Postoperative kinetics of common inflammatory biomarkers after congenital heart defect procedures with extracorporeal circulation in children

Haponiuk, Ireneusz; Jaworski, Radosław; Paczkowski, Konrad; Chojnicki, Maciej; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Gierat-Haponiuk, Katarzyna; Kwaśniak, Ewelina; Paśko-Majewska, Marta; Leszczyńska, Katarzyna; Zieliński, Jacek; Szymanowicz, Wiktor

doi:10.5603/kp.a2018.0038

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…The surgical ligation or clamping via the incision of the left fourth or fth intercostal space is the common treatment approach. Importantly, the operation involves an evident scar, which augments the possibility of infection, an evident pain at the incision site, and a long postoperative hospital stay 4 . For the past several years, the percutaneous transcatheter device closure has become leading to the closure of most PDAs 5 .…”

Section: Introductionmentioning

confidence: 99%

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

Luo

Liu

Zheng

et al. 2022

Preprint

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Background The percutaneous device closure of patent ductus arteriosus (PDA) is widely used in clinical practice, however full data on the changes in myocardial injury and systemic inflammatory markers’ levels after PDA in children are not fully reported. Methods We have conducted a retrospective analysis of the medical records of 385 pediatric patients in our hospital from January 2017 to December 2019. The patients were distributed into five groups. The first four (A, B, C and D) included patients divided by the type of the surgical closure methods, namely ligation, clamping, ligation-combined suturing and ligation-combined clamping, respectively. The fifth group E comprised of percutaneous device PDA patients. All recorded medical and trial data from the five groups were statistically studied. Results No serious complications in the patients regardless of the classification group were reported. Our results suggested that there were no considerable differences between the groups at the baseline (P > 0.05). Group E demonstrated a significantly smaller operative time and length of hospital stay (LOS), less intraoperative blood loss while on the other hand, a higher total hospital cost than the other four groups (P < 0.001). Interestingly, the comparison of the inflammatory factors such as white blood cells (WBC) count, C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6), as well as the myocardial injury markers (CK-MB and troponin I) did not show a significant increase ( P > 0.05) among the four groups. On the contrary, when the aforementioned factors and markers of all the surgical groups were compared to those in group E, we observed significantly higher speed and magnitude of changes in group E than those in groups A, B, C, and D (P < 0.001). Conclusion Although the percutaneous device closure of PDA is more comforting and drives fast recuperation in comparison to conventional surgery, it provokes myocardial injury and overall inflammation. Group E in our studies showcased a significant increase in the measured pro-inflammatory and myocardial injury blood markers.

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Section: Introductionmentioning

confidence: 99%

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

Luo

Liu

Zheng

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The surgical ligation or clamping via the incision of the left fourth or fifth intercostal space is the common treatment approach. Importantly, the operation involves an evident scar, which augments the possibility of infection, an evident pain at the incision site, and a long postoperative hospital stay [ 4 ]. For the past several years, the percutaneous transcatheter device closure has become leading to the closure of most PDAs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus

Luo

Liu

Zheng

et al. 2022

BMC Cardiovasc Disord

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Background The percutaneous device closure of patent ductus arteriosus (PDA) is widely used in clinical practice, however full data on the changes in myocardial injury and systemic inflammatory markers’ levels after PDA in children are not fully reported. Methods We have conducted a retrospective analysis of the medical records of 385 pediatric patients in our hospital from January 2017 to December 2019. The patients were distributed into five groups. The first four (A, B, C and D) included patients divided by the type of the surgical closure methods, namely ligation, clamping, ligation-combined suturing and ligation-combined clamping, respectively. The fifth group E comprised of percutaneous device PDA patients. All recorded medical and trial data from the five groups were statistically studied. Results No serious complications in the patients regardless of the classification group were reported. Our results suggested that there were no considerable differences between the groups at the baseline (with all P > 0.05). Group E demonstrated a significantly smaller operative time (42.39 ± 3.88, min) and length of hospital stay (LOS) (4.49 ± 0.50, day), less intraoperative blood loss (7.12 ± 2.09, ml) while on the other hand, a higher total hospital cost (24,001.35 ± 1152.80, RMB) than the other four groups (with all P < 0.001). Interestingly, the comparison of the inflammatory factors such as white blood cells (WBC) count, C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6), as well as the myocardial injury markers (CKMB and troponin I) did not show a significant increase (P > 0.05) among the four groups. On the contrary, when the aforementioned factors and markers of all the surgical groups were compared to those in group E, we observed significantly higher speed and magnitude of changes in group E than those in groups A, B, C, and D (with all P < 0.001). Conclusion Although the percutaneous device closure of PDA is more comforting and drives fast recuperation in comparison to conventional surgery, it provokes myocardial injury and overall inflammation. Timely substantial and aggressive intervention measures such as the use of antibiotics before operation and active glucocorticoids to suppress inflammation and nourish the myocardium need be applied if the myocardial and inflammatory markers are eminent.

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“…In the last 20 years, transcatheter device closure and minimally invasive transthoracic device closure guided by transesophageal echocardiography or transthoracic echocardiography (TTE) have been widely used for secundum ASDs, especially in China [ 5 , 6 ] . Many articles have discussed the changes in inflammatory markers after the correction of congenital heart diseases [ 7 - 9 ] . However, few studies have focused on the changes in inflammatory markers after the device closure of an ASD.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Postoperative Changes in Inflammatory Marker Levels Between Transthoracic and Transcatheter Device Closures of Atrial Septal Defects in Children

Hong

Huang

Kim

et al. 2020

Braz J Cardiovasc Surg

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Objective To explore the postoperative changes in inflammatory markers in children who underwent device closure of an atrial septal defect (ASD) via a transthoracic or transcatheter approach. Methods The experimental and clinical data were retrospectively collected and analyzed for a total of 53 pediatric patients between September 2018 and December 2018. According to the different treatments, 19 patients who underwent transthoracic device closure were assigned to group A, and the remaining 34 patients who underwent a transcatheter approach were assigned to group B. Results All patients were successfully occluded without any device-related severe complication. Compared with the preoperative levels, the postoperative levels of most inflammatory cytokines in both groups were significantly increased and reached a peak on the first day after the procedure. The level of postoperative inflammatory cytokines was significantly lower in group B than in group A. In addition, there was no significant difference in procalcitonin before and after the transcatheter approach. Conclusion Systemic inflammatory reactions occurred after transthoracic or transcatheter device closure of ASDs in pediatric patients. However, these inflammatory reactions were more significant in patients who underwent a transthoracic approach than in patients who underwent a transcatheter approach.

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Postoperative kinetics of common inflammatory biomarkers after congenital heart defect procedures with extracorporeal circulation in children

Abstract: Background: The extracorporeal circulation is associated with systemic inflammatory

Cited by 7 publications

References 17 publications

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus Running Title: Myocardial and inflammatory response of patent ductus arteriosus

Myocardial injury and inflammatory response in percutaneous device closures of pediatric patent ductus arteriosus

Comparison of Postoperative Changes in Inflammatory Marker Levels Between Transthoracic and Transcatheter Device Closures of Atrial Septal Defects in Children

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