Desflurane-induced Myocardial Protection

Desflurane-induced Myocardial Protection in Aortic Valve Surgery: A Pilot Study

This study examines pharmacological preconditioning and post conditioning of desflurane by comparing cardiac troponin release in patients receiving either desflurane or propofol for the aortic valve surgery.

Patients scheduled for aortic valve replacement with use of cardiopulmonary bypass are included in the study. Patients are assigned to desflurane group (Des) or propofol group (Prop). Des receives desflurane (1-2 MAC) inhalation between the induction of anesthesia and cardiopulmonary bypass (CPB). After the induction of CPB, the anesthesia in Des is switched to a total intravenous anesthesia (TIVA) with propofol. Prop receives a TIVA during the surgery. All patients receive a continuous infusion of remifentanil. Biomarker of myocardial damage troponin I is examined at 4 points; T1: after the induction of anesthesia, T2: arrival at ICU, T3: 12 hours after the ICU arrival, T4: 24 hours after the ICU arrival, T5: third post operative day (3POD).

Inclusion Criteria:

• Patients scheduled for aortic valve replacement with use of cardiopulmonary bypass.

Exclusion Criteria:

• Patients younger than 20 years old.
• Recent myocardial infarction (within 1 year).
• Renal dysfunction (GFR less than 50ml/min).
• Known allergy to study drugs including propofol.