Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

February 7, 2025 No Comments

This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

February 6, 2025 No Comments

This expert consensus document from the American Association for Thoracic Surgery outlines standardized best practices for donor lung procurement and preservation. It highlights significant variability in existing techniques and emphasizes the role of ex vivo lung perfusion (EVLP), cold storage, and normothermic regional perfusion. The document provides 34 evidence-based recommendations aimed at improving organ utilization and lung transplant outcomes.

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

January 2, 2025 No Comments

This study evaluates the effectiveness of Trendelenburg position and carotid ultrasound in predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Findings reveal that carotid corrected flow time (FTcBaseline) and stroke volume index variation (ΔSVITrend) are accurate and non-invasive predictors. These methods outperform traditional markers like pulse pressure variation, enhancing fluid management strategies in critical care.

A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma

December 28, 2024 No Comments

This article presents a rare case of a 33-year-old woman with a left atrial myxoma, a benign cardiac tumor, causing bilateral lower limb ischemia due to systemic embolization. The patient’s myxoma, identified as the source of emboli, was successfully excised through open-heart surgery. The case underscores the critical need for timely surgical intervention to prevent potentially fatal complications such as stroke. Postoperative outcomes were excellent, with the patient resuming normal activities.

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

December 21, 2024 No Comments

This article discusses the significance of monitoring indexed oxygen delivery (DO2i), oxygen extraction ratio (O2ERi), and carbon dioxide production (VCO2) during normothermic regional perfusion (NRP) in Donation after Circulatory Death (DCD) donors. These metrics ensure optimal oxygenation, reduce ischemic injuries, and prevent organ dysfunction. Personalized perfusion strategies, informed by these parameters, improve organ viability and transplantation outcomes while lowering post-transplant complications like acute kidney injury.

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

December 3, 2024 No Comments

A conceptual representation of the “Five Pillars” framework for aRHF therapy. The image shows five pillars, each labeled with key aspects: Etiological Treatment, Hemodynamic Support, Ventilation, Fluid Optimization, and Mechanical Support. A heart is balanced on top of these pillars, symbolizing stability. The design is clean and professional, with subtle arrows indicating the interconnectedness of the pillars.

Extracorporeal Off-Pump Antegrade Cerebral Perfusion in Reconstructive Surgery for Type A Aortic Dissection with Cerebral Malperfusion

November 28, 2024 No Comments

This study evaluates a novel off-pump axillo-axillary shunt technique for antegrade cerebral perfusion (ACP) during total aortic arch replacement (BF-TAR) in patients with Type A aortic dissection (TAAD) complicated by cerebral malperfusion (CM). The method provides continuous bihemispheric perfusion, reducing risks linked to cardiopulmonary bypass. Among 18 patients, outcomes included low mortality (5.6%), no permanent neurological deficits, and improved perfusion times compared to traditional methods.

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

November 17, 2024 No Comments

This study explores the association between cerebral overperfusion and postoperative delirium (POD) in cardiac surgery patients. Continuous monitoring of cerebral blood flow, oxygen levels, and brain activity revealed increased middle cerebral artery velocity (MCAV) in patients with POD, despite stable oxygen saturation and autoregulation. The findings suggest that impaired cortical metabolism may render the brain vulnerable to overperfusion during surgery, increasing POD risk.

Wavelet and Time-Based Cerebral Autoregulation Analysis Using Diffuse Correlation Spectroscopy on Adults Undergoing Extracorporeal Membrane Oxygenation Therapy

November 3, 2024 No Comments

This study examines cerebral autoregulation (CA) in adult patients on extracorporeal membrane oxygenation (ECMO) therapy using diffuse correlation spectroscopy (DCS), a noninvasive approach to monitoring cerebral blood flow. Neurological injuries, common in ECMO patients due to underlying conditions or the therapy itself, can impair CA, potentially worsening brain damage. Using wavelet coherence analysis (WCA), researchers found that DCS-based markers identified significant CA differences in ECMO patients with brain injuries versus those without, highlighting the potential of DCS as a monitoring tool for this population.

A Modified Intraventricular Balloon Method for Functional Assessment of Hearts From Donation After Circulatory Death

May 6, 2024 No Comments

This study evaluates a modified intraventricular balloon method for functional assessment of hearts from donation after circulatory death. By using a saline-filled balloon in the left atrium, the study measures left ventricular pressure during reperfusion in juvenile pigs. Results show significant correlations between contractility and relaxation parameters measured by the modified method and those in working mode. This technique offers a mitral valve-sparing option for early heart viability assessment during ex-vivo heart perfusion.

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Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection

The 2024 American Association for Thoracic Surgery Expert Consensus Document: Current Standards in Donor Lung Procurement and Preservation

Predictive Value of Trendelenburg Position and Carotid Ultrasound for Fluid Responsiveness in Patients on VV-ECMO with Acute Respiratory Distress Syndrome in the Prone Position

A Firing Cannon: Bilateral Lower Limb Ischemia as a Manifestation of Cardiac Myxoma

The Potential Benefits of Monitoring Oxygen Delivery in Relation to O2ERi and VCO2 During Normothermic Regional Perfusion in DCD Donors

Acute Right Ventricular Heart Failure, ECMO, RVAD, Hemodynamic Support, Five Pillars Framework

Extracorporeal Off-Pump Antegrade Cerebral Perfusion in Reconstructive Surgery for Type A Aortic Dissection with Cerebral Malperfusion

Cerebral Overperfusion Despite Reduced Cortical Metabolism Is Linked to Postoperative Delirium in Cardiac Surgery Patients

Wavelet and Time-Based Cerebral Autoregulation Analysis Using Diffuse Correlation Spectroscopy on Adults Undergoing Extracorporeal Membrane Oxygenation Therapy

A Modified Intraventricular Balloon Method for Functional Assessment of Hearts From Donation After Circulatory Death

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