Pediatric Cardiology

, Volume 38, Issue 5, pp 1071–1076 | Cite as

Arterial Switch Operation and Plasma Biomarkers: Analysis and Correlation with Early Postoperative Outcomes

  • Raffaele Giordano
  • Massimiliano Cantinotti
  • Luigi Arcieri
  • Vincenzo Poli
  • Vitali Pak
  • Bruno Murzi
Original Article


The aims of our study were to describe plasma brain natriuretic peptide (BNP), Troponin I (TnI), and Cystatin C (Cys-C) concentration kinetics in the postoperative period after arterial switch operation in neonate, and to test the correlation between the plasma biomarkers and early clinical outcomes. We prospectively enrolled 29 neonates who underwent ASO. All patients received Custodiol cardioplegia. Blood samples were collected preoperatively (one day before) and in the ICU immediately after admission, and then 6, 12, 24, and 48 h after surgery. TnI peak (mean 17.23 ± 7.0 ng/mL) occurred between the arrival in the ICU and the 6th hour, then we had a constant decrease. TnI had a good correlation with the inotropic support time (r = 0.560, p = 0.0015) and ICU time (r = 0.407, p = 0.028), less than with ventilation and Hospital stay (r = 0.37, p = 0.0451 and r = 0.385, p = 0.0404). BNP peak (mean 4773.79 ± 2724.52 ng/L) was in the preoperative time with a constant decrease after the operation and it had no significant correlations with clinical outcomes. The CyS-C had the highest preoperative values, which decreased during the operating phase, and then constantly increased upon arrival to the ICU with a peak at 48 h (mean 1.76 ± 0.35 mg/L). CyS-C peak had a good correlation with a plasmatic creatinine peak (r = 0.579, p = 0.0009) but not with other clinical outcomes. Our study demonstrated significant correlations between the Tnl peak and early clinical outcomes in neonates undergoing arterial switch operation. Other plasma biomarkers such as the BNP and CyS-C had no direct correlation.


Custodiol Brain natriuretic peptide Troponin Cystatin Transposition of great artery 



This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Raffaele Giordano
    • 1
    • 2
  • Massimiliano Cantinotti
    • 1
  • Luigi Arcieri
    • 1
  • Vincenzo Poli
    • 1
  • Vitali Pak
    • 1
  • Bruno Murzi
    • 1
  1. 1.Pediatric Cardiac Surgery Unit, Heart HospitalTuscany Foundation CNR “G. Monasterio”MassaItaly
  2. 2.Department of Advanced Biomedical Sciences, Adult and Pediatric Cardiac SurgeryUniversity of Naples “Federico II”NaplesItaly

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