scholarly journals TROPONIN T AFTER CARDIAC SURGERY: WHAT IS NORMAL? A REVIEW OF THE LITERATURE

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Jessy Nellipudi
Keyword(s):  
Cardiac Surgery ◽  
Troponin T ◽  
Postoperative Mortality ◽  
Myocardial Damage ◽  
Point Of View ◽  
Cardiac Biomarkers ◽  
Mortality And Morbidity ◽  
Serial Measurement ◽  
Risk Patients ◽  
Post Cardiac Surgery

It is well established that cardiac biomarkers are universally raised post-cardiac surgery. This is due to various preoperative, intraoperative, and postoperative factors. At present, no reliable tool or model considers intraoperative and postoperative factors to predict morbidity and mortality after cardiac surgery. Troponin T as a single or serial measurement to predict postoperative mortality and morbidity, is an attractive diagnostic tool due to the direct relationship to myocardial damage and the availability of testing. Currently, there is no consensus regarding the expected release of troponin T post-cardiac surgery. From a diagnostic and prognostic point of view, troponin T testing could be beneficial in recognising high-risk patients and any imminent compilations early. Therefore, this review aims to assess the expected release profile and prognostic value of troponin T after cardiac surgery. Keywords: troponin T., CABG, MPM, SAPS

scholarly journals Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 58-69 ◽  
Author(s):  
Matthias Heringlake ◽  
Christof Garbers ◽  
Jan-Hendrik Käbler ◽  
Ingrid Anderson ◽  
Hermann Heinze ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Clinical Outcomes ◽  
Natriuretic Peptide ◽  
Troponin T ◽  
Area Under The Curve ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Mortality And Morbidity ◽  
High Sensitive Troponin

Background The current study was designed to determine the relation between preoperative cerebral oxygen saturation (Sco2), variables of cardiopulmonary function, mortality, and morbidity in a heterogeneous cohort of cardiac surgery patients. Methods In this study, 1,178 consecutive patients scheduled for on-pump surgery were prospectively studied. Preoperative Sco2, demographics, N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T, clinical outcomes, and 30-day and 1-yr mortality were recorded. Results Median additive EuroSCORE was 5 (range: 0-19). Thirty-day and 1-yr mortality and major morbidity (at least two major complications and/or a high-dependency unit stay of at least 10 days) were 3.5%, 7.7%, and 13.3%, respectively. Median minimal preoperative oxygen supplemented Sco2 (Sco2min-ox) was 64% (range: 15-92%). Sco2min-ox was correlated (all: P value <0.0001) with N-terminal pro-B-type natriuretic peptide (ρ: -0.35), high-sensitive troponin T (ρ: -0.28), hematocrit (ρ: 0.34), glomerular filtration rate (ρ: 0.19), EuroSCORE (τ: 0.20), and left ventricular ejection fraction class (τ: 0.12). Thirty-day nonsurvivors had a lower Sco2min-ox than survivors (median 58% [95% CI, 50.7-62%] vs. 64% [95% CI, 64-65%]; P < 0.0001). Receiver-operating curve analysis of Sco2min-ox and 30-day mortality revealed an area-under-the-curve of 0.71 (95% CI, 0.68-0.73%; P < 0.0001) in the total cohort and an area-under-the-curve of 0.77 (95% CI, 0.69-0.86%; P < 0.0001) in patients with a EuroSCORE more than 10. Logistic regression based on different EuroSCORE categories (0-2; 3-5, 6-10, >10), Sco2min-ox, and duration of cardiopulmonary bypass showed that a Sco2min-ox equal or less than 50% is an independent risk factor for 30-day and 1-yr mortality. Conclusions Preoperative Sco2 levels are reflective of the severity of cardiopulmonary dysfunction, associated with short- and long-term mortality and morbidity, and may add to preoperative risk stratification in patients undergoing cardiac surgery.

scholarly journals Peri-operative Myocardial Damage in Higher-risk Patients Undergoing Elective Non-cardiac Surgery

2011 ◽  
Vol 20 ◽  
pp. S210
Author(s):  
R. Alcock ◽  
D. Kouzios ◽  
C. Naoum ◽  
G. Hillis ◽  
D. Brieger
Keyword(s):  
Cardiac Surgery ◽  
Myocardial Damage ◽  
Risk Patients

scholarly journals Fast-track Cardiac Surgery in Children: Feasibility in Bangladeshi Setting

1970 ◽  
Vol 3 (1) ◽  
pp. 50-54 ◽  
Author(s):  
SA Quader ◽  
R Sarker ◽  
F Ahmed ◽  
MK Hasan ◽  
AK Beg ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Hospital Stay ◽  
Fast Track ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Postoperative Mortality ◽  
Control Group ◽  
Mortality And Morbidity ◽  
Surgical Closure ◽  
Fast Tracking

Background: Fast-track recovery protocols in cardiac surgery is gaining worldwide popularity and have contributed to significant reductions in the postoperative hospital stay and cost without any increase in postoperative mortality and morbidity. The aim of this study was to find out the feasibility of fast track paediatric cardiac surgery in Bangladeshi setting. Method: It was a prospective study conducted in National Institute of Cardio-vascular Diseases, Dhaka, from July 2009 to June 2010. All patients, between 3 to 18 years, underwent surgical closure of atrial or ventricular septal defect under cardio-pulmonary bypass. 20 patients from our unit served as fast track group and 30 patients from other units of the same hospital served as conventional group. Fast track patients were extubated in less than 6 hours after surgery, shifted from ICU in less than 24 hours and geared up to discharge home within 3 days of surgery. Result: 18 (90%) of the 20 patient of the fast track group were discharged within 3 days of surgery, 2 patients cannot be discharged within this time frame. Mean post operative hospital stay for study group was 3.1 days, whereas the mean hospital stay in the control group was 7.5 days. Follow-up was 100% complete at 30 days. There was no major in-hospital or out-of-hospital complications in either group. No patient was readmitted at our centre or elsewhere for any complication arising from this process. Conclusion: Fast tracking is feasible and safe in low-risk paediatric open-heart surgery in Bangladeshi scenario. A multidisciplinary approach with a set protocol is required to achieve this goal in a safe and reproducible manner. Keywords: Cardiac surgery; Congenital heart disease; Fast track; Hospital discharge. DOI: 10.3329/cardio.v3i1.6427Cardiovasc. j. 2010; 3(1): 50-54

RIPC Remains a Promising Technique for Protection of the Myocardium during Open Cardiac Surgery: A Meta-Analysis and Systematic Review

2015 ◽  
Vol 18 (2) ◽  
pp. 074 ◽  
Author(s):  
Robert E. Payne ◽  
James Aldwinckle ◽  
John Storrow ◽  
Robert S. Kong ◽  
Michael E. Lewis
Keyword(s):  
Cardiac Surgery ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Myocardial Damage ◽  
Post Surgery ◽  
Mesh Terms ◽  
Pressure Cuff ◽  
Troponin Release ◽  
Mean Differences ◽  
Post Cardiac Surgery

<strong>Background</strong>: Remote ischemic preconditioning (RIPC) is the process of inducing brief ischemia in a tissue to prevent ischemic damage in another. This preconditioning can be induced simply by inflating a blood pressure cuff on a limb. Previous randomized controlled trials (RCT) have suggested that RIPC may infer myocardial protection during open cardiac surgery. One method of assessing the degree of myocardial damage incurred in these studies is to assay troponin concentration. Troponin is a cardiac enzyme released by damaged myocardiocytes. With the recent publication of several large RCTs in this area, a meta-analysis of the evidence was undertaken.<br /><strong>Methods</strong>: A systematic search of PubMed, EMBASE, and clinicaltrials.gov.uk was conducted using MeSH terms “ischaemic preconditioning” and “cardiac surgery.” RCTs that examined post-surgery troponin concentrations were included in this review. The primary outcome investigated was troponin levels at six hours post–cardiac surgery. Secondary outcomes included six to eight hour and twenty-four hour troponin release.<br /><strong>Results</strong>: Thirteen RCTs, comprising 1398 participants, were identified for inclusion in this meta-analysis. Twelve hour postoperative troponin was significantly reduced by RIPC, standardized mean difference 1.29 (95% CI 0.34-2.24). Six to eight and twenty-four hour troponin were also significantly reduced, standardized mean differences 1.23 (95% CI 0.62-1.84) and 1.25 (95% CI 0.31-2.19) respectively.<br /><strong>Conclusion</strong>: The reduction in troponin concentration suggests that RIPC reduces myocardial damage during open cardiac surgery, however, the degree of bias in the studies assessed may have had a significant impact on this result.

scholarly journals Monitoring myocardial damage in cardiac surgery by troponin T detection.

Heart ◽  
1994 ◽  
Vol 71 (1) ◽  
pp. 109-109 ◽  
Author(s):  
M. Triggiani ◽  
A. Dolci ◽  
F. Donatelli ◽  
A. Grossi
Keyword(s):  
Cardiac Surgery ◽  
Troponin T ◽  
Myocardial Damage
Sign in / Sign up

Export Citation Format

Share Document