Perioperative Levels of Tumor Necrosis Factor-α Correlate With Outcomes in Children and Adults With Tetralogy of Fallot Undergoing Corrective Surgery

Abstract

We demonstrated a rise in serum TNF-α levels in patients with TOF undergoing definitive repair on CPB, which correlated with preoperative severity of cyanosis, nutritional status, and adverse clinical outcomes. The TNF-α levels may be monitored to identify cyanotic patients at an increased risk of exhibiting augmented IR to CPB.

Risk Factors for Systemic Inflammatory Response After Congenital Cardiac Surgery

“…It has been shown that pro‐inflammatory cytokines are present in the myocardium of patients with congenital heart disease and concentrations are higher in patients with tetralogy of Fallot than in those with ventricular septal defects . A recent study demonstrated a rise in serum tumor necrosis factor α (TNF‐α) levels in patients undergoing intracardiac repair for tetralogy of Fallot . The authors attributed such a result to pressure overload of the right ventricle leading to upregulation of TNF‐α or repression of anti‐inflammatory interleukin‐10 by chronic hypoxemia.…”

Serum TNF‐α levels in children with congenital heart disease undergoing cardiopulmonary bypass: A cohort study in China and a meta‐analysis of the published literature

“…A total of 12 studies met our inclusion criteria for this meta‐analysis . These 12 included studies were composed of 190 CHD patients treated with CPB surgery.…”

“…A total of 12 studies met our inclusion criteria for this metaanalysis. 21,24,[32][33][34][35][36][37][38][39][40][41] These 12 included studies were composed of 190 CHD patients treated with CPB surgery. The heterogeneity was significantly observed (T1 vs T2: I 2 =92.4%, P h <.001; T2 vs T3:…”

“…Furthermore, as a proinflammatory cytokine, TNF‐α may play a crucial role in inflammatory response secondary to surgical intervention, infection, or ischemia‐reperfusion injury . Previous reports have also showed that the TNF‐α levels may be changed during cardiac surgery with CPB or off‐pump fashion . However, defining a clear relationship between TNF‐α serum levels and cardiac surgery with CPB or off‐pump fashion has been elusive, and the precise role and pathogenic mechanisms of TNF‐α serum levels in CPB is still unclear.…”

“…20 Previous reports have also showed that the TNFα levels may be changed during cardiac surgery with CPB or off-pump fashion. [21][22][23][24] However, defining a clear relationship between TNFα serum levels and cardiac surgery with CPB or offpump fashion has been elusive, and the precise role and pathogenic mechanisms of TNFα serum levels in CPB is still unclear.…”