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Normothermic Crystalloid Polarizing Cardioplegia Improves Systolic and Diastolic Function in a Porcine Model of Cardiopulmonary Bypass.

Biomedicines

December 2024

Ludwig Boltzmann Institute for Cardiovascular Research, Center for Biomedical Research and Translational Surgery, Medical University of Vienna, 1090 Vienna, Austria.

Previously, we showed that blood-based polarizing cardioplegia exerted beneficial cardioprotection during hypothermic ischemia; however, these positive effects of blood-based polarizing cardioplegia were reduced during normothermic ischemia compared to blood-based hyperkalemic (depolarizing) cardioplegia. This study compares crystalloid polarizing cardioplegia to crystalloid depolarizing cardioplegia in a normothermic porcine model of cardiopulmonary bypass; Methods: Twelve pigs were randomized to receive either normothermic polarizing ( = 7) or depolarizing ( = 5) crystalloid cardioplegia. After the initiation of cardiopulmonary bypass, normothermic arrest (34 °C, 60 min) was followed by 60 min of on-pump and 90 min of off-pump reperfusion.

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Introduction: Off-pump coronary artery bypass graft surgery (OPCAB) has been suggested as superior to on-pump coronary artery bypass graft surgery (ONCAB) in certain high-risk subgroups, but its benefit in patients with chronic obstructive pulmonary disease (COPD) remains controversial. This meta-analysis aimed to evaluate OPCAB versus ONCAB outcomes in COPD patients.

Methods: We followed PRISMA guidelines and searched PubMed, Embase, and the Cochrane Library in August 2024 for studies comparing OPCAB and ONCAB in COPD patients.

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Postoperative atrial fibrillation complicates 15-40% of cardiac surgery cases and is associated with various adverse health outcomes including high mortality. Although vasopressin administration decreases postoperative atrial fibrillation in on-pump coronary artery bypass grafting, its use in off-pump coronary artery bypass grafting has not been investigated. Therefore, we evaluated the effect of vasopressin use in off-pump coronary artery bypass grafting.

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Off-Pump Coronary Artery Bypass Grafting is Overutilized.

Semin Thorac Cardiovasc Surg

December 2024

Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address:

Off-pump coronary artery bypass grafting (CABG), developed to avoid the potential complications of cardiopulmonary bypass, remains a subject of debate. Studies have demonstrated that off-pump CABG is associated with higher rates of incomplete revascularization, inferior graft patency, and increased reintervention rates compared to on-pump CABG, leading to worse outcomes. The theoretical neuroprotective and renal-protective benefits associated with off-pump CABG have not been definitively proven, with stroke and renal failure rates similar to those of on-pump CABG in both short- and long-term follow-up.

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Background: Unlike on-pump beating coronary artery bypass grafting, off-pump coronary artery bypass grafting (OPCAB) rarely causes intracardiac air embolisms. However, there have been several reports of air embolisms that occurred during OPCAB using a CO blower, which is commonly used to facilitate visualization of the anastomotic site. Herein, we describe a rare case of air bubbles detected only in the left ventricle during OPCAB.

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