General Thoracic and Cardiovascular Surgery最新文献

{"title":"Novel pulmonary abdominal normothermic regional perfusion circuit for simultaneous in-donor evaluation and preservation of lungs and abdominal organs in donation after circulatory death.","authors":"Shin Tanaka, Masashi Umeda, Hiroyuki Ujike, Tsuyoshi Ryuko, Yasuaki Tomioka, Kentaroh Miyoshi, Mikio Okazaki, Seiichiro Sugimoto, Shinichi Toyooka","doi":"10.1007/s11748-025-02137-y","DOIUrl":"https://doi.org/10.1007/s11748-025-02137-y","url":null,"abstract":"<p><strong>Objective: </strong>To overcome limitations of traditional ex vivo lung perfusion (EVLP) for controlled donation after circulatory death (cDCD) lungs, this study aimed to evaluate a novel pulmonary abdominal normothermic regional perfusion (PANRP) technique, which we uniquely designed, for in situ assessment of lungs from cDCD donors.</p><p><strong>Methods: </strong>We modified the abdominal normothermic regional perfusion circuit for simultaneous lung and abdominal organ assessment using independent extracorporeal membrane oxygenation components. Blood was oxygenated via a membrane oxygenator and returned to the body, with pulmonary flow adjusted to maintain pressure < 25 mmHg. Femoral cannulation was performed, and the lungs were ventilated with standard settings. Organ function was assessed over 2 h using PaO2/FiO2, AST, ALT, BUN, and Cr measurements to monitor perfusion and oxygen delivery.</p><p><strong>Results: </strong>PANRP maintained stable lung function, with P/F ratios above 300, and preserved abdominal organ parameters, including stable AST, ALT, BUN, and Cr levels. Adequate urine output was observed, indicating normal renal function. Pulmonary artery pressure remained < 20 mmHg, and pulmonary vascular resistance was kept at 400 dyn・s/cm⁵, showing no signs of lung dysfunction or injury throughout the circuit.</p><p><strong>Conclusions: </strong>PANRP offers a promising alternative to traditional EVLP for cDCD lung evaluation, allowing in situ assessment of multiple organs simultaneously. This approach may overcome logistical and economic challenges associated with ex vivo techniques, enabling a more efficient evaluation process. Further studies are warranted to confirm its clinical applicability and impact on long-term outcomes.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 30 year experience of truncus arteriosus repair at a single institution: usefulness of staged approach for complicated lesions.","authors":"Yusuke Ando, Toshihide Nakano, Akinori Hirano, Takeaki Harada, Ryusuke Hosoda, Keisuke Iwahashi, Hideaki Kado","doi":"10.1007/s11748-025-02134-1","DOIUrl":"https://doi.org/10.1007/s11748-025-02134-1","url":null,"abstract":"<p><strong>Objectives: </strong>Primary repair is currently preferred for truncus arteriosus, however, staged repair may be useful when the lesion is complex. This study aimed to compare the mortality and reoperation rates of primary versus staged repair.</p><p><strong>Methods: </strong>Nineteen patients undergoing primary repair and 30 undergoing staged repair between 1991 and 2021 were reviewed. The main indications for staged repair were moderate or greater truncal valve insufficiency, arch obstruction, and low weight (< 2.5 kg).</p><p><strong>Results: </strong>The staged group included more patients with moderate or greater truncal valve insufficiency (primary vs staged, 11 vs 53%, P = 0.001) and more small patients (median, 3.4 kg vs 2.8 kg, P = 0.002). In the staged group, 26 patients (87%) achieved definitive repair with a median weight of 6.3 kg. The 15 year survival rate after initial surgery was 90% in the primary group and 90% in the staged group (P = 0.906). In patients with moderate or greater truncal valve insufficiency or arch obstruction, the survival rate was higher in the staged group than in the primary group (P = 0.024). There was no difference in the cumulative incidence of reoperation on the right ventricular outflow tract (72 vs 72% at 15 years, P = 0.448) or pulmonary artery branches (20 vs 38% at 15 years, P = 0.179).</p><p><strong>Conclusions: </strong>Truncus arteriosus can now be treated with low mortality risk. In patients with complex lesions, the use of a staged approach may yield similar results as in patients without complex lesions.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey on perioperative antibiotic use for minimally invasive coronary artery bypass grafting.","authors":"Xiuxiu Zhang, Chaohua Wang, Huanjun Yu, Yichang Song, Yingxue He, Tiantong Zhao, Tingting Liu, Xinyan Liu, Dapeng Yu","doi":"10.1007/s11748-025-02136-z","DOIUrl":"https://doi.org/10.1007/s11748-025-02136-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the use of antimicrobials during the perioperative period of minimally invasive coronary artery bypass grafting (MICS CABG) and traditional open-heart bypass grafting. We aimed to determine whether the duration of perioperative antibiotic use and infection rate is significantly different between different surgical methods.</p><p><strong>Methods: </strong>A total of 471 cases of coronary artery bypass grafting (CABG) were collected from January 2019 to December 2022. Patients were divided into minimally invasive group (229 cases) and a conventional group (242 cases) according to the type of surgery. We compared differences in the duration of antimicrobial use and infection rates between the two groups.</p><p><strong>Results: </strong>Compared with the conventional group, the minimally invasive group had a significantly shorter average duration of antimicrobial therapy [(1.95 ± 2.40) d vs. (4.67 ± 5.89) d, P < 0.001], a higher rate of short antibiotic treatment duration (T ≤ 24 h) [51.97% vs. 7.02%, P < 0.001], lower postoperative pneumonia rate [38.86% vs. 56.20%, P < 0.001], lower positive rate of blood and surgical site sample culture (1 case and 0 case) vs. (7 cases and 3 cases), P < 0.001. Subgroup analysis of different durations of antimicrobial treatment (T ≤ 24 h, 24 h < T ≤ 48 h, and 48 h < T ≤ 96 h) in the minimally invasive group showed that there was no statistically significant difference in the incidence of infection among the various medication durations (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with traditional surgery, MICS CABG requires a significantly shorter duration of perioperative antibiotic treatment duration and a reduced incidence of infection. Extending the duration of antibiotic treatment did not reduce the incidence of infection.</p><p><strong>Trial registration: </strong>chictr.org.cn ChiCTR2400091571.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial ischemia risk in Fontan candidates with pulmonary atresia with intact ventricular septum.","authors":"Naoki Masaki, Hideki Tatewaki, Satoshi Matsuo, Masaru Kumae, Kohei Yagi, Takehiko Onoki, Eiichiro Kawai, Megumi Nitta, Akira Ozawa, Sadahiro Sai","doi":"10.1007/s11748-025-02131-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02131-4","url":null,"abstract":"<p><strong>Objectives: </strong>Sinusoidal communication (SC) is prevalent among Fontan candidates with pulmonary atresia with intact ventricular septum (PA/IVS), making it crucial in understanding its dynamics and potential impact on myocardial perfusion. This study aimed to assess the risk of myocardial ischemia in these patients.</p><p><strong>Methods: </strong>Sixteen Fontan candidates with PA/IVS were included in this study. All patients initially underwent Blalock-Taussig shunt (BTS), followed by bidirectional Glenn shunt in 15 cases, culminating in a total cavopulmonary connection (TCPC) at a median age of 24 months. SC severity and risk of myocardial ischemia were assessed via angiography and scintigraphy, respectively. Changes in SCs across the procedural stages and their correlation with ischemic responses in scintigraphy were retrospectively analyzed.</p><p><strong>Results: </strong>No deaths occurred during the study period. Ischemic events were observed in only one patient. SCs were observed in all 16 patients (100%). Significant regression of SCs occurred after BTS, particularly in coronary arteries with major SCs. However, no significant changes were found thereafter, particularly among coronary arteries without major SCs. No improvement or exacerbation of ischemic lesions was observed from pre- to post-TCPC. A positive correlation was revealed between angiographic SC grade and positive ischemic response on scintigraphy.</p><p><strong>Conclusions: </strong>In Fontan candidates with PA/IVS, an SC grade of 2 or higher was associated with a high risk of myocardial ischemia, emphasizing the need for careful monitoring and clinical management.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient neurologic dysfunction after aortic arch surgery.","authors":"Mesut Engin, Abdurrahman Demirel, Ahmet Kağan As, Şenol Yavuz","doi":"10.1007/s11748-024-02110-1","DOIUrl":"10.1007/s11748-024-02110-1","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"198-199"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between recovery from desaturation after stair climbing and postoperative complications in lung resection.","authors":"Kensuke Takei, Hayato Konno, Shinya Katsumata, Koki Maeda, Hideaki Kojima, Mitsuhiro Isaka, Keita Mori, Yasuhisa Ohde","doi":"10.1007/s11748-024-02059-1","DOIUrl":"10.1007/s11748-024-02059-1","url":null,"abstract":"<p><strong>Objective: </strong>The stair-climbing test (SCT) is used as a surrogate for cardiopulmonary exercise testing, which measures maximal oxygen uptake, and considered a useful method for assessing exercise capacity in thoracic surgery. This study aims to investigate whether the recovery time of percutaneous oxygen saturation (SpO₂) after stair climbing is a predictor of postoperative complications after lobectomy.</p><p><strong>Methods: </strong>We retrospectively identified 54 patients who performed SCT and underwent lobectomy between January 2015 and February 2023 at Shizuoka Cancer Center. The SpO₂ recovery time was defined as the time required to recover from the minimum to resting value after stair climbing. The association between SpO₂ recovery time and early postoperative pulmonary complications within 30 days after surgery was analyzed.</p><p><strong>Results: </strong>Eleven patients (20.4%) had postoperative pulmonary complications (≥ Clavien-Dindo Classification Grade 2). The cutoff value of SpO₂ recovery time obtained from the receiver operating characteristic curve analysis was 90 s [sensitivity, 81.8%; specificity, 72.1%; AUC, 0.77 (95% confidence interval, 0.64-0.90)]. The occurrence of postoperative pulmonary complications was 42.9% in the delayed recovery time (DRT; SpO₂ recovery time ≥ 90 s) group and 6.1% in the non-DRT (SpO₂ recovery time < 90 s) group (p = 0.002). DRT was a predictor of postoperative pulmonary complications (odds ratio, 11.60; 95% CI 2.19-61.80).</p><p><strong>Conclusions: </strong>DRT of SpO₂ after stair climbing is a predictor of postoperative pulmonary complications following lobectomy in borderline patients who require exercise capacity assessment. SpO₂ monitoring after stair climbing may be useful as one of the preoperative assessments in patients undergoing lobectomy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"171-179"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypercoagulable state and effect of low-molecular-weight heparin prophylaxis on coagulation after lung cancer resection: results from thrombo-elastography.","authors":"Xiaoxiao Yang, Yongsheng Cai, Lihui Ke, Bo Wei","doi":"10.1007/s11748-024-02062-6","DOIUrl":"10.1007/s11748-024-02062-6","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients undergoing surgery are at increased risk for Venous thromboembolism (VTE). We monitored changes in perioperative coagulation status through Thrombo-elastography (TEG), and monitored the anticoagulant effect of low molecular weight heparin through TEG for the first time.</p><p><strong>Methods: </strong>From July 2019 to January 2020, 207 patients receiving curative surgery were retrospectively screened. and 23 patients were excluded because they did not meet the inclusion criteria. Blood samples were required at three time points (prior to, the first and third day after surgery). Some patients were administrated nadroparin calcium daily from the first day after surgery. Repeated measures ANOVA and Chi-square test were used to analyze the coagulation states variation. To balance the confounders, propensity score matching (PSM) was used to determine the differences of coagulation states between patients with or without Low-molecular-weight heparin (LMWH) prophylaxis.</p><p><strong>Results: </strong>In 184 patients, TEG parameters displayed significant procoagulant changes after lung surgery but conventional coagulation tests exhibited paradoxical trends. There were 6.5% (12/184) of patients identified as hypercoagulability before surgery. According to TEG results, the proportion of patients with hypercoagulability rose from 21.7% to 25% postoperatively, but more were classified into platelet or mixed hypercoagulability at third day compared with that at first day (3.8% vs 14.1%, P < 0.001). By PSM analysis, there were no significant differences in the proportion of hypercoagulable patients postoperatively between chemoprophylactic and nonprophylactic group.</p><p><strong>Conclusions: </strong>TEG was eligible to distinguish changing states of hypercoagulability postoperatively and indicate the role of platelet in blood hypercoagulability. Administration of postoperative LMWH prophylaxis showed little mitigation on hypercoagulable states.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"180-189"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation vs cardiopulmonary bypass in lung transplantation: an updated meta-analysis.","authors":"Rachid Eduardo Noleto da Nobrega Oliveira, Felipe S Passos, Bernardo Mulinari Pessoa","doi":"10.1007/s11748-024-02114-x","DOIUrl":"10.1007/s11748-024-02114-x","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs). DerSimonian and Laird random-effects model was applied for all endpoints. I² statistics was used to assess heterogeneity.</p><p><strong>Results: </strong>Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25-0.90), hemodialysis (OR 0.62, 95% CI 0.43-0.88), severe graft rejection (OR 0.43, 95% CI 0.23-0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I² = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46-0.86). Additionally, ECMO reduced the length of hospital stay (MD - 5.69 days, 95% CI - 9.31 to - 2.08) and ICU stay (MD - 6.02 days, 95% CI - 8.32 to - 3.71). However, ECMO was associated with longer total ischemic time (MD 61.07 min, 95% CI 3.51 to 118.62). No significant differences were observed for stroke, thromboembolic events, atrial fibrillation, or 30-day and 3-year mortality.</p><p><strong>Conclusions: </strong>ECMO offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.</p><p><strong>Trial registry: </strong>International Prospective Register of Systematic Reviews; N°: CRD42024604049; URL: https://www.crd.york.ac.uk/prospero/ .</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"137-146"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic floating thrombus in patients with COVID-19: a report of eight cases.","authors":"K Soumer, M Mallouki, N Azabou, H Horchani, S Nsiri, M Bousnina, A Jemel","doi":"10.1007/s11748-024-02072-4","DOIUrl":"10.1007/s11748-024-02072-4","url":null,"abstract":"<p><strong>Background: </strong>Thromboembolic events of COVID-19 are due to hyperinflammatory process associated with hypercoagulable state. The aim of the study was to determine characteristics and clinical outcomes of patients with COVID-19 who presented with aortic thrombus.</p><p><strong>Methods: </strong>We retrospectively conducted a single-center, descriptive study over a period of 1 year and 7 months, between June 2021 and December 2022, involving eight patients with documented SARS-CoV-2 infection associated with aortic thrombus revealed by acute limb ischemia.</p><p><strong>Results: </strong>The mean age of patients was 67 years with a median of 64, 5 ± 14. Of the eight included patients, six were men and two were women. Aortic thrombus was diagnosed in all cases. Six patients developed one episode of acute limb ischemia and one patient had recurrent upper and lower ischemia despite full anticoagulation whereas one patient had distal embolization with palpable pulses. In six patients, the thrombi were located in descending and abdominal aorta, while two patients presented with ascending aorta floating thrombus. Seven patients required urgent revascularization whereas medical treatment was recommended for one patient. The primary outcomes were successful in five cases, one patient had to be amputated above elbow, whereas two patients died due to a rapid deterioration of respiratory condition.</p><p><strong>Conclusion: </strong>Aortic thrombosis is a rare clinical presentation in SARS-CoV-2 infection but with potentially fatal embolic complication. Physicians should maintain a high degree of clinical suspicion to diagnose thromboembolic consequences of SARS-CoV-2 infection for timely management and avoiding morbidities like ischemic stroke and major amputations.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"164-170"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro protamine addition for coagulation assessment using TEG 6s system during cardiopulmonary bypass: a pilot study.","authors":"Koichi Yoshinaga, Yusuke Iizuka, Yoshihiko Chiba, Yusuke Sasabuchi, Masamitsu Sanui","doi":"10.1007/s11748-024-02061-7","DOIUrl":"10.1007/s11748-024-02061-7","url":null,"abstract":"<p><strong>Objective: </strong>Systemic heparinization during cardiopulmonary bypass (CPB) can significantly affect thromboelastography (TEG). This study investigated the feasibility of adding protamine in vitro to allow assessment of coagulation status using the TEG 6s system during CPB.</p><p><strong>Methods: </strong>In this prospective observational study, 21 patients undergoing elective cardiac valve surgery were evaluated. During CPB, protamine was added in vitro to the heparinized blood of these patients at a concentration of 0.05 mg/mL and analyzed with the TEG 6s (Pre). The TEG parameters were compared to those analyzed after CPB withdrawal and systemic protamine administration (Post).</p><p><strong>Results: </strong>The citrated kaolin maximal amplitude (CK-MA) and the citrated functional fibrinogen maximal amplitude (CFF-MA) exhibited strong correlations between Pre and Post measurements (r = 0.790 and 0.974, respectively, P < 0.001 for both), despite significant mean differences (-2.23 mm for CK-MA and -0.68 mm for CFF-MA). Bland-Altman analysis showed a clinically acceptable agreement between Pre and Post measurement of CK-MA and CFF-MA (the percentage error was 10.6% and 12.2%, respectively). In contrast, the citrated kaolin reaction time (CK-R) showed no significant correlation between Pre and Post measurements (r = 0.328, P = 0.146), with a mean difference of 1.42 min (95% CI: -0.45 to 3.29).</p><p><strong>Conclusions: </strong>In vitro protamine addition allows assessment of coagulation status during CPB using the TEG 6s system. CK-MA and CFF-MA measured during CPB using this method revealed a strong correlation and agreement with post-CPB measurements, suggesting that our method potentially facilitates early prediction of post-CPB coagulation status and decision-making on transfusion strategies.</p><p><strong>Clinical trial registration: </strong>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, registration number: UMIN000041097, date of registration: July 13, 2020, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046925 ) before the recruitment of participants.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"147-154"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}