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Extracorporeal Life Support

Abstract This is a review of the University of Michigan experience with extracorporeal life support (ECLS) also known as extracorporeal membrane oxygenation (ECMO). Two thousand patients were managed with ECMO..

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Visceral organ protection in aortic arch surgery: safety of moderate hypothermia

Abstract OBJECTIVES Although antegrade selective cerebral perfusion (ASCP) provides good brain protection during aortic arch surgery, the issue of distal organ protection during circulatory arrest remains to be clarified. The..

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Platelet factor 4/heparin-particle gel immunoassay (PaGIA) is a weak method for heparin-induced thrombocytopenia (HIT) evaluation of post cardio-pulmonary bypass surgery…

Abstract Diagnosis of heparin induced thrombocytopenia (HIT) is not always easy, especially when a confirmatory functional test is not available. In most cases the diagnosis relies on the combination of..

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The Efficacy, Safety and Cost-Effectiveness of Intra-Operative Cell Salvage in High-Bleeding-Risk Cardiac Surgery with Cardiopulmonary Bypass: A Prospective Randomized and…

Abstract Objective: Intra-operative cell salvage (CS) was reported to be ineffective, safe and not cost-effective in low-bleeding-risk cardiac surgery with cardiopulmonary bypass (CPB), but studies in high-bleeding-risk cardiac surgery are limited...

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Post-Operative Bleeding Risk Stratification in Cardiac Pulmonary Bypass Patients Using Artificial Neural Network

Abstract The prediction of bleeding risk in cardiopulmonary bypass (CPB) patients plays a vital role in their postoperative management. Therefore, an artificial neural network (ANN) to analyze intra-operative laboratory data..

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Ex-vivo perfusion of donor hearts for human heart transplantation (PROCEED II): a prospective, open-label, multicentre, randomised non-inferiority trial

Abstract Background The Organ Care System is the only clinical platform for ex-vivo perfusion of human donor hearts. The system preserves the donor heart in a warm beating state during..

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Ventricular assist devices: The future is now

Abstract Heart failure has become a global epidemic. For advanced heart failure, a broad assortment of device options have been introduced for both acute and prolonged intervals of  assistance. Durable implantable  (VADs)..

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Severe antiphospholipid syndrome and cardiac surgery: Perioperative management

Abstract Antiphospholipid syndrome is an antiphospholipid antibody-mediated prothrombotic state leading to arterial and venous thrombosis. This condition alters routine in-vitro coagulation tests, making results unreliable. Antiphospholipid syndrome patients requiring cardiac..

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Intra‐aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock

Abstract Background Intra‐aortic balloon pump counterpulsation (IABP) is currently the most commonly used mechanical assist device for patients with cardiogenic shock due to acute myocardial infarction. Although there has been..

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Timing and Strategy for Weaning From Venoarterial ECMO are Complex Issues

Abstract Objective Weaning from venoarterial extracorporeal membrane oxygenation (VA ECMO) usually is performed without clear guidelines; yet, patients still die after removal of extracorporeal circulation because of inadequate heart or..

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Tissue near infra red spectroscopy change is not correlated with patients' outcome in elective cardiac surgery

Abstract Background Microcirculatory disturbances following cardiac surgery with cardiopulmonary bypass (CPB) are thought to be at the origin of organ dysfunction, although few studies have correlated microvascular alterations with outcome...

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The prothrombotic paradox of severe obesity after cardiac surgery under cardiopulmonary bypass

Abstract Background Obesity is suggested to reduce postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) but perioperative hemostasis variations have not been studied. Therefore, we investigated the..

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Multidisciplinary Approach to Transvenous Lead Extraction: A Single Center’s Experience

Abstract Objective To evaluate the success and complication rates of a single center’s multidisciplinary approach to transvenous lead extraction. Setting One university hospital. Participants One hundred ninety-five patients scheduled for..

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Red Blood Cells and Mortality After Coronary Artery Bypass Graft Surgery: An Analysis of 672 Operative Deaths

Abstract Background Prior studies have implicated transfusion as a risk factor for mortality in coronary artery bypass graft surgery (CABG). To further our understanding of the true association between transfusion..

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Prolonged Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery

Abstract Background. Invasive Mycobacterium chimaera infections were diagnosed in 2012 in 2 heart surgery patients on extracorporeal circulation. We launched an outbreak investigation to identify the source and extent of the potential outbreak..

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Genetic variation influences the risk of bleeding after cardiac surgery: novel associations and validation of previous findings

Abstract Background Severe post‐operative bleeding in cardiac surgery is associated with increased morbidity and mortality. We hypothesized that variation in genetic susceptibility contributes to post‐operative bleeding in addition to clinical..

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Combined Cerebral and Renal Near-Infrared Spectroscopy After Congenital Heart Surgery

Abstract The maintenance of an adequate oxygen supply to tissues after congenital heart surgery is essential for good outcomes. The objective of this study was to assess the usefulness of..

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Peripheral circulation evaluation with near-infrared spectroscopy in skeletal muscle during cardiopulmonary bypass

Abstract Background: We designed a non-invasive, observational, real-time study, using near-infrared spectroscopy (NIRS) to assess the in vivo effects of cardiopulmonary bypass (CPB) on patients’ skeletal muscle as well as..

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Protection strategies during cardiopulmonary bypass

Abstract Purpose of review  To provide an update of research findings regarding the protection strategies utilized for patients undergoing cardiopulmonary bypass (CPB), including perioperative ventilatory strategies, different anesthetic regimens, and..

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The role of fibrinogen and fibrinogen concentrate in cardiac surgery: an international consensus statement from the Haemostasis and Transfusion Scientific…

Abstract Summary To date, data regarding the efficacy and safety of administering fibrinogen concentrate in cardiac surgery are limited. Studies are limited by their low sample size and large heterogeneity..

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Blood Conservation in Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome

Abstract Background  support (ECMO) typically requires multiple  and is associated with frequent bleeding complications. Blood transfusions are known to increase morbidity and mortality in critically ill patients, which may extend to..

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Hemolytic characteristics of three suctioning systems for use with a newly developed cardiopulmonary bypass system

Abstract Introduction: We have been developing a closed-circuit cardiopulmonary bypass (CPB) system (“Dihead CPB”) for application during coronary artery bypass grafting (CABG) and valve surgery. To strive for minimal hemolysis..

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Predictors for acute and chronic renal failure and survival in patients supported with veno-arterial extracorporeal membrane oxygenation

Abstract Background: Renal failure is a common occurrence in patients with refractory cardiogenic shock including those supported with veno-arterial extracorporeal membrane oxygenation. Prevalence and outcome of acute and chronic kidney..

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Post-operative blood loss is higher among African American neonates undergoing open-heart surgery with cardiopulmonary bypass for CHD

Abstract Background: Neonates are at high risk of bleeding after open-heart surgery. We sought to determine pre-operative and intra-operative risk factors for increased bleeding after neonatal open-heart surgery with cardiopulmonary..

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Platelet Function Changes during Neonatal Cardiopulmonary Bypass Surgery: Mechanistic Basis and Lack of Correlation with Excessive Bleeding

Abstract Thrombocytopenia and platelet dysfunction induced by extracorporeal blood circulation are thought to contribute to postsurgical bleeding complications in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB). In this study,..

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Effect of nitric oxide on postoperative acute kidney injury in patients who underwent cardiopulmonary bypass: a systematic review and meta-analysis…

Abstract Background The effect of nitric oxide (NO) on renal function is controversial in critical illness. We performed a systematic meta-analysis and trial sequential analysis to determine the effect of..

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High Hemoglobin Level As a Limiting Factor for Extracorporeal Membrane Oxygenation

Abstract We report the case of a 47 year old male who developed acute respiratory distress syndrome after bariatric surgery, requiring a venovenous extracorporeal membrane oxygenation. An inadequate extracorporeal membrane..

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Changes in Erythrocyte Morphology at Initiation of Cardiopulmonary Bypass Without Blood Transfusion Were Not Associated With Less Deformability During Cardiac…

Abstract Objectives During cardiac surgery, circulating red blood cells (RBCs) are at risk of exposure to environmental factors during  and transfusion of stored RBCs. For this study, the authors observed morphological..

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Impact of Perioperative Levosimendan Administration on Risk of Bleeding After Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials

Abstract Background Levosimendan, a calcium sensitizer and potassium channel opener, has been demonstrated to improve myocardial function without increasing oxygen consumption and to show protective effects in other organs. Recently,..

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Does magnesium-supplemented cardioplegia reduce cardiac injury? A meta-analysis of randomized controlled trials

Abstract Background: Magnesium is often used to supplement cardioplegic solutions during cardiopulmonary bypass due to its cardioprotective effect during ischemia and reperfusion. The aim of this meta-analysis was to evaluate the..

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