Dysbiosis and Intestinal Barrier Dysfunction in Pediatric Congenital Heart Disease Is Exacerbated Following Cardiopulmonary Bypass

• Published in: JACC. Basic to translational science 2021-04, Vol.6 (4), p.311-327
• Main Authors: Salomon, Jeffrey, Ericsson, Aaron, Price, Amber, Manithody, Chandrashekhara, Murry, Daryl J., Chhonker, Yashpal S., Buchanan, Paula, Lindsey, Merry L., Singh, Amar B., Jain, Ajay K.
• Format: Article
• Language: English
• Subjects: bacterial interactions; cardiovascular disease; Clinical Research; enteric bacterial microflora; intestinal barrier function; intestinal microbiology
• ISSN: 2452-302X; 2452-302X
• DOI: 10.1016/j.jacbts.2020.12.012

[Display omitted] •Little is understood regarding the connection between congenital heart disease, the intestinal Microbiome, and how this could influence systemic inflammation.•To date, no study has evaluated the microbiome in congenital heart disease and the effects of cardiopulmonary bypass.•There is significant dysbiosis in patients with congenital heart disease and this is exacerbated following cardiopulmonary bypass.•Cardiopulmonary bypass induces intestinal barrier dysfunction which was not seen in control surgeries.•This data improves our understanding of intestinal dysbiosis, intestinal barrier dysfunction, and intestinal inflammatory eicosanoids and their interactions with cardiopulmonary bypass. There are no data evaluating the microbiome in congenital heart disease following cardiopulmonary bypass. The authors evaluated patients with congenital heart disease undergoing cardiopulmonary bypass and noncardiac patients undergoing surgery without bypass. Patients with congenital heart disease had differences in baseline microbiome compared with control subjects, and this was exacerbated following surgery with bypass. Markers of barrier dysfunction were similar for both groups at baseline, and surgery with bypass induced significant intestinal barrier dysfunction compared with control subjects. This study offers novel evidence of alterations of the microbiome in congenital heart disease and exacerbation along with intestinal barrier dysfunction following cardiopulmonary bypass.