Acute Kidney Injury After Neonatal Aortic Arch Surgery: Deep Hypothermic Circulatory Arrest Versus Moderate Hypothermia With Distal Aortic Perfusion

Böttcher, Wolfgang; Weixler, Viktoria; Redlin, Matthias; Muríň, Peter; Dehmel, Frank; Schmitt, Katharina; Cho, Young Min; Miera, Oliver; Sinzobahamvya, Nicodème; Photiadis, Joachim

doi:10.1177/21501351211014824

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…This is also consistent with the finding that intra- and postoperative 4th to 6th h lactate level is an independent predictor of early mortality. Böttcher et al,[ 17 ] in their study, reported that the use of moderate hypothermia with distal aortic perfusion was associated with a significantly lower incidence of kidney injury. On the other hand, Kulyabin et al[ 18 ] reported that double arterial cannulation did not reduce the acute kidney injury incidence, compared to deep HCA.…”

Section: Discussionmentioning

confidence: 99%

Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method

Kılıç¹,

Selçuk²,

Korun³

et al. 2022

Turk Gogus Kalp Dama

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Background: The aim of this study was to analyze the effect of additional lower body perfusion, compared to antegrade selective cerebral perfusion, on early postoperative outcomes after aortic arch repair in neonates with biventricular morphology. Methods: Between January 2017 and April 2020, a total of 46 neonates (34 males, 12 females; median age: 10 days; range, 7 to 14 days) with biventricular morphology underwent an aortic arch reconstruction were retrospectively analyzed. The effects of antegrade selective cerebral perfusion and additional lower body perfusion techniques on vital organ preservation and mortality were evaluated in these patients who underwent arch reconstruction. Results: In the univariate analysis of the whole cohort, postoperative creatinine level was lower in the additional lower body perfusion group, while there was no significant difference between the other parameters. In the multivariate analysis, intraoperative highest lactate level (odds ratio: 1.7; 95% confidence interval: 1.07-2.68; p=0.02) and postoperative 4th t o 6 th h lactate levels (odds ratio: 2.34; 95% confidence interval: 1.08-5.09; p=0.03) were independent predictors of early mortality. Mortality rate was higher in the antegrade selective cerebral perfusion group (22% vs. 7%), although it did not reach statistical significance. In the receiver operating characteristic curve analysis, the cut-off value for intraoperative lactate was 6.2 mmol/L (sensitivity: 85.7%, specificity: 71.1%) and the cut-off value for the lactate level at the postoperative 4th to 6th h was 4.9 mmol/L (sensitivity: 85.7%, specificity: 73.7%). Above these lactate levels were found to be associated with mortality. Conclusion: Additional lower body perfusion may have a role in vital organ protection in aortic arch repair of neonates, compared to antegrade selective cerebral perfusion.

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Section: Discussionmentioning

confidence: 99%

Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method

Kılıç¹,

Selçuk²,

Korun³

et al. 2022

Turk Gogus Kalp Dama

View full text Add to dashboard Cite

show abstract

“…Many ischemic events can be anticipated with opportunities to prevent ischemic injury. For example, major cardiovascular surgeries including repair of the ascending or abdominal aorta, coronary revascularization, and heart valve surgery may lead to ischemic injury of the heart, brain, and kidneys ( Naito et al, 2020 ; Böttcher et al, 2021 ). In addition, organs harvested for transplantation including hearts, kidneys, livers, and lungs are all subject to ischemic injury ( Naito et al, 2020 ).…”

Section: Gja1-20k Induces Protective Mitochondrial Fissionmentioning

confidence: 99%

“…The extent of ischemic injury in such surgeries is minimized by limiting the ischemic time and packing organs in ice ( Naito et al, 2020 ). However, ischemic injury remains a common complication ( Naito et al, 2020 ; Böttcher et al, 2021 ).…”

Section: Gja1-20k Induces Protective Mitochondrial Fissionmentioning

confidence: 99%

Internal translation of Gja1 (Connexin43) to produce GJA1-20k: Implications for arrhythmia and ischemic-preconditioning

Whisenant

Shaw

2022

Front. Physiol.

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Internal translation is a form of post-translation modification as it produces different proteins from one mRNA molecule by beginning translation at a methionine coding triplet downstream of the first methionine. Internal translation can eliminate domains of proteins that otherwise restrict movement or activity, thereby creating profound functional diversity. Connexin43 (Cx43), encoded by the gene Gja1, is the main gap junction protein necessary for propagating action potentials between adjacent cardiomyocytes. Gja1 can be internally translated to produce a peptide 20 kD in length named GJA1-20k. This review focuses on the role of GJA1-20k in maintaining cardiac electrical rhythm as well as in ischemic preconditioning (IPC). Connexin43 is the only ion channel we are aware that has been reported to be subject to internal translation. We expect many other ion channels also undergo internal translation. The exploration of post-translational modification of ion channels, and in particular of internal translation, has the potential to greatly increase our understanding of both canonical and non-canonical ion channel biology.

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EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ

Czerny,

Grabenwöger,

Berger

et al. 2024

The Annals of Thoracic Surgery

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Acute Kidney Injury After Neonatal Aortic Arch Surgery: Deep Hypothermic Circulatory Arrest Versus Moderate Hypothermia With Distal Aortic Perfusion

Cited by 7 publications

References 26 publications

Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method

Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method

Internal translation of Gja1 (Connexin43) to produce GJA1-20k: Implications for arrhythmia and ischemic-preconditioning

EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ

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