title: Myocardial revascularization by left ventricular assisted beating heart is associated with reduced systemic inflammatory response.
abstract: BACKGROUND
  The present study was designed to investigate whether use of left ventricular assisted technique (LVA) in beating-heart myocardial revascularization would exert less impact on patients' inflammatory response, as compared with minimal extracorporeal circulation (MECC).
  
  
  METHODS
  Seventy-three consecutive high-risk patients undergoing myocardial revascularization were randomly assigned either to LVA (group A) or to MECC (group B). Monocyte count and plasma concentration of C-reactive protein, inflammatory cytokines interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha, and polymorphonuclear elastase were measured at baseline and at various time points postoperatively.
  
  
  RESULTS
  Preoperative clinical and demographic data did not differ between the two groups. The two groups also were similar with respect to mortality, number of grafts performed, duration of extracorporeal circulation, and need for inotropes. However, LVA was associated with significantly less inflammatory response postoperatively compared with MECC, as indicated by a significant difference in interleukin-6 (p = 0.002), C-reactive protein (p = 0.002), monocyte percentage (p = 0.006), tumor necrosis factor-alpha (p = 0.002), and polymorphonuclear elastase (p = 0.001).
  
  
  CONCLUSIONS
  High-risk patients undergoing beating-heart myocardial revascularization with LVA show reduced inflammatory response compared with patients treated with the MECC.
authors.affiliation: Cardiac Surgery Unit, School of Medicine, University Federico II, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Stassano
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Tommaso
authors.forename: Mario
authors.initials: M
authors.lastname: Monaco
authors.forename: Severino
authors.initials: S
authors.lastname: Iesu
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Brando
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buonpane
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Benedetto
authors.forename: Paolo
authors.initials: P
authors.lastname: Pepino
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism*; D002315:Cardiopulmonary Bypass; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery; D016207:Cytokines / Q000032:analysis / Q000378:metabolism; D017558:Elective Surgical Procedures; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018836:Inflammation Mediators / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis / Q000378:metabolism; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011336:Probability; D011859:Radiography; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein