International Perfusion Association

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Category: Cardiac Surgery

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Early Outcome of Endoscopic Mitral Valve Surgery in Elderly Patients: A High-Volume Single Center Experience

This study analyzes the outcomes of endoscopic mitral valve surgery (MVS) in 756 patients, focusing on those aged ≥75. Despite the elderly patients’ increased surgical risk and prevalence of comorbidities like hypertension and diabetes, the perioperative outcomes were favorable. The use of minimally invasive techniques, including 3D-camera visualization, resulted in low rates of postoperative complications and a 2.2% acute mortality rate at 30 days for elderly patients. Thus, endoscopic MVS is deemed a viable option for elderly patients, underlining the importance of including it in heart-team discussions.

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February 24, 2024
Pulmonary CABG

Clinical and Functional Outcomes Associated with Pulmonary Complications After Coronary Artery Bypass Grafting

This study explores the clinical and functional outcomes related to pulmonary complications in patients post-coronary artery bypass grafting (CABG). It contrasts the recovery of patients without complications (Non Complicated Group) against those with complications (Complicated Group), using various functional tests like the six-minute walk test, gait speed, and pulmonary function tests. Results indicate significant declines in functional performance, muscle strength, and pulmonary function in the Complicated Group, highlighting the impact of pulmonary complications on postoperative recovery.

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February 18, 2024
Perfusion Heart

Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

This editorial emphasizes the critical role of statistical analysis in pediatric cardiac surgery, highlighting how surgeons can use statistical tools to improve patient outcomes. It covers the importance of descriptive statistics, hypothesis testing, regression analysis, and survival analysis in crafting personalized treatment plans. By integrating statistical data, surgeons can make informed decisions, enhancing the success of surgeries and the well-being of their young patients.

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February 17, 2024
Doppler

Clinical Relevance of Transcranial Doppler in a Cardiac Surgery Setting: Embolic Load Predicts Difficult Separation from Cardiopulmonary Bypass

This study explores the use of transcranial Doppler (TCD) for detecting cerebral microemboli during cardiac surgery and its correlation with difficulties in separating from cardiopulmonary bypass (CPB) and postoperative complications. Analyzing 354 patients, it found that a higher quantity of cerebral embolic material significantly increases the odds of challenging CPB separation. The presence of microemboli was also linked to more complex surgeries, extended CPB durations, prolonged organ dysfunction, longer ICU stays, and increased mortality rates, particularly in the high embolic material (HEM) group.

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February 15, 2024
Post CABG

Factors Affecting Duration of Stay in the Intensive Care Unit After Coronary Artery Bypass Surgery and Its Impact on In-Hospital Mortality: A Retrospective Study

This retrospective study investigates the risk factors influencing prolonged stays in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) surgery. It analyzed 1070 patients, identifying several univariate predictors for extended ICU stays, such as larger left atrial diameter, chronic obstructive pulmonary disease, hypertension, diabetes, pre-surgery beta-blocker use, intraoperative blood transfusions, and postoperative complications like acute kidney injury, sepsis, pneumonia, and atrial fibrillation. Multivariate analysis pinpointed significant predictors like left atrial diameter > 4 cm, absence of pre-surgery beta-blocker use, extended ventilation support, development of pneumonia, and postoperative atrial fibrillation as key factors associated with stays longer than three nights. The study emphasizes the need to mitigate these complications to reduce ICU stays, thereby decreasing healthcare costs and improving resource availability.

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February 14, 2024
Inflammation Patient

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery

This retrospective study at the National Cardiovascular Center Harapan Kita analyzed 1056 on-pump CABG procedures from January 2019 to December 2022, finding that high preoperative systemic immune-inflammation index (SII) values were significantly associated with poor perioperative outcomes. Patients with an SII value ≥528.715 × 103/mm3 experienced longer surgery and cardiopulmonary bypass times, prolonged mechanical ventilation, ICU and hospital stays, and an increased risk of postoperative complications such as atrial fibrillation, cardiac arrest, acute myocardial infarction, and mortality. The study underscores the importance of preoperative SII values as predictors of morbidity and mortality in on-pump CABG surgery

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February 14, 2024
Blood Cells Lich

Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures

This study investigates the impact of preoperative anemia on postoperative outcomes in cardiac surgery, particularly focusing on acute kidney injury (AKI) and hospital stay duration. Analyzing over 4,000 patients, the findings reveal that preoperative anemia significantly increases the risk of AKI and extends hospital stays, with a notable portion of these effects directly attributed to anemia rather than mediated through intraoperative red blood cell transfusions. The research underscores the need for further exploration into anemia’s role in postoperative complications and highlights the importance of addressing preoperative anemia in cardiac surgery patients.

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February 11, 2024
Heart Failure

Novel Pan-ERR Agonists Ameliorate Heart Failure Through Enhancing Cardiac Fatty Acid Metabolism and Mitochondrial Function

This study introduces two pan-ERR agonists, SLU-PP-332 and SLU-PP-915, demonstrating their efficacy in improving heart function in a heart failure (HF) model. By activating ERRα and ERRγ, these agonists significantly enhance ejection fraction, reduce fibrosis, and increase survival without affecting cardiac hypertrophy. Their action activates metabolic genes, particularly those involved in fatty acid metabolism and mitochondrial function, leading to normalized metabolic profiles and increased mitochondrial oxidative capacity. ERRγ was identified as the primary mediator of these beneficial effects, offering potential for ERR agonists as novel HF therapeutics.

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February 10, 2024
Peep

Maintaining Moderate Versus Lower PEEP After Cardiac Surgery: A Propensity-Scored Matched Analysis

This retrospective study investigated the impact of applying moderate versus lower positive end-expiratory pressure (PEEP) in the early postoperative period for cardiac surgery patients in the ICU. It involved 334 patients, with 102 receiving moderate PEEP (≥ 7 cm H2O). After propensity-score matching, the moderate PEEP group showed marginally shorter mechanical ventilation durations and significantly better oxygenation compared to the lower PEEP group, without affecting ICU length of stay or the need for prone positioning. The findings suggest that moderate PEEP could facilitate earlier mechanical ventilation liberation due to improved oxygenation in selected cardiac surgery patients.

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February 9, 2024
CV Surgery Baby

Intra-abdominal Hypertension Predicts Worse Hospital Outcomes in Children After Cardiac Surgery: A Pilot Study

This study highlights the incidence and impact of postoperative intra-abdominal hypertension (IAH) in children undergoing open-heart surgery, showing that 24.7% of patients experienced IAH, with significant occurrences within the first 24 hours of ICU admission. Factors like right-sided heart lesions, redo sternotomies, and prolonged cardiopulmonary bypass were identified as predictors of IAH. The condition was associated with increased inotropic support needs, gastrointestinal complications, sepsis, multiple organ dysfunction syndrome, and extended stays in the ICU and hospital. This underscores the importance of monitoring and managing IAH to improve postoperative outcomes in pediatric cardiac surgery patients

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February 8, 2024
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