Prognostic markers of adverse outcomes following cardiac surgery in patients with congenital heart disease

Summary

Congenital heart disease represents a significant proportion of all congenital defects, affecting 1% of live births. While surgical advancements have increased the life expectancy of this population (95% surviving into adulthood) 1 in 4 of these adults will require multiple cardiac surgeries as part of ongoing care.

Due to the complex nature and operative time required, perioperative complications following surgery are common and have recently been recognised as a research priority1. The most frequent complications are related to the kidneys and neurological deficits, both potentially leading to longer-term clinical implications at great cost to the patients quality-of-life and the NHS. The time taken to start treatment for perioperative complications is critical to how well the patient will respond, and this study aims to quickly identify these complications, within the first 24h post-surgery.

Having collected pre-, peri- (2h post-surgery) and post-operative samples (24h post-surgery) from both adults and children undergoing reparative congenital heart disease surgery we are uniquely positioned to assess changes in circulating markers of organ-specific inflammation as well as correlating these with in-depth, longitudinal electronic health record data. Previous studies have identified both neurological and kidney markers which may be useful to predict perioperative complication2,3 and our pilot work has already identified two microRNAs in plasma showing promise to identify at-risk patients.

Our multidisciplinary team involving bioinformaticians, scientists and clinicians combined with our unparalleled access to these clinical cohorts we plan produce biomarker-led models that can help predict which patients are at risk from secondary surgical complications.