OBJECTIVE: The objective of the study was to determine perioperative B-type natriuretic peptide levels in infants and children undergoing bidirectional cavopulmonary anastomosis or total cavopulmonary connection, and the predictive value of B-type natriuretic peptide levels for outcome. METHODS: Plasma B-type natriuretic peptide levels were measured before and 2, 12, and 24 hours after surgery in 36 consecutive patients undergoing bidirectional cavopulmonary anastomosis (n = 25) or total cavopulmonary connection (n = 11). B-type natriuretic peptide levels were evaluated as predictors of outcome. RESULTS: B-type natriuretic peptide levels increased after surgery, peaking at 12 hours in most patients. In the bidirectional cavopulmonary anastomosis group, patients with 12-hour B-type natriuretic peptide > or = 500 pg/mL had a longer duration of mechanical ventilation (165 +/- 149 hours vs 20 +/- 9 hours, P = .004), longer intensive care unit stay (11 +/- 7 days vs 4 +/- 2 days, P = .001), and longer hospital stay (20 days +/- 12 vs 9 days +/- 5, P = .003). A 12-hour B-type natriuretic peptide > or = 500 pg/mL had a sensitivity of 80% and a specificity of 80% for predicting an unplanned surgical or transcatheter cardiac intervention, including transplantation (P = .03). In the total cavopulmonary connection group, preoperative B-type natriuretic peptide levels were highest in patients with total cavopulmonary connection failure compared with patients with a good outcome (88 +/- 46 pg/mL vs 15 +/- 6 pg/mL, P = .03). CONCLUSION: Postoperative B-type natriuretic peptide levels predict outcome after bidirectional cavopulmonary anastomosis, and preoperative levels are greater in patients with both early and late total cavopulmonary connection failure compared with patients with a good outcome.
OBJECTIVE: The objective of the study was to determine perioperative B-type natriuretic peptide levels in infants and children undergoing bidirectional cavopulmonary anastomosis or total cavopulmonary connection, and the predictive value of B-type natriuretic peptide levels for outcome. METHODS: Plasma B-type natriuretic peptide levels were measured before and 2, 12, and 24 hours after surgery in 36 consecutive patients undergoing bidirectional cavopulmonary anastomosis (n = 25) or total cavopulmonary connection (n = 11). B-type natriuretic peptide levels were evaluated as predictors of outcome. RESULTS: B-type natriuretic peptide levels increased after surgery, peaking at 12 hours in most patients. In the bidirectional cavopulmonary anastomosis group, patients with 12-hour B-type natriuretic peptide > or = 500 pg/mL had a longer duration of mechanical ventilation (165 +/- 149 hours vs 20 +/- 9 hours, P = .004), longer intensive care unit stay (11 +/- 7 days vs 4 +/- 2 days, P = .001), and longer hospital stay (20 days +/- 12 vs 9 days +/- 5, P = .003). A 12-hour B-type natriuretic peptide > or = 500 pg/mL had a sensitivity of 80% and a specificity of 80% for predicting an unplanned surgical or transcatheter cardiac intervention, including transplantation (P = .03). In the total cavopulmonary connection group, preoperative B-type natriuretic peptide levels were highest in patients with total cavopulmonary connection failure compared with patients with a good outcome (88 +/- 46 pg/mL vs 15 +/- 6 pg/mL, P = .03). CONCLUSION: Postoperative B-type natriuretic peptide levels predict outcome after bidirectional cavopulmonary anastomosis, and preoperative levels are greater in patients with both early and late total cavopulmonary connection failure compared with patients with a good outcome.
Authors: Werner Budts; Jolien Roos-Hesselink; Tanja Rädle-Hurst; Andreas Eicken; Theresa A McDonagh; Ekaterini Lambrinou; Maria G Crespo-Leiro; Fiona Walker; Alexandra A Frogoudaki Journal: Eur Heart J Date: 2016-01-18 Impact factor: 29.983
Authors: Alexander Lowenthal; Benjamin Villareal Camacho; Shiri Lowenthal; Luz Natal-Hernandez; Walter Liszewski; Nancy K Hills; Jeffrey R Fineman; Harold S Bernstein Journal: Am J Cardiol Date: 2011-12-22 Impact factor: 2.778
Authors: Monique Radman; Roberta L Keller; Peter Oishi; Sanjeev A Datar; Kari Wellnitz; Anthony Azakie; Frank Hanley; Danton Char; Jong-Hau Hsu; Rambod Amrinovin; Ian Adatia; Jeffrey R Fineman Journal: J Thorac Cardiovasc Surg Date: 2013-09-27 Impact factor: 5.209
Authors: Bhupinder Reel; Peter E Oishi; Jong-Hau Hsu; Ginny Gildengorin; Michael A Matthay; Jeffrey R Fineman; Heidi Flori Journal: Pediatr Pulmonol Date: 2009-11
Authors: Amee Shah; Angela M Feraco; Cynthia Harmon; Theresa Tacy; Jeffrey R Fineman; Harold S Bernstein Journal: Am J Cardiol Date: 2009-11-01 Impact factor: 2.778