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Protracted aortic valve closure during peripheral veno-arterial extracorporeal life support: is intra-aortic balloon pump an effective solution?

Abstract Background: Left ventricular (LV) afterload increase with protracted aortic valve (AV) closure may represent a complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO). The aim of the present study..

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Acquired von Willebrand syndrome and impaired platelet function during venovenous extracorporeal membrane oxygenation: Rapid onset and fast recovery

Abstract Background Bleeding contributes to the high mortality of venovenous  membrane oxygenation (vvECMO). The development of acquired von Willebrand syndrome (AVWS) has been identified as relevant pathology during ECMO. This study..

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Chipmunk Brain Is Resistant to Injury from Deep Hypothermic Circulatory Arrest During Cardiopulmonary Bypass

Abstract Chipmunk as a food-storing hibernator naturally undergoes hibernation that is linked to great changes in systemic physiology and could protect the central nervous system during drastically reduced cerebral blood..

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Impact of Crystalloid or Albumin Priming of the Heart–Lung Machine on Inhospital Outcome after Coronary Artery Bypass Surgery

Abstract Background Crystalloid priming is a cost-effective, free from immunological reactions, and independent from human plasma delivery. However, there is some debate on the negative impact of low plasma colloid..

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Hypothermia, pH, and Postoperative Red Blood Cell Transfusion in Massively Transfused Adult Cardiac Surgery Patients: A Retrospective Cohort Study

Objective To determine the relationships between hypothermia and pH at surgery end and postoperative red blood cell (RBC) transfusion in massively transfused adult cardiac surgery patients. Design . Setting Single..

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Malperfusion During Hypothermic Antegrade Cerebral Perfusion: Cerebral Perfusion Index—An Early Indicator Compared to Cerebral Oximetry

HYPOTHERMIC CIRCULATORY arrest combined with selective cerebral perfusion commonly is employed to permit surgical repair of the ascending and transverse aorta. A variety of perfusion techniques are employed, including retrograde..

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Cerebral Hypoxia Caused by Flow Confliction During Minimally Invasive Cardiac Surgery With Retrograde Perfusion: A Word of Caution

CURRENTLY, MINIMALLY INVASIVE cardiac surgery (MICS) is very popular. In most cases, cardiopulmonary bypass (CPB) is used with femoral arterial cannulation, and the whole body is perfused in a retrograde..

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Assessment of Heparin Anticoagulation Measured Using i-STAT and Hemochron Activated Clotting Time

Objective Adequate , measured using  (ACT), is important during vascular and cardiac surgeries. Unfractionated heparin is the most common  used. The purpose of this analysis was to compare the i-STAT ACT (iACT) to..

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Hypothermic Cardiopulmonary Bypass Weaning and Prolonged Postoperative Rewarming in a Patient With Intraoperative Oxygenator Thrombosis

THE INCIDENCE OF oxygenator thrombosis during cardiopulmonary bypass (CPB) has decreased significantly with the advent of modern heparin-coated bypass circuits, but rare failures continue to be reported at a rate..

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Hemodynamic energy during pulsatile extracorporeal circulation using flexible and rigid arterial tubing: a reassessment

Abstract Introduction: Pulsatile extracorporeal circulation may improve organ perfusion during cardiac surgery. Some minimally invasive extracorporeal circulation (MiECC) systems allow pulsatile perfusion. The present study investigated the influence of arterial..

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Hemolysis-mediated Toxicity during Cardiopulmonary Bypass Ameliorated by Inhaled Nitric Oxide Gas

Abstract In a randomized clinical trial in China of 244 adults undergoing elective, multiple valve replacement surgery, Lei and colleagues administered 80 parts per million nitric oxide (NO) gas during..

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Preventing and managing catastrophic bleeding during extracorporeal circulation

Abstract The use of extracorporeal circulation for cardiac surgery and extracorporeal life support poses tremendous challenges to the hemostatic equilibrium given its diametric tendency to trigger hyper‐ and hypocoagulopathy. The..

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Off-Pump Versus On-Pump Impact: Diabetic Patient 5-Year Coronary Artery Bypass Clinical Outcomes

Abstract Background For diabetic patients who require  (CABG) operation, controversy persists whether an off-pump or an on-pump approach may be advantageous. This US-based, multicenter, randomized, controlled trial, Department of Veterans Affairs..

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Meta-Analysis Comparing the Incidence of Infective Endocarditis Following Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement

Abstract  (IE) after  (TAVI) and surgical  (SAVR) is a rare but life-threatening complication. Paravalvular regurgitation, compression of native leaflets, and space between transcatheter  and native valves could dispose  recipients at increased risk of IE..

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Left Ventricular Distension in Veno-arterial Extracorporeal Membrane Oxygenation: From Mechanics to Therapies

Abstract Veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) is increasingly commonly used to treat acute cardiac or pulmonary failure because of a wide range of etiologies. However, despite progressively improving outcomes,..

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Low-level light therapy reduces platelet destruction during extracorporeal circulation

Abstract Extracorporeal circulation causes many deleterious effects on blood cells. Low-level light therapy (LLLT) in the red/near-infrared spectral range is known for its cytoprotective properties but its use during cardiopulmonary..

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Tranexamic Acid Dosing for Cardiac Surgical Patients With Chronic Renal Dysfunction: A New Dosing Regimen

Abstract BACKGROUND:  Tranexamic acid (TXA) is a common antifibrinolytic agent used to minimize bleeding in cardiac surgery. Up to 50% cardiac surgical patients have chronic renal dysfunction (CRD). Optimal dosing..

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The Perioperative Management of Ascending Aortic Dissection

Abstract Acute aortic syndromes are a distinct group of pathologies involving the wall of the aorta that present acutely and can be potentially fatal unless treated in a timely fashion...

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An introduction to point-of-care testing in extracorporeal circulation and LVADs

Abstract There is a delicate balance between bleeding and clotting in patients on circuits such as ventricular assist devices or extracorporeal membrane oxygenation. Traditional coagulation tests, prothrombin time, activated partial..

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Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Percutaneous Left Ventricular Decompression Therapy with Impella Is Associated with Improved Outcomes in Refractory…

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous..

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Nitric oxide provides myocardial protection when added to the cardiopulmonary bypass circuit during cardiac surgery: Randomized trial

Abstract Objectives The aim of this pilot study was to elucidate the effects of exogenous  (NO) supply to the  circuit for cardioprotection against  during  (CABG) with  (CPB). Methods A total of 60 patients with  scheduled for..

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The influence of ultrafiltration on red blood cell transfusion during cardiopulmonary bypass

Abstract Background: Ultrafiltration during cardiopulmonary bypass (CPB) reduces fluid overload and inflammatory mediators in open-heart surgery and is thought to reduce the risk of red blood cell (RBC) transfusion. We..

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Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies

Abstract Complications and critical events during cardiopulmonary bypass (CPB) are very challenging, difficult to manage, and in some instances have the potential to lead to fatal outcomes. Massive cerebral air..

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Lactate clearance in infants undergoing surgery for congenital heart disease

Abstract Measurement of lactate concentrations during cardiac surgery with cardiopulmonary bypass (CPB) is a reliable monitoring tool for the assessment of the adequacy of perfusion, and a predictor of poor..

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Heparin-induced thrombocytopaenia diagnostic testing after adult cardiac surgery: a single-centre experience and development

Abstract OBJECTIVES To assess the incidence and outcome of heparin-induced thrombocytopaenia (HIT) in patients after cardiac surgery on cardiopulmonary bypass (CPB) and to review the time course of platelet counts..

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Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution

Abstract Introduction: Patients under the error-prone and complication-burdened extracorporeal membrane oxygenation (ECMO) are looked after by a highly trained, multidisciplinary team. Simulation-based training (SBT) affords ECMO centers the opportunity to..

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Clinical impact of disinvestment in hydroxyethyl starch for patients undergoing coronary artery bypass surgery: a retrospective observational study

Abstract Purpose To examine the effect of discontinuing hydroxyethyl starch (HES) solutions on length of hospital stay, transfusion, risk of death, acute kidney injury (AKI), and dialysis. Methods We conducted..

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Conventional or minimized cardiopulmonary bypass support during coronary artery bypass grafting? – An analysis by means of perfusion and body…

Abstract The use of minimized cardiopulmonary bypass support to reduce the side effects of extracorporeal circulation is still contradictorily discussed. This study compares perfusion operated by conventional (CCPB) and minimized..

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Outline Images Download Cite Share Favorites Permissions INVITED COMMENTARY Anything Goes? High Time for Smart Blood Volume Monitors

Abstract In this issue of the ASAIO Journal, Keane et al. present the results of their exploratory study on the combined use of whole body bioimpedance (WBB) and relative blood volume (RBV)..

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Circulatory Support with Extracorporeal Membrane Oxygenation and/or Impella for Cardiogenic Shock During Myocardial Infarction

Abstract Temporary mechanical circulatory support (TCS) is recommended for patients with profound cardiogenic shock (CS). Extracorporeal membrane oxygenation (ECMO) and Impella are possible TCS devices, but the device choice and the implantation..

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