Category: Podcast

Innominate Artery Graft Cannulation

Innominate Artery Graft Cannulation for Selective Antegrade Cerebral Perfusion in Aortic Surgery: Clinical Findings and Feasibility

This retrospective study evaluates the safety and efficacy of innominate artery (IA) graft cannulation for selective antegrade cerebral perfusion (SACP) in aortic surgery. Analyzing 196 patients, including those with Type A acute aortic dissection and Marfan syndrome, the results showed low rates of stroke (2.04%), mortality (3.06%), and acute renal failure (3.06%). IA graft cannulation emerged as a reliable and efficient technique for cerebral protection during complex aortic procedures.

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CytoSorb Hemoadsorption of Apixaban

CytoSorb Hemoadsorption of Apixaban During Cardio-Pulmonary Bypass for Heart Transplantation

This case study reports on the successful intraoperative removal of apixaban using a CytoSorb hemoadsorption device during emergency heart transplantation. The 61-year-old patient, previously on apixaban, underwent cardiopulmonary bypass (CPB), during which the device significantly reduced anticoagulant levels without complications. The results suggest CytoSorb may offer a viable method to manage DOACs in urgent cardiac surgery settings.

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Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

Impact of Different Sweep Gas Flow Rates on Respiratory Alkalosis and Cerebral Oxygenation During Cardiopulmonary Bypass

This randomized clinical study assessed how varying sweep gas flow rates affect respiratory alkalosis and cerebral oxygenation during cardiopulmonary bypass (CPB) in 84 open-heart surgery patients. The findings revealed that lower sweep gas flow rates help maintain normal carbon dioxide levels and enhance cerebral oxygen saturation post-rewarming. Adjusting the sweep gas flow rate before rewarming may prevent complications associated with respiratory alkalosis.

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Cardiopulmonary Bypass and Cross-Clamping Times in Aortic Valve Replacement Surgery by Ministernotomy with Sutureless Prosthesis Implantation Compared to Conventional Prosthesis: A Cross-Sectional Study

Cardiopulmonary Bypass and Cross-Clamping Times in Aortic Valve Replacement Surgery by Ministernotomy with Sutureless Prosthesis Implantation Compared to Conventional Prosthesis: A Cross-Sectional Study

This study compares cardiopulmonary bypass (CPB) and cross-clamping times in aortic valve replacement surgeries performed via ministernotomy using either sutureless PERCEVAL® or conventional bioprostheses. Among 93 patients, both techniques showed similar outcomes regarding CPB and cross-clamping times, hospital stays, and early postoperative complications. Echocardiographic results improved postoperatively in both groups.

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Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

Impact of Extracorporeal Life Support on Outcome in Patients with Idiopathic Pulmonary Arterial Hypertension Awaiting Lung Transplantation

This study evaluates the impact of extracorporeal life support (ECLS) as a bridge to lung transplantation (BTT) for patients with idiopathic pulmonary arterial hypertension (iPAH). A comparison between two cohorts (1997–2005 and 2006–2010) shows that ECLS significantly reduced waiting list mortality (from 22% to 0%) while slightly increasing ICU stay. The findings suggest that aggressive ECLS management can improve survival rates for iPAH patients awaiting lung transplants.

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Outcomes of Donation After Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion

Outcomes of Donation After Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion

This study examines outcomes of donation after circulatory death (DCD) heart transplantation using thoracoabdominal normothermic regional perfusion (TA-NRP). A retrospective analysis of 32 recipients between 2020-2023 found 100% one-year survival, low rejection rates, and acceptable primary graft dysfunction (PGD) and cardiac allograft vasculopathy (CAV) rates. No significant differences were observed between co-localized and distant donor transplants. TA-NRP proves to be a viable method for DCD heart transplantation.

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Staying in Place: In Vitro Comparison of Extracorporeal Membrane Oxygenation Cannula Fixation for Dislodgment Prevention

Staying in Place: In Vitro Comparison of Extracorporeal Membrane Oxygenation Cannula Fixation for Dislodgment Prevention

This study evaluates the effectiveness of different fixation methods for ECMO cannulas to prevent dislodgment. Using an in vitro porcine skin model, researchers compared traditional sutures with adhesive securement devices. Results showed that adhesive methods, particularly CathGrip, provided superior stability in micro-movements while maintaining comparable fixation strength to sutures. The study suggests that adhesive anchors may offer a viable alternative for improving ECMO cannula security.

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Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

Sex-Related Differences in Systemic Inflammatory Response and Outcomes After Cardiac Surgery and Cardiopulmonary Bypass

This study investigates the impact of sex on systemic inflammatory response syndrome (SIRS) and outcomes after cardiac surgery. Analyzing 1,005 patients, researchers found that women had a higher incidence of SIRS (41.8% vs. 22.8%) and worse outcomes, including prolonged ICU stays and increased need for vasopressor support. SIRS mediated over 50% of the sex-related risks, with preoperative anemia and hyperlactatemia as contributing factors. Addressing inflammation may improve outcomes for female patients.

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Relatively Increased CO2 Delivered to the Brain From the Descending Aorta Leading to an Elevated Respiratory Rate Causing Differential Hypocapnia (RIDDLER or East-West Syndrome): New Pitfalls in Awake Peripheral V-A ECMO

Relatively Increased CO2 Delivered to the Brain From the Descending Aorta Leading to an Elevated Respiratory Rate Causing Differential Hypocapnia (RIDDLER or East-West Syndrome): New Pitfalls in Awake Peripheral V-A ECMO

This article describes a newly recognized physiological phenomenon, RIDDLER (East-West Syndrome), in patients on awake peripheral V-A ECMO. It occurs when CO2-rich blood from the ECMO circuit reaches the brain, triggering an increased respiratory rate despite paradoxically low CO2 levels in the right radial artery. This leads to a cycle of worsening hypercapnia, respiratory distress, and potential neurological injury. Proper CO2 monitoring strategies are needed to prevent mismanagement.

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Thoracoabdominal Normothermic Regional Perfusion: Real-World Experience and Outcomes of DCD Liver Transplantation

Thoracoabdominal Normothermic Regional Perfusion: Real-World Experience and Outcomes of DCD Liver Transplantation

This study evaluates the effectiveness of thoracoabdominal normothermic regional perfusion (TA-NRP) in liver transplantation from donation after circulatory death (DCD) donors. Compared to static cold storage (SCS), TA-NRP significantly reduces ischemic cholangiopathy (IC) at six months (1.2% vs. 9.5%, p = 0.03), despite higher-risk donor-recipient pairs. The findings suggest TA-NRP improves organ utilization and supports its integration into liver transplantation protocols.

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