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Airway ciliary dysfunction: Association with adverse postoperative outcomes in nonheterotaxy congenital heart disease

Eileen Stewart1, Phillip S Adams2, Xin Tian3

  • 1Division of Pediatric Cardiology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa.

The Journal of Thoracic and Cardiovascular Surgery
|October 24, 2017
PubMed

Insights

Infants with congenital heart disease (CHD) and abnormal ciliary motion (CM) face higher risks of respiratory issues after surgery. Low nasal nitric oxide (nNO) in these patients may indicate reduced heart function, warranting further study.

Area of Science:

  • Pediatric Cardiology
  • Pulmonology
  • Genetics

Background:

  • Ciliary dysfunction (CD) is linked to increased respiratory problems in Heterotaxy (HTX) congenital heart disease (CHD) patients post-surgery.
  • This study investigates if non-HTX CHD infants with CD also experience heightened postoperative morbidity, particularly respiratory complications.

Purpose of the Study:

  • To determine the association between ciliary dysfunction (CD) and postoperative outcomes in infants with non-HTX congenital heart disease (CHD).
  • To explore the relationship between abnormal ciliary motion (CM) and low nasal nitric oxide (nNO) with specific postoperative morbidities in this patient group.

Main Methods:

  • Sixty-three infants with non-HTX CHD undergoing cardiac surgery were assessed for CD using nasal nitric oxide (nNO) measurements and ciliary motion (CM) assessment.
  • Baseline characteristics and postoperative outcomes were collected and analyzed to identify correlations.

Main Results:

  • A significant prevalence of abnormal CM (32%) and low nNO (39%) was observed in non-HTX CHD infants.
  • Abnormal CM was associated with increased odds of requiring noninvasive positive pressure ventilation and respiratory medication.
  • Low nNO correlated with abnormal pre- and postoperative systolic function and a higher likelihood of infections.

Conclusions:

  • Abnormal ciliary motion (CM) in non-HTX CHD infants is linked to increased postoperative respiratory morbidity.
  • Low nasal nitric oxide (nNO) may serve as a potential indicator of reduced hemodynamic function.
  • Screening for abnormal CM could enable interventions to mitigate pulmonary complications, while the prognostic value of low nNO for hemodynamic function requires further research.
Abstract

Keywords:
airway epitheliacongenital heart diseasenitric oxidepostsurgical outcomeprimary ciliary dyskinesiarespiratory cilia

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