Perfusion-Uk最新文献

{"title":"High vasoactive-inotropic score is associated with poor outcomes in patients undergoing coronary artery bypass grafting: A systematic review and meta-analysis.","authors":"Nanush Damarlapally, Roopeessh Vempati, Srivatsa Surya Vasudevan, Gaurav Mathur, Prathibha Banda, Denise Mourad, Afrasayab Khan, Harshavardhan Polamarasetty, Rupak Desai, Krishidhar Rao Nunna","doi":"10.1177/02676591251364482","DOIUrl":"https://doi.org/10.1177/02676591251364482","url":null,"abstract":"<p><p>BackgroundVasoactive-inotropic score (VIS) has been previously utilized as one of the predictors in open heart procedures postoperatively, but its association with poor outcomes in patients who underwent coronary artery bypass graft (CABG) is still unclear. We aim to find the association in this population.MethodsPubMed, Google Scholar, and Scopus were systematically searched for studies showing an association of poor cardiovascular (CV) outcomes, including mortality with VIS from inception to May 2024 following CABG surgery. Pooled effect sizes (aOR, OR, and ROC AUC) were estimated using CMA version 4 with a fixed-effect model and 95% confidence intervals (CI). I2-Statistic was used to measure heterogeneity. Leave-one-out sensitivity analysis and meta-regression analysis were utilized to measure the robustness of our findings and detect influencing confounding variables, respectively. Quality assessment of the studies was done through the Joanna Briggs Institute (JBI) tool. <i>p</i>-value <0.05 was considered significant.ResultsSix studies with a total sample size of 6504 patients following CABG surgery, with a mean age of 63.6 ± 3.15 years, containing predominantly males (71.8%) reported poor outcomes such as CV morbidity, cardiopulmonary resuscitation, mechanical ventilation, stroke, and mortality. Most studies had hypertension, diabetes, and chronic kidney disease as comorbidities. VIS greater than 5 is validated by pooled ROC AUC of 80.1% [95% CI: 73.5-85.4]. Our meta-analysis found a significant association between VIS >5 and poor outcomes, including mortality in six studies with pooled unadjusted OR-1.08 [95% CI: 1.06-1.10, <i>p</i> < 0.0001] and in four studies with adjusted OR-1.07 [95% CI: 1.04-1.09, <i>p</i> < .0001] among those who underwent CABG. Sensitivity analysis showed no variations among studies and confirmed the robustness of our findings. Additionally, meta-regression analysis indicated that mean age was associated with a minimal progression rate of mortality in patients succeeding CABG with a VIS > 5 (<i>p</i> = .04). High scores in the JBI tool revealed high quality among the studies selected.ConclusionOur study suggests a significant association of VIS > 5 with poor cardiovascular outcomes in patients following CABG surgery. This association can help in predicting deleterious cardiovascular outcomes.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251364482"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762111","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":"Clinical success of re-redo pulmonary valve and pulmonary trunk homograft replacement during the second trimester of pregnancy.","authors":"Ihor Krasivskyi, Christian Alan Origel Romero, Andrea Gieselmann, Eissa Alaj, Farhad Bakhtiary, Kaveh Eghbalzadeh","doi":"10.1177/02676591251366419","DOIUrl":"https://doi.org/10.1177/02676591251366419","url":null,"abstract":"<p><p><i>Introduction:</i> Mechanical valve thrombosis in pregnancy is a rare but critical condition requiring precise management.<i>Case Description:</i> This report describes a successful re-redo pulmonary valve and truncus pulmonalis replacement using a homograft in a 30-year-old patient at 18 + 0 weeks gestation. Despite initial management with anticoagulation therapy, no improvement was noted. An interdisciplinary heart team determined that surgical intervention was the only option after the failure of conservative treatment. Pulmonary artery graft with pulmonary valve replacement using homograft was performed successfully using beating-heart technique.<i>Conclusion:</i> Emphasizing a \"beating heart\" technique and optimized cardiopulmonary bypass (CPB) parameters, this case demonstrates that surgical intervention can serve as an ultima ratio therapy when conservative treatments fail.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251366419"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765733","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":"Temporal trends and risk factors for bleeding and thrombosis in pediatric ECMO: A multicenter cohort study.","authors":"Kevin J Doré, Carlton M Kelly, Timothy T Cornell, Lindsey K Rasmussen, Shelby Burk, Laura L Loftis, Christine Allen, Melania M Bembea, Brian M Boville, Jamie Furlong-Dillard, Santosh Kaipa, Bridget Norton, Heather Viamonte, Linda Wallenkamp, Ahmed Said, Marie E Steiner, Matthew P Malone, Aaron Kline, Daniel Tawfik","doi":"10.1177/02676591251365417","DOIUrl":"https://doi.org/10.1177/02676591251365417","url":null,"abstract":"<p><p>IntroductionBleeding and thrombosis are major causes of morbidity and mortality in pediatric extracorporeal membrane oxygenation (ECMO), yet their evolving, time-dependent risks remain poorly defined. This study evaluated clinical predictors of bleeding and thrombotic events using time-to-event analysis.MethodsA retrospective cohort study was conducted using the Pediatric ECMO Outcomes Registry (PEDECOR) from October 2011 to September 2024. Patients aged ≤18 years undergoing their first ECMO run were included. Two time-varying Cox proportional hazards models assessed associations between prior complications and time to first bleed or thrombosis, adjusting for clinical and ECMO-related variables.ResultsAmong 1444 patients, median age was 0.4 years (IQR: 0.0-4.4), and 53.6% were male. Bleeding occurred in 65% and thrombosis in 28%. Time to first bleeding events had a median of 2 days (IQR: 0-4) while time to first thrombosis had a median of 3 days (IQR: 2-6). Prior thrombosis was associated with lower early bleeding risk (HR: 0.39, 95% CI: 0.25-0.62, <i>p</i> < 0.001), which reversed over time (interaction HR: 1.44, 95% CI: 1.08-1.92, <i>p</i> = 0.013; crossover at 12.4 days). Similarly, prior bleeding was associated with reduced early thrombosis risk (HR: 0.49, 95% CI: 0.34-0.71, <i>p</i> < 0.001), but reversed over time (interaction HR: 1.63, 95% CI: 1.26-2.11, <i>p</i> < 0.001; crossover at 4.3 days). Central cannulation, cardiac surgery, and non-pulmonary indications were associated with bleeding; sepsis was associated with thrombosis. Anticoagulant type and sex were not significant.ConclusionsBleeding and thrombosis are common and time-dependent in pediatric ECMO. These findings support dynamic anticoagulation strategies tailored to evolving risk.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251365417"},"PeriodicalIF":1.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755007","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":"An initiative to reduce blood stream infections (BSI) in patients on ECMO.","authors":"Adeeb Khan, Mohammed Abraar Quraishi, Anthony Hume, Kurt Osterby, Paula Fanning, Paul Campbell","doi":"10.1177/02676591251360914","DOIUrl":"https://doi.org/10.1177/02676591251360914","url":null,"abstract":"<p><p>IntroductionBlood Stream Infections (BSI) occur in 3-35% of patients on ECMO (Extracorporeal membrane Oxygenation). With the increased use of ECMO since the COVID-19 pandemic, the magnitude of this problem has increased. There are no clear established practice guidelines for BSI prevention on ECMO.MethodsSingle center retrospective study. Data collected for adult and pediatric ECMO patients between the ages of 0-82 years between January 2017 - December 2023. Outcomes from patients before and after we implemented our ECMO-specific BSI prevention bundle in February 2021. This bundle includes two person ECMO cannula and central line dressing changes, daily chlorhexidine (CHG) bathing of the entire tubing of the ECMO circuit, including the hubs and connectors and avoiding prophylactic antibiotic use.Results142 admissions for ECMO and ECPR during the study period were evaluated. 110 admissions were finally included for data analysis after 32 met exclusion criteria. 47 patients included from the preintervention and 63 in the post-intervention periods. The difference in BSI per admission between the preintervention and postintervention groups was statistically significant (<i>p</i> = .0003). The mean BSI rate was 0.468 in the preintervention group and 0.0159 in the post intervention group. Mortality showed a trend towards statistical significance (p = .082). There were no statistical differences in age, sex of the patient, body mass index (BMI), CRRT/AKI use/incidence, type of ECMO (VV or VA), presence of COVID-19 infection, and duration of ECMO.ConclusionsThe introduction of an ECMO-specific BSI reduction bundle resulted in a greater than 10-fold reduction in BSI. There was a trend towards statistically significant improvement in mortality between the two groups. We believe that this intervention is implementable at other hospitals.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251360914"},"PeriodicalIF":1.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755005","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":"Re-evaluating the association between thrombocytopenia and bleeding in extracorporeal membrane oxygenation (ECMO).","authors":"Albert Leng, Hannah Rando, Manuj Shah, Armaan Akbar, Benjamin Shou, Andrew Kalra, Sung-Min Cho, Glenn J R Whitman","doi":"10.1177/02676591251364481","DOIUrl":"https://doi.org/10.1177/02676591251364481","url":null,"abstract":"<p><p>ObjectivesThe platelet trigger at which to transfuse platelets to prevent bleeding complications in patients supported with extracorporeal membrane oxygenation (ECMO) is unclear. We aimed to elucidate the association between platelet count and bleeding sequelae in this patient population.MethodsWe conducted a single-center retrospective study of all adult patients who received ECMO support from 2017 to 2022. Patients were stratified into two groups: \"non-thrombocytopenic\" (>30 × 10³ cells /μL) versus \"thrombocytopenic\" (≤30 × 10³ cells /μL). Multivariable logistic regression was used to determine the association between thrombocytopenia and bleeding complications; covariates were selected a priori. A post-hoc analysis investigating platelet transfusion status and nadir platelet count as an ordinal variable was also performed.ResultsOf 291 VV- and VA-ECMO patients, 69 (24%) were categorized as \"thrombocytopenic\" and 144 (50%) experienced at least one major bleeding event. Compared to \"non-thrombocytopenic\" patients, \"thrombocytopenic\" patients were more likely to be male (<i>p</i> = 0.049), to require veno-arterial central canulation (<i>p</i> < 0.001), and to have been on dialysis (<i>p</i> < 0.001). Confounded by a 72% prophylactic transfusion rate, \"Thrombocytopenia\" was not associated with an increased risk of major bleeding (aOR: 0.59 [95% CI: 0.31-1.10]). However, in patients with a nadir platelet count between 31 and 50 × 10³ cells/μL, the 63% with a prophylactic platelet transfusion had a significant reduction in major bleeding complications (<i>p</i> = 0.003).ConclusionsOur findings suggest that a platelet transfusion trigger of ≤50 × 10³ cells/μL is of benefit for prophylaxis against bleeding during ECMO support.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251364481"},"PeriodicalIF":1.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755006","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":"Veno-arterial extracorporeal membrane oxygenation support for cardiogenic shock secondary to immune checkpoint inhibitors.","authors":"Quynh Nguyen, Hossein Shayan","doi":"10.1177/02676591251363379","DOIUrl":"https://doi.org/10.1177/02676591251363379","url":null,"abstract":"<p><p>IntroductionTremelimumab in combination with Durvalumab has recently been approved for the treatment of unresectable hepatocellular carcinoma (HCC). While immune checkpoint inhibitors (ICIs) have transformed cancer therapy, they are associated with rare but potentially fatal immune-related adverse events, including myocarditis.Case reportWe report a case of fulminant myocarditis in a 66-year-old female with advanced HCC, 38 days after initiating the Tremelimumab/Durvalumab STRIDE protocol. She presented with cardiogenic shock requiring V-A ECMO support. High-dose corticosteroid therapy resulted in full recovery of cardiac function.DiscussionICI-associated myocarditis has a reported prevalence of 1.14%, with a high rate of major adverse cardiac events. We reported a case of Tremelimumab/Durvalumab-associated myocarditis requiring mechanical circulatory support. Prompt recognition and immunosuppression were critical for recovery.ConclusionClinicians should maintain a high index of suspicion for myocarditis in patients on ICI therapy, as early intervention can be lifesaving.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251363379"},"PeriodicalIF":1.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734942","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":"Blood ionized calcium concentration following administration of fresh frozen plasma, platelet concentrates and calcium chloride solution during modified ultrafiltration in cardiac surgery for neonates and infants.","authors":"Kouki Fukuda, Tatsuhiko Masue","doi":"10.1177/02676591251363377","DOIUrl":"https://doi.org/10.1177/02676591251363377","url":null,"abstract":"<p><p>IntroductionDuring neonatal and infant cardiac surgery, rapid transfusion of fresh frozen plasma (FP) and platelet concentrates (PC), with simultaneous removal of excess water, are performed during modified ultrafiltration (MUF), to raise plasma fibrinogen concentration and platelet counts. Although calcium is administered to treat citrate transfused during this procedure, the appropriate dose of calcium relative to transfusion volume is unknown.MethodsThis retrospective study included neonates (babies under 28 days of age) and infants (babies from 28 days old to less than 1 year old) who underwent MUF during cardiac surgery at our institution in 2 years. Blood ionized calcium concentration ([Ca²⁺]) at the end of cardiopulmonary bypass (CPB) (T₀), end of administration of FP, PC and CaCl₂ during MUF (T₁), and chest closure (T₂) were analyzed. Volumes of FP and PC and dose of CaCl₂ administered between T₀ and T₁ and between T₁ and T₂ were examined.ResultsEight neonates and 45 infants were included. Regression equations for the total transfusion volume (mL) of FP & PC (y) relative to supplemented dose CaCl₂ (mg) (x) were as follows: y = 1.00*x (<i>r</i>² = 1.00, <i>p</i> < .001) during MUF, and y = 1.05*x (<i>r</i>² = 0.76, <i>p</i> < .001) after MUF. Blood ionized calcium concentrations ([Ca²⁺]) were within the normal range at both T₁ (end of transfusion during MUF) and T₂ (chest closure).ConclusionsAdministering 20 mg CaCl₂ per 20 mL of FP & PC maintains adequate [Ca²⁺] levels at T₁ and T₂ during cardiac surgery in neonates and infants.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251363377"},"PeriodicalIF":1.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734941","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 proposed clinical guide to delivering Lower Extremity Extracorporeal Distal Revascularization (LEEDR) as a bridge to definitive care in acute limb ischemia.","authors":"May Dvir, Grzegorz Jodlowski, David P Stonko, Rebecca Treffalls, Jack Nelson, Patrick F Walker, Jonathan J Morrison","doi":"10.1177/02676591251363374","DOIUrl":"https://doi.org/10.1177/02676591251363374","url":null,"abstract":"<p><p>IntroductionLower Extremity Extracorporeal Distal Revascularization (LEEDR) is a novel, preclinically tested technique designed to provide temporary limb perfusion in cases of acute limb ischemia when immediate revascularization is not feasible.MethodsLEEDR employs an extracorporeal pump and circuit to draw arterial blood from a proximal inflow site and deliver it to an outflow artery within the ischemic limb. The system is designed for bedside initiation using percutaneous access.ResultsALI from embolism, thrombosis, or trauma rapidly leads to irreversible tissue damage. Delays in revascularization are associated with high rates of limb loss and systemic complications. LEEDR offers a time-sensitive intervention aimed at mitigating these risks and preserving limb viability until definitive treatment is available.ConclusionLEEDR is a promising temporary perfusion strategy for limb salvage in ALI. This manuscript outlines its procedural components, technical considerations, and anticipated role in bridging patients to definitive revascularization.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251363374"},"PeriodicalIF":1.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709698","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":"Factors associated with acute kidney injury in patients on extracorporeal membrane oxygenation support: A retrospective cohort study.","authors":"Henry Robayo-Amortegui, Michel Pérez-Garzón, Alex Forero-Delgadillo, Natalia Valezuela-Faccini, Mariam Baghdoust-De la Peña, Claudia Poveda-Henao, Alirio Bastidas-Goyes, Mario Mercado-Diaz","doi":"10.1177/02676591251360900","DOIUrl":"https://doi.org/10.1177/02676591251360900","url":null,"abstract":"<p><p>IntroductionAcute kidney injury (AKI) is prevalent in critically ill patients, especially in those needing extracorporeal membrane oxygenation (ECMO) due to cardiogenic shock or acute respiratory distress syndrome. The incidence of AKI in this patient population varies from 26% to 85%. This study explored the factors associated with AKI after the initiation of ECMO in the intensive care unit (ICU).MethodsA retrospective cohort study was conducted, including patients aged 18 years and above undergoing veno-arterial or veno-venous ECMO between 1 January, 2020 and 1 May, 2023.ResultsA total of 267 patients undergoing ECMO were included in this study. The development of AKI was associated with the use of vasopressors, specifically norepinephrine (odds ratio [OR]: 3.7, 95% confidence interval [95% CI]: 1.65-8.14) and vasopressin (OR: 2.5, 95% CI: 1.49-4.30).The protective factors included heparin use (OR: 0.51, 95% CI: 0.26-0.97) and the absence of vasopressors (OR: 0.39, 95% CI: 0.17-0.77).ConclusionsAKI poses a significant concern in critically ill patients undergoing ECMO. Multiple risk factors were identified, including vasopressor use and ECMOrelated complications. Identifying risks and protective factors is crucial for optimising ECMO management to reduce complications and mortality risk. Further studies are needed to understand the exact mechanisms of AKI during ECMO, which can inform the development of new targeted intervention checkpoints to improve outcomes in critically ill patients undergoing ECMO.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251360900"},"PeriodicalIF":1.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651061","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":"Time-dose response of oxygen delivery during cardiopulmonary bypass in mitral valve surgery: does surgical approach matter?","authors":"Maximilian Reisinger, Mateusz Kachel, Chunhui Wang, Luigi Pirelli, Arnar Geirsson, Michael Argenziano, Paul Kurlansky, Christine Chan, Kenmond Fung, James Beck, Isaac George","doi":"10.1177/02676591251361358","DOIUrl":"https://doi.org/10.1177/02676591251361358","url":null,"abstract":"<p><p>IntroductionIncreased time-dose-response (TDR) of suboptimal oxygen delivery (DO₂) during cardiopulmonary bypass (CPB) has been associated with increased postoperative complications. The impact of surgical approach - minimally invasive vs. median sternotomy - on TDR during mitral valve surgery has not been studied.MethodsAll patients that underwent isolated mitral valve surgery at our institution between 05/2018-06/2024 were included. Perfusion variables were collected continuously (second-to-second) during CPB with a threshold of DO₂ index <300 mL O₂/min/m₂ (DO₂i^<300) to quantify depth and duration of insufficient oxygen supply. The primary outcomes used for analysis were maximum and total TDR of DO₂i^<300. Logistic regression was used to assess the relationship of TDR with surgical outcomes.ResultsA median sternotomy and right minithoracotomy was performed in 377 (84.1%) and 74 (15.9%) patients, respectively. The maximum and total cross-clamp (XC) TDR of DO₂i^<300 (577.7 vs. 91.7 AUC<300 mL O₂/min/m², <i>p</i><0.0001; 1116.0 vs. 143.1 AUC<300 mL O₂/min/m², <i>p</i><0.0001) and post-XC TDR of DO₂i^<300 (472.4 vs. 281.0 AUC<300 mL O₂/min/m², <i>p</i>=0.0004; 606.5 vs. 334.4 AUC<300 mL O₂/min/m², <i>p</i><0.0001) were significantly higher with a right minithoracotomy. Total post-XC TDR of DO₂i^<300 was independently associated with postoperative AKI (OR: 1.271, CI: 1.01-1.6, <i>p</i>=0.0413).ConclusionsA right minithoracotomy approach was associated with an increased TDR of DO₂i^<300. Post-XC TDR of DO₂i^<300 was independently associated with postoperative AKI. These findings highlight the importance of goal-directed-perfusion and the pivotal role of perfusionists in minimally invasive mitral valve surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251361358"},"PeriodicalIF":1.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644007","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}