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Pathology‐Related Troponin I Release and Clinical Outcome after Pediatric Open Heart Surgery
Author(s) -
Modi Paul,
Imura Hajime,
Angelini Gianni D.,
Pawade Ash,
Parry Andrew J.,
Suleiman M.Saadeh,
Caputo Massimo
Publication year - 2003
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1046/j.1540-8191.2003.02031.x
Subject(s) - medicine , troponin , troponin i , cardiology , intensive care medicine , pathology , myocardial infarction
Backgound : Perioperative myocardial injury is determined by the ischemic duration, pathology, and preoperative myocardial status. Our aim was to evaluate pathology‐related differences in troponin I (TnI) release, a sensitive and specific marker of myocardial injury, and its relation to clinical outcome after pediatric open heart surgery. Methods : Troponin I was measured serially postoperatively in 133 children undergoing repair of atrial (ASD, n = 41 ) and ventricular septal defects (VSD, n = 46 ), and tetralogy of Fallot (TOF, n = 46 ). The length of the right ventricular outflow tract (RVOT) incision in the latter was classified as either minimum (n = 33) or extended (n = 13) . Results : Postoperative TnI levels were lesion specific and did not correlate with clinical outcome for ASDs. Peak TnI correlated with inotropic duration for VSD (r = 0.69, p < 0.0001) and TOF (r = 0.51, p = 0.0004) . Significant correlations were also observed for the durations of ventilation ( r = 0.64 and 0.36, respectively) and ICU stay ( r = 0.60 and 0.55). Younger age (<1 year old) in children with VSDs and an extended incision into the RVOT in TOF were associated with greater TnI release and worse clinical outcome. Conclusions : Postoperative TnI release is pathology related and reflects myocardial damage from both ischemia‐reperfusion injury and direct myocardial trauma. (J Card Surg 2003; 18:295‐300)