Masroor H Sharfi*, Mohamed H Mashaly, Abdelmonem Helal, Abdullah A Al-Shehri, Osama Abdelaziz and Abdul Hadi Al-Ghamdi

Pediatric Cardiology Department, King Faisal Specialist Hospital and RC, Jeddah, Saudi Arabia

*Corresponding Author: Masroor H Sharfi, Assistant Consultant, Pediatric Cardiology Department, King Faisal Specialist Hospital and RC, Jeddah, Saudi Arabia.

Received:June 26, 2021; Published: July 14, 2021

Citation: Masroor H Sharfi., et al. “Association of Different Post-Operative Complications with Cardiac Troponin I and Cardiopulmonary Bypasses". Acta Scientific Paediatrics 4.8 (2021): 41-46.

Abstract

Background: Cardiac troponin I (cT-I) is considered as gold standard due to its increased sensitivity and specific markers for myocardial infraction and accordingly, it is used in the diagnosis of myocardial infarction in patients with acute coronary syndrome. Necrosis and myocardial damage occur as a result of conditions following postoperative myocardial ischemia.

Objective: This study is aimed to examine association between elevated cardiac troponin-I (cT-I) levels as cardiac biomarker and its association with the development of post cardiac surgery complications after cardiopulmonary bypass in paediatric population.

Methodology: This prospective study was conducted to monitor cardiopulmonary bypass post-operative complications in response to cardiac troponin-I (cT-I) levels in paediatric population to examine, particular patterns prognostic significance.

Results: A total of 190 paediatric patients with congenital heart defect were enrolled in the study. Most frequently observed cardiac lesion in CPB group was atrial septal defect (ASD) 27% and ventricular septal defect (VSD) 5% in CPB with ventricular incision group. A significant correlation was observed in both acute kidney injury incidence (P < 0.01) in both CPB and CPB with ventricular incision groups. Also, statistically significant correlation was observed in both groups in relation to hypo perfusion injuries increasing admission duration to CTICU (P < 0.03).

Conclusion: The current study confirmed that cT-I trends correlate with clinical outcome in paediatric patients with cardiopulmonary bypass specially in post-operative prognostic monitoring. The rate of morbidity and mortality in the patients diagnosed with myocardial injury can be decreased by improving perioperative management.

Keywords: Cardiopulmonary Bypass; Cardiac Troponin-I; Sensitivity

Bibliography

1. Mardani D and Bigdelian H. “Predictors and clinical outcomes of postoperative delirium after administration of dexamethasone in patients undergoing coronary artery bypass surgery”. International Journal of Preventive Medicine6 (2012): 420.
2. Mazzeffi M., et al. “In-hospital mortality after cardiac surgery: patient characteristics, timing, and association with postoperative length of intensive care unit and hospital stay”. Annals of Thoracic Surgery 4 (2014): 1220-1225.
3. Fazelifar S and Bigdelian H. “Effect of esmolol on myocardial protection in pediatrics congenital heart defects”. Advanced Biomedical Research 4 (2015).
4. Mardani D and Bigdelian H. “Prophylaxis of dexamethasone protects patients from further post-operative delirium after cardiac surgery: a randomized trial”. Journal of Research in Medical Sciences 2 (2013): 137.
5. Alizadeh Z., et al. “A systematic review of pain assessment method in children”. Annals of Tropical Medicine and Public Health4 (2017): 847.
6. Mehdiani A., et al. “Prognostic value of the new high sensitive cardiac troponin T assay (hs-cTnT) after coronary artery bypass grafting”. Acta Cardiologica3 (2017): 276-283.
7. Hausenloy DJ., et al. “Cardioprotection during cardiac surgery”. Cardiovascular Research2 (2012): 253-265.
8. Kamenshchikov NO., et al. “Nitric oxide provides myocardial protection when added to the cardiopulmonary bypass circuit during cardiac surgery: randomized trial”. The Journal of Thoracic and Cardiovascular Surgery6 (2019): 2328-2336.
9. Braathen B and Tønnessen T. “Cold blood cardioplegia reduces the increase in cardiac enzyme levels compared with cold crystalloid cardioplegia in patients undergoing aortic valve replacement for isolated aortic stenosis”. The Journal of Thoracic and Cardiovascular Surgery 4 (2010): 874-880.
10. Al-Sarraf N., et al. “Cross-clamp time is an independent predictor of mortality and morbidity in low-and high-risk cardiac patients”. International Journal of Surgery 1 (2011): 104-109.
11. Lurati Buse GA., et al. “Troponin T and B-type natriuretic peptide after on-pump cardiac surgery: prognostic impact on 12-month mortality and major cardiac events after adjustment for postoperative complications”. Circulation 12 (2014): 948-957.
12. Tevaearai Stahel HT., et al. “Clinical Relevance of Troponin T Profile Following Cardiac Surgery”. Frontiers in Cardiovascular Medicine 5 (2018): 182.
13. Fransen EJ., et al. “Evaluation of “new” cardiac markers for ruling out myocardial infarction after coronary artery bypass grafting”. Chest 4 (2002): 1316-1321.
14. Bodor GS. “Biochemical markers of myocardial damage”. Ejifcc2 (2016): 95.
15. Naffaa ME., et al. “Cardiac troponin-I as a predictor of mortality in patients with first episode acute atrial fibrillation”. QJM: An International Journal of Medicine8 (2017): 507-511.
16. Immer FF., et al. “Troponin-I for prediction of early postoperative course after pediatric cardiac surgery”. Journal of the American College of Cardiology6 (1999): 1719-1723.
17. Masson S., et al. “Serial measurement of cardiac troponin T using a highly sensitive assay in patients with chronic heart failure: data from 2 large randomized clinical trials”. Circulation2 (2012): 280-288.
18. Omland T., et al. “Prognostic value of cardiac troponin I measured with a highly sensitive assay in patients with stable coronary artery disease”. Journal of the American College of Cardiology 12 (2013): 1240-1249.
19. Solecki K., et al. “Kinetics of high-sensitivity cardiac troponin T or troponin I compared to creatine kinase in patients with revascularized acute myocardial infarction”. Clinical Chemistry and Laboratory Medicine (CCLM)5 (2015): 707-714.
20. ter Avest E., et al. “Point-of-care troponin T is inferior to high-sensitivity troponin T for ruling out acute myocardial infarction in the emergency department”. European Journal of Emergency Medicine 2 (2016): 95-101.
21. de Antonio M., et al. “Combined use of high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide improves measurements of performance over established mortality risk factors in chronic heart failure”. American Heart Journal5 (2012): 821-828.

Copyright: © 2021 Masroor H Sharfi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.