Association Between Cardiopulmonary Bypass Weaning Time and Adverse Outcomes in Patients With Aortic Dissection Who Underwent Total Arch Replacement Combined With Stented Elephant Trunk Implantation

February 28, 2026 No Comments

This retrospective single-center study of 475 patients with acute type A aortic dissection undergoing total arch replacement with stented elephant trunk implantation found that prolonged cardiopulmonary bypass (CPB) weaning time was independently associated with increased in-hospital mortality and postoperative stroke. A cutoff of 90 minutes strongly predicted early mortality and reduced short-term survival, though mid-term survival was unaffected.

Seamless Transition: Single-Circuit ECMO to CPB in Pediatric Surgery

ECMO to CPB: A Single Circuit Approach

February 27, 2026 No Comments

This technique article describes a novel method for converting pediatric patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to cardiopulmonary bypass (CPB) using a single circuit with the addition of a cardiotomy reservoir. In seven patients (eight procedures), the approach preserved circulating blood volume, limited donor exposure, and maintained effective surgical support. All patients were successfully decannulated, demonstrating feasibility and safety in complex congenital heart surgery.

Outcomes of Heart Failure Hospitalizations at Urban Teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States

February 26, 2026 No Comments

This nationwide propensity-matched study of 7.5 million U.S. heart failure hospitalizations (2016–2022) found that urban teaching hospitals had higher inpatient mortality, complication rates, length of stay, costs, and palliative care consultations compared with urban non-teaching hospitals. Despite worse in-hospital outcomes, 30- and 90-day readmission rates were similar. Findings likely reflect referral bias and greater illness severity at teaching centers rather than differences in care quality.

Comparing Myocardial Protection Strategies in Heart Transplantation

Long-Term Outcome of Myocardial Protection in Heart Transplantation: Comparison Among 3 Different Solutions

February 23, 2026 No Comments

This 20-year single-center study of 528 heart transplant recipients compared three preservation solutions: Celsior, HTK-Custodiol, and St Thomas. HTK-Custodiol was associated with a significantly higher rate of severe primary graft dysfunction (10.2% vs 4.5%), but long-term survival and rejection rates were similar across groups. Severe PGD, ischemic time, and donor/recipient age predicted late mortality. Authors advise caution with HTK-Custodiol.

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

February 20, 2026 No Comments

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.

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

February 18, 2026 No Comments

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.

Preoperative Anemia Management and Its Economic Impact on Red Blood Cell Transfusion in Cardiac Surgery

Predictors and Economic Impact of Red Blood Cell Transfusion in Cardiac Surgery: A Simulated Cost Reduction Model for Preoperative Anemia Management

February 16, 2026 No Comments

This retrospective cohort study of 661 elective cardiac surgery patients identified preoperative anemia as the strongest independent predictor of red blood cell (RBC) transfusion (OR 3.67). Transfusion was associated with longer hospital stay, higher infection rates, prolonged ventilation, and a median cost increase of €2264 per patient. A simulation model estimated that eliminating preoperative anemia could prevent 47 transfusions and save €106 429 over 13 months.

Intravenous Lidocaine Infusion During Cardiopulmonary Bypass Cardiac Surgery

Evaluation of the Effect of Intravenous Lidocaine on the Systemic Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized Clinical Trial

February 16, 2026 No Comments

This single-center, double-blind randomized clinical trial (LEONARD Trial) evaluates whether intravenous lidocaine reduces systemic inflammation triggered by cardiopulmonary bypass in elective valvular and/or coronary cardiac surgery. Ninety patients will receive lidocaine or placebo, with IL-6 at 6 hours postoperatively as the primary endpoint. Secondary outcomes include inflammatory biomarkers, organ dysfunction, atrial fibrillation, ICU stay, opioid use, and 30-day mortality.

Optimising Protamine Dosing for Heparin Reversal After Cardiopulmonary Bypass: A Population Pharmacokinetic—Pharmacodynamic Study

February 15, 2026 No Comments

This prospective study of 68 cardiac surgery patients used pharmacometric modeling to determine optimal protamine dosing for reversing unfractionated heparin after cardiopulmonary bypass. Researchers found that a protamine-to-heparin ratio of 0.625:1 achieved complete reversal in 95% of patients, lower than the commonly used 1:1 ratio. The study also revealed that activated clotting time (ACT) unreliably reflects residual heparin, suggesting fixed low-ratio dosing may be a practical alternative requiring validation.

Zero-Balance Ultrafiltration Reduces Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Controlled Trial

February 5, 2026 No Comments

This single-center randomized controlled trial evaluated whether adding zero-balance ultrafiltration (Z-BUF) to conventional ultrafiltration during cardiopulmonary bypass reduces postoperative delirium after cardiac surgery. Among 106 analyzed patients, Z-BUF significantly lowered delirium incidence within 7 postoperative days compared with conventional ultrafiltration alone, while no significant differences were observed in longer-term cognitive outcomes at 1 or 3 months.