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Oxidative Medicine and Cellular Longevity
Volume 2016, Article ID 1971452, 10 pages
Review Article

Oxidative Stress after Surgery on the Immature Heart

Bristol Heart Institute, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK

Received 17 January 2016; Revised 11 March 2016; Accepted 15 March 2016

Academic Editor: Serafina Perrone

Copyright © 2016 Daniel Fudulu and Gianni Angelini. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Paediatric heart surgery is associated with increased inflammation and the production of reactive oxygen species. Use of the extracorporeal cardiopulmonary bypass during correction of congenital heart defects generates reactive oxygen species by various mechanisms: haemolysis, neutrophil activation, ischaemia reperfusion injury, reoxygenation injury, or depletion of the endogenous antioxidants. The immature myocardium is more vulnerable to reactive oxygen species because of developmental differences compared to the adult heart but also because of associated congenital heart diseases that can deplete its antioxidant reserve. Oxidative stress can be manipulated by various interventions: exogenous antioxidants, use of steroids, cardioplegia, blood prime strategies, or miniaturisation of the cardiopulmonary bypass circuit. However, it is unclear if modulation of the redox pathways can alter clinical outcomes. Further studies powered to look at clinical outcomes are needed to define the role of oxidative stress in paediatric patients.