Abstract Background. The evaluation of long-term inflammatory response and function in postoperative patients with aortic valve replacement (AVR) deserves special analysis because it is important to try to prevent reoperation and improve durability and functionality of the prostheses. Methods In this study we included a cohort of patients with aortic valve damage treated by AVR with mechanical prosthesis, bioprosthesis and we included a control group. Results. We found that IL-4 and OPN levels were higher in patients with mechanical vs. biological prostheses (p = 0.01 and p = 0.04 respectively), OPG levels were decreased (p = 0.01), women had lower levels of ET-1 and IL-6, (p = 0.02) (p = 0.04) respectively. Patients older than 60 years had decreased levels of IL-1ß p <0.001) and a higher concentration of IL-4 p < 0.05). IL-1ß, OPG and TNFα were higher in patients with less than 5 years of evolution versus more than 10 years (p = 0.004, p = 0.02 and p = 0.03 respectively). Factors such as age, gender, prosthetic, and elevated IL-1B and ET-1 levels are associated with valve dysfunction prosthetic. These results indicate that the inflammatory involvement present prior to valve replacement may be perpetuated by various factors in the long term. Conclusions The findings provide us with the opportunity to effectively treat patients with AVR in the postoperative period, which could prolong the functionality of the bioprostheses.

Objective: To determine the impact and usefulness of the combination of structural and functional biomarkers in the diagnosis of acute renal injury (AKI) and short-term prognosis of patients undergoing cardiac surgery (CS). Material and Methods. Prospective cohort study (March 2018 to December 2019). 63 adults older than 18 years old, on the Intensive Care Unit (ICU) were included. Interventions: Patients had undergone CS with extracorporeal circulation (ECC). Surgery was elective in 80% of cases; it was urgent in 18% and emergent in 3%. Exclusion criteria included chronic kidney disease, contrast medium application ≤24 hour before surgery, cancer, infectious and autoimmune diseases. On admission to the ICU, serum creatinine, urinary creatinine, urinary sediment, urinary NGAL, urinary cystatin, microalbuminuria and serum cystatin were measured. Results. AKI was found 31 cases (49%). ECC without renal damage was found when time of extracorporeal circulation was of 85 ± 25 minutes and with renal damage when it lasted 114 ± 32 (p = 0.0001). Serum creatinine has a likelihood ratio (LR) + of 5.5, the combination of serum cystatin c (cystatin C) and normalized NGAL, showed a better LR. In patients with severe irreversible AKI, the combination of cystatin C + NGAL adjusted to urinary creatinine (NGAL/uCr) + microalbuminuria had a LR+ of 18.75 and LR - of 0.26. Conclusions: The combination of biomarkers predicts and identifies severity of AKI and Biomarkers combination in Cardiac Surgery