Serum cardiac troponin-I elevation in neonatal cardiac surgery is lesion-dependent.
OBJECTIVE
Serum cardiac troponin-I (cTn-I) is a marker for myocardial injury in adults that undergoes developmental isoform change. To determine its utility as a myocardial injury marker in neonates, the authors examined the perioperative pattern of cTn-I elevation in neonates undergoing surgical repair for hypoplastic left-heart syndrome (HLHS) and transposition of great arteries (TGA).


METHODS
A prospective cohort study.


METHODS
The study was performed in a tertiary teaching hospital that is a major referral center for congenital cardiac surgery.


METHODS
Forty-five neonates were enrolled, 17 with HLHS, 15 with TGA with intact septum (TGA + IVS), 8 with TGA with ventricular septal defect (TGA + VSD), and 5 neonates undergoing extracardiac surgery who did not require cardiopulmonary bypass (CPB).


METHODS
None.


RESULTS
Preoperative cTn-I was elevated in all neonates undergoing cardiac surgery with CPB. Increases in postoperative cTn-I correlated with duration of aortic cross-clamp application and CPB. Peak elevation in serum cTn-I occurred between 6 and 24 hours postoperatively in all neonates after cardiac surgery. The perioperative pattern of cTn-I was different in TGA + VSD (peak cTn-I = 10.9 +/- 5.9 ng/mL) compared with HLHS (peak cTn-I = 4.62 +/- 3.4 ng/mL) and TGA + IVS (peak cTn-I = 4.46 +/- 3.5 ng/mL).


CONCLUSIONS
It was found that perioperative elevations in serum cTn-I in neonates with TGA and HLHS were influenced by duration of aortic cross-clamp application, CPB, and the presence of VSD.
Saraiya
Neeta R
NR
Department of Anesthesiology, Columbia University, New York, NY 10032, USA.
Sun
Lena S
LS
Jonassen
Amy E
AE
Pesce
Michael A
MA
Queagebeur
Jan M
JM
D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000097:blood / Q000628:therapy; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000097:blood / Q000628:therapy; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000097:blood / Q000628:therapy; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*
D002316:Cardiotonic Agents; D019210:Troponin I; D052279:Creatine Kinase, MB Form