Anticoagulation Monitoring Strategies During Cardiopulmonary Bypass in Patients With Antiphospholipid Syndrome: A Systematic Review

This systematic review examines anticoagulation monitoring during cardiopulmonary bypass in patients with antiphospholipid syndrome, a high-risk prothrombotic condition that can make activated clotting time unreliable. Across 17 studies and 62 patients, ACT, Hepcon, anti-Xa, and viscoelastic testing were used inconsistently. The review found no evidence proving one strategy superior but highlights the need for multimodal monitoring and future prospective research.

April 23, 2026

Thrombotic Mitral Valve Obstruction During Venoarterial Extracorporeal Membrane Oxygenation With Left Ventricular Venting Following Complex Valve Surgery

This case report describes a 69-year-old woman who developed thrombotic obstruction of a mitral bioprosthesis while receiving VA-ECMO with left ventricular venting after complex multivalve surgery. Delayed anticoagulation, prosthetic material, altered intracardiac flow, and postoperative bleeding likely combined to trigger thrombosis. The report highlights diagnostic difficulty during ECMO weaning and stresses individualized anticoagulation, echocardiographic monitoring, and careful unloading strategy selection.

April 14, 2026

The Invisible Face of ECMO: Anxiety Levels and Challenges Among Intensive Care Nurses

This cross-sectional study examined 137 ICU nurses in Turkey who cared for patients receiving ECMO, a complex life-support therapy. Nurses reported mild-to-moderate anxiety, with higher stress linked to bleeding risk, infection concerns, workload, complications, and team-related organizational problems. More ECMO-specific experience was associated with lower anxiety, highlighting the value of structured training, standardized protocols, and experienced staffing.

April 12, 2026

Elevated Oxygen Extraction During Heart Transplantation Is Associated With Increased Morbidity and Mortality: Implications for Goal-Directed Perfusion

This single-center retrospective study of 381 adult heart transplants found that prolonged oxygen extraction ratio, or O2ER, above 0.20 during cardiopulmonary bypass was linked to higher post-transplant morbidity and early mortality. O2ER outperformed low indexed oxygen delivery alone in predicting risk, especially around reperfusion, suggesting that perfusion strategies should focus on matching oxygen delivery to metabolic demand rather than relying only on fixed delivery thresholds.

April 12, 2026

Heart-Liver-Kidney Transplantation for AL Amyloidosis Using Normothermic Recovery and Storage From a Donor Following Circulatory Death: Short-Term Outcome in a First-in-World Experience

This case report describes the first known heart-liver-kidney transplant for AL amyloidosis using organs recovered from a donation-after-circulatory-death donor with thoracoabdominal normothermic regional perfusion. A 40-year-old man with terminal multiorgan AL amyloidosis underwent sequential heart, liver, and kidney transplantation and remained free of graft dysfunction or rejection at 8 months, highlighting a new path to expand complex transplant access.

April 8, 2026

Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury Requiring Dialysis After Cardiac Surgery: A Retrospective Study from the National Heart Institute of Malaysia

This retrospective Malaysian cohort study examined 6,779 adult cardiac surgery patients and found that 4.5% developed postoperative acute kidney injury requiring dialysis. Risk was higher in patients with chronic kidney disease, urgent surgery, diabetes, reoperation, and longer ICU stay. Dialysis-requiring AKI was linked to sharply increased mortality, especially among patients without baseline CKD, highlighting the need for earlier renal risk stratification and kidney-protective perioperative care.

April 6, 2026

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