Perfusion-Uk最新文献

{"title":"Comparative efficacy of leukocyte removal by blood filters in autologous cell salvage.","authors":"Mark Alm, Natasha Bush, Alisa Maznytsya, Mary Dooley, Laura Dell'aiera, Stuart A McCluskey, Mark Vallelonga","doi":"10.1177/02676591261485073","DOIUrl":"https://doi.org/10.1177/02676591261485073","url":null,"abstract":"<p><p>BackgroundAutotransfusion devices concentrate white blood cells (WBCs) within the washed product that may lead to undesirable clinical effects when reinfused to the patient. This quality improvement project evaluated the leukocyte removal efficacy of three types of salvaged blood filters in autologous cell salvage.MethodsUsing a prospective observational cohort approach, we evaluated microaggregate, lipid-reducing, and leukocyte-reducing salvaged blood filters in adult patients undergoing surgery with autologous cell salvage. Filters were evaluated one after another, with samples of processed autologous blood collected prior to filtration and again after 30 mL had passed through each type of filter to allow for direct comparison of each filter's effects on WBC concentrations.ResultsSalvaged blood samples were collected from 35 patients. Median pre-filtration WBC count was 9.8 [6.8-13.3] × 10⁹/L, being reduced to 9.3 [6.6-12.6] × 10⁹/L after microaggregate filtration (1.7 [-0.6-4.6]% removal), 0.8 [0.5-2.5] × 10⁹/L after lipid filtration (89.7 [83.3-93.9]% removal), and 0.0 [0.0-0.0] × 10⁹/L after leukocyte filtration (100 [100-100]% removal). The microaggregate filter achieved significantly less WBC reduction than both the leukocyte-reducing filter (<i>p</i> < 0.0001) and lipid-reducing filter (<i>p</i> < 0.0001). There was no significant difference observed between the leukocyte-reducing and lipid-reducing filters (<i>p</i> = 0.3124).ConclusionsLeukocyte- and lipid-reducing filters were effective at reducing WBCs from processed autologous blood by nearly 10-fold, while microaggregate filters were significantly less effective at removing leukocytes. Use of leukocyte- or lipid-reducing filters minimizes the number of activated WBCs reinfused to the patient during autologous cell salvage.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485073"},"PeriodicalIF":1.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946056","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":"Hypotension during cardioplegia: a cardiac depressor reflex?","authors":"Michael W Vespe, Marc E Stone","doi":"10.1177/02676591261485080","DOIUrl":"https://doi.org/10.1177/02676591261485080","url":null,"abstract":"<p><p>Profound, transient hypotension refractory to α₁-agonists and increased bypass flow during cardioplegia administration (intermittent vasoplegia) is a well-recognized yet unexplained phenomenon in cardiac surgery. Retrograde cardioplegia has been shown to cause profound hypotension with greater frequency than antegrade administration despite identical formulations, ischemic intervals, and perfusion parameters. It seems plausible that the link between cardioplegia administration to the arrested heart and the intermittent vasoplegic systemic response may result from a vagally mediated cardiac depressor reflex.Electrophysiologic and histologic studies have identified multiple vagal receptors within the ventricular myocardium and coronary vasculature that, when stimulated, produce a centrally mediated and prolonged withdrawal of efferent sympathetic activity to the systemic vasculature. During antegrade cardioplegia, hypotension most likely arises from activation of left ventricular chemoreceptors terminating in the inferoposterior wall. These afferents respond to endogenous mediators of ischemia and reperfusion such as bradykinin and prostaglandins.In contrast, the depressor reflex observed during retrograde cardioplegia likely arises from vagal afferent ventricular mechanoreceptors. In the arrested, decompressed heart, only 20-33% of retrograde cardioplegia traverses the capillaries, while the remainder is shunted through the Thebesian system. The resulting surge in coronary venous pressure causes distension that is easily transmitted to the surrounding interstitial space, creating the mechanical effects of grossly elevated end-diastolic pressure and pathological myocardial stretch despite the absence of true ventricular filling and wall tension.If the intermittent vasoplegic response to cardioplegia is viewed within the mechanistic framework of a vagally mediated depressor reflex, the optimal intervention to mitigate prolonged hypotension may not be stronger vasopressors (e.g., norepinephrine or vasopressin), but rather the inclusion of lidocaine in the microplegia additive. Lidocaine is known to markedly attenuate reflex vasodepressor responses through the blockade of sodium channels in nerve fibers.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485080"},"PeriodicalIF":1.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907864","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 rewarming rate during cardiopulmonary bypass and postoperative delirium in patients receiving olanzapine after cardiac surgery: A retrospective cohort study.","authors":"Dan Dan Xu, Shuang Xu, XinYu Zhu, Lei Wang, Yun Wang, Jie Shi","doi":"10.1177/02676591261487331","DOIUrl":"https://doi.org/10.1177/02676591261487331","url":null,"abstract":"<p><p>BackgroundThe relationship between rewarming rate during cardiopulmonary bypass (CPB) and postoperative delirium (POD) in cardiac surgery remains unclear. This retrospective study aimed to evaluate whether rapid rewarming is associated with an increased risk of POD.MethodsA total of 548 adult cardiac surgery patients (January 2021-December 2023) were enrolled. POD was identified through medical record review based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)criteria or documented delirium symptoms combined with olanzapine use (serving as a surrogate marker). Rewarming rate was defined as the average temperature increase per minute from the lowest nasopharyngeal temperature during CPB to 36.5°C, calculated as (36.5°C - lowest temperature)/rewarming time (min). Multivariable logistic regression and ROC analysis were performed.ResultsRewarming rate was significantly higher in the POD group (<i>n</i> = 300) than the non-POD group (<i>n</i> = 248) (0.095 ± 0.044 vs 0.072 ± 0.034°C/min, <i>p</i> < 0.001). Olanzapine dosage (18.5 ± 8.2 mg vs 0 mg) and duration (4.2 ± 2.1 days vs 0 days) in the POD group showed significant positive correlations with rewarming rate (r = 0.887 and r = 0.814, respectively, both <i>p</i> < 0.01). Rewarming rate (OR = 1.782), red blood cell transfusion (OR = 1.456), CPB duration (OR = 1.023), and mean CVP (OR = 1.156) were identified as independent risk factors for POD (all <i>p</i> < 0.05). The predictive model achieved an AUC of 0.775 (95% CI: 0.736-0.814).ConclusionsRapid rewarming during CPB is associated with increased POD risk and may be a modifiable perioperative factor. Prospective studies with standardized POD screening are warranted to validate these findings.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261487331"},"PeriodicalIF":1.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892751","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":"Hospital frailty risk score and 90-day mortality in patients receiving venoarterial extracorporeal membrane oxygenation.","authors":"Leon Fan, Yiting Lin, Ernesto Marin, Beichen Shen, Annie Wang, Baiyue Zhao, Glenn J R Whitman, Sung-Min Cho","doi":"10.1177/02676591261485086","DOIUrl":"https://doi.org/10.1177/02676591261485086","url":null,"abstract":"<p><p>BackgroundFrailty is increasingly recognized as a key determinant of outcomes in critically ill patients, yet its utility among patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO) remains unclear. We evaluated the hospital frailty risk score (HFRS) as a risk factor of 90-day mortality in VA ECMO patients.MethodsWe conducted a retrospective analysis of VA ECMO patients at Johns Hopkins Hospital from 2016 to 2024. HFRS was derived from ICD-10 codes. An optimal frailty cut point was determined using maximally selected rank statistics, and patients were subsequently stratified into high (>10) and low (<=10) frailty groups. Cox proportional hazards models evaluated the association between frailty and mortality, adjusting for demographics, comorbidities, and clinical variables.Results180 patients receiving VA ECMO were included (median age:53 years, 46.2% female). Overall, 25 patients (13.9%) were classified as high frailty (HFRS >10) and 155 (86.1%) as low frailty (HFRS≤10). Of the 180 patients, 80 patients survived 90-days following initial ECMO cannulation. Median HFRS was higher among non-survivors (4.9 vs 3.4), with a greater proportion classified as high frailty (18.0% vs 8.8%). In multivariable Cox regression adjusting for demographics, comorbidities, and clinical covariates, low HFRS remained independently associated with reduced 90-day mortality (HR=0.47, 95% CI 0.26-0.87, p=0.017), while obesity (HR=10.44) and older age (HR 1.02) were independently associated with increased mortality.ConclusionHFRS is independently associated with 90-day mortality in patients undergoing VA ECMO. Incorporating frailty into pre-ECMO evaluation may enhance prognostication and inform patient selection and clinical decision-making.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485086"},"PeriodicalIF":1.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888731","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":"Scar-specific outcomes following minimally invasive versus conventional median sternotomy in cardiac surgery: A systematic review and meta-analysis.","authors":"Karanjot Chhatwal, Anthony On Chun Siu, Sammy Arab, Ahmed Salih, Aishwarya Shah, Arian Arjomandi Rad, Gordon Lap Wai Chong, Monjur Showkat, Sangeeta Punjabi, Prakash Punjabi","doi":"10.1177/02676591261452059","DOIUrl":"10.1177/02676591261452059","url":null,"abstract":"<p><p>BackgroundWith improved cardiac surgical outcomes, attention has shifted to patient-centred outcomes, including cosmetic appearances of surgical scars. Minimally invasive cardiac surgery (MICS) is often promoted for its cosmetic benefits, yet empirical evidence remains limited. This study aimed to systematically evaluate scar-specific outcomes comparing MICS to conventional full median sternotomy (FMS) in adult cardiac surgery.MethodsA systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed, Embase, Central, and Scopus were searched from inception to August 2025. Studies comparing MICS to FMS, reporting scar-related patient-reported outcomes, wound complications, or cosmetic satisfaction, were included. The primary outcome was scar assessment using validated instruments. Random-effects models calculated standardised mean differences (SMD) and risk ratios (RR) with 95% confidence intervals.ResultsTwenty-two studies comprising 3131 patients (1459 MICS, 1672 FMS) met inclusion criteria. MICS demonstrated significantly better scar assessment scores (SMD -0.74, 95% CI -1.27 to -0.22; p < 0.01; I² = 88%, six studies), higher patient satisfaction rates (RR 1.42, 95% CI 1.21-1.66; p < 0.001; I² = 84%, 12 studies), and reduced wound complications (RR 0.31, 95% CI 0.20-0.47; p < 0.001; I² = 0%, nine studies). Only six studies reported validated scar assessment scores, highlighting limited integration of these measures. Substantial heterogeneity was observed due to diverse assessment tools and surgical techniques.ConclusionsMICS can offer significant advantages in scar-specific outcomes compared to FMS in carefully selected patient populations. Cosmetic outcomes should be interpreted within the context of overall effectiveness and may support shared decision making only when clinical outcomes between surgical approaches are comparable. The lack of standardised scar assessment protocols and limited reporting of cosmetic outcomes represent critical gaps. Future research should prioritise standardised scar evaluation tools and expand cosmetic outcome reporting across all cardiac surgical procedures.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"814-828"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206314","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":"Novel use of negative pressure ventilation for weaning of venovenous extracorporeal membrane oxygenation.","authors":"Adam Green, Sandhya Ashokkumar, Nafisa Wadud, Ben Feng, Nitin Puri, Jason Bartock","doi":"10.1177/02676591251388793","DOIUrl":"10.1177/02676591251388793","url":null,"abstract":"<p><p>Negative pressure ventilation (NPV) has been used to assist patients with respiratory failure. Venovenous extracorporeal membrane oxygenation (V-V ECMO) supports patients with acute lung injury who do not respond to conventional therapy. Some patients remain on prolonged ECMO support without access to lung transplantation. We report a 40-year-old woman cannulated for V-V ECMO due to refractory hypoxemia (PaO₂/FiO₂ of 58) on hospital day 20 for ARDS from bacteremia and native mitral valve endocarditis. After 108 days, she continued to require ventilator and ECMO support. Applying a negative-pressure Cuirass device in combination with positive pressure ventilation (PPV) improved her carbon dioxide clearance, enhanced overall ventilation/perfusion matching, and facilitated decannulation. Using NPV to assist in V-V ECMO weaning is a novel application of a legacy technology. This case shows NPV as an effective adjunct to PPV for patients on prolonged ECMO support with no other options.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1065-1067"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309807","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":"VV-ECMO as a lifesaving measure for refractory bronchospasm in anaphylactic shock: A case report.","authors":"Juan P Garcia-Mendez, Troy G Seelhammer, Patrick M Wieruszewski, Erica D Wittwer, Juan G Ripoll","doi":"10.1177/02676591251385891","DOIUrl":"10.1177/02676591251385891","url":null,"abstract":"<p><p>Refractory anaphylaxis is rare but carries high mortality, particularly when complicated by severe bronchospasm and respiratory failure. We present a 32-year-old individual with food-induced anaphylaxis and profound bronchospasm unresponsive to first- and second-line therapies, resulting in severe hypoxemic and hypercapnic respiratory failure despite mechanical ventilation. Peripheral venovenous extracorporeal membrane oxygenation (VV-ECMO) was emergently initiated, leading to rapid stabilization and full recovery. This case demonstrates the successful use of VV-ECMO as a life-saving bridge in anaphylaxis-induced respiratory failure. This is one of the few reported cases of successful use of VV-ECMO for refractory bronchospasm secondary to anaphylaxis.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1068-1071"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193749","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":"Impact of changes in cardiopulmonary bypass circuit design on pressure loss, wall shear stress, and venous drainage flow.","authors":"Noriaki Sakai, Takuya Ishigami, Naoto Hagino, Taisei Yamaguchi, Miho Takimoto, Tomoyuki Goto, Masafumi Matsumura","doi":"10.1177/02676591251388335","DOIUrl":"10.1177/02676591251388335","url":null,"abstract":"<p><p>IntroductionBlood damage during cardiopulmonary bypass can trigger postoperative inflammatory responses and organ injury. Therefore, optimizing the blood circuit design to minimize damage remains essential. However, variations in venous drainage circuit configurations persist across facilities, and standardization remains limited.MethodsHerein, we conducted computational fluid dynamics (CFD) analysis using the finite volume method to investigate the influence of venous drainage circuit shape on pressure loss, wall shear stress (WSS), and venous drainage flow. The circuit inner diameter (8-14 mm) and branching angle (20°-160°) varied, while the head pressure was set at -70 cmH₂O.ResultsThe venous drainage flow decreased as the branching angle increased, although not significantly. The pressure loss increased at higher flow rates, with a more pronounced effect when the inner diameter was reduced. Similarly, the WSS increased with both higher flow rates and smaller inner diameters, suggesting an elevated risk of blood damage. Multiple regression analysis identified venous drainage flow and circuit inner diameter as the primary determinants of WSS. Moreover, an inner diameter of 12 mm was determined to be optimal, as it effectively maintained venous drainage, while minimizing pressure loss and reducing the WSS.ConclusionsAppropriate selection of circuit inner diameter is critical for mitigating the risk of blood damage, while ensuring the necessary venous drainage flow (∼7.0 L/min) for cardiopulmonary bypass in adults. These findings may facilitate the standardization and optimization of cardiopulmonary bypass circuit designs, thereby advancing safer cardiopulmonary support technologies.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"928-936"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259427","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":"Preparation of a cardiopulmonary bypass priming solution for infants and neonates - effect of pre-bypass ultrafiltration on heparinization.","authors":"Paul G Davies, Suelyn Van Den Helm, Natasha Letunica, Shannon Morrison, Ben Davies, Igor Konstantinov, Stephen Horton, Stephen Bottrell, Andrew Davidson, Vera Ignjatovic, Paul Monagle, Chantal Attard","doi":"10.1177/02676591251394850","DOIUrl":"10.1177/02676591251394850","url":null,"abstract":"<p><p>IntroductionHeparin is usually added to infant cardiopulmonary bypass circuit primes. Ultrafiltration is often used to minimise prime volume before commencing bypass. The extent of heparin removal from bypass primes by ultrafiltration is unknown, however at our institution it was assumed that heparin is freely filtered. The primary aim of this study was to investigate heparin removal during pre-bypass ultrafiltration of a bypass prime for infants. The secondary aim was to investigate the effect of pre-bypass ultrafiltration on heparinization of the patient shortly after commencing bypass.MethodsPatients under 1 year of age having cardiopulmonary bypass were enrolled. Prime solutions contained red blood cells, albumin, PlasmaLyte and 3 IU/ml heparin prior to pre-bypass ultrafiltration. Patient blood samples were collected before and after commencing bypass along with samples of the filtrate and the priming solution. Anti-Xa and antithrombin levels were measured by chromogenic assay.ResultsNineteen patients were enrolled. Patient weight ranged from 2.4 kg to 7.7 kg. Anti-Xa in the filtrate was 0.94 IU/ml (IQR 0.84 to 1.06 IU/ml). Anti-Xa in the primes was 6.80 IU/ml (IQR 6.68 to 7.84 IU/ml). Anti-Xa once on bypass was 3.31 IU/ml (IQR 2.08 to 4.46 IU/ml). Antithrombin level on bypass was 38 % (IQR 26 to 57 %). On bypass anti-Xa level was associated with patient weight and antithrombin level but not with activated clotting time.ConclusionsHeparin is not freely filtered from the prime, leading to more heparin being present in the prime than desired. Anti-Xa levels on commencing bypass appear to be predictably influenced by hemodilution such that the gap between total heparin present and anti-Xa activity is wider in smaller patients. The activated clotting time does not differentiate lower levels of anti-Xa activity in the setting of extreme haemodilution.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"900-908"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423299","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":"Prosthetic valve thrombosis on venoarterial extracorporeal membrane oxygenation support: Risk factors and outcomes.","authors":"Berhane Worku, Camilla Rossi, Nabeel Sami, Ivancarmine Gambardella, Sandhya Balaram, Iosif Gulkarov, Charles Mack, Mohit Aspal, Monika Tukacs, Yoshifumi Naka, Ankur Srivastava","doi":"10.1177/02676591251393361","DOIUrl":"10.1177/02676591251393361","url":null,"abstract":"<p><p>IntroductionIn patients with prior valve replacement requiring venoarterial extracorporeal membrane oxygenation (VA ECMO), there is a risk of prosthetic valve thrombosis (PVT) due to intracardiac stasis. We describe our experience with PVT in patients on VA ECMO.MethodsThis was a retrospective cohort study of patients with prior valve replacement undergoing VA ECMO. Patients who developed PVT on VA ECMO were compared to those who did not.ResultsForty-six patients who had prior valve replacement (total of 63 valves) were placed on VA ECMO. Six patients (13%) suffered PVT on VA ECMO. There was no difference in the rate of PVT in mitral versus aortic valve prostheses (22% [5/23] vs 3% [1/32]; <i>p</i> = .07) or between tissue and mechanical valves (16% [8/50] vs 0% [0/13]; <i>p</i> = .19). There were no differences in ECMO parameters, including site of cannulation (central vs peripheral), initial ECMO flow, time to initiation of anticoagulation, or use of a concomitant IABP between patients who did and did not develop PVT. Patients who developed PVT demonstrated significantly lower pulse pressures compared to those who did not (12.7 mmHg vs 32.7 mmHg; <i>p</i> = .03). Surgical thrombectomy was performed in three of the six patients with PVT and one survived to discharge.ConclusionPVT occurred in 13% of patients on VA ECMO after prior valve replacement. The only predictor of PVT on VA ECMO was a lower pulse pressure. Strategies to maintain intracardiac flow and pulsatility may reduce this risk. Treatment options are limited and pose significant risk, and therefore prevention is key.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"909-916"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427144","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}