Abstract
Objective To assess the value of N-terminal probrain natriuretic peptide (NT-proBNP) in short-term and long-term follow-up after a modified Fontan procedure. Methods We retrospectively enrolled children who had undergone a modified Fontan procedure in the Heart Center of Guangzhou Women and Children's Medical Center from January 2014 to September 2020 and collected data on NT-proBNP values before bidirectional Glenn procedure, before Fontan procedure, and on 1, 3, 7, 30, 90, and 180 days and 1, 2, 3, 4, 5, and 6 year after Fontan procedure. The relationship between changes in NT-proBNP levels and the outcomes in children was analyzed. Results A total of 108 children (78 boys and 30 girls, mean age: 54.62 ± 29.38 weeks) were included in the analysis. According to one-way analysis of variance, the left ventricular type and biventricular type of single ventricle physiology showed shorter duration on cardiopulmonary bypass during the operation and lower levels of NT-proBNP after the operation than the right ventricular type and univentricular type physiology. Conclusion NT-proBNP is a good indicator for mid and long-term follow-up after a modified Fontan procedure. The left ventricular type and biventricular type of single ventricle physiology show better mid and long-term benefits from the modified Fontan procedure than the right ventricular type and univentricular type physiology.
Highlights
Introduction e modifiedFontan procedure is a final palliative procedure for treating complex congenital heart diseases such as anatomical or functional single ventricle that are not suitable for biventricular correction [1]. e Fontan operation aims to eliminate the symptoms of hypoxia and reduce the volume load of the single ventricle
To our knowledge, only limited data are available regarding the perioperative and postoperative values of NT-proBNP in the diagnosis of heart failure and the follow-up of outcomes. In this retrospective study of patients undergoing Fontan procedures, we investigated the changes in NT-proBNP over the perioperative period and long-term postoperative follow-up period, analyzed the relationship between NT-proBNP and echocardiographic parameters during follow-up, and discussed the value of NT-proBNP in the postoperative followup of cardiac function in children with single ventricle physiology
It has been demonstrated that the increased mortality rate after operation is mainly caused by heart failure, arrhythmia, protein-losing enteropathy, pulmonary arteriovenous fistula, thrombosis, renal failure, and Fontan-related nephropathy; many indicators have been suggested to monitor Fontan circulation during follow-up [4]
Summary
Value of Follow-Up N-Terminal Probrain Natriuretic Peptide (NT-proBNP) after a Modified Fontan Procedure. Jianbin Li ,1,2 Li Ma ,1,3 Minghui Zou ,1,3 Wenlei Li ,1,3 Xinxin Chen ,1,3 Yanqin Cui, and Xiaoyan Hu 4. Received 15 June 2021; Revised 2 July 2021; Accepted 9 October 2021; Published 15 October 2021
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