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.

Survival Analysis of Minimally Invasive Mitral Valve Surgery Versus Conventional Median Sternotomy in the United States

April 11, 2025 No Comments

This retrospective cohort study compares survival outcomes and surgical efficiency between minimally invasive mitral valve surgery (MiMVS) via mini-thoracotomy and conventional sternotomy. Among 422 elective cases, MiMVS was associated with shorter hospital stays, less postoperative bleeding, and shorter operative times. Although no significant survival difference was found, mitral valve replacement showed higher mortality risk than repair.

Vasoplegic Syndrome in Cardiac Surgery: Bridging Therapeutic Gaps with Best Practices and Future Research

April 6, 2025 No Comments

This article explores vasoplegic syndrome (VS), a serious complication following cardiac surgery involving cardiopulmonary bypass. It discusses inconsistent definitions, risk factors, and treatment strategies. Methylene blue emerges as a promising therapy due to its ability to counteract the nitric oxide-cGMP pathway. The authors advocate for standardized definitions, early intervention, and large-scale trials to validate therapeutic protocols.

Real-Time Blood Gas Management: Evaluating Quantum Perfusion System’s Accuracy Against a Standard Blood Gas Analysis in CPB

April 3, 2025 No Comments

This non-inferiority study evaluates the Quantum Perfusion System (QPS) for continuous blood gas monitoring during cardiopulmonary bypass (CPB) against the standard blood gas analyzer (BGA). Using data from 40 patients undergoing cardiac surgeries, QPS demonstrated high accuracy and agreement with BGA across all key parameters, adhering to Clinical Laboratory Improvement Amendments (CLIA) standards, and validating its utility as a trending device.

A Clinical Comparison of the Effects of Six Disposable Cardiopulmonary Bypass Circuits on Bleeding and Coagulation: A Quality Assurance Project

March 30, 2025 No Comments

This study compared six Health Canada-approved cardiopulmonary bypass (CPB) circuits in 872 cardiac surgery patients to assess their effects on bleeding and coagulation. While all circuits impaired coagulation, significant differences in bleeding severity and transfusion requirements were found after adjusting for patient and procedural factors. Circuit 6 showed the best performance in minimizing transfusion needs.

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

March 25, 2025 No Comments

This randomized clinical study assessed how varying sweep gas flow rates affect respiratory alkalosis and cerebral oxygenation during cardiopulmonary bypass (CPB) in 84 open-heart surgery patients. The findings revealed that lower sweep gas flow rates help maintain normal carbon dioxide levels and enhance cerebral oxygen saturation post-rewarming. Adjusting the sweep gas flow rate before rewarming may prevent complications associated with respiratory alkalosis.