International Perfusion Association

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IPA

Category: Cardiac Surgery

Protamine Done

Protamine Dosing for Heparin Reversal After Cardiopulmonary Bypass: A Double-Blinded Prospective Randomized Control Trial Comparing Two StrategieS

This study compared two protamine dosing strategies for heparin reversal after cardiopulmonary bypass: a fixed 250-mg dose versus a 1:1 (1 mg:100 U heparin) ratio-based approach. The trial included 125 elective adult cardiac surgery patients. Both methods showed similar activated clotting times and postoperative bleeding, but the fixed-dose group used significantly less protamine. These results suggest fixed dosing may optimize drug conservation without compromising safety or efficacy.

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November 24, 2024
BSA CPB

Predictive Role of Cardiopulmonary Bypass Exposure Indexed to Body Surface Area on Postoperative Organ Dysfunction: A Retrospective Cohort Study

This study analyzed the relationship between cardiopulmonary bypass (CPB) exposure indexed to body surface area (bypass index) and postoperative outcomes in 2,413 cardiac surgery patients. A higher bypass index was predictive of increased hospital stay and organ dysfunction, particularly renal and cardiac rhythm issues, but not pulmonary dysfunction. These findings highlight the bypass index as a valuable metric for assessing risk and optimizing resource use during cardiac surgery.

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November 24, 2024
Robo MVR

A Historical Perspective and Update on Robotic Mitral Valve Surgery

This study reviews the evolution of minimally invasive mitral valve repair, emphasizing the use of robotic platforms from 2005 to 2023. Analyzing 1,412 robotic repairs, it highlights improvements in outcomes, including reduced cross-clamp and bypass times and high repair durability. Degenerative disease was the most common indication, with 98.1% repair success and a ten-year survival rate exceeding 91%. The findings support robotic surgery as a durable, teachable, and safe option for mitral valve repair.

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November 19, 2024
DHCA

Temperature Management in Acute Type A Aortic Dissection Treatment: Deep vs. Moderate Hypothermic Circulatory Arrest

This study compares the clinical outcomes of deep hypothermic circulatory arrest (DHCA, <20°C) and moderate hypothermic circulatory arrest (MHCA, 20-28°C) in 143 patients undergoing acute type A aortic dissection surgery. DHCA was associated with higher rates of acute kidney injury (25.2% vs. 7.5%), delirium (22.3% vs. 5%), longer ICU stays, and greater complication risks compared to MHCA. While survival rates after two years were similar, MHCA proved to be safer and more beneficial in minimizing postoperative complications when feasible.

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November 17, 2024
Cerebral 2024

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

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November 17, 2024
CABG A-FIB

Risk Factors of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting Surgery in the Recent 10 Years: Clinical Analysis of 6229 Patients

This retrospective study analyzed 6,229 patients who underwent isolated coronary artery bypass grafting (CABG) from 2015 to 2023 to determine the risk factors for postoperative atrial fibrillation (POAF). The incidence of POAF was 30.94%. Univariate analysis revealed factors such as age, hypertension, smoking, CPB time, and ejection fraction (EF) as significant. Multivariate analysis identified older age and low EF as independent risk factors for POAF.

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October 22, 2024
AKI 2024

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

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October 15, 2024
OPCABG 2024

On-Pump or Off-Pump Impact of Diabetic Patients Undergoing Coronary Artery Bypass Grafting: 5-Year Clinical Outcomes

This study evaluates the long-term outcomes of on-pump vs. off-pump coronary artery bypass grafting (CABG) in diabetic patients. A retrospective review of 1,269 patients found that off-pump CABG was associated with a lower 5-year all-cause death rate (4.23% vs. 5.95%) and reduced risks of postoperative stroke and atrial fibrillation. These results suggest potential advantages for diabetic patients undergoing off-pump CABG procedures.

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October 4, 2024
CABG Block

In-Hospital Graft Occlusion in Post-Coronary Artery Bypass Grafting Patients in the Early Postoperative Period: A Systematic Review and Meta-Analysis

This study evaluates the incidence and risk factors of early in-hospital graft occlusion in post-coronary artery bypass grafting (CABG) patients. The meta-analysis, including 22 studies with 35,798 patients, found a 5% occlusion rate. The rate varied based on symptom-driven or systematic graft patency assessments. Vein graft presence, female gender, and other factors like composite grafts may increase the risk of early occlusion.

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October 2, 2024
Lung Ventilation

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

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October 1, 2024
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