TY - JOUR
T1 - Neonatal Myocardial Perfusion in Right Ventricle Dependent Coronary Circulation
T2 - Clinical Surrogates and Role of Troponin-I in Postoperative Management Following Systemic-to-Pulmonary Shunt Physiology
AU - VanLoozen, Dennis H.
AU - Murdison, Kenneth A.
AU - Polimenakos, Anastasios C.
N1 - Funding Information:
The authors would like to express their gratitude to Brent Shafer, PA and our team of pediatric echocardiographic sonographers; Celeste Kessler RDCS, Kyle G. West RDCS, Angie Galan RDCS and Megan Ragan RDCS for their assistance with this interesting case. The authors have no conflicts of interest to report.
Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Right ventricle dependent coronary circulation (RVDCC) in pulmonary atresia with intact ventricular septum (PA/IVS) is associated with significant mortality risk in the immediate post-operative period following the initial stage of surgical palliation. Prognosis remains guarded during the interstage period towards conversion to the superior cavopulmonary shunt physiology. Current literature is scarce regarding this specific patient population. Cardiac troponin-I is widely used as a marker of coronary ischemia in adults, but its use for routine monitoring of neonatal myocardial tissue injury due to supply/demand perfusion mismatch is, yet to be determined. We sought to evaluate the clinical correlation of cTnl perioperative use in a PA/IVS RVDCC case and assess its interplay with established clinical, echocardiographic, and laboratory variables in guiding a real-time (dynamic) management strategy following systemic-to-pulmonary shunt palliation.
AB - Right ventricle dependent coronary circulation (RVDCC) in pulmonary atresia with intact ventricular septum (PA/IVS) is associated with significant mortality risk in the immediate post-operative period following the initial stage of surgical palliation. Prognosis remains guarded during the interstage period towards conversion to the superior cavopulmonary shunt physiology. Current literature is scarce regarding this specific patient population. Cardiac troponin-I is widely used as a marker of coronary ischemia in adults, but its use for routine monitoring of neonatal myocardial tissue injury due to supply/demand perfusion mismatch is, yet to be determined. We sought to evaluate the clinical correlation of cTnl perioperative use in a PA/IVS RVDCC case and assess its interplay with established clinical, echocardiographic, and laboratory variables in guiding a real-time (dynamic) management strategy following systemic-to-pulmonary shunt palliation.
KW - Congenital
KW - Post-operative
KW - Pulmonary atresia
KW - Right ventricle dependent coronary circulation
KW - Troponin-I
UR - http://www.scopus.com/inward/record.url?scp=85050829947&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050829947&partnerID=8YFLogxK
U2 - 10.1007/s00246-018-1940-6
DO - 10.1007/s00246-018-1940-6
M3 - Article
C2 - 30056521
AN - SCOPUS:85050829947
SN - 0172-0643
VL - 39
SP - 1496
EP - 1499
JO - Pediatric Cardiology
JF - Pediatric Cardiology
IS - 7
ER -