Cardiac surgery in children has markedly advanced and is a mainstay for the treatment of serious congenital cardiac malformations. Because the heart, great vessels, and total blood volume are much smaller in children than in adults, the cardiopulmonary bypass procedure is challenging with respect to maintaining organ perfusion during cardiac surgery. Most pediatric surgeries involves cross-clamping major vessels, greater degrees of vascular repair, and operations that, overall, are more complicated than common coronary artery bypass graft surgeries in adults. Another major difference between cardiac surgeries in children and those in adults is that children undergoing cardiac surgery are largely free of diabetes and hypertension and, thus, have normal renal function and a full complement of functioning nephrons capable of dramatically up-regulating response and repair proteins after injury. Thus, children undergoing cardiac surgery and cardiopulmonary bypass are ideal for the study of ischemia and reperfusion injury (cardiac surgery-associated acute kidney injury [CSA-AKI]) to the normal human kidney(1). Read more >
Source: JACC
