International Perfusion Association

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IPA

Category: Cardiac Surgery

AVR 2

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.

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May 16, 2024
TEG2

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.

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May 15, 2024
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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May 12, 2024
Myocardial Injury

Hybrid Feature Selection in a Machine Learning Predictive Model for Perioperative Myocardial Injury in Noncoronary Cardiac Surgery with Cardiopulmonary Bypass

This study developed a predictive model for perioperative myocardial injury (PMI) using hybrid feature selection (FS) methods in patients undergoing noncoronary cardiac surgery with cardiopulmonary bypass (CPB). Conducted at Fuwai Hospital, China, the retrospective study included 1130 patients, with an overall PMI incidence of 20.3%. Various machine learning models were evaluated, with the Naïve Bayes model achieving the highest AUC. The study highlighted the importance of factors like prolonged CPB, aortic clamp time, and preoperative low platelet count in predicting PMI risk.

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May 12, 2024
Revasculatization

Hybrid Total Arterial Minimally Invasive Off-Pump Coronary Revascularization and Percutaneous Coronary Intervention Strategy for Multivessel Coronary Artery Disease: A Cohort Study with a Median 11-Year Follow-Up

This study examines hybrid coronary revascularization (HCR), a treatment combining minimally invasive coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for multivessel coronary artery disease (MV CAD). It involved 138 patients who underwent either MIDCAB or MICS-CABG, with a median follow-up of 11 years. Results showed a 36.7% incidence of major adverse cardiac and cerebral events (MACCE) and a higher mean survival rate for those completing hybrid treatment. The study supports HCR as a safe and effective option, highlighting the need for organized PCI steps post-surgery.

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May 11, 2024
Heart Bandage

Intraoperative Haemoadsorption for Antithrombotic Drug Removal During Cardiac Surgery: Initial Report of the International Safe and Timely Antithrombotic Removal (STAR) Registry

The STAR registry study explores the use of haemoadsorption for removing antithrombotic drugs during cardiac surgery to reduce bleeding risks. This report covers 165 patients from Austria, Germany, Sweden, and the UK. Patients on P2Y12 inhibitors and DOACs were assessed. The device, integrated into the cardiopulmonary bypass, showed promising results in mitigating bleeding risks. Group 1 (P2Y12) and Group 2 (DOAC) patients experienced similar bleeding events, suggesting the procedure’s safety and effectiveness.

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May 8, 2024
CPB Time

The Impact of Cardiopulmonary Bypass Time on the Sequential Organ Failure Assessment Score After Cardiac Surgery

This study investigates the effect of cardiopulmonary bypass (CPB) time on postoperative Sequential Organ Failure Assessment (SOFA) scores. The analysis of data from 1,032 patients reveals that longer CPB times correlate with higher SOFA scores, particularly affecting cardiovascular and renal functions. Prolonged CPB times (>200 minutes) are associated with an increased likelihood of severe dysfunction, emphasizing the predictive power of CPB duration on postoperative organ health.

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May 6, 2024
Infection 1

Nosocomial Infections After Pediatric Congenital Heart Disease Surgery: Data from National Center for Cardiovascular Diseases in China

This study evaluates nosocomial infections in pediatric patients post-cardiac surgery, analyzing data from the National Center for Cardiovascular Diseases in China. Out of 4776 patients, the nosocomial infection rate was 2.1%, with multidrug-resistant organisms (MDROs) found in 36 patients. Pneumonia and sepsis were the most common infections, with pneumonia showing an incidence density of 7.2/1000 patient-days. MDRO infections were associated with significantly longer intensive care unit stays compared to non-MDRO infections. The results highlight the impact of MDRO infections on surgical outcomes and the importance of infection prevention and control measures.

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May 4, 2024
Ischemic Heart

Remote Ischemic Preconditioning and Cognitive Dysfunction Following Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review and meta-analysis evaluates the effectiveness of remote ischemic preconditioning (RIPC) in preventing cognitive dysfunction after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. Despite hypothesized benefits, the meta-analysis of five studies encompassing 1,843 participants showed that RIPC does not significantly reduce the incidence or severity of postoperative cognitive dysfunction. The findings suggest that RIPC is not effective as a neuroprotective strategy in CABG patients.

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April 27, 2024
Predication Models

A Systematic Review of Cardiac Surgery Clinical Prediction Models That Include Intra-operative Variables

This systematic review assesses clinical prediction models (CPMs) that incorporate intra-operative variables to predict outcomes following adult cardiac surgery. It highlights the identification of 24 CPMs, predominantly predicting acute kidney injury and peri-operative mortality, using common variables like cardiopulmonary bypass time. Despite acceptable discrimination in internally validated models, poor calibration and high bias risk limit their practical use. The review suggests potential improvement in model accuracy with intra-operative data, advocating for more robust studies.

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April 26, 2024
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