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Venting the Left Ventricle from the Atrium: A Case Series of transeptal LA Vent VA-ECMO

Abstract Introduction: In cardiogenic shock, peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide hemodynamic support, however this results in adverse left ventricular afterload. Left ventricle (LV) venting (unloading) has favorable effects..

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Application of ultrasound microbubble contrast to evaluate the effect of sitaxentan on renal microvascular perfusion in beagles undergoing cardiopulmonary bypass

Abstract BACKGROUND & OBJECTIVE: We aimed to evaluate the effect of sitaxentan on renal microvascular perfusion via application of ultrasound microbubble contrast. METHODS: Male beagles were randomly divided into: Sham,..

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Red Blood Cell Conservation and Use in the Cardiovascular Operating Rooms at Ben Taub General Hospital

Abstract Objectives A conservative hemoglobin transfusion threshold is noninferior to a liberal threshold in cardiac surgery. However, red blood cell (RBC) transfusion remains common during cardiac surgery. The authors’ single-center,..

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Prehospital high‑dose methylprednisolone in resuscitated out‑of‑hospital cardiac arrest patients (STEROHCA): a randomized clinical trial

Abstract Purpose: Patients who are successfully resuscitated following out‑of‑hospital cardiac arrest (OHCA) are still at a highrisk of neurological damage and death. Inflammation and brain injury are components of the..

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Mortality on extracorporeal membrane oxygenation: Evaluation of independent risk factors and causes of death during venoarterial and venovenous support

Abstract Introduction Most patients on extracorporeal membrane oxygenation (ECMO) decease during therapy on the system. However, the actual causes of death have not been studied sufficiently. This study analyses the..

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The Cost of Being a Woman in Academic Cardiothoracic Surgery: Joint Collaboration of The Society of Thoracic Surgeons Workforces on…

Abstract Background Gender disparity in the cardiothoracic surgery workforce is challenging to enumerate and quantify. The purpose of our work is to use the most current data to quantify the..

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Using Digital Biomarkers for Objective Assessment of Perfusionists’ Workload and Acute Stress During Cardiac Surgery

Abstract The cardiac operating room (OR) is a high-risk, high-stakes environment inserted into a complex socio-technical healthcare system. During cardiopulmonary bypass (CPB), the most critical phase of cardiac surgery, the..

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Intraoperative neurological pupil index and postoperative delirium and neurologic adverse events after cardiac surgery: an observational study

Abstract Neurological pupil index (NPi) calculated by automated pupillometry predicts clinical outcomes in critically ill patients. However, there are few data on intraoperative NPi and postoperative outcome after cardiac surgery...

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Re-Dosing del Nido cardioplegia in adult cardiac surgery: Perfusion characteristics and outcomes--Is there an optimal redosing strategy?

Abstract Objectives del Nido cardioplegia is utilized for myocardial protection in adult patients undergoing cardiac surgery; however, no standardized re-dosing protocol exists. We describe perfusion characteristics and clinical outcomes in..

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Major Adverse Cardiac and Cerebrovascular Events in Patients Undergoing Simultaneous Heart Surgery and Carotid Endarterectomy

Abstract Background Patients with simultaneous relevant internal carotid artery stenosis and coronary artery heart or valve disease represent a high-risk collective with respect to cerebral or cardiovascular severe events when..

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Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials

Abstract Congenital heart disease (CHD) represents one of the most common congenital malformations, affecting greater than 40,000 births annually in the United States, many of which require surgery during the..

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Subfatin, Asprosin, Alamandine and Maresin-1 Inflammation Molecules in Cardiopulmonary Bypass

Abstract Purpose: Cardiopulmonary bypass (CPB) is a nonphysiological procedure in which inflammatory reactions and oxidative stress are induced, hormones and hemodynamic parameters are affected, and circulation is maintained outside the body...

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A Deep Dive Into Retroesophageal Major Aortopulmonary Collateral Arteries

Abstract Background: The anatomy of major aortopulmonary collateral arteries (MAPCAs) can be highly variable with regard to number, anatomic origin, course, and relationship to the native pulmonary arteries. Some MAPCAs travel..

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Continuous Ultrafiltration Enhances Recovery After Adult Cardiac Surgery With Cardiopulmonary Bypass: A Systematic Review and Meta-analysis

Abstract Background Cardiac surgery with cardiopulmonary bypass is associated with systemic inflammation. Ultrafiltration used throughout the cardiopulmonary bypass time, continuously, is hypothesized to be an immunomodulatory therapy. Methods A systematic..

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Reduced Invasiveness of Cardiopulmonary Bypass: The Mini-Circuit and the Micro-Cardioplegia

Abstract The aim of cardiopulmonary bypass is the maintenance of a sufficient whole body perfusion and gas exchange during open or closed heart surgery procedure (coronary artery bypass grafting, valve..

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Heparin-induced thrombocytopenia: An illustrated review

Abstract Heparin-induced thrombocytopenia (HIT) is an immune-mediated  from unfractionated or low-molecular-weight heparin that results in thrombocytopenia and potentially catastrophic thrombosis. HIT occurs due to the development of platelet-activating antibodies against multimolecular..

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Maintenance of pig brain function under extracorporeal pulsatile circulatory control (EPCC)

Abstract Selective vascular access to the brain is desirable in metabolic tracer, pharmacological and other studies aimed to characterize neural properties in isolation from somatic influences from chest, abdomen or..

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Perioperative Red Blood Cell Transfusion Is Associated With Adverse Cardiovascular Outcomes in Heart Valve Surgery

Abstract BACKGROUND:  We examined the relationship between blood transfusion and long-term adverse events to evaluate the clinical impact of red blood cell (RBC) transfusion on patients undergoing cardiac valve surgery...

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Five years since defining global cardiac surgery: from afterthought to tipping point

Abstract BACKGROUND Six billion people lack access to safe, timely and affordable cardiac surgical care [1, 2]. In low- and middle-income countries (LMICs), access to cardiac surgery has been poor due..

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Low postoperative perfused vessel density is associated with increased soluble endothelial cell adhesion molecules during circulatory shock after cardiac surgery.

Abstract Introduction Microcirculatory dysfunction after  is associated with significant morbidity and worse clinical outcomes. Abnormal  can occur from multiple causes, including cytokine-mediated vascular , , and an inadequate balance between  and . In response to ,  produce cellular  (CAMs)..

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Management of priming fluids in cardiopulmonary bypass for adult cardiac surgery: network meta-analysis

Abstract Background Cardiopulmonary bypass (CPB) is frequently employed for cardiac surgery, and selecting a suitable priming fluid is a prerequisite for CPB. Currently, the commonly used priming fluids in clinics..

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De senectute and the art of medicine: how old is too old for ECMO in cardiogenic shock?

Abstract Complexity and a certain level of uncertainty are inherent to the clinical scenarios faced by the treating teams, often inundated with exhaustive details. Disease arises from a multitude of..

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Peripheral Veno-Arterial-Extracorporeal Membrane Oxygenation for Refractory Septic Shock in Children: A Multicenter Review

Abstract Background Extracorporeal membrane oxygenation (ECMO) is utilized as a rescue therapy in the management of pediatric patients with refractory septic shock. Multiple studies support the use of a central..

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Early Changes in Arterial Partial Pressure of Carbon Dioxide and Blood Pressure After Starting Extracorporeal Membrane Oxygenation in Children: Extracorporeal…

Abstract Objective:  Neurologic complications in pediatric patients supported by extracorporeal membrane oxygenation (ECMO) are common and lead to morbidity and mortality; however, few modifiable factors are known. Design:  Retrospective study..

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Outcomes in Obese Are Comparable to Non-Obese Patients: A Propensity Matched Cohort Study

Abstract Introduction: Obesity, defined as a body mass index ≥ 40 kg/m2, was considered a relative contraindication to cannulation for extra-corporeal membrane oxygenation (ECMO) during the coronavirus pandemic. While body habitus can..

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A safe and effective method for percutaneous, awake, bedside decannulation of peripheral VA ECMO using vascular closure devices: a case…

Abstract Decannulation of patients on peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) typically involves femoral arterial cutdown and surgical arteriotomy closure in an operating room under general anesthesia. However, this..

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Levosimendan in extracorporeal membrane oxygenation in refractory cardiac arrest

Abstract Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can re-establish tissue perfusion in refractory cardiac arrest requiring cardiopulmonary resuscitation (CPR). Levosimendan showed potential benefit in VA-ECMO weaning and mortality but was not..

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How I manage differential gas exchange in peripheral venoarterial extracorporeal membrane oxygenation

Abstract Dual circulation is a common but underrecognized physiological occurrence associated with peripheral venoarterial extracorporeal membrane oxygenation (ECMO). Competitive flow will develop between blood ejected from the heart and blood..

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Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Abstract Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia..

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The systemic inflammatory response syndrome and cardiopulmonary bypass

Abstract Cardiac surgery using cardiopulmonary bypass (CPB) provokes a systemic inflammatory response. This is mainly triggered by contact activation of blood by artificial surfaces of the extracorporeal circuit. Although often..

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