Normothermic Regional Perfusion in Donor Heart Recovery: Establishing a New Normal
The article discusses the evolving landscape of heart transplantation, mainly focusing on using Normothermic Regional Perfusion (NRP) in donor heart recovery. With the scarcity of heart donors being a persistent issue, the medical community has been exploring innovative ways to expand the donor pool, including using hearts from donors who are not brain-dead, a process…
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Comparing Post-Transplant Survival in Heart Transplants: Normothermic Regional Perfusion vs. Direct Procurement and Perfusion
A new study led by Gege Ran BA and colleagues examines the outcomes of heart transplants from donors after circulatory death (DCD), focusing on the two main heart procurement techniques: Normothermic Regional Perfusion (NRP) and Direct Procurement and Perfusion (DPP). Since 2019, the use of DCD hearts in transplantation has surged in the United States,…
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Evaluation of Cannula Sizes and Flow Rates in Venoarterial Extracorporeal Membrane Oxygenation: Insights from a Simulation Study
The study by Avishka Wickramarachchi and colleagues investigates the performance of different arterial and drainage cannulae sizes in venoarterial extracorporeal membrane oxygenation (VA ECMO) using a simulated patient model. Large cannulae, though effective, are associated with increased complications, while the efficacy of smaller cannulae still needs to be understood. The research tested arterial cannulae sizes…
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Optimizing Left Ventricular Unloading with ECPELLA: A Case Study and Decision-Making Guide
Left ventricular (LV) unloading using the Impella device in conjunction with veno-arterial extracorporeal membrane oxygenation (VA ECMO), known as ECPELLA, has demonstrated improved survival for patients experiencing cardiogenic shock, particularly those resuscitated post-cardiac arrest. Clear criteria and additional diagnostic and therapeutic tools for optimal LV unloading remain undefined despite its benefits. This article by John…
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Outcomes Associated with Absent Blood Product Utilization in Jehovah’s Witness Patients Compared to the Standard of Care in Cardiac Surgery: A Ten-Year Experience
A ten-year retrospective study by Nathan Fields et al. examined the outcomes of Jehovah’s Witness (JW) patients undergoing cardiac surgery without blood transfusions in comparison to non-JW patients who either received or did not receive blood products. Given JW patients’ refusal of blood transfusions, alternative strategies such as erythropoietin-stimulating agents, intravenous iron, and non-pharmacologic interventions…
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The Multifactorial Dynamic Perfusion Index: A Predictive Tool of Cardiac Surgery-Associated Acute Kidney Injury
Marco Ranucci and a team of dedicated colleagues have introduced a multifactorial dynamic perfusion index (MDPI) to enhance the prediction of cardiac surgery-associated acute kidney injury (CSA-AKI). This collaborative study, involving a retrospective analysis of 910 consecutive adult cardiac surgery patients, aimed to develop a dynamic predictive model that incorporates various preoperative and intraoperative risk…
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Risk Factors for Elective and Emergency Oxygenator Exchanges During Veno-Venous Extracorporeal Membrane Oxygenation
Oxygenator dysfunction remains a prevalent technical complication during Extracorporeal Membrane Oxygenation (ECMO) despite systemic anticoagulation and antithrombotic surface coating measures. The timing of oxygenator exchange, particularly emergency exchanges, presents a significant risk due to potential complications. This study by Olivier van Minnen et al. aimed to identify the risk factors and predictors for both elective…
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Non iatrogenic Hypoglycemia as a Marker for Poor Outcomes in Cardiac Surgery
Recent findings by Hannah Rando et al. have unveiled critical insights into the impact of hypoglycemia on postoperative outcomes in cardiac surgery patients. The study, conducted at a single institution from 2016 to 2021, sought to differentiate between iatrogenic and noniatrogenic causes of hypoglycemia and their respective impacts on patient health. The research aimed to…
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Mechanical Circulatory Support in Patients with Congenital Heart Disease: A European Registry for Patients with Mechanical Circulatory Support (EUROMACS) Study
A study led by Maddalena Ardissino and colleagues examined the characteristics and clinical outcomes of patients with congenital heart disease (CHD) who received mechanical circulatory support (MCS) across Europe. Utilizing data from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) from 2011 to 2023, the study analyzed 5340 participants, separating adult and pediatric…
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Update on Anticoagulation Strategies in Patients with ECMO—A Narrative Review
The newsletter “Update on Anticoagulation Strategies in Patients with ECMO—A Narrative Review” by Ján Šoltés et al. examines the intricate challenges of anticoagulation management in patients receiving extracorporeal membrane oxygenation (ECMO) therapy. ECMO has surged recently and is favored for treating severe respiratory or circulatory failure. This therapy disrupts the delicate balance of hemostasis due…
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A Split-Lung Ex Vivo Perfusion Model for Efficient Therapeutic Evaluation of Donor Lungs
Nicholas J S Chilvers and colleagues have introduced an innovative split-lung ex vivo perfusion (EVLP) model to tackle the persistent shortage of donor lungs. This model is designed to provide a more time- and cost-effective method for evaluating therapeutic interventions on human donor lungs, which are essential for clinical translation. The traditional use of animal…
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Teleflex receives FDA 510(k) clearance of the Ringer™ Perfusion Balloon Catheter
Teleflex announced that the FDA has granted 510(k) clearance for the company’s Ringer perfusion balloon catheter for percutaneous transluminal coronary angioplasty (PTCA), the only commercially available Percutaneous Transluminal Coronary Angioplasty perfusion balloon. The Ringer Perfusion Balloon Catheter will enter a limited market release phase in August 2024.The Ringer™ PBC is indicated for balloon dilatation of…
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