Blood-Based Versus Crystalloid Cardiopulmonary Bypass Priming in Left Ventricular Assist Device Surgery: Impact on End-Organ Function and Survival

August 7, 2026 No Comments

This retrospective study compared blood-based versus crystalloid cardiopulmonary bypass priming in 92 patients undergoing HeartMate 3 LVAD implantation. Blood-based priming was associated with significantly less postoperative right heart failure and delirium and a trend toward less dialysis. Major bleeding was numerically lower, while survival differences were not statistically significant. Prospective randomized trials are needed to confirm these findings.

Does Sternal-Sparing Outweigh Prolonged Bypass? Inflammatory Resolution in MICS Versus Median Sternotomy: A SIRI-Based Analysis

August 6, 2026 No Comments

A propensity score-matched study of 178 patients undergoing mitral valve surgery compared minimally invasive cardiac surgery (MICS) with conventional median sternotomy. Although MICS required longer operative, cardiopulmonary bypass, and cross-clamp times, patients experienced faster resolution of systemic inflammation by postoperative day 5, measured using the Systemic Inflammation Response Index (SIRI). Early postoperative SIRI also showed promise for predicting pulmonary complications.

Impact of Antegrade Selective Cerebral Perfusion Flow Ranges on Clinical and Neurological Outcomes in Aortic Arch Surgery

August 6, 2026 No Comments

This retrospective single-center study evaluated 492 adults undergoing aortic arch surgery with bilateral selective antegrade cerebral perfusion (SACP). Patients were grouped by indexed cerebral perfusion flow (<10, 10–15, or >15 mL/kg/min). No significant differences were found in 30-day mortality, permanent neurological dysfunction, or transient neurological deficits across flow ranges. The findings support individualized intraoperative perfusion management while maintaining recommended flow targets.

Topical Use of Tranexamic Acid for Antifibrinolysis in Cardiac Surgery With Cardiopulmonary Bypass: A Randomized Clinical Study

May 5, 2026 No Comments

This randomized trial compared topical intrapericardial tranexamic acid (TXA) with standard intravenous TXA in 492 adults undergoing cardiac surgery with cardiopulmonary bypass. Topical TXA appeared similarly safe, with fewer composite 30-day adverse events numerically, but it did not meet strict efficacy non-inferiority: red blood cell transfusions and 24-hour drainage were higher. IV TXA remains first-line; topical TXA may suit selected patients who cannot tolerate systemic therapy.

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

April 14, 2026 No Comments

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.

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

April 6, 2026 No Comments

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.

Quality Management of Comprehensive Blood Conservation Strategies During Cardiopulmonary Bypass in Pediatric Cardiac Surgery

April 2, 2026 No Comments

This retrospective single-center study evaluated 9,792 children aged 14 years or younger undergoing cardiac surgery with cardiopulmonary bypass. After implementation of a quality-managed, multimodal blood conservation program, matched analysis showed lower PRBC and plasma transfusion rates, smaller CPB priming volumes, and fewer postoperative complications, especially liver injury and acute kidney injury, without increased mortality or longer recovery.

The Impact of Re-operation on Aortic Arch Reconstructive Surgery: Evidence from a Multicentre, National Registry

April 1, 2026 No Comments

This multicenter Canadian registry study examined 2,481 patients who underwent aortic arch reconstruction between 2002 and 2021, including 374 redo cases after prior open-heart surgery. Despite a higher comorbidity burden, redo surgery was not associated with significantly higher overall operative mortality or major morbidity than primary surgery. Risk increased with older age, acute dissection or rupture, and longer cardiopulmonary bypass time.

Artificial Intelligence in Adult Cardiovascular Medicine and Surgery: Real-World Deployments and Outcomes

April 1, 2026 No Comments

Artificial intelligence (AI) is transforming adult cardiovascular medicine and surgery by enhancing diagnostics, surgical planning, intraoperative precision, and postoperative monitoring. Tools such as AI-ECG, automated imaging, and predictive analytics improve risk stratification and outcomes. While real-world deployments show promise, challenges including data quality, bias, and limited prospective validation remain barriers to widespread adoption.

Sevoflurane Delivery During Cardiopulmonary Bypass

Estimated End-Tidal Sevoflurane Concentration to Maintain Optimal Anesthetic Depth During Cardiopulmonary Bypass: A Meta-Analysis

March 29, 2026 No Comments

This meta-analysis examined how much end-tidal sevoflurane is needed to maintain appropriate anesthetic depth during cardiopulmonary bypass. Across five prospective studies involving 129 adults, the pooled estimate was 0.88 vol% for a BIS target of 40–60. Older patients required less sevoflurane, while body temperature did not significantly change dosing needs. The findings offer a practical reference point, although evidence certainty remained limited by heterogeneity and small study sizes.