The Effect of Surgery Started at Different Time Points During the Day on the Clinical Outcomes of Mitral Valve Surgery

March 8, 2024 No Comments

This study investigates the impact of mitral valve surgery conducted at different times of the day (morning, afternoon, and evening) on short-term and long-term clinical outcomes. Across 947 patients from January 2018 to December 2020, divided into morning, afternoon, and evening groups based on surgery start time, results showed no significant differences in long-term mortality, stroke risk, reoperation rates, or in-hospital outcomes such as cardiopulmonary bypass time and ICU length of stay. The study concludes that mitral valve surgery is safe regardless of the time of day it is performed.

Difference Between Cardiopulmonary Bypass Time and Aortic Cross-Clamping Time as a Predictor of Complications After Coronary Artery Bypass Grafting

March 7, 2024 No Comments

This study examines the impact of the time difference between cardiopulmonary bypass and aortic cross-clamping on complications after coronary artery bypass grafting. Analyzing data from 3,090 patients, it identifies a correlation between increased time differences and higher risks of reoperation, stroke, kidney failure, and in-hospital mortality. The findings suggest that the time difference serves as a significant predictive factor for postoperative complications, highlighting the importance of incorporating this metric in future research for better complication prediction.

Higher Perfusion Pressure and Pump Flow During Cardiopulmonary Bypass Are Beneficial for Kidney Function-A Single-Centre Prospective Study

March 3, 2024 No Comments

This study investigates the impact of higher mean arterial pressure (MAP) and pump flow during cardiopulmonary bypass (CPB) on kidney function. One hundred nine patients were divided into groups with standard and increased CPB pump flow to maintain MAP > 90 mmHg. Results showed that a higher MAP did not affect the incidence of acute kidney injury but improved intraoperative and postoperative diuresis and reduced renin release. Additionally, higher MAP did not increase cerebrovascular complications and may reduce postoperative delirium incidence, suggesting that maintaining MAP > 90 mmHg during CPB is beneficial for kidney function and potentially for the central nervous system.

Effects of Pulsatile and Non-Pulsatile Cardiopulmonary Bypass Techniques in Coronary Artery Bypass Grafting Surgeries on Cerebral Perfusion

March 1, 2024 No Comments

This study investigates the impact of pulsatile and non-pulsatile cardiopulmonary bypass (CPB) techniques on cerebral perfusion in coronary artery bypass grafting surgeries. Using near-infrared spectroscopy for cerebral oximetry monitoring, S100β protein levels, and neurocognitive function tests, it was found that pulsatile perfusion may offer benefits for cerebral perfusion based on specific biomarker levels, despite no significant differences in neurocognitive outcomes between groups. The findings suggest further research is needed to fully understand the advantages of pulsatile flow for cerebral health post-surgery.

Blood Pressure Fragmentation as a New Measure of Blood Pressure Variability: Association with Predictors of Cardiac Surgery Outcomes

February 29, 2024 No Comments

This study introduces a novel measure for assessing beat-to-beat blood pressure variability (BPV) called blood pressure fragmentation (BPF). It examines the association of increased preoperative BPF with older age, higher cardiac surgical risk, and longer ICU stay after cardiac surgery. A sample of 497 patients undergoing cardiac surgery was analyzed, showing that higher systolic BPF is linked to older age, increased surgical risk scores, and extended ICU stays. The study suggests BPF as a potential tool for preoperative health status and risk stratification, encouraging further research into its utility.

Right Anterior versus Right Transaxillary Access for Minimally Invasive Aortic Valve Replacement: A Propensity Matched Competitive Analysis

February 28, 2024 No Comments

This study compares the procedural and clinical outcomes of two minimally invasive techniques for aortic valve replacement: right anterior thoracotomy (RAT-AVR) and transaxillary access (MICLATS-AVR). With a cohort of 918 patients, after propensity score matching, both methods showed comparable major adverse cardio-cerebral events, cardiopulmonary bypass, and aortic cross-clamp times. However, MICLATS-AVR patients had a significantly shorter hospital stay and lower rates of postoperative wound issues, suggesting MICLATS-AVR as a safe, efficient, and feasible alternative for aortic valve replacement.

Levels of Circulating Ketone Bodies in Patients Undergoing Cardiac Surgery on Cardiopulmonary Bypass

February 26, 2024 No Comments

This study explores the dynamics of circulating ketone bodies (KBs) in 192 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), examining pre- and post-operative blood samples. It finds that median levels of KBs significantly decrease perioperatively, inversely correlating with Troponin T levels, which indicate myocardial cell injury. The research underscores the distinct perioperative changes in KBs compared to Troponin T and suggests that patient characteristics might influence these biomarkers differently. The inverse relationship between KBs and myocardial injury opens avenues for further investigation into the metabolic impacts of cardiac surgery.

Contributing Factors to Heparin Resistance During Cardiopulmonary Bypass

February 20, 2024 No Comments

This study delves into heparin resistance (HR) during cardiopulmonary bypass (CPB) surgeries, analyzing 371 patients to identify contributing factors. HR, defined as the inability to achieve an activated clotting time of >480 seconds with an initial unfractionated heparin dose, was observed in 9.7% of cases. Key findings include the significant association of preoperative use of unfractionated heparin, certain blood parameters (e.g., white blood cell counts, fibrinogen levels), and notably, albumin and fibrinogen as independent predictors for HR. The research highlights the need for precise preoperative assessments to mitigate HR risks in CPB.

Comparison of Blood Concentration and Weight-Based Heparin and Protamine Dosing Strategies for Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis

February 17, 2024 No Comments

This article reviews randomized controlled trials and prospective studies comparing individualized heparin and protamine dosing based on real-time blood heparin concentration versus traditional total body weight methods during cardiopulmonary bypass (CPB). Meta-analysis shows that individualized dosing significantly reduces postoperative blood loss, improves protamine-to-heparin ratios, and increases early postoperative platelet counts. These findings suggest that precision in heparin and protamine dosing could decrease bleeding and transfusion needs, highlighting the potential of machine learning for future advancements in anticoagulation management for CPB.

Clinical Relevance of Transcranial Doppler in a Cardiac Surgery Setting: Embolic Load Predicts Difficult Separation from Cardiopulmonary Bypass

February 15, 2024 No Comments

This study explores the use of transcranial Doppler (TCD) for detecting cerebral microemboli during cardiac surgery and its correlation with difficulties in separating from cardiopulmonary bypass (CPB) and postoperative complications. Analyzing 354 patients, it found that a higher quantity of cerebral embolic material significantly increases the odds of challenging CPB separation. The presence of microemboli was also linked to more complex surgeries, extended CPB durations, prolonged organ dysfunction, longer ICU stays, and increased mortality rates, particularly in the high embolic material (HEM) group.

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The Effect of Surgery Started at Different Time Points During the Day on the Clinical Outcomes of Mitral Valve Surgery

Difference Between Cardiopulmonary Bypass Time and Aortic Cross-Clamping Time as a Predictor of Complications After Coronary Artery Bypass Grafting

Higher Perfusion Pressure and Pump Flow During Cardiopulmonary Bypass Are Beneficial for Kidney Function-A Single-Centre Prospective Study

Effects of Pulsatile and Non-Pulsatile Cardiopulmonary Bypass Techniques in Coronary Artery Bypass Grafting Surgeries on Cerebral Perfusion

Blood Pressure Fragmentation as a New Measure of Blood Pressure Variability: Association with Predictors of Cardiac Surgery Outcomes

Right Anterior versus Right Transaxillary Access for Minimally Invasive Aortic Valve Replacement: A Propensity Matched Competitive Analysis

Levels of Circulating Ketone Bodies in Patients Undergoing Cardiac Surgery on Cardiopulmonary Bypass

Contributing Factors to Heparin Resistance During Cardiopulmonary Bypass

Comparison of Blood Concentration and Weight-Based Heparin and Protamine Dosing Strategies for Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis

Clinical Relevance of Transcranial Doppler in a Cardiac Surgery Setting: Embolic Load Predicts Difficult Separation from Cardiopulmonary Bypass

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