Yearly Archives: 2021

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Two cases of “stone heart” with fatal outcome

Abstract  The “stone heart” syndrome is a rare but often fatal complication of cardiac surgery associated with hypertrophy of the myocardium. The mechanisms behind the syndrome are not fully understood...

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Pre-hospital extra-corporeal cardiopulmonary resuscitation

Abstract Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extra-corporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides..

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Aortic cross-clamp time and cardiopulmonary bypass time: prognostic implications in patients operated on for infective endocarditis

Abstract OBJECTIVES Prolonged aortic cross-clamp (XCT) and cardiopulmonary bypass time (CPBT) are associated with increased morbidity and mortality following cardiac surgery. The aim of this study was to assess the..

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Steroids in cardiac surgery: a systematic review and meta-analysis

Abstract Background  (CPB) induces a systemic inflammatory reaction that may contribute to . Preventing this reaction with steroids may improve outcomes. We performed a systematic review to evaluate the impact of..

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Comparison of Two Major Perioperative Bleeding Scores for Cardiac Surgery Trials: Universal Definition of Perioperative Bleeding in Cardiac Surgery and…

Abstract Editor’s Perspective What We Already Know about This Topic Major bleeding can occur during cardiac surgery. Although different scoring systems exist, the assessment of bleeding can be variable, and..

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Comprehensive blood conservation program in a new congenital cardiac surgical program allows bloodless surgery for the Jehovah Witness and a…

Abstract Background: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative..

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The effect of protamine dosing variation on bleeding and transfusion after heparinisation for cardiopulmonary bypass

Abstract Introduction: Accurate dosing of protamine reversal following on-pump cardiac surgical procedures is challenging, with both excessive and inadequate administration recognised to increase bleeding risk. We aimed to examine the..

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Systemic Inflammatory Response Syndrome After Acute Myocardial Infarction Complicated by Cardiogenic Shock

Abstract Background  The role of inflammation in patients with coronary artery disease is emerging. We sought to assess the profile and outcomes of patients with a clinical syndrome of severe systemic..

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Clinical review: Interpretation of arterial pressure wave in shock states

Abstract In critically ill patients monitored with an arterial catheter, the arterial pressure signal provides two types of information that may help the clinician to interpret haemodynamic status better: the..

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Mechanisms of vascular hyporesponsiveness in septic shock

Abstract Purpose: To define some of the most common characteristics of vascular hyporesponsiveness to catecholamines during septic shock and outline current therapeutic approaches and future perspectives. Methods: Source data were obtained from..

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Vasopressin: Mechanisms of action on the vasculature in health and in septic shock

Abstract Background:  Vasopressin is essential for cardiovascular homeostasis, acting via the kidney to regulate water resorption, on the vasculature to regulate smooth muscle tone, and as a central neurotransmitter, modulating..

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Systemic release of cytokines and heat shock proteins in porcine models of polytrauma and hemorrhage

Abstract Objective:  To define systemic release kinetics of a panel of cytokines and heat shock proteins in porcine polytrauma/hemorrhage models and to evaluate whether they could be useful as early trauma biomarkers...

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Vasoplegia treatments: the past, the present, and the future

Abstract Vasoplegia is a ubiquitous phenomenon in all advanced shock states, including septic, cardiogenic, hemorrhagic, and anaphylactic shock. Its pathophysiology is complex, involving various mechanisms in vascular smooth muscle cells..

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Statistical primer: basics of survival analysis for the cardiothoracic surgeon

Abstract Survival analysis incorporates various statistical methods specific to data on time until an event of interest. While the event is often death, giving rise to the phrase ‘survival analysis’,..

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The use of acute normovolemic hemodilution in paediatric cardiac surgery

Abstract Background Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood‐loss surgeries. We determined the association between ANH and the..

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Predictors of Heparin Resistance Before Cardiovascular Operations in Adults

Background Heparin resistance (HR) is often encountered during cardiovascular operations that require cardiopulmonary bypass. Clinical risk factors and the mechanism underlying heparin resistance are yet to be determined. The aim..

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Safety of Perioperative Aprotinin Administration During Isolated Coronary Artery Bypass Graft Surgery: Insights From the ART (Arterial Revascularization Trial)

Abstract Background There is still uncertainty about the safety of aprotinin for coronary artery bypass graft surgery. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral versus..

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Long-Term Outcomes of On- Versus Off-Pump Coronary Artery Bypass Grafting

Abstract Background When comparing effects of on- versus  (CABG), it is important to assess the long-term clinical outcomes. However, most research conducted thus far has concentrated on short-term outcomes and ignored..

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Better platelet function, less fibrinolysis and less hemolysis in re-transfused residual pump blood with the Ringer’s chase technique – a…

Abstract Introduction: Residual pump blood from the cardiopulmonary bypass (CPB) circuit is often collected into an infusion bag (IB) and re-transfused. An alternative is to chase the residual blood into..

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Pulmonary hypoplasia

Pulmonary hypoplasia is common in the perinatal period and a significant cause of death in newborn infants. Wigglesworth and Desai reported an incidence of 14.5% in a series of perinatal..

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Role of ECMO in congenital diaphragmatic hernia

Abstract Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology..

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Optimizing patient care and outcomes through the congenital heart center of the 21st century

Abstract Pediatric cardiovascular services are responding to the dynamic changes in the medical environment, including the business of medicine. The opportunity to advance our pediatric cardiology field through collaboration is..

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Prophylactic intra-aortic balloon counterpulsation before surgical myocardial revascularization in patients with acute myocardial infarction

Abstract Introduction: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study..

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Position paper for the organization of ECMO programs for cardiac failure in adults

Abstract Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock,..

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Glycocalyx and its involvement in clinical pathophysiologies

Abstract Vascular hyperpermeability is a frequent intractable feature involved in a wide range of diseases in the intensive care unit. The glycocalyx (GCX) seemingly plays a key role to control..

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Prediction of Postoperative Blood Loss Using Thromboelastometry in Adult Cardiac Surgery: Cohort Study and Systematic Review

Objective The aim was to evaluate the predictive value of  for  in adult cardiac surgery with . Design Retrospective  and systematic review of the literature. Setting A tertiary university hospital. Participants 202 patients undergoing..

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The association between borderline pre‐operative anaemia in women and outcomes after cardiac surgery: a cohort study

Summary Anaemia is common before cardiac surgery and is associated with increased morbidity and mortality. The World Health Organization (WHO) definition of anaemia is lower for women than for men..

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Measuring fibrinolysis: from research to routine diagnostic assays

Abstract Summary Development and standardization of fibrinolysis methods have progressed more slowly than coagulation testing and routine high‐throughput screening tests for fibrinolysis are still lacking. In laboratory research, a variety..

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Cerebral near‐infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults

Background Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near‐infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain..

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Predicting long-term survival after coronary artery bypass graft surgery

Abstract OBJECTIVES To develop a model for predicting long-term survival following coronary artery bypass graft surgery. METHODS This study included 46 573 patients from the Australian and New Zealand Society of..

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