$Stepwise Rescue Therapy for Refractory Vasoplegia$

Evaluating the Impact of a Standardized Protocol for Managing Refractory Vasoplegia After Cardiopulmonary Bypass

March 2, 2026 No Comments

This single-center pre-post study evaluated a standardized stepwise protocol for refractory vasoplegia after cardiopulmonary bypass (CPB). Compared to provider-directed therapy, the protocol—escalating from methylene blue to angiotensin II and hydroxocobalamin—accelerated norepinephrine-equivalent reduction and reduced vasopressor costs by 26% at 48 hours, without worsening hemodynamic or clinical outcomes.

Nanoscale Impact of Cardiopulmonary Bypass on Red Blood Cells

The Impact of Cardiopulmonary Bypass on the Structure and Mechanics of Red Blood Cells: Pilot Study

March 1, 2026 No Comments

This pilot study evaluated how cardiopulmonary bypass (CPB), with and without hypothermic circulatory arrest (HCA), affects red blood cell (RBC) morphology, membrane nanostructure, and mechanical properties using atomic force microscopy. In 14 cardiac surgery patients, CPB increased RBC stiffness, while CPB+HCA caused more severe morphological damage and membrane roughness. The findings suggest distinct cellular injury mechanisms depending on perfusion strategy.

Association Between Cardiopulmonary Bypass Weaning Time and Adverse Outcomes in Patients With Aortic Dissection Who Underwent Total Arch Replacement Combined With Stented Elephant Trunk Implantation

February 28, 2026 No Comments

This retrospective single-center study of 475 patients with acute type A aortic dissection undergoing total arch replacement with stented elephant trunk implantation found that prolonged cardiopulmonary bypass (CPB) weaning time was independently associated with increased in-hospital mortality and postoperative stroke. A cutoff of 90 minutes strongly predicted early mortality and reduced short-term survival, though mid-term survival was unaffected.

Cardiopulmonary Bypass Supporting High-Risk PCI and TAVR

Cardiopulmonary Bypass as Safe and Effective Support for Concomitant High-Risk Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement

February 28, 2026 No Comments

This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.

Indexed Delivery of Oxygen Predicts In-Hospital Mortality and Morbidity in Reoperative Adult Cardiac Surgery Patients: A Retrospective Cohort Study

February 20, 2026 No Comments

This retrospective cohort study of 343 reoperative cardiac surgery patients found that low indexed oxygen delivery (DO₂i) during cardiopulmonary bypass independently predicted in-hospital mortality and major morbidity. A median DO₂i below 289 mL/min/m² was associated with a fourfold increase in mortality risk, higher rates of acute kidney injury, cardiac complications, and prolonged ventilation. Optimizing intraoperative oxygen delivery may improve outcomes in this high-risk population.

Active Myocardial Protection During Cardioplegic Arrest

Molecular and Cellular Mechanisms of Cardioplegic Protection in Surgical Myocardial Revascularization

January 31, 2026 No Comments

This comprehensive review explores how cardioplegia actively protects the myocardium during coronary artery bypass grafting. Beyond inducing cardiac arrest, cardioplegic solutions modulate calcium homeostasis, mitochondrial function, oxidative stress, inflammation, and apoptosis. By suppressing electromechanical activity and metabolic demand, cardioplegia prolongs ischemic tolerance and mitigates reperfusion injury, offering critical insights for optimizing myocardial protection strategies in modern cardiac surgery.

Outcomes of a Standardized Protocol on the Management of Acute Type A Aortic Dissection: A Retrospective Cohort Study

May 15, 2025 No Comments

This retrospective study assessed a standardized surgical protocol implemented in 2016 for managing acute Type A aortic dissection (AAAD). Comparing pre- and post-protocol cohorts, the study found that standardized techniques improved consistency in surgical approach, reduced rates of aortic reoperations and dilations, and introduced safer cannulation and perfusion strategies. Mortality rates remained statistically unchanged, but the protocol significantly enhanced surgical outcomes.

Del Nido Cardioplegia in Adult Cardiac Surgery: A Narrative Review

May 13, 2025 No Comments

This review explores the use of Del Nido cardioplegia in adult cardiac surgery, originally developed for pediatric use. It outlines its composition, benefits over traditional blood cardioplegia, and its mechanism in protecting the myocardium from ischemia-reperfusion injury. The article compiles data showing its efficacy in reducing cross-clamp times, myocardial injury, and transfusion requirements, with comparable or improved clinical outcomes.

Impact of Prolonged Cardiopulmonary Bypass on Gastrointestinal Complications in Cardiac Surgery: A Retrospective Cohort Study

April 17, 2025 No Comments

This retrospective cohort study assessed the effect of prolonged cardiopulmonary bypass (CPB ≥ 120 minutes) on gastrointestinal complications (GICs) after cardiac surgery. Analyzing 1,444 patients and using propensity score matching, the study found a significantly higher rate of GICs in the prolonged CPB group. Key risk factors included hypertension, lower left ventricular ejection fraction (LVEF), and undergoing aortic surgery.

The Past, Present, and Future of Off-Pump Coronary Artery Bypass Grafting

April 16, 2025 No Comments

This review traces the evolution and prospects of off-pump coronary artery bypass grafting (OPCAB). Despite early skepticism due to technical difficulty, OPCAB offers major advantages for high-risk patients, including reduced stroke risk and faster recovery. Modern trials and meta-analyses show comparable or superior outcomes to on-pump CABG when performed by experienced surgeons. Emphasis is placed on arterial grafting, no-touch techniques, and hybrid strategies for future optimization.