embolism 87 Aspirin 119, 250 Atrial fibrillation 161 -function 134 -septal aneurysm 87 -size 150 Atrioventricular canal 231 -nodal tachycardia 264 -reentry tachycardia 264 Beriberi 92 Bernoulli equation 205 Bioelectrical impedance 127 Björk-Shiley convexo-concave valve 96 Blood flow 184 --velocity 173 Body fat 127 -mass 140 Bradycardia 268

The perioperative risk after repair of the complete atrioventricular canal is reported to be low provided there is a balanced relationship of both ventricles, and elevated pulmonary vascular resistance has been demonstrated to be reversible. However, some pre- and perioperative conditions may adversely affect early postoperative outcome. A consecutive series of 42 patients (mean age 8.5 months, 34/42, 81%, with trisomy 21) operated between 1994 and 1998 was analyzed prospectively for pre- and perioperative risk factors. Echocardiography alone was performed in 35 patients whereas cardiac catheterization was performed in 7 patients aged more than 18 months to confirm operability. Additional malformations were found in 20 patients. Early mortality was 2.3% (1/42), and postoperatively a low cardiac output was observed in 25 patients (59%); NO inhalation was used in 12 patients. Only the size of the ventricular septal defect (> than the diameter of the aortic annulus) could be identified as a predictor of adverse postoperative outcome in multivariate analysis. The presence of associated intracardiac malformations showed a trend to increased perioperative risk in multivariate analysis. Early results after repair of the complete atrioventricular canal are excellent. Survival, postoperative morbidity and normalization of pulmonary artery pressure can be related to the size of the ventricular septal defect. Continuous monitoring of the pulmonary artery pressure (with consequent NO application when indicated) is probably responsible for the low perioperative risk encountered in this series, despite the high incidence of postoperative pulmonary artery hypertension.

Troponin‐T (cTnT) as a marker of myocardial damage is well established in adults, but not yet in children. cTnT was measured in 85 children (aged 1 day‐204 months, mean 46 months). Twenty‐five children were non‐surgical patients, with possible myocardial damage suspected on clinical grounds. The other 60 patients had cardiac surgery leading to a defined myocardial damage. In these children, troponin‐T (cTnT), creatine kinase activity (CK), creatine kinase‐MB activity (CK‐MB), and creatine kinase‐MB‐Mass (CK‐MB‐Mass) were measured preoperatively and 3–4 times during the first 55 postoperative h. Except in four children with probable preoperative myocardial damage, all troponin‐T values were in the normal range (< 0.1 μig/1). All children with intracardiac surgery showed a postoperative increase in troponin‐T. Children with extracardiac surgery of the great vessels showed no postoperative increase of troponin‐T. For the assessment of myocardial damage, troponin‐T was more specific and more sensitive than the other markers tested, troponin‐T might significantly improve the diagnostic assessment of myocardial damage in children.