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Scott A. LeMaire
Jay K. Bhama
Peter J. Oberwalder
Joseph S. Coselli
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Ann Thorac Surg 2001;71:1913-1919
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

S100ß correlates with neurologic complications after aortic operation using circulatory arrest

Scott A. LeMaire, MDa, Jay K. Bhama, MDa, Zachary C. Schmittling, MDa, Peter J. Oberwalder, MDa, Cüneyt Köksoy, MDa, Steve A. Raskin, CCPa, Patrick E. Curling, MDa, Joseph S. Coselli, MDa

a Michael E. DeBakey Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA

Address reprint requests to Dr Coselli, 6560 Fannin, #1100, Houston, TX 77030
e-mail: jcoselli{at}bcm.tmc.edu

Presented at the Thirty-sixth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 31–Feb 2, 2000.

Background. Astrocyte protein S100ß is a potential serum marker for neurologic injury. The goals of this study were to determine whether elevated serum S100ß correlates with neurologic complications in patients requiring hypothermic circulatory arrest (HCA) during thoracic aortic repair, and to determine the impact of retrograde cerebral perfusion (RCP) on S100ß release in this setting.

Methods. Thirty-nine consecutive patients underwent thoracic aortic repairs during HCA; RCP was used in 25 patients. Serum S100ß was measured preoperatively, after cardiopulmonary bypass, and 24 hours postoperatively.

Results. Neurologic complications occurred in 3 patients (8%). These patients had higher postbypass S100ß levels (7.17 ± 1.01 µg/L) than those without neurologic complications (3.63 ± 2.31 µg/L, p = 0.013). Patients with S100ß levels of 6.0 µg/L or more had a higher incidence of neurologic complications (3 of 7, 43%) compared with those who had levels less than 6.0 µg/L (0 of 30, p = 0.005). Retrograde cerebral perfusion did not affect S100ß release.

Conclusions. Serum S100ß levels of 6.0 µg/L or higher after HCA correlates with postoperative neurologic complications. Using serum S100ß as a marker for brain injury, RCP does not provide improved cerebral protection over HCA alone.




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