• J. Cardiothorac. Vasc. Anesth. · Nov 2021

    Changes in Plasma Angiopoietin Levels After Transcatheter Aortic Valve Replacement and Surgical Aortic Valve Replacement: A Prospective Cohort Study.

    • Osama Abou-Arab, Said Kamel, Stéphane Bar, Christophe Beyls, Pierre Huette, Cathy Gomila, Carine Avondo, Gilles Touati, Christophe Tribouilloy, Hervé Dupont, Emmanuel Lorne, and Pierre-Grégoire Guinot.
    • Department of Anaesthesiology and Critical Care Medicine, Amiens Picardie University Hospital, Amiens, France; MP3CV, EA7517, CURS, Jules Verne University of Picardie, Amiens, France. Electronic address: osama.abouarab@gmail.com.
    • J. Cardiothorac. Vasc. Anesth. 2021 Nov 1; 35 (11): 3215-3222.

    ObjectiveAngiopoietins (Angs) regulate endothelial permeability. Ang-1 and 2 (Ang-1 and Ang-2) are implied in endothelial stability through an antagonism effect. The objectives of the present study were to describe and compare changes in Ang levels after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).DesignA prospective, single-center study.ParticipantsAdult patients with aortic stenosis scheduled for SAVR or TAVR.InterventionsNone.Measurements And Main ResultsAng-1 and Ang-2 were measured using an enzyme-linked immunosorbent assay right before surgery (T0), at the end of surgery (T1), and at day one (T2). Sixty consecutive patients (SAVR group [n = 30] and TAVR group [n = 30]) were included between January and June 2017. Ang-1 decreased significantly after both TAVR (T0: 3,663 [2,602-4,262]; T1: 1,611 [981-2,409]; T2: 1,082 [652-1,589] ng/mL; p < 0.0001) and SAVR (T0: 1,603 [975-2,849]; T1: 783 [547-1,024]; T2: 828 [460-1,227] ng/mL; p = 0.0001). Ang-2 increased significantly after SAVR (T0: 2,472 [1,502-3,622]; T1: 2,997 [1,759-3,839]; T2: 5,421 [3,557-7,087] ng/mL; p < 0.0001) but did not change markedly after TAVR (T0: 3,343 [2,661-6,272]; T1: 3,788 [2,574-5,016]; T2: 3,446 [3,029-6,313] ng/mL; p = 0.066). Among patients with paravalvular leakage, the changes in the plasma Ang-2 level and the Ang-2/Ang-1 ratio were greater.ConclusionSAVR induces greater alterations of Ang homeostasis than TAVR, confirming a role for the use of cardiopulmonary bypass. Paravalvular leakage after TAVR is associated with Ang changes similar to those observed with SAVR.Copyright © 2021 Elsevier Inc. All rights reserved.

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