| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2006;81:685-689
© 2006 The Society of Thoracic Surgeons
a Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan
b Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, England
c Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan
Accepted for publication July 13, 2005.
* Address correspondence to Dr Yagihara, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan (Email: yagihara{at}hsp.ncvc.gojp).
BACKGROUND: To investigate whether the Fontan procedure in an off-pump fashion is less invasive in terms of the systemic inflammatory reaction.
METHODS: Plasma levels of complement and cytokines were measured during and after the Fontan procedure in consecutive 38 patients. Of these, 16 underwent the extracardiac method without use of cardiopulmonary bypass (off-pump group), while the machine was used in the remaining 22 because of intracardiac maneuvers concomitantly needed (CPB group).
RESULTS: There was no difference, between these two groups, in any value of plasma complement or cytokines after anesthetic induction. Immediately after commencement of the Fontan circulation, however, plasma concentration was significantly lower in the off-pump group for activated complement 3 (C3a), interleukin-6, interleukin-8, and polymorphonuclear elastase. The C3a value was also lower at 2 hours later in the off-pump group than in the CPB group. Furthermore, the values even stayed within the normal ranges, in the off-pump group, for tumor necrosis factor alpha (TNF
) and thrombomodulin. A pulmonary venous oxygen tension divided by an inspired oxygen tension (PpvO2/FiO2) ratio immediately after commencement of the Fontan circulation was 528 ± 93 mm Hg (410 to 580 mm Hg) in the off-pump group, and 258 ± 167 mm Hg (86 to 540 mm Hg) in the CPB group (p = 0.01). Duration of drainage for fluid sequestration was shorter in the former group (6.3 ± 0.7 days versus 13.9 ± 2.5 days, p = 0.02).
CONCLUSIONS: Inflammatory reactions were attenuated when the Fontan procedure was employed in an off-pump fashion compared with the usual procedure on bypass.
This article has been cited by other articles:
|
|
 |
|
  F. Shikata, T. Yagihara, K. Kagisaki, I. Hagino, S. Shiraishi, J. Kobayashi, and S. Kitamura Does the off-pump Fontan procedure ameliorate the volume and duration of pleural and peritoneal effusions? Eur. J. Cardiothorac. Surg., September 1, 2008; 34(3): 570 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Castellheim, T. N. Hoel, V. Videm, E. Fosse, A. Pharo, J. L. Svennevig, A. E. Fiane, and T. E. Mollnes Biomarker Profile in Off-Pump and On-Pump Coronary Artery Bypass Grafting Surgery in Low-Risk Patients Ann. Thorac. Surg., June 1, 2008; 85(6): 1994 - 2002. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. S. Goksel and E. Tireli Factors influencing early and late outcome following Fontan procedure in the current era Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 553 - 553. [Full Text] [PDF]
|
|
|
|
|
|
I. Adachi, T. Yagihara, K. Kagisaki, I. Hagino, T. Ishizaka, J. Kobayashi, S. Kitamura, and H. Uemura Preoperative small pulmonary artery did not affect the midterm results of Fontan operation Eur. J. Cardiothorac. Surg., July 1, 2007; 32(1): 156 - 162. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
