Management of Systemic Inflammatory Response Syndrome After Cardiovascular Interventions. Diagnostic, Prognostic, and Therapeutic Implications

Carlo Mannina, Annapoorna Kini, Andreina Carbone, Eric Neibart, Eduardo Bossone, Francesca Romana Prandi, Rami Tadros, Giovanni Esposito, Raimund Erbel, Samin K. Sharma, Stamatios Lerakis

Research output: Contribution to journalReview articlepeer-review

Abstract

A substantial number of patients may experience systemic inflammatory response syndrome (SIRS) and related adverse events after transcatheter aortic valve implantation and endovascular aortic aneurysm repair. Although a clear etiology has not been established, endothelial disruption and tissue-ischemic response secondary to the foreign material may represent the trigger events. A latency period (0 to 48 hours) may occur between the initial injury and onset of symptoms mirroring an initial local response followed by a systemic response. Clinical presentation can be mild or severe depending on external triggers and characteristics of the patient. Diagnosis is challenging because it simulates an infection, but lack of response to antibiotics, negative cultures are supportive of SIRS. Increased in-hospital stay, readmissions, major cardiovascular events, and reduced durability of the device used are the main complications. Treatment includes non-steroidal anti-inflammatory drugs or corticosteroids. In conclusion, further studies are warranted to fully explore pathophysiologic mechanisms underpinning SIRS and the possibility of enhancing device material immune compatibility to reduce the inflammatory reaction of the host tissue.

Original languageEnglish
Pages (from-to)84-93
Number of pages10
JournalAmerican Journal of Cardiology
Volume221
DOIs
StatePublished - 15 Jun 2024

Keywords

  • aortic aneurysm repair
  • cardiovascular outcomes
  • systemic inflammatory response syndrome
  • transcatheter aortic valve implantation

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