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IPA

Category: Cardiac Surgery

Aortic Surgery

Exploring Differences in Surgical Outcomes Depending on the Arterial Cannulation Strategy for Acute Type A Aortic Dissection: A Single-Center Study

This single-center retrospective study evaluated the impact of different arterial cannulation strategies on surgical outcomes for patients with acute type A aortic dissection (AD) and intramural hematoma (IMH). By comparing 32 patients who underwent antegrade cannulation with 114 patients who underwent retrograde cannulation, the study found significant differences in total surgical time and intensive care unit stay duration. However, no significant differences were observed in 30-day mortality or postoperative cerebrovascular accident rates. The findings suggest that the choice of cannulation strategy should be tailored to individual patient needs.

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July 6, 2024
Patient Blood Management

Methodologic Quality and Pharmacotherapy Recommendations for Patient Blood Management Guidelines for Cardiac Surgery on Cardiopulmonary Bypass

This study evaluated the methodology and pharmacotherapy recommendations of Patient Blood Management (PBM) guidelines for cardiac surgery under cardiopulmonary bypass (CPB). It analyzed nine guidelines using the AGREE II tool, finding that “Stakeholder involvement” scored lowest. Drug therapy strategies include anemia therapy, antithrombotic and anticoagulation drugs, and hemostatic drugs, with distinct recommendations for pediatric and adult patients.

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June 29, 2024
AI TEE

Continuous Monitoring of Left Ventricular Function in Postoperative Intensive Care Patients Using Artificial Intelligence and Transesophageal Echocardiography

This study explores the efficacy of using artificial intelligence (autoMAPSE) with transesophageal echocardiography (TEE) to continuously monitor left ventricular (LV) function in postoperative intensive care patients. The prospective observational study involved 50 patients, monitored for 120 minutes post-cardiac surgery. Results showed that autoMAPSE provided precise, low-bias, and concordant measurements compared to manual methods, demonstrating excellent feasibility and trending ability.

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June 13, 2024
Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

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June 12, 2024
Valve Suture

First Experiences with Automated Annular Suturing Device in Totally Endoscopic Aortic and Mitral Valve Replacement

This study investigates the early clinical outcomes of using an automated annular suturing device, the RAM® device, in endoscopic minimally invasive aortic and mitral valve replacement surgeries. Conducted between September 2020 and June 2023, the study involved 66 patients with an average age of 61.8 years. The results showed no intraoperative complications, no paravalvular leaks, and zero 30-day and in-hospital mortality, indicating the procedure’s safety and effectiveness. Larger studies are recommended to further evaluate the device’s efficacy.

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June 4, 2024
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
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