Off-Pump Coronary Artery Bypass Grafting

The Past, Present, and Future of Off-Pump Coronary Artery Bypass Grafting

This review traces the evolution and prospects of off-pump coronary artery bypass grafting (OPCAB). Despite early skepticism due to technical difficulty, OPCAB offers major advantages for high-risk patients, including reduced stroke risk and faster recovery. Modern trials and meta-analyses show comparable or superior outcomes to on-pump CABG when performed by experienced surgeons. Emphasis is placed on arterial grafting, no-touch techniques, and hybrid strategies for future optimization.

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Evaluation of Transcutaneous Non-Invasive Blood Gas Analysis

Evaluation of Transcutaneous Non-Invasive Blood Gas Analysis for Monitoring Gas Exchange in Pediatric Cardiac Surgical Patients Post Extubation

This study evaluates the effectiveness of transcutaneous blood gas monitoring (TcPCO₂ and TcPO₂) in detecting carbon dioxide and oxygen levels in pediatric cardiac surgery patients after extubation. It found a strong correlation between TcPCO₂ and arterial PaCO₂, suggesting transcutaneous CO₂ can be a reliable, non-invasive monitoring tool. However, TcPO₂ showed less precision and cannot substitute PaO₂.

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Survival Analysis of Minimally Invasive Mitral Valve Surgery

Survival Analysis of Minimally Invasive Mitral Valve Surgery Versus Conventional Median Sternotomy in the United States

This retrospective cohort study compares survival outcomes and surgical efficiency between minimally invasive mitral valve surgery (MiMVS) via mini-thoracotomy and conventional sternotomy. Among 422 elective cases, MiMVS was associated with shorter hospital stays, less postoperative bleeding, and shorter operative times. Although no significant survival difference was found, mitral valve replacement showed higher mortality risk than repair.

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Near-Infrared Spectroscopy to Monitor Cerebral and Renal Oxygen Saturation During Cardiopulmonary Bypass Surgery

Near-Infrared Spectroscopy to Monitor Cerebral and Renal Oxygen Saturation During Cardiopulmonary Bypass Surgery for Paediatric Congenital Heart Disease: Study Protocol for a Prospective Observational Cohort Trial

This BMJ Open study outlines a prospective cohort trial evaluating near-infrared spectroscopy (NIRS) to monitor cerebral and renal oxygen saturation during pediatric cardiopulmonary bypass surgery. It aims to link intraoperative oxygenation levels with postoperative brain and kidney injuries, assessing outcomes with biomarkers and quality-of-life metrics. Findings could improve organ injury prediction and perioperative care in congenital heart disease surgeries.

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Evaluation of Postoperative Delirium

Evaluation of Postoperative Delirium in Cardiac Surgery Patients With the SDACS Screening Tool: A Multicenter-Multiphase Study

This study developed and validated the SDACS screening tool to predict postoperative delirium in cardiac surgery patients. Conducted across three academic hospitals with 920 participants, it identified four key predictors: chronic opioid use, hearing impairment, benzodiazepine history, and poor postoperative sleep. The tool demonstrated strong predictive power (AUC = 0.897), offering clinicians a practical instrument to guide early interventions.

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Vasoplegic Syndrome in Cardiac Surgery

Vasoplegic Syndrome in Cardiac Surgery: Bridging Therapeutic Gaps with Best Practices and Future Research

This article explores vasoplegic syndrome (VS), a serious complication following cardiac surgery involving cardiopulmonary bypass. It discusses inconsistent definitions, risk factors, and treatment strategies. Methylene blue emerges as a promising therapy due to its ability to counteract the nitric oxide-cGMP pathway. The authors advocate for standardized definitions, early intervention, and large-scale trials to validate therapeutic protocols.

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Impact of Inflammation After Cardiac Surgery

Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction

This study investigates the effects of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develops machine learning models to predict SIRS. Analyzing data from 1,908 patients, researchers found SIRS significantly raised mortality risk. Key predictors included preoperative anemia and intraoperative lactate peaks. Predictive models using random forest achieved high accuracy, offering insights for tailored interventions.

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5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement

5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis

This study presents 5-year outcomes from the Evolut Low Risk trial, comparing transcatheter aortic valve replacement (TAVR) with surgery in low-risk patients with severe aortic stenosis. Results showed no significant difference in all-cause mortality or disabling stroke between the groups, affirming TAVR as a noninferior option. Both treatments maintained excellent valve performance, similar quality-of-life improvements, and low reintervention rates.

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Quantum Perfusion

Real-Time Blood Gas Management: Evaluating Quantum Perfusion System’s Accuracy Against a Standard Blood Gas Analysis in CPB

This non-inferiority study evaluates the Quantum Perfusion System (QPS) for continuous blood gas monitoring during cardiopulmonary bypass (CPB) against the standard blood gas analyzer (BGA). Using data from 40 patients undergoing cardiac surgeries, QPS demonstrated high accuracy and agreement with BGA across all key parameters, adhering to Clinical Laboratory Improvement Amendments (CLIA) standards, and validating its utility as a trending device.

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Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury in On-pump Cardiac Surgery—A Post-hoc Analysis of a Randomized Clinical Trial

A post-hoc analysis of the ALBICS randomized trial with 1,386 cardiac surgery patients found that perioperative bleeding, as classified by the Universal Definition of Perioperative Bleeding (UDPB), was not independently linked to acute kidney injury (AKI). Rather, bleeding indirectly contributed to AKI through hypotension and fluid overload. The only transfusion product independently associated with AKI was fresh frozen plasma.

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