This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Background: Children with single ventricle physiology frequently form aorto-pulmonary collateral vessels during the staged palliation of their disease. These are most often seen before the second and third stages (the bidirectional cavopulmonary shunt and the Fontan) at cardiac catheterization. When found, attempts are made to coil or surgically remove the APCs in order to prevent them from interfering with the intended circulation. The APCs may not be eliminated and may cause postoperative complications such as systemic venous congestion, chronic pleural effusions, or cyanosis. There is little information on the incidence of and risk factors for the formation of APCs as well as the potential associated complications. We plan to compare levels of circulating angiogenic plasma proteins in children with and without APCs during staged repair for single ventricle disease. Since there may be a difference in levels of angiogenic proteins in the venous versus arterial blood of these patients, we will study both circulations in this study population. We will also study the clinical risk for APC development and complications associated with APCs. Methods: We will draw systemic venous and arterial samples from patients undergoing a bidirectional cavopulmonary shunt or a Fontan procedure. Using sandwich ELISA as well as Western blotting techniques we will quantify 19 plasma proteins known to have angiogenic properties including: Ang, GCSF, HGF, VEGF, Leptin, Interleukin-1?, Interleukin-1?, IL-6, IL8, PIGF, FGFa, FGFb, TNF?, TGF?, IFN?, IL-12, IP-10, TIMP-1, TIMP-2. We will also collect clinical data as indicated on the attached data collection sheets in an attempt to determine the risk factors for development of APCs and APC associated complications.
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