Perfusion.com Cardiovascular News Roundup: September 19, 2022

Luc Puis

Relevant reading, listening or viewing – curated by the creator of Tiny Perfusion Letter, Luc Puis


Every week, we collect 10 or 20 articles from the peer-reviewed literature that we think will be of interest to the perfusionist community. Feel free to comment on the findings or suggest entries for the newsletter by emailing the Editor – Luc Puis.

Today, we have three submissions on cardiopulmonary bypass. The 2021 Update on Minimal Invasive Extracorporeal Circulation (MiECC) in Cardiac Surgery is exactly what the title says. It presents new evidence to advocate the use of MiECC, thereby enhancing biocompatibility and offering a more physiologic strategy for cardiopulmonary bypass (CPB).

Next, researchers from South Korea looked into the potential role of microvascular reactivity as an early predictor of major adverse events after cardiac surgery.

And last, in CPB-specific research, we have an exciting study from our colleagues from down-under. They used computational fluid dynamics to simulate the Trendelenburg position with different CPB flows. It turns out that it might be a good idea to go to a lower flow when using the Trendelenburg position to move air emboli away from the aortic arch branch arteries.

Further on, we have four publications on patient blood management (PBM) and anticoagulation. Two of them discuss the use of hemoadsorption filters. One to eliminate residual argatroban concentrations during cardiopulmonary bypass for heart transplantation, and the other for removal of apixaban, rivaroxaban, and ticagrelor, studied in an in-vitro model with bovine blood. Clinical trials are coming soon to a surgical theater near you!

A different technique that might be coming nearer to you is using cell salvage to treat massive hemorrhage during ectopic pregnancy. Safe and effective, according to the authors.

Lastly, in PBM and Antico, a case report on a rare paraprotein-associated heparin resistance was found in a patient during cardiopulmonary bypass. Triple doses of heparin were needed to go safely on bypass. First, finding out what paraproteins are…

In general science, we have an article recently discussed in a different post on Perfusion.com about the recovery of cells after prolonged warm ischemia (the pig one) and a review on assessments of microvascular function in different organ systems.

To conclude this Roundup, we have a nice summarization of configurations, technical aspects, and present literature on the ProtekDuo cannula.

Enjoy the read!

Cardiopulmonary bypass

2021 Miectis Focused Update on the 2016 Position Paper for the Use of Minimal Invasive Extracorporeal Circulation in Cardiac Surgery. https://journals.sagepub.com/doi/abs/10.1177/02676591221119002?journalCode=prfa

Microvascular Reactivity as A Predictor of Major Adverse Events in Patients with On-Pump Cardiac Surgery. https://ekja.org/journal/view.php?doi=10.4097/kja.22097

Improving Trendelenburg Position Effectiveness by Varying Cardiopulmonary Bypass Flow. https://journals.sagepub.com/doi/10.1177/02676591221108810

Blood Management and (Anti)Coagulation

Use of the Cytosorb® Filter for Elimination of Residual Therapeutic Argatroban Concentrations During Heparinized Cardiopulmonary Bypass for Heart Transplantation. https://journals.sagepub.com/doi/10.1177/02676591221093875

Antithrombotic Drug Removal from Whole Blood Using Haemoadsorption with a Porous Polymer Bead Sorbent. https://academic.oup.com/ehjcvp/advance-article/doi/10.1093/ehjcvp/pvac036/6601391

Application of Salvage Autologous Blood Transfusion for treating Massive Hemorrhage during Ectopic Pregnancy. https://www.frontiersin.org/articles/10.3389/fsurg.2022.896526/full

Paraprotein Associated Heparin Resistance During Cardiopulmonary Bypass. https://journals.sagepub.com/doi/abs/10.1177/02676591221109143

Science

Cellular Recovery after Prolonged Warm Ischaemia of the Whole Body. https://www.nature.com/articles/s41586-022-05016-1

Assessments Of Microvascular Function in Organ Systems. https://journals.physiology.org/doi/abs/10.1152/ajpheart.00589.2021

Devices

The Novel Protekduo Ventricular Assist Device: Configurations, Technical Aspects, and Present Evidence. https://journals.sagepub.com/doi/10.1177/02676591221090607