Perfusion-Uk最新文献

{"title":"Successful rescue for anaphylactic shock due to sugammadex using extracorporeal cardiopulmonary resuscitation.","authors":"Soojin Lee, Ho Seong Cho, Seunghwan Song","doi":"10.1177/02676591261424676","DOIUrl":"https://doi.org/10.1177/02676591261424676","url":null,"abstract":"<p><p>IntroductionSugammadex (Bridion®, MSD, Seoul, Republic of Korea) is widely used for neuromuscular blockade reversal at the end of general anesthesia. We report a rare case of refractory cardiac arrest secondary to sugammadex-induced anaphylaxis, successfully managed with extracorporeal cardiopulmonary resuscitation.Case presentationA 44-year-old man with no history of cardiovascular disease underwent robotic-assisted partial nephrectomy for a renal mass; 3 min after sugammadex intravenous administration, the patient developed ventricular fibrillation. Advanced cardiac life support was initiated, and the extracorporeal membrane oxygenation (ECMO) team was activated. Venoarterial ECMO was initiated 37 min after cardiac arrest onset. The patient was successfully weaned off the ECMO the following day. During admission, intradermal and ergonovine provocation tests confirmed a hypersensitivity reaction to sugammadex and coronary artery spasm, respectively. The patient was discharged on postoperative day 71, without any neurological sequelae.ConclusionThis successful extracorporeal cardiopulmonary resuscitation (ECPR) in refractory perioperative cardiac arrest due to sugammadex-induced anaphylaxis, highlights that early ECMO team activation and rapid ECPR implementation may lead to favorable neurological recovery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"188S-190S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845204","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":"Prophylactic temporary mechanical circulatory support: The new paradigm in cardiac surgery.","authors":"Silvia Mariani, Gabor Bari, Paolo Meani, Alvaro Perazzo, Mariusz Kowalewski, Daniele Ronco, Matteo Matteucci, Giulio Massimi, Leonardo Salazar, Roberto Lorusso","doi":"10.1177/02676591261427298","DOIUrl":"https://doi.org/10.1177/02676591261427298","url":null,"abstract":"<p><p>BackgroundPost-cardiotomy cardiogenic shock (PCCS) remains one of the most lethal complications of cardiac surgery, with high in-hospital mortality despite major improvements in operative techniques, and intensive care management. Temporary mechanical circulatory support (tMCS) is widely applied as a rescue therapy for refractory PCCS. However, outcomes remain suboptimal, also due to delayed initiation after the onset of severe hemodynamic collapse and irreversible compromised end-organ states. This review summarizes current concepts of PCCS management and evaluates the emerging role of prophylactic tMCS within the framework of \"protected cardiac surgery\".MethodsA narrative review of the current international guidelines, expert consensus statements, and major observational studies addressing post-cardiotomy tMCS and prophylactic support strategies was carried out. Emphasis was placed on pathophysiology, indications, timing of support, and device selection.ResultsProphylactic tMCS has been applied in selected high-risk scenarios including acute coronary syndromes, acute valvular dysfunction, ventricular septal rupture, papillary muscle rupture, advanced heart failure requiring bridge-to-decision or to-transplant, or difficult and complex weaning from cardiopulmonary bypass. The concepts of preoperative (Type 1), planned intraoperative (Type 2), and unplanned early intraoperative (Type 3) protected cardiac surgery provide a practical framework for a timely evaluation and related action aiming at metabolic stabilization to reduce or prevent postoperative low cardiac output syndrome. Successful implementation depends on multidisciplinary Heart Team decision-making, advanced hemodynamic assessment, and tailored perfusion strategies as well as device selection also based on local resources and expertise.ConclusionsProphylactic tMCS represents a paradigm shift from reactive rescue therapy toward proactive cardio-circulatory protection in selected high-risk patients undergoing cardiac surgery procedures. While early observational data are encouraging, prospective trials, standardized risk stratification tools, and cost-effectiveness analyses are required to define its role in modern cardiac surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"66S-82S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845221","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":"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":"392-400"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","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":"Staged systemic hyperkalemia and deep hypothermia for myocardial protection in mini-thoracotomy reintervention: Preserving patency in post-CABG patent grafts.","authors":"Manoj Sadasivan, Rajesh M Ramankutty, Jecco Ani Babu, Nisha Joseph Pattani, Sari Sankaran Lilli, Jose Sasidharan Lilli, Aiswarya Mohan","doi":"10.1177/02676591251367870","DOIUrl":"10.1177/02676591251367870","url":null,"abstract":"<p><p>BackgroundTraditional cardioplegia strategies often fail in cases with patent coronary grafts due to continuous myocardial perfusion, this necessitates for alternate approaches such as systemic hyperkalemic cardiac arrest. During redo cardiac surgeries, a patent left internal mammary artery (LIMA) might prevent the heart from maintaining electrical cardiac arrest. Induced systemic hyperkalaemia is a novel approach to maintain cardiac electromechanical arrest.Case summaryWe report a case of 66 year-old male with a history of Post CABG for Triple vessel disease (TVD) who required mini-thoractomy for left atrial myxoma excision. Given the existence of patent coronary grafts, attaining cardiac arrest with standard cardioplegia was not possible, necessitating the use of systemic hyperkalaemia for myocardial arrest. The patient was placed on Femoro-femoral cardiopulmonary bypass (CPB) and cooled to 20°C. To induce myocardial arrest, multiple potassium boluses were delivered, totalling 120 mEq/L potassium chloride (KCl) over multiple stages. Despite high potassium levels (6.7 mEq/L in the third arterial blood gas), CPB was successfully weaned off, and the surgical recuperation went smoothly. This case highlights the complexities of myocardial protection in redo cardiac surgery and underscores the role of systemic hyperkalaemia, perfusion management, ultrafiltration, and careful electrolyte management in such high-risk settings. To the best of our knowledge this is the first documented case report of its kind internationally. While there are previous reports of left atrial myxoma excision in post-CABG patients, including those managed using ventricular fibrillation, this is the first reported case in which systemic hyperkalemia combined with deep hypothermia was successfully utilized via a mini-thoracotomy approach in a post-CABG patient with a patent LIMA graft, without the use of aortic cross-clamping or ventricular fibrillation.ConclusionThis case shows the complexities of myocardial protection in redo cardiac surgeries with patent grafts. The use of systemic hyperkalemia is a viable but challenging alternative to cardioplegia, requiring meticulous potassium management and close hemodynamic monitoring.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"478-484"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859853","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":"The role of the perfusionist in the extracorporeal life support management: An international survey.","authors":"Cristina Scoppa, Desiree Toscano, Maria Cristina Costa, Leen Vercaemst, Gerdy Debeuckelaere, Marta Velia Antonini, Giovanni Marchetto, Mirko Belliato, Roberto Lorusso, Justyna Swol, Silvia Mariani","doi":"10.1177/02676591261430620","DOIUrl":"https://doi.org/10.1177/02676591261430620","url":null,"abstract":"<p><p>BackgroundExtracorporeal Life Support (ECLS) services are characterised by variability in resource availability, specific expertise, device management and team organisation, especially regarding the role of perfusionists. This international survey aimed to investigate perfusionists' education, training and role within the ECLS team.MethodsThis is a descriptive, self-reporting, cross-sectional, voluntary, confidential international survey addressed to professionals involved in ECLS management, including perfusionists. The survey was distributed from April to August 2025 through congress, newsletter and social media platforms.ResultsA total of 178 ECLS centres submitted completed surveys. Most centres provided both cardiac and respiratory support (<i>n</i> = 153, 86%) for over 10 years (<i>n</i> = 117, 65.2%). Perfusionists, mainly holding a bachelor's degree (<i>n</i> = 77, 47.5%), were reported to be responsible for ECLS device in 87.1% (<i>n</i> = 155) of centres, including priming (<i>n</i> = 156, 87.6%), setting management (<i>n</i> = 123, 69.1%), circuit/membrane lung replacement (<i>n</i> = 151, 84%) and running the emergency hand-crank (<i>n</i> = 133, 74.7%); though roles were often shared with multidisciplinary teams. Perfusionists were reported as part of retrievals/transports teams by 81.5% (<i>n</i> = 145) of responders. Education practices were reported as heterogeneous, with limited periodic ECLS-specific training programs (monthly: <i>n</i> = 19, 10.7%; every 6 months: <i>n</i> = 48, 27%; yearly: <i>n</i> = 31, 17.4%; no continuous education provided: <i>n</i> = 55, 30.9%).ConclusionsThis international survey revealed marked variability in perfusionist education, training and roles within the ECLS teams, and related organization. Despite their technical responsibilities, a growing multidisciplinary collaboration is reshaping team dynamics. The absence of a standardized education remains a critical gap, requiring appropriate actions and planning by professional and scientific societies.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"39S-50S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845188","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":"Case report: Successful ECPR for drug-induced cardiac arrest.","authors":"Stanislav Shkolnyi, Viktoriia Matviichuk, Enes Lamaashy","doi":"10.1177/02676591261424673","DOIUrl":"https://doi.org/10.1177/02676591261424673","url":null,"abstract":"<p><p>IntroductionOne potential indication for ECPR is drug poisoning complicated by shock and severe cardiac failure. Over the past 3 years, only one case of in-hospital cardiac arrest due to poisoning was managed with ECPR at our center.Case reportThe patient was a 12-year-old girl with a body weight of 60 kg. She attempted suicide by ingesting molsidomine and cinnarizine tablets. Shortly after admission, she developed cardiac arrest, and ECPR was indicated. After 67 min of CPR, ECMO support was established. A pigtail catheter was subsequently inserted for left ventricular unloading. During treatment, the patient was converted to V-V ECMO due to the development of Harlequin syndrome. Finally, she was discharged from the hospital with a good neurological outcome.DiscussionRecent advances in ECPR highlight its potential role in the management of drug-induced cardiac arrest. Centers providing ECPR must be prepared for subsequent ECMO management, including the need for conversion to alternative ECMO configurations.ConclusionThe use of ECPR, particularly in cases of cardiac arrest caused by drug overdose, is justified and effective, as ECMO provides time for drug metabolism and subsequent organ recovery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"191S-197S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845282","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":"Hemodynamic monitoring during veno-venous extracorporeal membrane oxygenation: A scoping review.","authors":"Roberto Lorusso, Maria Elena De Piero, Silvia Mariani, Justine M Ravaux, Pasquale Nardelli, Jeffrey P Jacobs, Fabio Guarracino, Nicoló Patroniti, Bas C T van Bussel, Iwan C C van der Horst, Fabio Silvio Taccone, Silver Heinsar, Kiran Shekar, Michael H Yamashita, Nchafatso G Obonyo, Anna L Ciullo, Jordi Riera, Heidi Dalton, Anson Wang, Akram M Zaaqoq, Graeme MacLaren, Kollengode Ramanathan, Jacky Y Suen, Gianluigi Li Bassi, Kei Sato, John F Fraser, Giles J Peek, Rakesh C Arora","doi":"10.1177/02676591261429826","DOIUrl":"https://doi.org/10.1177/02676591261429826","url":null,"abstract":"<p><p>BackgroundIn adult patients receiving veno-venous Extracorporeal Membrane Oxygenation (VV ECMO), cardiovascular performance plays a critical role in determining oxygen delivery, organ perfusion and safe titration of extracorporeal support. Despite the increasing VV ECMO use, contemporary guidance on hemodynamic monitoring remains limited and largely experience-based. This scoping review aimed to map available basic and advanced monitoring approaches and to identify current evidence gaps.MethodsPubMed, EMBASE, and Cochrane CENTRAL were searched from inception until September 2025, along with reference lists of relevant articles. We included studies of any design reporting techniques, targets, or protocols for hemodynamic monitoring during VV ECMO.ResultsOf 465 records screened, 106 met inclusion criteria. No protocolized, evidence-based hemodynamic monitoring protocol specific to VV ECMO was identified. The available evidence was heterogeneous and mostly derived from physiologic studies or single-center observational cohorts. Findings were narratively synthesized across three domains: basic bedside monitoring, diagnostic/prognostic tools and advanced assessment of cardiopulmonary interaction. Across studies, no monitoring strategy consistently reduced time-to-wean or mortality. Observational data suggested that care bundles and multidisciplinary approaches may reduce complications. However, the risk of bias limits causal inference.ConclusionsDespite the complex interaction between native cardiovascular function and extracorporeal circulation, VV ECMO lacks consensus on evidence-based hemodynamic monitoring pathways. A pragmatic core monitoring bundle with tiered triggers for escalation is necessary. Future priorities include implementation models based on multidisciplinary teams, specific training, standardized bundles, and multicenter studies aimed to define right ventricular-centered targets to improve safety and clinical decision-making.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"95S-109S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845326","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":"Persistent asystole on extracorporeal life support following neonatal E-CPR: Considerations under hypothermia.","authors":"Xabier Freire-Gomez, Enrique Garcia-Torres, Javier Arias-Dachary, Rianseres Garcia-Benitez, Mayte Garcia-Maellas, Olga Ordoñez-Saez, Luisa Baron-Gonzalez de Suso, Imanol Tajuelo-Llopis, Clara Aymerich-de Franceschi, Sylvia Beld-Hofheinz","doi":"10.1177/02676591251415350","DOIUrl":"https://doi.org/10.1177/02676591251415350","url":null,"abstract":"<p><p>IntroductionPersistent asystole following restoration of mechanical circulation during extracorporeal cardiopulmonary resuscitation (E-CPR) is typically considered fatal. However, in profound hypothermia, electrical silence may not reflect irreversible myocardial injury.Case ReportA term neonate with severe meconium aspiration syndrome (MAS) was initially supported on veno-arterial ECMO at a regional hospital and transported to a tertiary ECMO facility. Following decannulation, she suffered cardiac arrest. Mechanical circulation was achieved after prolonged E-CPR with central cannulation, but the patient remained asystolic in the context of profound hypothermia (31.2°C). Electrical activity reappeared only after controlled rewarming to 33°C. She was discharged home on day 35 with a good long term neurological outcome.DiscussionNeonates are particularly prone to rapid hypothermia during resuscitation. Controlled rewarming is essential to determine cardiac viability before establishing futility.ConclusionUnder profound hypothermia, asystole after restoration of mechanical circulation does not preclude irreversible myocardial damage. Cautious rewarming is mandatory to assess myocardial prognosis.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"176S-178S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845124","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":"Hybrid venoarteriopulmonary extracorporeal membrane oxygenation for severe respiratory failure and refractory right ventricular injury: A case report.","authors":"Joseph M Brewer, Jordan Phillips, Obaid Ashraf, Clayne Benson, Mircea R Mihu, Laura V Swant, Marshall T Bell, Robert S Schoaps","doi":"10.1177/02676591251413741","DOIUrl":"https://doi.org/10.1177/02676591251413741","url":null,"abstract":"<p><p>IntroductionExtracorporeal membrane oxygenation (ECMO) provides lifesaving support for severe respiratory and cardiac failure. Hybrid modes such as venoarteriopulmonary (VAP) may be necessary when conventional modes fail to meet complex physiological demands.Case ReportA 31-year-old woman with dermatomyositis-associated interstitial lung disease developed severe respiratory failure. She was initiated on venovenous (VV) ECMO, later complicated by right ventricular injury (RVI) requiring conversion to venopulmonary (VP) ECMO, and ultimately required hybrid VAP ECMO for progressive RVI and cardiogenic shock while awaiting heart-lung transplantation. The unique cannulation configuration provided additional cardiorespiratory support and hemodynamic stabilization, which later enabled safe transfer for transplantation.DiscussionHybrid VAP ECMO may provide effective rescue support for patients with refractory RVI and respiratory failure despite VP ECMO, preserve a surgically naïve chest, avoid differential oxygenation, and serve as a bridge to combined heart-lung transplant.ConclusionHybrid VAP ECMO represents an effective salvage strategy and bridge-to-transplant in complex cardiopulmonary failure.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":"41 1_suppl","pages":"169S-172S"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845270","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":"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":"485-489"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","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}