title: Alterations in plasma soluble vascular endothelial growth factor receptor-1 (sFlt-1) concentrations during coronary artery bypass graft surgery: relationships with post-operative complications.
abstract: BACKGROUND
  Plasma concentrations of sFlt-1, the soluble form of the vascular endothelial growth factor receptor (VEGF), markedly increase during coronary artery bypass graft (CABG) surgery with extracorporeal circulation (ECC). We investigated if plasma sFlt-1 values might be related to the occurrence of surgical complications after CABG.
  
  
  METHODS
  Plasma samples were collected from the radial artery catheter before vascular cannulation and after opening the chest, at the end of ECC just before clamp release, after cross release, after weaning from ECC, at the 6th and 24th post-operative hour. Thirty one patients were investigated. The presence of cardiovascular, haematological and respiratory dysfunctions was prospectively assessed. Plasma sFlt-1 levels were measured with commercially ELISA kits.
  
  
  RESULTS
  Among the 31 investigated patients, 15 had uneventful surgery. Patients with and without complications had similar pre-operative plasma sFlt-1 levels. Lowered plasma sFlt-1 levels were observed at the end of ECC in patients with haematological (p = 0.001, ANOVA) or cardiovascular (p = 0.006) impairments, but not with respiratory ones (p = 0.053), as compared to patients with uneventful surgery.
  
  
  CONCLUSIONS
  These results identify an association between specific post-CABG complication and the lower release of sFlt-1 during ECC. sFlt-1-induced VEGF neutralisation might, thus, be beneficial to reduce the development of post-operative adverse effects after CABG.
authors.affiliation: UMR CNRS 6101, Centre National de la Recherche Scientifique, Université de Limoges, France. yves.denizot@unilim.fr
authors.forename: Yves
authors.initials: Y
authors.lastname: Denizot
authors.forename: Alexandre
authors.initials: A
authors.lastname: Leguyader
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cornu
authors.forename: Marc
authors.initials: M
authors.lastname: Laskar
authors.forename: Isabelle
authors.initials: I
authors.lastname: Orsel
authors.forename: Christelle
authors.initials: C
authors.lastname: Vincent
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nathan
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000097:blood* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1