International Perfusion Association


Category: Cardiac Surgery

Anesthesia MICS

Anesthesia for Minimally Invasive Cardiac Surgery: The Bonn Heart Center Protocol

This article outlines the anesthetic management protocol for minimally invasive cardiac surgery (MICS) at the Bonn Heart Center. It covers preoperative assessment, tailored anesthesia induction, and intraoperative techniques designed to maintain hemodynamic stability and ensure optimal ventilation. Advanced monitoring methods, including transesophageal echocardiography (TEE), processed EEG, and near-infrared spectroscopy (NIRS), are utilized to optimize patient safety. The article emphasizes the importance of peripheral cannulation techniques for cardiopulmonary bypass (CPB) and discusses the necessity of a multidisciplinary approach to perioperative care to enhance recovery and patient outcomes.

Cardioplegia 2024

Comparative Analysis of Del Nido Cardioplegia Versus Blood Cardioplegia in Isolated Coronary Artery Bypass Grafting

This study examined the efficacy of del Nido cardioplegia compared to traditional blood cardioplegia in adult coronary artery bypass grafting. Among 119 patients, the del Nido group showed superior myocardial protection, indicated by lower Troponin I levels and fewer defibrillation attempts post-surgery. Additionally, this group experienced shorter surgery durations, including reduced aortic cross-clamping and total operative times. The findings suggest del Nido cardioplegia as a viable option for these procedures, necessitating a standardized protocol.

Aortic Surgery

Exploring Differences in Surgical Outcomes Depending on the Arterial Cannulation Strategy for Acute Type A Aortic Dissection: A Single-Center Study

This single-center retrospective study evaluated the impact of different arterial cannulation strategies on surgical outcomes for patients with acute type A aortic dissection (AD) and intramural hematoma (IMH). By comparing 32 patients who underwent antegrade cannulation with 114 patients who underwent retrograde cannulation, the study found significant differences in total surgical time and intensive care unit stay duration. However, no significant differences were observed in 30-day mortality or postoperative cerebrovascular accident rates. The findings suggest that the choice of cannulation strategy should be tailored to individual patient needs.

Patient Blood Management

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluated the methodology and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery under cardiopulmonary bypass (CPB). It analyzed nine guidelines using the AGREE II tool, finding that “Stakeholder involvement” scored lowest. Drug therapy strategies include anemia therapy, antithrombotic and anticoagulation drugs, and hemostatic drugs, with distinct recommendations for pediatric and adult patients.


Continuous Monitoring of Left Ventricular Function in Postoperative Intensive Care Patients Using Artificial Intelligence and Transesophageal Echocardiography

This study explores the efficacy of using artificial intelligence (autoMAPSE) with transesophageal echocardiography (TEE) to continuously monitor left ventricular (LV) function in postoperative intensive care patients. The prospective observational study involved 50 patients, monitored for 120 minutes post-cardiac surgery. Results showed that autoMAPSE provided precise, low-bias, and concordant measurements compared to manual methods, demonstrating excellent feasibility and trending ability.

Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

Valve Suture

First Experiences with Automated Annular Suturing Device in Totally Endoscopic Aortic and Mitral Valve Replacement

This study investigates the early clinical outcomes of using an automated annular suturing device, the RAM® device, in endoscopic minimally invasive aortic and mitral valve replacement surgeries. Conducted between September 2020 and June 2023, the study involved 66 patients with an average age of 61.8 years. The results showed no intraoperative complications, no paravalvular leaks, and zero 30-day and in-hospital mortality, indicating the procedure’s safety and effectiveness. Larger studies are recommended to further evaluate the device’s efficacy.


Comparative Analysis of Long-Term Outcomes in Valve-Sparing Aortic Root Reimplantation: Full Sternotomy versus Mini-Sternotomy Approach

This study compares long-term outcomes between mini-sternotomy and full sternotomy approaches for valve-sparing aortic root reimplantation. The mini-sternotomy group had longer surgical times but similar in-hospital outcomes and shorter hospital stays compared to the full sternotomy group. Over a median follow-up of 5.5 years, survival rates were comparable, with no need for repeat interventions on the aortic valve. The mini-sternotomy approach shows promise for its potential advantages, including cosmetic outcomes.


Use of Thromboelastography in Coronary Artery Bypass Grafting in a Patient With Factor Ⅴ Deficiency With Platelet Function Disorders: A Case Report and Literature Review

This case report examines the role of thromboelastography (TEG) in managing a 64-year-old hemodialysis patient with Factor V deficiency and platelet function disorders undergoing coronary artery bypass grafting. Despite a mild decrease in Factor V activity, preoperative transfusions corrected platelet dysfunction, allowing for successful surgery. Postoperative strategies were also TEG-guided, showcasing its utility in complex clinical scenarios.

FDA Warning

Safety and Quality Concerns with Getinge Cardiovascular Devices – Letter to Health Care Providers

On May 8, 2024, the FDA warned healthcare providers about ongoing safety concerns with Getinge/Maquet cardiovascular devices, specifically the Cardiosave Hybrid and Rescue IABP devices and the Cardiohelp system with HLS Sets. Despite corrective actions, these devices pose significant risks. The FDA advises transitioning to alternatives and reporting adverse events. Multiple recalls and serious injury reports have highlighted persistent issues with these devices, leading to enhanced FDA oversight.


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