Cardiac Surgery and Postoperative Organ Dysfunction

Study Overview
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Brief Summary
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The aim of the study is to identify the correlation between ischaemia reperfusion injury and postoperative multiorgan damage during cardiopulmonary cardiac surgery; and to investigate biomarkers that can predict postoperative organ damage in cardiac surgery.

Detailed Description
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This study proposes to observe multi-organ functional impairment of the heart, kidney and brain after extracorporeal circulation in a prospective study of clinical patients; to obtain markers with diagnostic and predictive efficacy by collecting pre and postoperative serum and heart and ear tissue samples from patients with postoperative organ functional impairment, performing combined proteomic and metabolomic analyses, and by analysing them with detailed postoperative clinical prognostic data using machine learning algorithms.

Official Title
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Cardiopulmonary Bypass Ischemia/Reperfusion Injury and Postoperative Multiple Organ Dysfunction in Elder Patients

Conditions
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Postoperative Complications

Intervention / Treatment
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* Procedure: ischemic reperfusion injury


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥50 years; patients requiring mitral valve replacement surgery or mitral valve plus aortic valve replacement under cardiopulmonary bypass Agreed to participate in this study, and signed the informed consent form. Exclusion Criteria: History of neurological disease (stroke, reversible ischemic hypoxia, transient ischemic attack, or Neurodegeneration) ; Patients with severe preoperative renal insufficiency (serum creatinine > 442 μmol/L or need renal replacement therapy) , liver dysfunction (Child-Pugh grade C) myocardial infarction within 4 weeks ASA grade ≥ V

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: ischemic reperfusion injury|ischemic reperfusion injury is a pathological process in which the ischemic myocardium is restored to normal perfusion, but the tissue damage is progressively aggravated when the coronary artery supply is completely blocked after cardiopulmonary bypass surgery and then recanalised at a certain time.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| incidence of postoperative cardiac injury | troponin I will be tested before and after surgery | from the ending of surgery to 7 days after surgery | 
| incidence of postoperative acute kidney injury | renal function will be tested before and after surgery | from the ending of surgery to 7 days after surgery | 
| incidence of postoperative brain injury | deliriumwill be tested before and after surgery | from the ending of surgery to 7 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative arrhythmia events | postoperative arrhythmia events are recorded according to follow-up visits after surgery | from the ending of surgery to 72 hours after surgery |