The effects of dexmedetomidine against ruptured abdominal aortic aneurysm injury to myocardial tissue induced by abdominal aorta clamping

Objectives: This study aims to examine the potential protective effect of the selective alpha-2 adrenergic receptor agonist dexmedetomidine (DEX) against aortic occlusion-induced myocardial injury. Patients and methods: A total of 30 rats were randomly assigned into three groups of 10 animals each as control, ischemia+reperfusion (I/Rep), and I/Rep+DEX. In the I/Rep and I/Rep+DEX groups, after the completion of the shock stage, 60-min lower torso ischemia was induced with the application of cross-clamps to the abdominal aorta, followed by 120-min reperfusion. The I/Rep+DEX group received intraperitoneal 100 μg/kg DEX 30 min before the ischemia period. Results: Malondialdehyde (MDA) levels in myocardial tissue increased with the application of I/Rep, while glutathione (GSH) levels decreased. We also observed swollen, degenerative, apoptotic cardiac myofibrils exhibiting caspase-3 positivity, widespread edematous areas, vascular congestion, and an increase in the heart damage scores. The MDA levels decreased with DEX administration, while the GSH levels increased. Degenerative, apoptotic cardiac myofibrils exhibiting loss of cytoplasm content, and vascular congestion also decreased. Conclusion: Our study results suggest that DEX may have a future role in the treatment of myocardial damage occurring due to reperfusion, following ruptured abdominal aortic aneurysm surgery.

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Significance of delayed surgical treatment of symptomatic non-ruptured abdominal aortic aneurysm

Medicinski pregled ◽

10.2298/mpns1904080b ◽

2019 ◽

Vol 72 (3-4) ◽

pp. 80-87

Author(s):

Slavko Budinski ◽

Janko Pasternak ◽

Vladimir Manojlovic ◽

Vladimir Markovic ◽

Dragan Nikolic

Keyword(s):

Abdominal Aortic Aneurysm ◽

Surgical Treatment ◽

Aortic Aneurysm ◽

Abdominal Aorta ◽

Ruptured Aneurysm ◽

Ruptured Abdominal Aortic Aneurysm ◽

Ruptured Aneurysms ◽

Abdominal Aortic ◽

Significant Difference ◽

The Impact

Introduction. An abdominal aortic aneurysm is a permanent focal dilation of the blood vessel wall to about 1.5 times larger than the normal diameter. Clinically, it may be divided into symptomatic and asymptomatic. It is still discussed whether patients with symptomatic non-ruptured abdominal aortic aneurysm benefit more from emergency or delayed surgical treatment. The aim of the study was to evaluate the results of the symptomatic non-ruptured aneurysms in regard to the diameter of ruptured and non-ruptured symptomatic aneurysms and the impact of the time elapsed from admission to surgery on its outcome. Material and Methods. The retrospective study included all 133 patients who underwent surgery due to symptomatic non-ruptured or ruptured abdominal aortic aneurysm at the Clinic of Vascular and Endovascular Surgery during the previous 3 years. Results. Out of a total of 133 patients, 75.19% underwent surgery in the first 24 hours after admission, while the rest 24.81% of patients were operated later. Intraoperative complications were recorded only in patients with ruptured aneurysms, 4% had cardiac arrest and 1.5% of patients had fatal outcome. The in-hospital mortality was 16.67% in patients with non-ruptured aneurysm of the abdominal aorta operated in the first 24 hours, and 9.91% in patients who were operated after 24 hours after admission. Conclusion. Early elective surgery is a method of choice in the treatment of symptomatic non-ruptured aneurysm of the abdominal aorta. However, surgical treatment in the first 24 hours is associated with a higher mortality rate than surgery after 24 hours after admission. Also, there is no statistically significant difference in the diameter of ruptured and non-ruptured symptomatic aneurysms, but the average size of the aneurysm diameter is higher in ruptured than in non-ruptured aneurysms, which confirms the fact that the increase in diameter increases the risk of aneurysm rupture.

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Resveratrol against lung injury in an ischemia/reperfusion model of abdominal aortic rupture

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2021.21737 ◽

2021 ◽

Vol 29 (3) ◽

pp. 330-338

Author(s):

Sedat Ozan Karakişi ◽

Doğuş Hemşinli ◽

Levent Tümkaya ◽

Şaban Ergene ◽

Tolga Mercantepe ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Lung Injury ◽

Dimethyl Sulfoxide ◽

Ischemia Reperfusion ◽

Lung Damage ◽

Control Group ◽

Ruptured Abdominal Aortic Aneurysm ◽

Abdominal Aortic ◽

Significant Difference

Background: The aim of this study was to examine the effects on the lungs of ischemia/reperfusion injury in a ruptured abdominal aortic aneurysm model in rats and to investigate the potential protective effects of resveratrol. Methods: Thirty-two male Sprague-Dawley rats were randomly divided into four groups: control, ischemia/reperfusion, sham (ischemia/ reperfusion + solvent/dimethyl sulfoxide), and ischemia/reperfusion + resveratrol. In the groups subjected to ischemia/reperfusion, following 60-min shock to the abdominal aorta, vascular clamps were attached from the levels of the infrarenal and iliac bifurcation. A total of 60-min ischemia was applied, followed by 120-min reperfusion. In the ischemia/ reperfusion + resveratrol group, intraperitoneal 10 mg/kg resveratrol was administered 15 min before ischemia and immediately after reperfusion. Malondialdehyde, glutathione, and catalase levels were analyzed and histopathological examination of the lung tissues was performed. Results: Malondialdehyde levels increased in the ischemia/reperfusion and ischemia/reperfusion + dimethyl sulfoxide groups, compared to the control group, while catalase levels decreased, and no significant difference was observed in the glutathione levels. Malondialdehyde levels decreased with the administration of resveratrol, while glutathione levels increased, and catalase levels remained unchanged. The increased inflammation in interstitial spaces, thickening in the alveolar septal walls, increased numbers of cleaved caspase-3 apoptotic pneumocytes, and increased histopathological lung damage scores observed in the ischemia/reperfusion and ischemia/reperfusion + dimethyl sulfoxide groups improved with the application of resveratrol. Conclusion: These findings suggest that resveratrol may exhibit a protective effect in preventing acute lung injury developing due to ischemia/reperfusion in ruptured abdominal aortic aneurysm surgery by reducing oxidative damage.

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