Femoro-Axillary VA-ECMO: Why Stable PCWP May Not Reflect Stable LV Loading
A recent Critical Care commentary by Coveliers and colleagues re-examines whether pulmonary capillary wedge pressure (PCWP) accurately reflects left ventricular (LV) loading during femoro-axillary venoarterial extracorporeal membrane oxygenation (VA-ECMO). The commentary addresses a study in which increasing ECMO flow from 2 to 4 L/min produced minimal changes in PCWP, prompting the original investigators to suggest…
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Angled Aortic Cannulation and Cerebral Embolic Transport During Cardiopulmonary Bypass
Nafis M. Arefin and Bryan C. Good examined the impact of arterial cannula orientation on hemodynamics during cardiopulmonary bypass (CPB) using patient-specific computational fluid dynamics (CFD). Four anatomically distinct ascending aortic models: pediatric, adolescent, adult, and geriatric, were reconstructed from imaging data to compare the conventional 90° (perpendicular) cannulation technique with a 30° angled approach….
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Beyond Transfusion: The Rise of Artificial Blood Technologies
Recent research in Annals of Blood (March 2026) highlights a shift in artificial blood development from experimental studies to clinically relevant oxygen therapeutics. The review notes that artificial blood aims to address key limitations of donor blood, including supply shortages, storage issues, and compatibility issues. These products offer immediate availability without cross-matching, reduced infectious risk,…
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Off-Pump CABG in 2026: Outcome Gains Driven by Experience and Patient Selection
Analysis of 2026 data from the Society of Thoracic Surgeons database, encompassing over 1.5 million coronary artery bypass grafting (CABG) cases, indicates that off-pump CABG (OPCAB) is associated with substantial reductions in early complications. Compared with on-pump CABG, OPCAB demonstrated approximately 10–20% lower operative mortality, a 15–30% reduction in stroke incidence, and notable reductions in…
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Rethinking Anticoagulation in ECMO
Tianyu Zhang and colleagues recently published a systematic review and meta-analysis in Frontiers in Medicine evaluating reduced-intensity and heparin-sparing anticoagulation strategies during Extracorporeal Membrane Oxygenation (ECMO). Systemic anticoagulation with unfractionated heparin has traditionally represented the standard of care in ECMO management; however, bleeding complications continue to pose a significant challenge. The study aimed to determine…
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FDA Approves Aficamten (Myqorzo) for Symptomatic Obstructive Hypertrophic Cardiomyopathy
The U.S. Food and Drug Administration (FDA) has approved Myqorzo® (aficamten) for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), denoting a major advancement in targeted pharmacologic management of this complex structural heart disease. Obstructive hypertrophic cardiomyopathy is a genetic myocardial disorder characterized by pathologic thickening of the ventricular myocardium, most notably involving…
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Myocardial Microcirculation Combined With Lactate Predicts LV Function After DCD Heart Transplantation
Assessment of donation after circulatory death (DCD) hearts during ex vivo blood perfusion (EVBP) has customarily relied heavily on lactate trends to guide transplantability decisions. However, concerns have been raised regarding whether lactate alone adequately reflects myocardial viability. In a recent experimental study, Saemann et al. (2026) and Colleagues evaluated whether combining myocardial microcirculatory assessment…
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Robotic-Assisted Mitral and Revascularization Procedures: Expanded FDA Clearance for da Vinci 5
Intuitive Surgical’s da Vinci 5 system has received expanded FDA 510(k) clearance for selected minimally invasive cardiac procedures, including mitral valve repair and coronary revascularization applications. From a clinical standpoint, this clearance supports the continued evolution of robotic-assisted cardiac surgery, particularly in procedures requiring high precision within confined operative fields. The platform’s advanced visualization, refined…
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Normothermic Regional Perfusion as a Platform for DCD Lung Assessment and Recovery
The article “Normothermic regional perfusion for donation after circulatory death in lung transplantation,” published in Frontiers in Cardiovascular Medicine in 2025, reviews the expanding evidence on thoracoabdominal normothermic regional perfusion (TA-NRP) for lungs recovered from donation after circulatory death (DCD) donors. Authored by Andrew J. Gorton, Daniel K. Mohammadi, Mohammad J. Malik, and Suresh Keshavamurthy,…
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Perspectives on Acute Decompensated RV Failure in Pulmonary Arterial Hypertension
Pulmonary Arterial Hypertension (PAH) is a progressive vascular disorder defined by increased Pulmonary Vascular Resistance (PVR), which leads to Right Ventricular (RV) dysfunction and ultimately Right Heart Failure (RHF). Rohit Masih and colleagues, in The Open Respiratory Medicine Journal, highlight the severe and life-threatening nature of acute decompensated RV failure in patients with PAH. Acute…
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Optimizing CO₂ Levels in Acute Brain Injury: Balancing Cerebral Blood Flow and Intracranial Pressure
The article “Carbon dioxide pathophysiology and targets following acute brain injury” by Shaurya Taran et al., published in Intensive Care Medicine, highlights the crucial role of arterial carbon dioxide tension (PaCO₂) in the management of acute brain injury (ABI). PaCO₂ strongly influences cerebral blood flow (CBF): higher levels cause vasodilation and increased CBF, while lower…
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The Influence of Cardiopulmonary Bypass Duration on Mortality and Mid-Term Survival in Acute Type A Aortic Dissection Repair
A recent study conducted by Mikko Uimonen and colleagues, published in the Journal of Cardiovascular Development and Disease by MDPI, investigated the relationship between cardiopulmonary bypass (CPB) time and postoperative outcomes in patients undergoing surgery for acute type A aortic dissection (ATAAD). The study retrospectively analyzed data from 1122 patients who underwent surgical treatment across…
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