This research endeavor is aimed at understanding the effects of cardiac bypass on the fetus, with the hope that this knowledge will contribute to the development of safe corrective surgery for congenital heart disease in the human fetus. The advantages of early surgical intervention are obvious in defects that would require a much more challenging repair after birth. Prenatal repair would prevent the subsequent development of complex lesions during the fetal period. However, a detailed understanding of the effect of cardiac surgery and extracorporeal circulation on the fetus is required. The focus of this project is to identity the inflammatory mediators responsible for the fetal and placental pathophysiologic response to cardiac bypass using a fetal primate model. The role of cytokines, eicosanoids, and autocoids as candidate mediators of fetal and placental dysfunction will be examined. The effectiveness of attenuating this response with pharmacological antagonists of these putative mediators will also be explored.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32HL010339-02
Application #
6388763
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Commarato, Michael
Project Start
2001-04-01
Project End
Budget Start
2001-04-01
Budget End
2001-06-30
Support Year
2
Fiscal Year
2001
Total Cost
$11,749
Indirect Cost
Name
University of California San Francisco
Department
Surgery
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Malhotra, Sunil P; Thelitz, Stephan; Riemer, R Kirk et al. (2003) Induced fibrillation is equally effective as crystalloid cardioplegia in the protection of fetal myocardial function. J Thorac Cardiovasc Surg 125:1276-82
Malhotra, Sunil P; Thelitz, Stephan; Riemer, R Kirk et al. (2003) Fetal myocardial protection is markedly improved by reduced cardioplegic calcium content. Ann Thorac Surg 75:1937-41
Malhotra, Sunil P; Reddy, V Mohan; Thelitz, Stephan et al. (2002) The role of oxidative stress in the development of pulmonary arteriovenous malformations after cavopulmonary anastomosis. J Thorac Cardiovasc Surg 124:479-85
Malhotra, Sunil P; Reddy, V Mohan; Thelitz, Stephan et al. (2002) Cavopulmonary anastomosis induces pulmonary expression of the angiotensin II receptor family. J Thorac Cardiovasc Surg 123:655-60
Malhotra, Sunil P; Le, David; Thelitz, Stephan et al. (2002) Robotic-assisted endoscopic thoracic aortic anastomosis in juvenile lambs. Heart Surg Forum 6:38-42