Factor XIII prevents development of myocardial edema in children undergoing surgery for congenital heart disease.
In a prospective investigation of perioperative cardiac edema formation requiring a delayed sternal closure, we identified thrombin increase combined with a simultaneous decrease of factor XIII as a probable cause. After experimental studies additionally revealed that factor XIII could protect endothelial barrier function, we did another prospective randomized trial in which factor XIII or placebo was preoperatively substituted. The substitution finally showed distinct effects minimizing the incidence of myocardial swelling. Therefore, the clinical application of factor XIII may have a valuable therapeutic benefit in cases of leakage syndrome during extracorporeal circulation in congenital heart surgery.
Wozniak
G
G
Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Rudolf-Buchheim-Str. 7, D-35392 Giessen, Germany. gernold.wozniak@chiru.med.uni-giessen.de
Noll
T
T
Akintürk
H
H
Thul
J
J
Müller
M
M
D009202:Cardiomyopathies / Q000517:prevention & control*; D002648:Child; D004487:Edema / Q000517:prevention & control*; D005176:Factor XIII / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D010919:Placebos; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures
D010919:Placebos; D005176:Factor XIII