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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2002 December;43(6):793-7
The role of plasma endothelin in the Fontan circulation
Yamagishi M. 1, Kurosawa H. 2, Hashimoto K. 2, Nomura K. 2, Kitamura N. 1
1 Department of Pediatric Cardiovascular Surgery Children’s Research Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan
2 Department of Cardiovascular Surgery Jikei University School of Medicine Tokyo, Japan
Background. Various vasoactive substances are released during cardiopulmonary bypass. They may deteriorate pulmonary circulation after the Fontan operation. Effects of plasma endothelin-1 (ET-1), a vasoconstricting peptide, on the Fontan circulation have not been investigated.
Methods. Eleven patients (aged 11.1±7.5 years) who underwent the modified Fontan operation (group F) and seven patients (aged 9.9±6.0 years) who underwent the biventricular repair (group C) were studied. Plasma samples were obtained for measuring ET-1 on the first postoperative day (Early I), on returning to floor care from the intensive care unit (Early II), and during postoperative cardiac catheterization (Late).
Results. Plasma concentrations of ET-1 increased in group F (Early I, 4.37±1.78 pg/ml; Early II, 4.07±1.90 pg/ml) as compared with the basal value of 1.0±0.5 pg/ml. The central venous pressure, which reflects the pulmonary circulatory state, soon after the Fontan operation correlated significantly with the increased ET-1 concentration (y=1.809 x+6.484; r=0.809; p=0.0026). Although the Late ET-1 concentrations in group F were significantly decreased, the central venous pressure and the ET-1 concentrations demonstrated a significant correlation (y=3.074 x +5.427; r=0.740; p=0.0227).
Conclusions. The increased humoral vasoactive substances such as ET-1, which induces pulmonary vasoconstriction following the Fontan operation, may have important implications for the Fontan circulation.