Salehi Abarghouei Forod, Chahkandi Tayyebeh, Shaban Sayeh, Raeiszadeh Bajestani Seyyed Farhad, Soleimani Mohammad Hosein, Amouzeshi Ahmad, Salehi Shiva
Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
Department of Pediatrics, Birjand University of Medical Sciences, Birjand, Iran.
ARYA Atheroscler. 2025;21(2):10-17. doi: 10.48305/arya.2025.42947.2989.
Congenital heart defects (CHDs) are common anomalies in children. Cardiopulmonary bypass (CPB) is widely used in cardiac surgeries, but it is associated with complications. Liver and kidney injuries frequently occur during CPB. This study aimed to evaluate liver and kidney damage in pediatric patients with CHDs undergoing cardiac surgery with CPB.
This retrospective study examined 51 patients with CHDs who underwent cardiac surgery with CPB at Vali-Asr and Razi hospitals in Birjand, Iran. The study period spanned from 2013 to 2019. Patient information was extracted from hospital records and compiled into checklists, which included demographic data, disease severity, liver function tests, cardiac ejection fraction, and serum levels of hematocrit, direct and indirect bilirubin, albumin, total protein, and creatinine.
Among the patients, 52.9% were male and 47.1% were female, with a mean age of 37 months. A total of 78.4% had cyanotic CHDs.After surgery, the levels of AST, ALT, and ALKP increased significantly (P < 0.001), while the levels of indirect bilirubin, albumin, and total protein decreased (P < 0.001). The cardiac ejection fraction also improved following surgery (P < 0.001). However, changes in creatinine and direct bilirubin were not significant. Notably, AST levels were markedly higher in deceased patients compared to survivors.
This study revealed significant alterations in liver enzyme levels in patients undergoing cardiac surgery using CPB, potentially indicating liver damage during the procedure. Furthermore, elevated postoperative AST levels were associated with a higher risk of mortality.
先天性心脏病（CHD）是儿童常见的先天性畸形。体外循环（CPB）在心脏手术中广泛应用，但它会引发并发症。CPB 期间经常发生肝损伤和肾损伤。本研究旨在评估接受 CPB 心脏手术的 CHD 患儿的肝损伤和肾损伤情况。
这项回顾性研究检查了 51 例在伊朗比尔詹德的瓦利 - 阿斯尔医院和拉齐医院接受 CPB 心脏手术的 CHD 患者。研究时间段为 2013 年至 2019 年。从医院记录中提取患者信息并整理成清单，其中包括人口统计学数据、疾病严重程度、肝功能检查、心脏射血分数以及血细胞比容、直接和间接胆红素、白蛋白、总蛋白和肌酐的血清水平。
患者中，52.9% 为男性，47.1% 为女性，平均年龄为 37 个月。共有 78.4% 的患者患有青紫型 CHD。手术后，AST、ALT 和 ALKP 水平显著升高（P < 0.001），而间接胆红素、白蛋白和总蛋白水平下降（P < 0.001）。心脏射血分数在术后也有所改善（P < 0.001）。然而，肌酐和直接胆红素的变化不显著。值得注意的是，与存活患者相比，死亡患者的 AST 水平明显更高。
本研究揭示了接受 CPB 心脏手术患者的肝酶水平有显著变化，这可能表明手术过程中存在肝损伤。此外，术后 AST 水平升高与更高的死亡风险相关。
