Document Detail


Perioperative myocardial injury and hemostasis in patients undergoing endovascular aneurysm repair for asymptomatic infrarenal abdominal aortic aneurysm.
MedLine Citation:
PMID:  22262114     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: (1) To report the incidence of myocardial injury in patients undergoing endovascular aortic aneurysm repair (EVAR) through the routine measurement of perioperative cardiac troponin-T (cTnT) and (2) to investigate and correlate changes in perioperative cTnT levels with any concomitant hemostatic derangement. Methods: Prospective study of 30 patients undergoing elective EVAR for infrarenal abdominal aortic aneurysm. Cardiac TnT was assayed at 24 hours postoperatively. Plasma thrombin antithrombin III complex (TAT), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) activity, and soluble P-selectin (sP-selectin) were assayed preoperatively and at 24 hours postoperatively. Results: Five (17%) patients demonstrated elevated cTnT levels at 24 hours; 3 patients had no clinical evidence of myocardial injury. There was a positive correlation between cTnT and TAT levels at 24 hours post-EVAR (r = .38, P = .039, Kendall-tau B = 0.26). Conclusions: Endovascular aortic aneurysm repair is associated with a significant risk of perioperative myocardial injury that is underdetected clinically and associated with a procoagulopathic state.
Authors:
Robert S M Davies; Mohamed Abdelhamid; Rajiv K Vohra; Andrew W Bradbury; Donald J Adam
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  45     ISSN:  1938-9116     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2012-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  712-6     Citation Subset:  IM    
Affiliation:
1University Department of Vascular Surgery, Heart of England NHS Foundation Trust, Birmingham, UK.
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