Bioprosthesis in aortic valve replacement. Long-term inflammatory
response and functionality.
Abstract
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.