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Perioperative Endothelin Levels in Patients Undergoing Intracardiac Repair for Tetralogy of Fallot
Author(s) -
Kapoor Poonam Malhotra,
Subramanian Arun,
Malik Vishwas,
Devagorou Velayoudam
Publication year - 2014
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 - 10.1111/jocs.12394
Subject(s) - medicine , intracardiac injection , tetralogy of fallot , perioperative , cardiopulmonary bypass , cardiology , adverse effect , endothelin receptor , anesthesia , heart disease , receptor
Background Endothelin, a pro‐inflammatory molecule, had been extensively studied in patients with cardiovascular illness. Impact on the perioperative outcome of patients with cyanotic congenital heart defects is still unknown. In the present study, we report perioperative changes in endothelin levels and their correlation with preoperative factors and clinical outcomes in a group of patients with tetralogy of Fallot (TOF) undergoing definitive repair. Methodology 167 patients with TOF undergoing intracardiac repair under cardiopumonary bypass were studied. Endothelin levels were taken at three different points of time and correlated with different clinical variables. Results The baseline endothelin level correlated with patients' nutritional status and degree of cyanosis. The magnitude of inflammatory response in the post‐cardiopulmonary bypass (post‐CPB) period as measured by endothelin level was much higher and correlated more consistently with adverse clinical outcomes in the younger age group. On multivariable analysis, age at operation, preoperative degree of hypoxemia, and endothelin levels were found to be independent predictors of clinical outcomes. Conclusions A rise in serum endothelin levels in patients with TOF undergoing definitive repair on CPB, with preoperative severity of cyanosis, nutritional status, and adverse clinical outcomes. The endothelin levels may be monitored to identify patients with cyanosis at an increased risk of exhibiting augmented inflammatory response to CPB. doi: 10.1111/jocs.12394 (J Card Surg 2014;29:670–677)