Desflurane Versus Propofol in Patients Undergoing Mitral Valve Surgery

Giovanni Landoni, Maria Grazia Calabrò, Chiara Marchetti, Elena Bignami, Anna Mara Scandroglio, Elisa Dedola, Monica De Luca, Luigi Tritapepe, Giuseppe Crescenzi, Alberto Zangrillo

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery, but it is unknown whether this benefit exists in patients undergoing valvular surgery with ischemia-reperfusion injury related to cardioplegic arrest and cardiopulmonary bypass. This study compared cardiac troponin release in patients receiving either volatile anesthetics or total intravenous anesthesia for mitral valve surgery. Design: Randomized controlled study. Setting: University hospital. Participants: One hundred twenty patients undergoing mitral valve surgery. Interventions: Fifty-nine patients received the volatile anesthetic desflurane for 30 minutes before cardiopulmonary bypass, whereas 61 patients received a total intravenous anesthetic with propofol. All patients had an opioid-based anesthetic for the mitral valve surgery. Measurements and Main Results: Peak postoperative troponin I release was measured as a marker of myocardial necrosis after mitral valve surgery. Patient mean age was 60 years, and 54% were men. There was no significant (p = 0.7) reduction in median (25th-75th percentiles) postoperative peak troponin, 11.0 (7.5-17.4) ng/dL in the desflurane group versus 11.5 (6.9-18.0) ng/dL in the propofol group. A subgroup of patients with concomitant coronary artery disease had the expected reduction (p = 0.02) of peak troponin I in those receiving desflurane, 14.0 (9.7-17.3) ng/dL, when compared with patients receiving total intravenous anesthesia, 31.6 (15.7-52.0) ng/dL. Conclusions: Myocardial damage measured by cardiac troponin release was not reduced by volatile anesthetics in patients undergoing mitral valve surgery, whereas it was reduced in patients with concomitant coronary artery disease.

Original languageEnglish
Pages (from-to)672-677
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume21
Issue number5
DOIs
Publication statusPublished - Oct 2007

Fingerprint

Propofol
Mitral Valve
Anesthetics
Troponin
Intravenous Anesthesia
Troponin I
Cardiopulmonary Bypass
desflurane
Coronary Artery Disease
Intravenous Anesthetics
Reperfusion Injury
Coronary Artery Bypass
Opioid Analgesics
Necrosis
Transplants

Keywords

  • coronary artery bypass grafting
  • desflurane
  • mitral valve surgery
  • preconditioning
  • troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Desflurane Versus Propofol in Patients Undergoing Mitral Valve Surgery. / Landoni, Giovanni; Calabrò, Maria Grazia; Marchetti, Chiara; Bignami, Elena; Scandroglio, Anna Mara; Dedola, Elisa; De Luca, Monica; Tritapepe, Luigi; Crescenzi, Giuseppe; Zangrillo, Alberto.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 21, No. 5, 10.2007, p. 672-677.

Research output: Contribution to journalArticle

Landoni, G, Calabrò, MG, Marchetti, C, Bignami, E, Scandroglio, AM, Dedola, E, De Luca, M, Tritapepe, L, Crescenzi, G & Zangrillo, A 2007, 'Desflurane Versus Propofol in Patients Undergoing Mitral Valve Surgery', Journal of Cardiothoracic and Vascular Anesthesia, vol. 21, no. 5, pp. 672-677. https://doi.org/10.1053/j.jvca.2006.11.017
Landoni, Giovanni ; Calabrò, Maria Grazia ; Marchetti, Chiara ; Bignami, Elena ; Scandroglio, Anna Mara ; Dedola, Elisa ; De Luca, Monica ; Tritapepe, Luigi ; Crescenzi, Giuseppe ; Zangrillo, Alberto. / Desflurane Versus Propofol in Patients Undergoing Mitral Valve Surgery. In: Journal of Cardiothoracic and Vascular Anesthesia. 2007 ; Vol. 21, No. 5. pp. 672-677.
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T1 - Desflurane Versus Propofol in Patients Undergoing Mitral Valve Surgery

AU - Landoni, Giovanni

AU - Calabrò, Maria Grazia

AU - Marchetti, Chiara

AU - Bignami, Elena

AU - Scandroglio, Anna Mara

AU - Dedola, Elisa

AU - De Luca, Monica

AU - Tritapepe, Luigi

AU - Crescenzi, Giuseppe

AU - Zangrillo, Alberto

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N2 - Objective: Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery, but it is unknown whether this benefit exists in patients undergoing valvular surgery with ischemia-reperfusion injury related to cardioplegic arrest and cardiopulmonary bypass. This study compared cardiac troponin release in patients receiving either volatile anesthetics or total intravenous anesthesia for mitral valve surgery. Design: Randomized controlled study. Setting: University hospital. Participants: One hundred twenty patients undergoing mitral valve surgery. Interventions: Fifty-nine patients received the volatile anesthetic desflurane for 30 minutes before cardiopulmonary bypass, whereas 61 patients received a total intravenous anesthetic with propofol. All patients had an opioid-based anesthetic for the mitral valve surgery. Measurements and Main Results: Peak postoperative troponin I release was measured as a marker of myocardial necrosis after mitral valve surgery. Patient mean age was 60 years, and 54% were men. There was no significant (p = 0.7) reduction in median (25th-75th percentiles) postoperative peak troponin, 11.0 (7.5-17.4) ng/dL in the desflurane group versus 11.5 (6.9-18.0) ng/dL in the propofol group. A subgroup of patients with concomitant coronary artery disease had the expected reduction (p = 0.02) of peak troponin I in those receiving desflurane, 14.0 (9.7-17.3) ng/dL, when compared with patients receiving total intravenous anesthesia, 31.6 (15.7-52.0) ng/dL. Conclusions: Myocardial damage measured by cardiac troponin release was not reduced by volatile anesthetics in patients undergoing mitral valve surgery, whereas it was reduced in patients with concomitant coronary artery disease.

AB - Objective: Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery, but it is unknown whether this benefit exists in patients undergoing valvular surgery with ischemia-reperfusion injury related to cardioplegic arrest and cardiopulmonary bypass. This study compared cardiac troponin release in patients receiving either volatile anesthetics or total intravenous anesthesia for mitral valve surgery. Design: Randomized controlled study. Setting: University hospital. Participants: One hundred twenty patients undergoing mitral valve surgery. Interventions: Fifty-nine patients received the volatile anesthetic desflurane for 30 minutes before cardiopulmonary bypass, whereas 61 patients received a total intravenous anesthetic with propofol. All patients had an opioid-based anesthetic for the mitral valve surgery. Measurements and Main Results: Peak postoperative troponin I release was measured as a marker of myocardial necrosis after mitral valve surgery. Patient mean age was 60 years, and 54% were men. There was no significant (p = 0.7) reduction in median (25th-75th percentiles) postoperative peak troponin, 11.0 (7.5-17.4) ng/dL in the desflurane group versus 11.5 (6.9-18.0) ng/dL in the propofol group. A subgroup of patients with concomitant coronary artery disease had the expected reduction (p = 0.02) of peak troponin I in those receiving desflurane, 14.0 (9.7-17.3) ng/dL, when compared with patients receiving total intravenous anesthesia, 31.6 (15.7-52.0) ng/dL. Conclusions: Myocardial damage measured by cardiac troponin release was not reduced by volatile anesthetics in patients undergoing mitral valve surgery, whereas it was reduced in patients with concomitant coronary artery disease.

KW - coronary artery bypass grafting

KW - desflurane

KW - mitral valve surgery

KW - preconditioning

KW - troponin

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