Background: Congenital heart disease patients with high blood flow with left to right shunting such as PDA, VSD and ASD had been known to have increased risk of wheezing. FeNO can be utilized to determine eosinophilic airway inflammation among patients with high flow CHD. We hypothesized that there will be an effect after surgical intervention on the FeNO levels of high flow congenital heart disease patients with airway inflammation.
Patients and Methods: All 6 to 18 years old with high flow congenital heart disease (VSD,PDA and ASD) referred to Pediatric Pulmonology for pre-operative risk stratification was included in this study. Pre-operatively FeNO levels and pulmonary function test was done. After 2 weeks of surgical intervention, FeNO levels and pulmonary function test was repeated.
Results: Thirty two subjects completed the study. Although there was a decrease in FeNO levels among the ASD and VSD subjects post-operatively, this study showed that there was no significant difference on the FeNO levels post-operatively among high flow congenital heart disease patients. FEV1 values increased post-operatively for both ASD and VSD subjects. There was a significant difference in the pre-operative and postoperative FEV1 values of VSD subjects (p-value 0.0266) but it did not reach a normal FEV1 value, FVC values increased to normal values in ASD patients post-operatively while VSD patients did not increased to normal values. FEV1/FVC ratio increased postoperatively in ASD and VSD patients. There was a significant difference in the
FEV1/FVC ratio of VSD subjects (0.0246).
Conclusion: Surgical intervention has no effect on the FeNO levels of high flow congenital heart disease patients with airway inflammation.