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Microcirculatory Monitoring in Children with Congenital Heart Disease Before and After Cardiac Surgery
Open accessAbstract
In this prospective observational study, we investigated whether congenital heart disease (CHD) affects the microcirculation and whether the microcirculation is altered following cardiac surgery with cardiopulmonary bypass (CPB). Thirty-eight children with CHD undergoing cardiac surgery with CPB and 35 children undergoing elective, non-cardiac surgery were included. Repeated non-invasive sublingual microcirculatory measurements were performed with handheld vital microscopy. Before surgery, children with CHD showed similar perfused vessel densities and red blood cell velocities (RBCv) but less perfused vessels (p < 0.001), lower perfusion quality (p < 0.001), and higher small vessel densities (p = 0.039) than children without CHD. After cardiac surgery, perfused vessel densities and perfusion quality of small vessels declined (p = 0.025 and p = 0.032), while RBCv increased (p = 0.032). We demonstrated that CHD was associated with decreased microcirculatory perfusion and increased capillary recruitment. The microcirculation was further impaired after cardiac surgery. Decreased microcirculatory perfusion could be a warning sign for altered tissue oxygenation and requires further exploration.
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Compared to children without congenital heart disease, cardiac patients before surgery showed similar perfused vessel densities and red blood cell velocities.
“Compared to children without CHD, cardiac patients showed similar perfused vessel densities and red blood cell velocities before surgery, but less perfused vessels, lower perfusion quality, and higher small vessel densities than children without CHD.”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [84]
After cardiac surgery, perfused vessel densities and perfusion quality of small vessels declined, while red blood cell velocities increased.
“After surgery, perfused vessel densities and perfusion quality of small vessels declined, while red blood cell velocities increased.”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [84]
Compared to children without congenital heart disease, cardiac patients before surgery had less perfused vessels, lower perfusion quality, and higher small vessel densities.
“Compared to children without CHD, cardiac patients showed similar perfused vessel densities and red blood cell velocities before surgery, but less perfused vessels, lower perfusion quality, and higher small vessel densities than children without CHD.”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [84]
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Citations
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Lorenzo, A. D., Fernandes, M., & Tibiriçá, E. V. (2024) · IJC Heart & Vasculature · doi:10.1016/j.ijcha.2024.101451 · Cited by 5
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“A recent single-center study investigated the microcirculation of patients with heart disease, before and after cardiac surgery [84].”
Liang, L., Hou, A., Xi, H., Yang, J., & Liu, C. (2025) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s530886 · Cited by 1
Chen, X., Huang, S.-T., Lin, J. Y., & Zheng, Y.-R. (2026) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000003968 · Cited by 1
Metadata
- Authors
- Erdem, Ö., de Graaff, J. C., Hilty, M. P., Kraemer, U. S., de Liefde, I. I., van Rosmalen, J., Ince, C., Tibboel, D., & Kuiper, J. W.
- Affiliations
- Erasmus MC (NL)
- University Hospital Zurich (CH)
- Corresponding author
- Erdem, Özge
- Venue
- Journal of Cardiovascular Translational Research
- Published
- 2023-07-14
- Volume
- 16
- Issue
- 6
- Pages
- 1333-1342
- ISSN
- 1937-5387 (ISSN-L)
- 1937-5395
- PMC
- PMC10721654
- OpenAlex
- W4384397875
- Cited by
- 5
- References
- 37
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Cardiovascular Translational Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Stichting Vrienden van het Sophia (S17-06)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- congenital heart disease, microcirculation, cardiac surgery, cardiopulmonary bypass, perfused vessel density, red blood cell velocity, capillary recruitment, tissue oxygenation, pediatric patients
- MeSH terms
- Cardiopulmonary Bypass, Child, Heart Defects, Congenital, Cardiac Surgical Procedures, Humans, Microcirculation, Prospective Studies
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