International Perfusion Association

Category: Cardiac Surgery

Chip Heart

Meta-Analysis of the Performance of AI-Driven ECG Interpretation in the Diagnosis of Valvular Heart Diseases

Artificial intelligence (AI) applied to electrocardiogram (ECG) interpretation shows high accuracy for early detection of valvular heart diseases (VHDs), based on a meta-analysis of data from 713,537 patients, with pooled accuracy and sensitivity of 81% and 83%, respectively. However, the low positive predictive value (PPV) of 13% suggests that AI should be used in conjunction with clinical judgment for VHD screening in primary care settings.

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Blood Cells Lich

Low-Volume Acute Normovolemic Hemodilution Does Not Reduce Allogeneic Red Blood Cell Transfusion in Cardiac Surgery in the Modern Era of Patient Blood Management: A Propensity Score-Matched Cohort Study

In a retrospective cohort study of 542 elective cardiac surgery patients, acute normovolemic hemodilution (ANH) did not significantly reduce perioperative red blood cell transfusion rates compared to controls. This suggests that in the context of modern patient blood management practices, the benefits of ANH in minimizing transfusion requirements may be less significant than previously thought.

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Multi CABG

New Research Highlights Superior Long-Term Survival with Multi-Arterial Coronary Artery Bypass Grafting Over Single Arterial Grafting

Research presented at The Society of Thoracic Surgeons’ 2024 Annual Meeting revealed that multi-arterial grafting (MAG) for coronary artery bypass grafting (CABG) results in better long-term survival than single arterial grafting (SAG), based on a study of over a million patients from 2008 to 2019. The findings, emphasizing MAG’s advantages across various patient groups except in severely obese and very elderly patients, offer critical guidance for cardiac surgeons in choosing the optimal revascularization strategy.

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Patient Recovery

Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS)

Enhanced Recovery After Surgery (ERAS) programs, which include protocolized evidence-based perioperative interventions, have been effective in reducing surgical stress, promoting quicker recovery, and improving clinical outcomes in various surgical specialties. An international expert panel has reviewed the literature and provided consensus statements on applying ERAS principles to cardiac surgery, laying the groundwork for best practices in managing adult cardiac surgery patients.

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Mechanical Ventilation

Development and Validation of Scores to Predict Prolonged Mechanical Ventilation after Cardiac Surgery

This study aimed to improve the early prediction of prolonged postoperative mechanical ventilation (>24 hours) after cardiac surgery. It involved analyzing data from the ANZSCTS database, validating a modified existing prediction score, and developing the ANZ-PreVent score, which showed improved performance in identifying high-risk patients for targeted interventions.

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AKI 2

The Multifactorial Dynamic Perfusion Index: A Predictive Tool of Cardiac Surgery Associated Acute Kidney Injury

This study aimed to develop a dynamic predictive model for cardiac surgery associated acute kidney injury (CSA-AKI) by combining preoperative and intraoperative risk factors, including cardiopulmonary bypass (CPB) related data. The resulting Multifactorial Dynamic Perfusion Index (MDPI) demonstrated better predictive ability than static risk models, showing that inclusion of dynamic CPB quality indices significantly improves risk assessment for CSA-AKI.

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Electroacupuncture

Efficacy of Electroacupuncture on Myocardial Protection and Postoperative Rehabilitation in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis

This study evaluated the efficacy of electroacupuncture (EA) in myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass, using data from fourteen randomized controlled trials involving 836 patients. The results suggest that EA may reduce myocardial ischaemia-reperfusion injury and enhance postoperative recovery, with no reported adverse reactions, although the findings are based on evidence of mostly low or moderate quality, indicating a need for more high-quality, large-scale studies.

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ICU Patient

Timing of Chest Tube Removal Following Adult Cardiac Surgery: A Cluster Randomized Controlled Trial

This study compared two fast-track chest tube removal protocols in cardiac surgery patients, focusing on risks of pleural or pericardial effusions, opioid requirements, respiratory function, and postoperative complications. Results showed that early chest tube removal did not significantly reduce analgesic needs, improve respiratory function, or decrease postoperative complications, and was associated with a high rate of pleural effusions, leading to the study’s early termination for futility.

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CABG Core

Safety-Net Hospital Status Is Associated With Coronary Artery Bypass Grafting Outcomes at an Urban Academic Medical Center

The study investigated the impact of socioeconomic factors and referral status from a county hospital (CH) on outcomes of coronary artery bypass grafting (CABG). It found that patients from CH had greater comorbidities, more often required nonelective surgery, and faced a significantly higher risk of major adverse cardiovascular events (MACE) postoperatively.

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The Rat

The Anti-Apoptotic Effect of Ranolazine on Cerebral Protection during Cardiopulmonary Bypass and Carotid Artery Surgery

This study investigated the neuroprotective effects of ranolazine (Rn) in a rat model of cerebral ischemia induced by carotid artery clamping. Results showed that Rn-treated groups had significant changes in various biochemical markers, indicating an antiapoptotic effect of Rn in brain ischemia-reperfusion, suggesting its potential usability in cardiac surgeries and carotid artery interventions.

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