Document Detail


Serum cardiac troponin-I elevation in neonatal cardiac surgery is lesion-dependent.
MedLine Citation:
PMID:  16202896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Serum cardiac troponin-I (cTn-I) is a marker for myocardial injury in adults that undergoes developmental isoform change. To determine its utility as a myocardial injury marker in neonates, the authors examined the perioperative pattern of cTn-I elevation in neonates undergoing surgical repair for hypoplastic left-heart syndrome (HLHS) and transposition of great arteries (TGA). DESIGN: A prospective cohort study. SETTING: The study was performed in a tertiary teaching hospital that is a major referral center for congenital cardiac surgery. PATIENTS: Forty-five neonates were enrolled, 17 with HLHS, 15 with TGA with intact septum (TGA + IVS), 8 with TGA with ventricular septal defect (TGA + VSD), and 5 neonates undergoing extracardiac surgery who did not require cardiopulmonary bypass (CPB). INTERVENTIONS: None. RESULTS: Preoperative cTn-I was elevated in all neonates undergoing cardiac surgery with CPB. Increases in postoperative cTn-I correlated with duration of aortic cross-clamp application and CPB. Peak elevation in serum cTn-I occurred between 6 and 24 hours postoperatively in all neonates after cardiac surgery. The perioperative pattern of cTn-I was different in TGA + VSD (peak cTn-I = 10.9 +/- 5.9 ng/mL) compared with HLHS (peak cTn-I = 4.62 +/- 3.4 ng/mL) and TGA + IVS (peak cTn-I = 4.46 +/- 3.5 ng/mL). CONCLUSION: It was found that perioperative elevations in serum cTn-I in neonates with TGA and HLHS were influenced by duration of aortic cross-clamp application, CPB, and the presence of VSD.
Authors:
Neeta R Saraiya; Lena S Sun; Amy E Jonassen; Michael A Pesce; Jan M Queagebeur
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  19     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-05     Completed Date:  2006-02-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  620-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Columbia University, New York, NY 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures*
Cardiopulmonary Bypass
Cardiotonic Agents / therapeutic use
Creatine Kinase, MB Form / blood
Female
Heart Septal Defects, Ventricular / blood,  therapy
Humans
Hypoplastic Left Heart Syndrome / blood,  therapy
Infant, Newborn
Length of Stay
Male
Postoperative Complications / blood,  etiology
Predictive Value of Tests
Prospective Studies
Survival Analysis
Time Factors
Transposition of Great Vessels / blood,  therapy
Treatment Outcome
Troponin I / blood*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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