Abstract
Cardiopulmonary bypass (CPB) may induce serious side effects, potentially leading to myocardial failure. The Na +–K +-ATPase is a key component for myocardial function. Due to its developmental regulation, results from adult studies cannot be adopted to the situation in childhood. Right atrial myocardium from patients with left-to-right shunts at atrial level (VO, n = 8) and those without (NO, n = 8) was excised during heart surgery before and after CPB. Na +–K +-ATPase isoforms ATP1A1 ( p = 0.008) and ATP1A3 ( p = 0.038) decreased during CPB, which decrease was restricted to the VO group. This study highlights the importance of the underlying heart defect for susceptibility to the effects of CPB, showing a reduced Na +–K +-ATPase mRNA expression only in patients with left-to-right shunts on the atrial level. This seemed to be an early molecular event, as apart from one, none of the patients showed heart failure before or after surgery.
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