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Category: Organ Perfusion

Cerebral Protection

Cannula Placement for Cerebral Protection Without Circulatory Arrest in Patients Undergoing Hemiarch Aortic Aneurysm Repair

This retrospective study evaluates the efficacy and outcomes of left carotid antegrade cerebral perfusion (LCP) versus traditional right-sided perfusion with hypothermic circulatory arrest in hemiarch aortic aneurysm repairs. The study, encompassing 68 patients between 2015 and 2019, suggests that LCP via distal arch cannulation is a viable and safer alternative, showing comparable clinical outcomes but reduced cardiopulmonary bypass and cerebral perfusion times. The findings advocate for LCP as a method that potentially reduces the risks associated with circulatory arrest.

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Liver Perfusion

The Use of Ex Situ Normothermic Machine Perfusion in Combined Cardiac and Liver Transplantation Procedures

Combined heart-liver transplantation (CHLT) is increasingly prevalent due to surgical and immunosuppression advancements. Indications for CHLT include familial amyloidosis, cardiac cirrhosis, dilated cardiomyopathy, and homozygous familial hypercholesterolemia. Challenges include hemodynamic instability and prolonged cold ischemia. Ex situ normothermic machine perfusion (NMP) offers a paradigm shift, allowing extended preservation times, facilitating hemodynamic stabilization post-cardiac surgery, and reducing metabolic disturbances during hepatic reperfusion. This article describes the first three CHLT procedures using ex situ NMP at Mayo Clinic Florida, highlighting its potential benefits.

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