, G12 9UE, UK

    Serafeim Chlapoutakis & Sanjeet Avtaar Singh

  2. Sismanoglio General Hospital, Athens, Greece

    Nikolaos Trakas

  3. Onassis Cardiac Surgery Center, Athens, Greece

    Dimitrios Degiannis

  4. University Hospital of Ioannina, Ioannina, Greece

    Efstratios Apostolakis

  5. Hippokrateio General Hospital of Athens, Athens, Greece

    Konstantinos Triantafyllou

Authors
  1. Serafeim Chlapoutakis
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  2. Sanjeet Avtaar Singh
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  3. Nikolaos Trakas
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  4. Dimitrios Degiannis
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  5. Efstratios Apostolakis
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  6. Konstantinos Triantafyllou
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Corresponding author

Correspondence to Serafeim Chlapoutakis.

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The authors declare that they have no conflict of interest.

Funding

This research was not supported by external funding.

Additional information

The research was carried out at Hippokrateio General Hospital of Athens, Greece.

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Chlapoutakis, S., Singh, S.A., Trakas, N. et al. Acute phase proteins and inflammatory factors: the peri-operative changes in on-pump versus off-pump cardiac surgery. Indian J Thorac Cardiovasc Surg 33, 205–212 (2017). https://doi.org/10.1007/s12055-017-0544-8

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  • DOI: https://doi.org/10.1007/s12055-017-0544-8

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