ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Effect of cardiopulmonary bypass on thiol/disulfide homeostasis in congenital heart surgery
Murat Tanyildiz1, Ayse Filiz Yetimakman2, Mutlu Uysal Yazici2, Ulas Kumbasar3, Murat Alisik4, Sinem Oguz1, Mehmet Bicer5, Benan Bayrakci2, Ozcan Erel4
1Department of Pediatric Intensive Care, Koç University School of Medicine, Istanbul, Türkiye
2Department of Pediatric Intensive Care, Hacettepe University School of Medicine, Ankara Türkiye
3Department of Cardiovascular Surgery, Hacettepe University School of Medicine, Ankara Türkiye
4Department of Medical Biochemistry, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2023.25283
Background: This study aims to investigate whether thiol/disulfide homeostasis parameters measurements could be used as a new biomarker to predict the pre- and post-cardiopulmonary bypass oxidative status of pediatric patients undergoing congenital heart surgery.

Methods: A total of 40 children with congenital heart disease (17 males, 23 females; mean age: 39.6±40.0 months; range, 2 to 216 months) who underwent open-heart surgery were included. The control group consisted of 40 age- and sex-matched healthy children (18 males, 22 females; mean age: 42.8±46.6 months; range, 12 to 156 months). The patients with congenital heart disease were divided into two groups as cyanotic patients (n=18) and acyanotic patients (n=22). Thiol/disulfide parameters were compared among the cyanotic, acyanotic congenital heart disease patients, and control group preoperatively (pre-CPB). The effects of cardiopulmonary bypass on thiol/disulfide parameters, pre-CBP, immediately after cardiopulmonary bypass (post-CPB0), and 24 h after cardiopulmonary bypass (post-CPB24) were investigated.

Results: The mean native and total thiol levels in the cyanotic patients were significantly lower than those in the acyanotic patients and control group (p<0.0001). The cyanotic group exhibited higher disulfide levels than the acyanotic group (p<0.01). The mean native thiol and total thiol levels significantly decreased in the post-CPB0 (p<0.0001). The mean disulfide levels significantly increased in the post-CPB0 than the pre-CPB values (p<0.001). Post-CPB24 native and total thiol levels were elevated compared to post-CPB0 (p<0.0001). The mean disulfide levels significantly increased in the post-CPB24 period than the post-CPB0 values (p<0.001). The survivor patients responded better to oxidative stress than non-survivor patients.

Conclusion: Thiol/disulfide measurement is a promising biomarker in determining the pre- and post-cardiopulmonary bypass oxidative status of pediatric patients undergoing congenital heart surgery. The interpretation of thiol/disulfide levels, pre- and postoperatively, may be used in predicting mortality and outcomes of these patients earlier.

Keywords : Cardiopulmonary bypass, congenital heart defect, oxidative stress, thiol/disulfide
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