Considering veno-venous extracorporeal membrane oxygenation as a first-line strategy for rewarming in accidental hypothermia complicated by cardiac arrest - a case series.

Severe accidental hypothermia can lead to cardiac arrest. The most efficient method of resuscitating and warming is by ECMO (Extracorporeal Membrane Oxygenation). While the convention is to use VA ECMO (Veno Arterial ECMO), using VV ECMO (Veno Venous ECMO) in which the blood is returned directly into the right ventricle could be an alternative and lead to conversion to life sustaining cardiac rhythm.

Perioperative extracorporeal membrane oxygenation support for pulmonary endarterectomy: A 17-year experience from the UK national cohort.

Background: Pulmonary endarterectomy (PEA) is the guideline-recommended treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, some patients develop severe cardiopulmonary compromise before surgery, intraoperatively, or early postoperatively. This may result from advanced CTEPH, reperfusion pulmonary edema, massive endobronchial bleeding, or right ventricular (RV) failure secondary to residual pulmonary hypertension.

Early experience with pulmonary endarterectomy in Bulgaria-case series.

Background: Pulmonary arterial hypertension (PAH) is a condition that limits the quality of life and life expectancy. The predicted mortality at 1 year is estimated at 30-40% without treatment. Of the types of PAH, chronic thromboembolic pulmonary hypertension (CTEPH) is most amenable to treatment and guidelines recommend pulmonary endarterectomy (PEA) surgery for 'operable' patients (where disease is found in the proximal pulmonary vessels).

Successful thrombolysis of early bioprosthetic mitral valve thrombosis following extracorporeal membrane oxygenation: Case report.

Bioprosthetic mitral valve thrombosis (BPMVT) following post-operative extracorporeal membrane oxygenation (ECMO) is a rare complication with high mortality. A 75-year-old man with a flail posterior mitral leaflet underwent a bioprosthetic mitral valve replacement and was subsequently placed on central veno-arterial high flow ECMO following intractable shock after protamine administration. He developed BPMVT over the following 48 hr, which did not resolve with 3 weeks of systemic heparin.

COVID-19 patient with coronary thrombosis supported with ECMO and Impella 5.0 ventricular assist device: a case report.

Background: COVID-19 can present with cardiovascular complications.

Case Summary: We present a case report of a 43-year-old previously fit patient who suffered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with thrombosis of the coronary arteries causing acute myocardial infarction. These were treated with coronary stenting during which the patient suffered cardiac arrest.

Deprescribing practices for anticonvulsants after benign seizures secondary to high-dose tranexamic acid in a single, large UK cardiothoracic centre.

Objective: High-dose tranexamic acid (TXA) can cause seizures in patients who have undergone pulmonary endarterectomy (PTE). Seizures secondary to TXA will resolve once the drug is excreted from the body, and the patients do not have to be on long-term anticonvulsants. The aim of the study is to find out if medication review in the hospital has led to deprescribing of anticonvulsants for TXA-associated seizures on discharge from the critical care unit (CCU) and hospital.

Thrombotic risk in central venoarterial extracorporeal membrane oxygenation post cardiac surgery.

Introduction: Post-cardiotomy cardiogenic shock is an accepted indication for venoarterial extracorporeal membrane oxygenation. The true incidence and risk factors for the development of thrombosis in this setting remain unclear.

Methods: Patients supported with central venoarterial extracorporeal membrane oxygenation due to ventricular dysfunction precluding weaning from cardiopulmonary bypass were retrospectively identified.

Severe acute respiratory distress syndrome requiring extracorporeal membrane oxygenation support: a consequence of vaping.

https://bit.ly/39hf2ZY.

Three consecutive cases of fatal intraoperative intracardiac thrombosis associated with the initiation of venoarterial extracorporeal membrane oxygenation in the presence of aprotinin.

Central venoarterial extracorporeal membrane oxygenation has been used since the 1970s to support patients with cardiogenic shock following cardiac surgery. Despite this, in-hospital mortality is still high, and although rare, thrombus within the cardiac chambers or within the extracorporeal membrane oxygenation circuit is often fatal. Aprotinin is an antifibrinolytic available in Europe and Canada, though not currently in the United States.

Use veno-venous extra corporeal membrane oxygenation in elderly patients with post-cardiotomy hypoxia: the changing paradigm of respiratory support in adult respiratory distress syndrome.

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) support for ARDS treatment after cardiac surgery has progressed remarkably in the last 20 years. However, one of the limitations of a successful recover is age, being a powerful predictor of mortality.

Case Presentation: In this case report we discuss a 78-year-old man who underwent aortic valve and aortic root replacement.

Mini-Stern Trial: A randomized trial comparing mini-sternotomy to full median sternotomy for aortic valve replacement.

Objective: Aortic valve replacement (AVR) can be performed either through full median sternotomy (FS) or upper mini-sternotomy (MS). The Mini-Stern trial aimed to establish whether MS leads to quicker postoperative recovery and shorter hospital stay after first-time isolated AVR.

Methods: This pragmatic, open-label, parallel randomized controlled trial (RCT) compared MS with FS for first-time isolated AVR in 2 United Kingdom National Health Service hospitals.

Advances in critical care management of patients undergoing cardiac surgery.

Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management.

Central Veno-Arterial Extracorporeal Membrane Oxygenation (C-VA-ECMO) After Cardiothoracic Surgery: A Single-Center Experience.

Objectives: Central veno-arterial extracorporeal membrane oxygenation (C-VA-ECMO) provides temporary cardiorespiratory support for patients in heart failure who cannot be weaned from cardiopulmonary bypass successfully. Outcomes are influenced by the reversibility of the initial insult and complications of the technique.

Methods: The authors reviewed their single-center experience over the last 8 years to inform future practice.