Monthly Archives: julio 2026

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Hemodynamic principles of arterial cannulation: Orientation, wall shear stress, turbulence, plaque destabilization, and cerebral microembolization

Abstract Background Arterial cannulation during cardiopulmonary bypass (CPB) significantly alters native aortic hemodynamics by generating a high-velocity jet that interacts with the ascending aorta and aortic arch geometry. These flow..

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Patient blood management protocol reduces allogeneic transfusion, morbidity, and mortality in coronary artery bypass surgery

Abstract Background Allogeneic blood is a limited and globally scarce resource. Protocols based on the Patient Blood Management (PBM) program, incorporating therapeutic alternatives to reduce the use of red blood..

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The role of biomarkers in the preoperative evaluation of cardiac surgical patients – A narrative review

Abstract Background Biomarkers play a crucial role in the preoperative assessment for cardiac surgery, aiding in risk stratification and evaluating comorbid diseases. Objective This narrative review summarizes current evidence on..

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Palliative Care Throughout the Entire Perioperative Pathway in Cardiovascular Surgery

Abstract Cardiovascular surgery has substantially improved survival and quality of life for patients with cardiovascular disease, yet contemporary surgical populations are increasingly older, multimorbid, and affected by advanced disease, rendering..

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Perioperative hyperoxia versus normoxia during cardiopulmonary bypass in adult cardiac surgery: a systematic review and meta-analysis of randomized controlled trials

Abstract Background While hyperoxia has conventionally been the standard during cardiopulmonary bypass (CPB) to prevent hypoxemia, recent concerns regarding oxygen-induced oxidative stress have sparked debate over whether a normoxic strategy..

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Challenging Venous Cannulation Pre-Cardiopulmonary Bypass During Aortic Surgery: An Interesting TEE Finding

Introduction Here, we present a case of forme fruste (incomplete) cor triatriatum dexter (ff-CTD), an incidental finding on pre–cardiopulmonary bypass (CPB) transesophageal echocardiography (TEE) that prevented appropriate venous cannulation, leading..

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A pilot study of the impact of enhanced cardiac index coupled with pulsatile flow on goal direct perfusion during cardiopulmonary…

Abstract Introduction: Providing sufficient organ perfusion during cardiopulmonary bypass (CPB) is a common research topic among extracorporeal technology researchers. The application of an elevated cardiac index (CI) to enhance CPB..

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Advances in Cardiovascular Pharmacotherapy. VIII. Angiotensin II in Vasodilatory Shock

Abstract An imbalance between the classical and alternative renin-angiotensin system (RAS) is a characteristic feature of the multifactorial pathophysiology responsible for vasodilatory shock and provides a rationale for its treatment..

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Crystalloid fluids choices during cardiopulmonary bypass, outcomes of acid–base and lactate levels in cardio surgery

Abstract Background Ultrafiltration is integral to cardiopulmonary bypass, yet the optimal replacement fluid for zero-balance ultrafiltration requires further investigation to guide clinical practice. This study aimed to compare the efficacy..

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Management of anticoagulation in patients with heparin-induced thrombocytopenia requiring cardiac surgery with cardiopulmonary bypass: guidance from the ISTH SSC on…

Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction characterized by thrombocytopenia and a high risk of thrombosis. Patients with HIT and a need for cardiac surgery with cardiopulmonary..

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Plasma PF4 is a reliable biomarker of platelet reactivity and predictive of bleeding risk in DAPT patients undergoing cardiac surgery

Abstract Background Platelet activation is crucial for hemostasis and thrombosis, particularly in patients on antiplatelet therapy. Managing bleeding risk during cardiac surgery requires understanding platelet dynamics, especially when antiplatelet agents..

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Accelerated epigenetic ageing in congenital heart disease: the AccelerAGE study

Abstract Background and Aims Adults with congenital heart disease tend to develop both cardiac and noncardiac age-related comorbidities earlier in life than the general population, suggesting accelerated biological ageing. Epigenetic..

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Association of serum lactate and one-year mortality among women with coronary artery bypass grafting surgery: filling gaps in female

Abstract Background An abnormal perioperative blood lactate level has been reported to be associated with poor outcomes after cardiac surgery. However, their impact on female patients remains underexplored. This large-scale..

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Perioperative management of adult sickle cell disease patients requiring cardiac surgery: A 25-year experience in a referral center

Abstract Introduction Cardiac surgery with cardiopulmonary bypass (CPB) induces extreme disturbances in physiological homeostasis, which may trigger vaso‑occlusive crises and hemolysis in patients with sickle cell disease (SCD). The aim..

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Trends and Outcomes of Mechanical Circulatory Support in Acute Myocardial Infarction and Cardiogenic Shock Patients Undergoing Coronary Artery Bypass Grafting

Abstract Background We sought to describe trends and outcomes of mechanical circulatory support (MCS) use in acute myocardial infarction and cardiogenic shock (AMI-CS) patients undergoing coronary artery bypass grafting (CABG)...

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Standard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial

Abstract Background In patients receiving extracorporeal membrane oxygenation (ECMO), standard practice is full-dose intravenous unfractionated heparin (UFH) targeting an activated partial thromboplastin time of 2·0–2·5 times baseline to reduce thrombotic..

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Intraoperative continuous noninvasive hemoglobin monitoring in patients undergoing thoracic surgery

Abstract Background This study aims to assess the agreement between noninvasive hemoglobin (SpHb) and invasive hemoglobin (InvHb) monitoring in guiding blood transfusions during thoracic procedures. Methods This study was not..

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A highly biocompatible chip for continuous blood electrolyte detection based on hydrophilic surface modification

Abstract In the course of extracorporeal circulation (ECC), real-time monitoring of blood electrolyte levels is crucial for ensuring patient safety and improving outcomes. A continuous detection chip of blood electrolytes..

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From Fast-Track to Enhanced Recovery After Surgery: A Definitive Review of Two Generations of Recovery in Cardiac Surgery

Abstract The evolution of perioperative care in cardiac surgery is uniquely captured by the 2 paradigms that define its modern history: fast-track recovery and Enhanced Recovery After Surgery (ERAS) ()...

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ECMO for patients with obesity: evidence and practice

Abstract Purpose Obesity is increasingly encountered among patients requiring extracorporeal membrane oxygenation (ECMO) for severe respiratory or cardiac failure. It alters respiratory and cardiovascular physiology and drug pharmacokinetics and introduces..

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Impact of Restrictive Versus Liberal Oxygenation on Pulmonary Decline After Cardiac Surgery: A Substudy of the GLORIOUS Randomized Clinical Trial

Abstract Objectives Pulmonary dysfunction is a known complication of cardiac surgery. High fractions of inspired oxygen (FiO2) during the critical pulmonary reperfusion phase of cardiopulmonary bypass (CPB) weaning is a..

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Inova ECMO Symposium: Advancing Excellence in Extracorporeal Life Support - March 5

The 2027 ECMO Symposium: Advancing Excellence in Extracorporeal Life Support will convene multidisciplinary experts to address emerging evidence, evolving technologies, and systems-based strategies influencing contemporary VA and VV ECMO practice...

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Interpretable machine learning to predict postoperative adverse outcomes in cardiac surgery

Abstract Background Cardiac surgery is associated with significant mortality and complication risks. This study aims to develop an interpretable machine learning (ML) model to predict adverse outcomes (AOs) after cardiac..

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Microcirculatory response and leukocyte activation in patients undergoing elective cardiac surgery with cardiopulmonary bypass

Abstract Background Fluid administration, priming solutions, and the use of cardiopulmonary bypass (CPB) during cardiac surgery are likely to promote hemodilution and inflammatory responses, leading to microcirculatory impairment. A new..

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Association of the red cell distribution with to total serum calcium ratio with severe AKI in patients undergoing cardiac surgery:…

Abstract Background Acute kidney injury (AKI) is a common complication following cardiac surgery. The RCR (ratio of RDW to total serum calcium (TSC)), which exhibits high predictive value for various..

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Risk Factor Analysis of Inadequate Heparin Response in Pediatric Cardiac Surgery

Abstract Objectives To identify risk factors associated with inadequate heparin response in pediatric congenital heart surgery requiring cardiopulmonary bypass and to develop age-specific predictive scoring systems. Design Retrospective cohort study...

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Use of argatroban as anticoagulation for cardiopulmonary bypass during heart transplantation: A case report

Abstract Background Heparin-induced thrombocytopenia rules out the possibility of adopting heparin for cardiopulmonary bypass. To overcome this problem two anticoagulants can be used: argatroban and bivalirudin. Case presentation We report..

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4-finger technique for retrograde cardioplegia cannula insertion

Abstract Background Despite the widespread use of retrograde cardioplegia in most institutions, some surgeons continue to encounter technical difficulties during insertion of the retrograde cardioplegia cannula. We introduce the 4-finger..

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The Gut Microbiome in Congenital Heart Disease: Dysbiosis, Intestinal Barrier Injury, and Translational Opportunities Across the Childhood—A Narrative Review

Abstract Congenital heart disease (CHD) is the most common congenital anomaly worldwide and is associated with substantial infant morbidity and mortality. This narrative review synthesizes evidence linking CHD to alterations..

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On-Scene, Residential Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest: Operational and Logistical Considerations

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging rescue strategy for select patients with refractory out-of-hospital cardiac arrest (OHCA). Mobile ECPR programs aim to reduce low-flow time by initiating extracorporeal..

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