OBJECTIVES It was the aim of the study to test the prognostic value of card
iac troponin-I (cTnI) concerning the early postoperative course after pedia
tric cardiac surgery.
BACKGROUND Cardiac troponin-I is a very specific and sensitive marker of my
ocardial damage in adults and children. As perioperative myocardial damage
may be a significant factor of postoperative cardiac performance, serial cT
nI values were analyzed in children undergoing open heart surgery.
METHODS Seventy-three children undergoing elective correction of congenital
heart disease including atrial and ventricular surgical manipulation were
studied. Cardiac troponin-I levels were measured serially and correlated wi
th intra- and postoperative parameters (such as doses and length of inotrop
ic support, renal and hepatic function, duration of intubation). Patients w
ith prolonged postoperative recovery were analyzed with special attention t
o the cTnI, levels.
RESULTS The cutoff point for the definition of a high and a low risk group
of cTnI values was set at 25 mu g/liter, 4 h after admission to the intensi
ve care unit (ICU) and at 35 mu g/liter considering the maximal value of cT
nI in the first 24 h in the ICU. The results showed a highly significant co
rrelation between the need for inotropic support, the severity of renal dys
function and the duration of intubation in relation to the serum levels of
cTnI.
CONCLUSIONS Cardiac troponin-I serum levels after open heart surgery in chi
ldren and infants 4 h after admission to the ICU allowed anticipation of th
e postoperative course and correlated with the incidence of significant pos
toperative complications, (C) 1999 by the American College of Cardiology.