As the perioperative care in cardiothoracic and vascular anesthesia continues to evolve, more emphasis is being placed on developing innovative methods for risk assessment and early detection of operative complications. This September issue of Seminars in Cardiothoracic and Vascular Anesthesia investigates these emerging methods while also examining the effectiveness of well-established interventions.

This issue features two original research articles which focus on developing novel approaches to assess the risk of operative complications in cardiac surgery by evaluating electrocardiographic markers and non-invasive hemodynamic monitoring.^1,2 Following these articles, we dive into a review article which evaluates both the clinical and economic effectiveness of extracorporeal membrane oxygenation (ECMO) for adult respiratory failure in a rapid review commissioned by the National Health Service (NHS) Wales for the purposes of guiding future healthcare policy in this critical area.³ An accompanying response letter by Pandey provides further perspective on this topic by discussing additional data, which offers a more comprehensive view of the available evidence.⁴ The theme of perioperative monitoring is revisited in a subsequent systematic review which evaluates the prognostic value of near-infrared spectroscopy (NIRS) in predicting postoperative acute kidney injury (AKI) in pediatric cardiac surgery.⁵ The issue concludes with two unique case reports. The first case report describes a newborn with congenital third-degree atrioventricular (AV) block and it highlights the clinical challenges which are faced during the management of clinical conditions which can require rapid decision making and multidisciplinary planning.⁶ The second case report describes the use of ECMO in the management of a preeclamptic patient who developed flash pulmonary edema and respiratory failure.