Emergency Repair of a Rupturing Ascending Aorta

Circulatory Arrest Time Above 30 Minutes Has Significantly Detrimental Effects on the Outcomes of Type A Aortic Dissection Repair

This retrospective study of 109 patients undergoing emergent type A aortic dissection repair found that deep hypothermic circulatory arrest (DHCA) times exceeding 30 minutes were associated with significantly higher 30-day mortality, 12-month mortality, and postoperative stroke rates. Cerebral perfusion strategy did not alter stroke risk. The findings suggest that limiting circulatory arrest to under 30 minutes may improve survival and neurological outcomes.

February 20, 2026

The Evolving Role of the ECMO Perfusionist

Redefining the Role of Perfusionists in ECMO: From Technical Operators to Clinical Stakeholders

This letter to the editor argues that perfusionists in ECMO programs should move beyond a narrowly defined technical role and be formally integrated as clinical stakeholders. The authors highlight perfusionists’ expertise in circuit management, anticoagulation, device troubleshooting, and physiology, advocating for their inclusion in ICU rounds, decision-making, quality improvement, and research. Greater integration could improve safety, efficiency, and patient outcomes in complex ECMO care.

February 19, 2026

High-Exchange Ultrafiltration During Pediatric Cardiopulmonary Bypass

High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The ULTRA Randomized Controlled Trial

The ULTRA randomized controlled trial evaluated whether high-exchange subzero-balance ultrafiltration (H-SBUF) during pediatric cardiopulmonary bypass improves recovery compared with low-exchange SBUF. In 104 children under 15 kg, high-exchange ultrafiltration did not reduce peak postoperative vasoactive-ventilation-renal (VVR) scores or improve clinical outcomes. Inflammatory mediator profiles were largely similar, suggesting limited immunomodulatory benefit.

February 18, 2026

Heart Transplantation Graft Survival Following Donation After Circulatory Death via Thoracoabdominal Normothermic Regional Perfusion

This national cohort study analyzed adult heart transplants in the United States from 2020–2024 to compare graft survival among donation after circulatory death (DCD) using thoracoabdominal normothermic regional perfusion (TA-NRP), DCD with direct procurement and perfusion (DPP), and donation after brain death (DBD). Two-year graft and patient survival were comparable across groups, supporting broader use of TA-NRP in heart transplantation.

February 18, 2026

Balancing Bleeding and Clotting: Anticoagulation Strategies During ECMO Support

Efficacy of Reduced-Intensity or No Heparin Versus Standard Heparin Anticoagulation in Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-AnalysiS

This systematic review and meta-analysis of 11 studies (958 ECMO patients) compared reduced-intensity or no heparin anticoagulation with standard heparin strategies. Low/no heparin significantly reduced bleeding complications (OR 0.49) without increasing thrombotic events or in-hospital mortality. Transfusion requirements showed no significant difference. Findings support individualized anticoagulation strategies, though high-quality randomized trials remain needed.

February 17, 2026

Peripheral Versus Central Cannulation for Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO): A Meta-Analysis of Bleeding and Vascular Complications

This meta-analysis of 15 studies (2,913 patients) compares peripheral and central cannulation strategies for VA-ECMO in refractory cardiogenic shock. Peripheral access significantly reduced major bleeding risk but increased limb ischemia. No meaningful differences were observed in infection, renal replacement therapy, or stroke. Findings support individualized cannulation decisions balancing bleeding risk against vascular complications.

February 16, 2026

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