International Perfusion Association

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IPA

Category: Coronary Artery Bypass

Superman Impella

The Role of Impella in the Pre-Procedural Management of Post-Infarct Ventricular Septal Defect: A Systematic Review

This systematic review explores the use of the Impella device in patients with post-infarct ventricular septal defect (VSD) prior to definitive treatment. Analyzing 68 patients across 20 studies, the Impella improved hemodynamic stability, reduced left ventricular strain, and delayed urgent intervention. Patients with surgically-placed Impella devices showed lower mortality and fewer complications compared to percutaneous alternatives. While effective, complications like bleeding and hemolysis must be carefully managed.

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December 17, 2024
Revascularization

Meta-Analysis Comparing Immediate Versus Staged Complete Revascularization for ST-Elevation Myocardial Infarction With Multivessel Disease

This meta-analysis compares immediate versus staged complete revascularization (CR) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease. Analyzing five randomized controlled trials (1,415 patients), no significant difference was observed in major adverse cardiovascular events (MACE), mortality, or myocardial infarction rates. However, staged CR showed a higher rate of unplanned ischemia-driven revascularization. Timing of staged intervention is crucial for optimized outcomes.

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December 17, 2024
Plasma CABG

Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery

This study compares the immune responses of patients undergoing coronary artery bypass grafting (CABG) via on-pump and off-pump methods. On-pump CABG induced a more significant immune response, with notable increases in extracellular vesicles (EVs) derived from platelets, endothelial cells, and B-cells. Off-pump surgery was associated with milder changes in cytokine and EV profiles. Findings highlight EVs’ role in regulating postoperative inflammation and suggest a potential mechanism for immune modulation.

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December 8, 2024
Off Pump CABG

The Value of Off-Pump Coronary Artery Bypass Grafting in Surgery for Combined Valvular and Coronary Heart Disease

This study explores the benefits of off-pump coronary artery bypass grafting (OPCABG) in surgeries combining valve and coronary interventions. Among 884 patients, the OPCABG group showed reduced incidences of postoperative atrial fibrillation (29.5% vs. 39.5%) and acute kidney injury (14.5% vs. 21.2%) compared to on-pump CABG. No differences in mortality or stroke rates were observed. The results suggest OPCABG is a safe and effective approach for improved short-term outcomes in complex cardiac surgeries.

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December 8, 2024
Cardioplegia 2024

Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

This study explores the potential benefits of gradual reperfusion in cardiac surgery patients experiencing cardioplegia-induced cardiac arrest, aiming to reduce ischemia-reperfusion injury. Fifty elective cardiac surgery patients were randomized into two groups: a hyperoxemic control group with conventional reoxygenation and a normoxemic study group with gradual reoxygenation. Results showed that gradual reperfusion was safe but did not significantly reduce ischemia-reperfusion injury compared to standard methods, although potassium levels were lower in the normoxemic group.

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November 3, 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
Surgery in Progress

New Approach to the Mitral Valve Through the Left Anterior Minithoracotomy for Combined Valve and Coronary Surgical Procedures

A new technique for accessing the mitral valve via the left anterior minithoracotomy has been developed for patients requiring both mitral valve surgery and coronary artery bypass grafting. From October 2020 to September 2022, 24 patients underwent this procedure, which involved specialized exposure maneuvers and conventional surgical techniques. The approach proved successful with no need for conversion to sternotomy, no major complications, and no mortality within 30 days post-procedure.

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June 8, 2024
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