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Normothermic Regional Perfusion is an Emerging Cost-Effective Alternative in Donation After Circulatory Death (DCD) in Heart Transplantation

Abstract In donation after circulatory death (DCD) organ transplantation, normothermic regional perfusion (NRP) restores oxygenated blood flow following cardiac arrest and reverses warm ischemia. Recently, NRP has also been used..

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The knowledge gap on the ECMO gap: The importance of speaking the same language

Abstract We read with great interest the article by Zhang and colleagues : a single-center experience showing that although 48.8% of all extracorporeal membrane oxygenation (ECMO) patients are successfully decannulated..

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Left ventricular unloading during VA-ECMO: A Gordian knot of physiology

Abstract Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a powerful hemodynamic support strategy for patients with cardiogenic shock and out-of-hospital cardiac arrest (OHCA).  Given that significant proportions of patients presenting with..

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Simple and secure thrombectomy without circulatory arrest for acute pulmonary embolism

Abstract Background Surgical pulmonary artery thrombectomy is a well-established emergency treatment for massive pulmonary embolism (PE) in which fibrinolysis or thrombolysis are not effective. However, surgery for massive PE that..

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Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-volume Extracorporeal Membrane Oxygenation Center

Abstract Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an emerging approach to cardiac arrest. We present two contrasting cases from a high-volume extracorporeal membrane oxygenation (ECMO) center (defined as greater than 30..

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Electroencephalography as a tool to predict cerebral oxygen metabolism during deep-hypothermic circulatory arrest in neonates with critical congenital heart disease

Abstract Objectives Recent research suggests that increased cerebral oxygen use during surgical intervention for neonates with congenital heart disease may play a role in the development of postoperative white matter..

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Thrombotic Microangiopathic Anemia After Cardiac Surgery

Abstract THROMBOTIC MICROANGIOPATHIES (TMAs) are characterized by intravascular platelet activation, hemolysis, and microvascular thrombosis, causing multiorgan dysfunction. Precipitants include genetic predispositions, acquired immune dysregulation, infection, trauma, medications, organ transplantation, and..

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After ECMO Decannulation, Are Patients Thriving or Just Surviving?

Abstract The use of extracorporeal membrane oxygenation (ECMO) to support patients with cardiac arrest, cardiogenic shock, and acute respiratory distress syndrome is rising worldwide.1 While ECMO may save the lives of..

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Lactate and lactate clearance as predictors of one-year survival in extracorporeal cardiopulmonary resuscitation – An international, multicentre cohort study

Abstract Aim Extracorporeal cardiopulmonary resuscitation (ECPR) can be considered in selected patients with refractory cardiac arrest. Given the risk of patient futility and high resource utilisation, identifying ECPR candidates, who..

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Intraoperative circulatory arrest secondary to high-risk pulmonary embolism. Case series and updated literature review

Abstract Background Intraoperative pulmonary embolism (PE) with cardiac arrest (CA) represents a critical and potentially fatal condition. Available treatments include systemic thrombolysis, catheter-based thrombus fragmentation or aspiration, and surgical embolectomy...

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Veno-arterial extracorporeal membrane oxygenation as a perioperative support to redo cardiac surgery for inoperable adult patients: a case series

Abstract Background The present article describes three cases of patients in cardiogenic shock (CS) with previous cardiac surgery that made them initially inoperable. Perioperative support with veno-arterial extracorporeal membrane oxygenation..

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Retrospective Comparison of Recombinant Activated Factor VII Versus 4-Factor Prothrombin Complex Concentrate in Cardiac Surgical Patients

Abstract Objectives To compare the incidences of postoperative thrombotic complications, transfusion of blood products, and chest tube output in congenital cardiac surgical patients who received either recombinant activated factor VII..

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Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta‑analysis and trial sequential analysis

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) may reduce mortality and improve neurological outcomes in patients with cardiac arrest. We updated our existing meta-analysis and trial sequential analysis to further evaluate..

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Fifth-time redo mitral valve replacement via right thoracotomy under systemic hyperkalemia cardiopulmonary bypass without aortic cross-clamp

Abstract Five times of cardiac reoperations for PVE are a complex operation with significant risk. Due to the difficulty of aortic cross-clamping, mitral valve replacement (MVR) is performed under beating..

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Selective aortic arch perfusion: a first-in-human observational cadaveric study

Abstract Background Selective aortic arch perfusion (SAAP) is a novel endovascular technique that combines thoracic aortic occlusion with extracorporeal perfusion of the brain and heart. SAAP may have a role..

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Transfusion of non–red blood cell blood products does not reduce survival following cardiac surgery

Abstract Objectives The literature supports the assertion that patients undergoing cardiac surgery who receive perioperative packed red blood cell (pRBC) transfusions have increased associated mortality. The aim of the current..

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Accredited cardiac arrest centers facilitate eCPR and improve neurological outcome

Abstract Background Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams..

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Direct Apical Cannulation With Protek Duo Rapid Deployment Cannula via Mini Thoracotomy for Ambulatory Venoarterial-Extracorporeal Membrane Oxygenation

Abstract National trends show rapid increases in the use of mechanical circulatory support devices (MCSD) over the last 20 years. While current literature has not proven a mortality benefit in..

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ECPELLA: Beyond a Left Ventricular Venting Strategy When to Unload the Left Ventricle and How to Decide

Abstract Left ventricular (LV) unloading has been shown to improve survival for patients requiring veno-arterial extracorporeal membrane oxygenation (VA ECMO) support for cardiogenic shock. A mortality benefit has been shown..

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Do we correctly calculate doses of cardioplegia during aortic valve replacement procedures? A preliminary report

Abstract Introduction Intraoperative myocardial protection during aortic valve replacement (AVR) for aortic stenosis (AS) is of paramount importance for outcomes. The dose of cardioplegia is usually calculated with reference to body mass. Aim..

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The state of emergency department extracorporeal cardiopulmonary resuscitation: Where are we now, and where are we going?

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged in the context of the emergency department as a life-saving therapy for patients with refractory cardiac arrest. This review examines the utility of..

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Timing of Initiation of Extracorporeal Membrane Oxygenation Support and Outcomes Among Patients With Cardiogenic Shock

Abstract Background Venoarterial extracorporeal membrane oxygenation (ECMO) provides full hemodynamic support for patients with cardiogenic shock, but optimal timing of ECMO initiation remains uncertain. We sought to determine whether earlier..

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The predictive value of highly malignant EEG patterns after cardiac arrest: evaluation of the ERC-ESICM recommendations

Abstract Purpose: The 2021 guidelines endorsed by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) recommend using highly malignant electroencephalogram (EEG) patterns (HMEP; suppression..

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ECPR Survivor Estimates: A Simulation-Based Approach to Comparing ECPR Delivery Strategies

Abstract Objective: The number of out-of-hospital cardiac arrest (OHCA) patients who may benefit from prehospital extracorporeal cardiopulmonary resuscitation (ECPR) is yet to be elucidated. Patient eligibility is determined both by case..

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Veno-arterial extracorporeal membrane oxygenation as a perioperative support to redo cardiac surgery for inoperable adult patients: a case series

Abstract Background The present article describes three cases of patients in cardiogenic shock (CS) with previous cardiac surgery that made them initially inoperable. Perioperative support with veno-arterial extracorporeal membrane oxygenation..

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Left-Ventricular Unloading With Impella During Refractory Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation: A Systematic Review and Meta-Analysis

Abstract Objectives:  Extracorporeal cardiopulmonary resuscitation (ECPR) is the implementation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) during refractory cardiac arrest. The role of left-ventricular (LV) unloading with Impella in addition to..

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Blend to Limit Oxygen in ECMO: A RanDomised ControllEd Registry (BLENDER) Trial: Study Protocol and Statistical Analysis Plan

Abstract Introduction Critically ill patients supported with venoarterial  (VA ECMO) are at risk of developing severe arterial , which has been associated with increased mortality. Lower saturation targets in this population may..

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Successful Prehospital Extracorporeal Cardiopulmonary Resuscitation: A Comprehensive Case Report and Analysis of the Current Experience and Knowledge

Abstract This case report describes a prehospital extracorporeal cardiopulmonary resuscitation (ECPR) in a female patient who suffered a sudden cardiac arrest while shopping in a supermarket. The success of this..

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Plasma Exosome Hemoglobin Released During Surgery Is Associated With Cardiac Injury in Animal Model

Abstract Background Patients with valvular heart disease require  and cardiac arrest. Here, we test the hypothesis that exosomal hemoglobin formed during  mediates acute cardiac injury in humans and in an animal model..

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Balloon atrial septostomy versus left atrial cannulation for left heart decompression in children with dilated cardiomyopathy and myocarditis on extracorporeal…

Abstract Introduction In children with myocarditis or dilated cardiomyopathy (DCM) on extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, it is often necessary to decompress the left heart to minimize distension..

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