$Stepwise Rescue Therapy for Refractory Vasoplegia$

Evaluating the Impact of a Standardized Protocol for Managing Refractory Vasoplegia After Cardiopulmonary Bypass

This single-center pre-post study evaluated a standardized stepwise protocol for refractory vasoplegia after cardiopulmonary bypass (CPB). Compared to provider-directed therapy, the protocol—escalating from methylene blue to angiotensin II and hydroxocobalamin—accelerated norepinephrine-equivalent reduction and reduced vasopressor costs by 26% at 48 hours, without worsening hemodynamic or clinical outcomes.

March 2, 2026

Nanoscale Impact of Cardiopulmonary Bypass on Red Blood Cells

The Impact of Cardiopulmonary Bypass on the Structure and Mechanics of Red Blood Cells: Pilot Study

This pilot study evaluated how cardiopulmonary bypass (CPB), with and without hypothermic circulatory arrest (HCA), affects red blood cell (RBC) morphology, membrane nanostructure, and mechanical properties using atomic force microscopy. In 14 cardiac surgery patients, CPB increased RBC stiffness, while CPB+HCA caused more severe morphological damage and membrane roughness. The findings suggest distinct cellular injury mechanisms depending on perfusion strategy.

March 1, 2026

Association Between Cardiopulmonary Bypass Weaning Time and Adverse Outcomes in Patients With Aortic Dissection Who Underwent Total Arch Replacement Combined With Stented Elephant Trunk Implantation

This retrospective single-center study of 475 patients with acute type A aortic dissection undergoing total arch replacement with stented elephant trunk implantation found that prolonged cardiopulmonary bypass (CPB) weaning time was independently associated with increased in-hospital mortality and postoperative stroke. A cutoff of 90 minutes strongly predicted early mortality and reduced short-term survival, though mid-term survival was unaffected.

February 28, 2026

Cardiopulmonary Bypass Supporting High-Risk PCI and TAVR

Cardiopulmonary Bypass as Safe and Effective Support for Concomitant High-Risk Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement

This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.

February 28, 2026

Seamless Transition: Single-Circuit ECMO to CPB in Pediatric Surgery

ECMO to CPB: A Single Circuit Approach

This technique article describes a novel method for converting pediatric patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to cardiopulmonary bypass (CPB) using a single circuit with the addition of a cardiotomy reservoir. In seven patients (eight procedures), the approach preserved circulating blood volume, limited donor exposure, and maintained effective surgical support. All patients were successfully decannulated, demonstrating feasibility and safety in complex congenital heart surgery.

February 27, 2026

Leveraging the Perfusionist-Surgeon Dyad to Improve the Culture of Safety

This article describes how a cardiac surgery program at Massachusetts General Hospital transformed its operating room culture by leveraging the unique perfusionist-surgeon relationship. By promoting psychological safety, challenging hierarchical assumptions, and implementing structured guidelines, checklists, and multidisciplinary briefings, the team improved communication, recruitment, teamwork, and resilience. The initiative demonstrates how deliberate cultural change enhances safety and performance.

February 27, 2026

Outcomes of Heart Failure Hospitalizations at Urban Teaching vs. Non-Teaching Hospitals: A Nationwide Propensity Score Matched Analysis in the United States

This nationwide propensity-matched study of 7.5 million U.S. heart failure hospitalizations (2016–2022) found that urban teaching hospitals had higher inpatient mortality, complication rates, length of stay, costs, and palliative care consultations compared with urban non-teaching hospitals. Despite worse in-hospital outcomes, 30- and 90-day readmission rates were similar. Findings likely reflect referral bias and greater illness severity at teaching centers rather than differences in care quality.

February 26, 2026

Comparative Efficacy and Safety of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Versus Impella for Cardiogenic Shock: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis of 10 observational studies (5,364 patients) compared Impella and VA-ECMO for cardiogenic shock. No significant difference in short-term mortality was found (RR 0.92). However, Impella was associated with lower risks of stroke, major bleeding, and limb ischemia. Evidence certainty was very low due to confounding bias. Device selection should be individualized pending randomized trials.

February 24, 2026

Comparing Myocardial Protection Strategies in Heart Transplantation

Long-Term Outcome of Myocardial Protection in Heart Transplantation: Comparison Among 3 Different Solutions

This 20-year single-center study of 528 heart transplant recipients compared three preservation solutions: Celsior, HTK-Custodiol, and St Thomas. HTK-Custodiol was associated with a significantly higher rate of severe primary graft dysfunction (10.2% vs 4.5%), but long-term survival and rejection rates were similar across groups. Severe PGD, ischemic time, and donor/recipient age predicted late mortality. Authors advise caution with HTK-Custodiol.

February 23, 2026

Expanding the Donor Pool: Rethinking Time to Death in DCD Liver Transplantation

Donor Time to Death and DCD Liver Transplant Outcomes: Challenging the Dogma That Shorter Is Better

This large UNOS registry study of 8,489 DCD liver transplants (2010–2024) found that shorter donor time to death (TTD) was associated with worse graft survival, while prolonged TTD did not negatively impact outcomes—even without normothermic regional perfusion (NRP). Despite this, liver utilization declined sharply after 15 minutes of TTD. Simulation modeling showed that avoiding TTD-based decline could increase utilization by 17%, potentially adding hundreds of safe transplants.