Biochemical markers of myocardial damage before and after endovascular and surgical repair of septal heart defects in children

A total of 60 patients after occlusion of ventricular septal defect (VSD; n=56) and atrial septal defect (ASD; n=4 pts) and 10 patients after ASD repair with bypass were examined with aim to assess the levels of troponin I (TI), fatty acid binding protein (FABP), and antibodies (AB) against cardiac tissue in children before and after endovascular and surgical repair of septal defects. We used enzyme-linked immunoassay, indirect immunofluorescence method, and fluorescence microscopy taking into account the presence of fibrillar, sarcolemmal, and nuclear antibodies. Echocardiography and Holter monitoring with assessment of heart rhythm variability were performed. We found that the levels of TI and FABP were significantly increased in blood of patients with sympathetic heart rhythm activation before the repair of hemodynamically significant ASD and VSD. Closure of septal heart defects by occluders was not accompanied by significant increases in the TI and FABP levels. These data suggested minimal degree of negative influence of occluder implantation on the myocardium unlike the presence of significant increase in the markers of myocardial damage after surgical closure of the defects. Endovascular and surgical VSD repair in children did not augment the autoimmune myocardial inflammation.