Assessment of cardiac function in infants with transposition of the great arteries after surgery: comparison of two meth

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ORIGINAL ARTICLE

Assessment of cardiac function in infants with transposition of the great arteries after surgery: comparison of two methods Fan Yang1 · Roberta Iacobelli2 · Jian‑Ming Wang1 · Fiore Salvatore Iorio2  Received: 19 January 2018 / Accepted: 19 July 2018 © Children’s Hospital, Zhejiang University School of Medicine 2018

Abstract Background  Assessment of cardiac function is crucial in pediatric patients undergoing cardiovascular surgery, monitoring cardiac output and changing hemodynamic conditions during surgery accordingly is important to improve post-surgical outcome. We aimed to measure cardiac index (CI) and maximal rate of the increase of left ventricular pressure dp/dt(max) with the pressure recording analytic method (PRAM, ­MostCare®) and compared it with transthoracic echocardiographic cardiac index estimation in infants with transposition of the great arteries (TGA) undergoing surgical correction. Methods  We enrolled 74 infants with TGA consecutively into this study. CI and dp/dt(max) were measured with PRAM and echocardiography at 0, 4, 8, 12, 24 and 48 h postoperatively. Blood brain natriuretic peptide (BNP) and blood lactate (Lac) were measured at baseline and after operation. Results  The median age at surgery was 13 days (range 1–25 days) with an average weight of 3.24 kg (range 2.31–4.17 kg). CI estimated by PRAM was 1.11 ± 0.12 L/min/m2 (range 0.69–1.36) and by Doppler echocardiography was 1.13 ± 0.13 L/min/m2 (range 0.76–1.40). dp/dt(max) estimated by PRAM was 1.31 ± 0.03 mmHg/s (range 1.23–1.43) and by Doppler echocardiography was 1.31 ± 0.04 L/min/m2 (range 1.25–1.47). CI (r = 0.817, P