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Cannulation Strategies in Adult Veno-arterial and Veno-venous Extracorporeal Membrane Oxygenation: Techniques, Limitations, and Special Considerations

Veno-arterial (VA) ECMO is used in selected patients with various etiologies of cardiogenic shock and entails either central or peripheral cannulation.

Medicare

CMS Changes in Reimbursement for ECMO Procedures

The Centers for Medicare and Medicaid Services (CMS) implemented changes for ECMO procedures in the Medical Severity-Diagnosis Related Group (MS-DRG) on October 1, 2018.

Incidence of Cerebral Microemboli in Single-Dose vs. Multidose Cardioplegia in Adult Cardiac Surgery

Incidence of Cerebral Microemboli in Single-Dose vs. Multidose Cardioplegia in Adult Cardiac Surgery

This study compared the incidence of microemboli during cardiac operations using conventional (multidose) and del Nido (single-dose) cardioplegia delivery.

Clinical Challenge: Effective De-Airing designed to Reduce the Risk of Air Embolism

Clinical Challenge: Effective De-Airing designed to Reduce the Risk of Air Embolism

Clinical Challenge: Effective De-Airing designed to Reduce the Risk of Air Embolism. Video presentation from Sanibel Symposium 2018 (18:10 minutes).

ECMO Summary

An Introduction to Extracorporeal Membrane Oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

Supply and Demand in the Perfusion Services Sector

Supply and Demand in the Perfusion Services Sector

Supply and Demand in the Perfusion Services Sector. This topic was presented at the 2018 Sanibel Symposium Conference.

Cell Washing in Contemporary Times: Should we Continue or Discontinue?

Cell Washing in Contemporary Times: Should we Continue or Discontinue?

Cell Washing in Contemporary Times: Should we Continue or Discontinue? This topics was presented at the 2018 Sanibel Symposium Conference.

Perfusion

The Influence of Oxygen Delivery During Cardiopulmonary Bypass on the Incidence of Delirium in CABG Patients; A Retrospective Study

INTRODUCTION: Postoperative delirium is the most common neurological complication of cardiac surgery. Hypoxia has been shown to increase the risk of postoperative delirium. The possibility to continuously monitor oxygen delivery (DO2) during cardiopulmonary bypass(CPB) offers an adequate approximation of the oxygen status in a patient. This study investigates the role of oxygen delivery during cardiopulmonary bypass in the…

Mitral Valve Surgery: Current Minimally Invasive and Transcatheter Options

Mitral Valve Surgery: Current Minimally Invasive and Transcatheter Options

In this article, we review current techniques for minimally invasive cardiac surgery (MICS) for mitral valve repair or replacement (MVR/r) and upcoming catheter-based therapies for the mitral valve.

Emergent Cardiac Surgery During Transcatheter Aortic Valve Implantation (TAVI): A Weighted Meta-Analysis of 9,251 Patients From 46 Studies

Emergent Cardiac Surgery During Transcatheter Aortic Valve Implantation (TAVI): A Weighted Meta-Analysis of 9,251 Patients From 46 Studies

Refinement in transcatheter aortic valve implantation (TAVI) technology should not only focus on miniaturisation and improving flexibility of the delivery systems and/or devices -which may have the potential for decreasing aortic dissection, annular rupture, and tamponade- but also incorporate modifications to prevent embolisation/dislocation of the valve.

Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery

Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery

We performed a patient-level combined analysis of randomized, controlled trials to compare radial-artery grafts and saphenous-vein grafts for coronary-artery bypass grafting (CABG).

Goal-Directed Therapy in Cardiac Surgery: A Systematic Review and Meta-Analysis

Goal-Directed Therapy in Cardiac Surgery: A Systematic Review and Meta-Analysis

There is evidence that perioperative goal-directed haemodynamic therapy (GDT) may reduce surgical mortality and morbidity in non-cardiac surgical patients, the data are less clear after cardiac surgery. The objective of this review is to perform a meta-analysis on the effects of perioperative GDT on mortality, morbidity, and length of hospital stay in cardiac surgical patients.

Transcatheter Aortic Valve Implantation (TAVI) by Centers with and without an On-Site Cardiac Surgery Program: Preliminary Experience from the German TAVI Registry

Transcatheter Aortic Valve Implantation (TAVI) by Centers with and without an On-Site Cardiac Surgery Program: Preliminary Experience from the German TAVI Registry

This study analysed patient characteristics, decision-making processes, and outcomes of TAVI performed in hospitals with versus those without on-site cardiac surgery (CS).

The Dutch Hospital Standardized Mortality Ratio (HSMR) Method and Cardiac Surgery: Benchmarking in a National Cohort Using Hospital Administration Data Versus a Clinical Database

The Dutch Hospital Standardized Mortality Ratio (HSMR) Method and Cardiac Surgery: Benchmarking in a National Cohort Using Hospital Administration Data Versus a Clinical Database

The objective of this study is to compare the accuracy of data from hospital administration databases and a national clinical cardiac surgery database and to compare the performance of the Dutch hospital standardised mortality ratio (HSMR) method and the logistic European System for Cardiac Operative Risk Evaluation, for the purpose of benchmarking of mortality across hospitals.

Comparison of Immediate Extubation Versus Ultrafast Tracking Strategy in the Management of Off-Pump Coronary Artery Bypass Surgery

Comparison of Immediate Extubation Versus Ultrafast Tracking Strategy in the Management of Off-Pump Coronary Artery Bypass Surgery

Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA.

The Feasibility and Safety of Off-Pump Coronary Bypass Surgery in Emergency Revascularization

The Feasibility and Safety of Off-Pump Coronary Bypass Surgery in Emergency Revascularization

The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) in emergency revascularization remains controversial despite its widespread use. The aim of our study was to examine the applicability and safety of OPCAB in patients who were indicated for emergency surgery.

Off-Pump Coronary Artery Bypass Grafting with Mini-Sternotomy in the Treatment of Triple-Vessel Coronary Artery Disease

Off-Pump Coronary Artery Bypass Grafting with Mini-Sternotomy in the Treatment of Triple-Vessel Coronary Artery Disease

We have developed off-pump coronary artery bypass approach with lower distal mini-sternotomy (TM-OPCAB) for multivessel coronary revascularization. The aim of this retrospective study is to provide evidence for the feasibility and safety of this technique in the treatment of triple-vessel diseases.

Five-Year Outcomes with PCI Guided by Fractional Flow Reserve

Five-Year Outcomes with PCI Guided by Fractional Flow Reserve

We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease.

Implementation of a Mechanical CPR Device in a Physician Staffed HEMS – A Prospective Observational Study

Implementation of a Mechanical CPR Device in a Physician Staffed HEMS – A Prospective Observational Study

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device.

Early LVAD Implantation in a Patient with Left Ventricular Failure after Aortic Dissection with Left Main Stem Involvement

Early LVAD Implantation in a Patient with Left Ventricular Failure after Aortic Dissection with Left Main Stem Involvement

Coronary involvement in aortic dissection heralds a poor outcome. Involvement of the left main stem may lead to left ventricular (LV) failure requiring mechanical circulatory support.

VV Extracorporeal Life Support for the Third Millennium: Will We Need Anticoagulation?

VV Extracorporeal Life Support for the Third Millennium: Will We Need Anticoagulation?

This review focuses on present day techniques for anticoagulation for ECLS and what future surface modifications may do to obviate the use of systemic anticoagulation entirely.

Hybrid Extracorporeal Membrane Oxygenation

Hybrid Extracorporeal Membrane Oxygenation

Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients’ conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency.

Successful Pulmonary Embolectomy for Massive Pulmonary Embolism During Pregnancy: A Case Report

Successful Pulmonary Embolectomy for Massive Pulmonary Embolism During Pregnancy: A Case Report

We report here the case of a patient with massive pulmonary embolism (PE) at 28 weeks’ gestation, who underwent emergency pulmonary embolectomy via cardiopulmonary bypass.

Perioperative Changes in Platelet Count and Function in Patients Undergoing Cardiac Surgery

Perioperative Changes in Platelet Count and Function in Patients Undergoing Cardiac Surgery

In the present study, we aimed at investigating the changes in platelet count and function during and after surgery as well as determining the association of the platelet dysfunction with bleeding and transfusion requirements in these patients.