Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

March 15, 2025 No Comments

This study examines the impact of gradual oxygen exposure during emergency coronary bypass surgery for acute myocardial infarction (MI). A retrospective cohort of 66 patients was analyzed, comparing outcomes between those receiving venous blood cardioplegia with controlled oxygen exposure and those undergoing standard hyperoxic procedures. The findings indicate a significant reduction in mortality, improved ventricular function, lower readmission rates for heart failure, and reduced need for defibrillators.

Evaluating the Need for Magnesium Administration Following Cardioplegic Arrest with Del Nido Cardioplegia Solution

March 11, 2025 No Comments

This study evaluates whether magnesium administration is necessary following cardioplegic arrest with del Nido cardioplegia (dNC) solution at Cincinnati Children’s Hospital Medical Center (CCHMC). Analyzing serum magnesium levels in 100 patients, results showed hypermagnesemia in most cases. Given the potential risks of excessive magnesium, findings suggest eliminating routine post-cross-clamp magnesium administration in dNC settings.

Microvascular Dysfunction Following Cardioplegic Arrest and Cardiopulmonary Bypass: Impacts of Diabetes and Hypertension

March 10, 2025 No Comments

This review examines microvascular dysfunction following cardioplegic arrest and cardiopulmonary bypass (CP/CPB), with a focus on diabetes and hypertension. It explores endothelial and vasomotor dysfunction, gene/protein expression changes, endothelial adherens junction impairment, and programmed cell death. The study highlights the role of oxidative stress, inflammation, and metabolic disruptions, providing insight into potential pharmacological interventions for improving surgical outcomes.

Efficacy and Safety of the Blood-Based Cardioplegia Solution Huaxi-1 in Cardiopulmonary Bypass Surgery: Protocol for a Multicentre Randomised Controlled Trial

February 20, 2025 No Comments

This study evaluates the safety and efficacy of the Huaxi-1 blood-based cardioplegia solution compared to the widely used HTK solution in cardiopulmonary bypass surgery. A randomized, multicenter trial involving 160 adult patients across four hospitals in China will measure myocardial injury markers, cardiac function, and post-surgical recovery. The goal is to establish Huaxi-1’s viability as a standardized cardioplegia solution for improved myocardial protection.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

Traditional vs. Modified Ringer Lactate-Based del Nido Cardioplegia: Impacts on Clinical Outcomes in Coronary Artery Bypass Grafting

December 26, 2024 No Comments

This prospective, randomized, and blinded study compared the impacts of traditional Plasma-Lyte A-based del Nido cardioplegia (PL DN) and a modified Ringer’s lactate-based formulation (LR DN) on clinical outcomes in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). Results showed that while both formulations had similar effects on several clinical parameters, PL DN offered superior myocardial protection, as indicated by lower postoperative cardiac enzyme levels and reduced need for epinephrine.

A Technique Avoiding Cardioplegia Delivery Complications: A Case Using Systemic Hyperkalemia Cardiopulmonary Bypass Combined with Circulatory Arrest

December 24, 2024 No Comments

This case study details a novel approach to avoid cardioplegia delivery complications during a high-risk redo mitral valve replacement. The 75-year-old patient, with severe mitral regurgitation and mild aortic regurgitation, underwent minimally invasive surgery using systemic hyperkalemia and circulatory arrest. The method eliminated the need for aortic cross-clamping, achieving effective myocardial protection and an uneventful recovery, despite complex surgical challenges.

Outcomes of Del Nido and Hyperkalemic Blood Cardioplegia in Adult Cardiac Surgery with Prolonged Aortic Cross-Clamp Times

December 21, 2024 No Comments

This study compares the effectiveness of Del Nido cardioplegia (DNC) and hyperkalemic blood cardioplegia (HKB) in adult cardiac surgery with prolonged aortic cross-clamp times. In a retrospective cohort of 388 patients, findings revealed no significant differences in clinical outcomes or myocardial protection, as assessed by troponin profiles. However, DNC required fewer doses, had longer ischemic intervals, and was associated with higher rates of spontaneous rhythm recovery, suggesting logistical and procedural benefits.

Early Postoperative Outcomes of Modified Del Nido Cardioplegia in Coronary Artery Bypass Surgery in Patients with Low Ejection Fraction

December 13, 2024 No Comments

This study compares the effectiveness of modified del Nido cardioplegia (DNC) with classic blood cardioplegia (BC) in coronary artery bypass grafting (CABG) patients with low ejection fraction (≤35%). Results show that DNC offers comparable myocardial protection to BC while reducing postoperative atrial fibrillation and the need for inotropic agents. DNC also showed lower troponin levels postoperatively, indicating better myocardial recovery, though no significant differences in mortality or hospital stay were observed.

Extracorporeal Off-Pump Antegrade Cerebral Perfusion in Reconstructive Surgery for Type A Aortic Dissection with Cerebral Malperfusion

November 28, 2024 No Comments

This study evaluates a novel off-pump axillo-axillary shunt technique for antegrade cerebral perfusion (ACP) during total aortic arch replacement (BF-TAR) in patients with Type A aortic dissection (TAAD) complicated by cerebral malperfusion (CM). The method provides continuous bihemispheric perfusion, reducing risks linked to cardiopulmonary bypass. Among 18 patients, outcomes included low mortality (5.6%), no permanent neurological deficits, and improved perfusion times compared to traditional methods.