Cardiac surgery-associated acute kidney injury is a common post-operative complication, mostly due to increasing oxidative stress. Recently, molecular hydrogen (H₂ gas) has also been applied to cardiac surgery due to its ability to reduce oxidative stress. We evaluated the potential effect of H₂ application on the kidney in an in vivo model of simulated heart transplantation. Pigs underwent cardiac surgery within 3 h while connected to extracorporeal circulation (ECC) and subsequent 60 min of spontaneous reperfusion of the heart. We used two experimental groups: T—pigs after transplantation and TH—pigs after transplantation treated with 4% H₂ mixed with air during inhalation of anesthesia and throughout oxygenation of blood in ECC. The levels of creatinine, urea and phosphorus were measured in plasma. Renal tissue samples were analyzed by Western blot method for protein levels of nuclear factor erythroid 2–related factor 2 (Nrf2), Kelch-like ECH-associated protein 1 (Keap-1), and superoxide dismutase (SOD1). After cardiac surgery, selected plasma biomarkers were elevated. However, H₂ therapy was followed by the normalization of all these parameters. Our results suggest activation of Nrf2/Keap1 pathway as well as increased SOD1 protein expression in the group treated with H₂. The administration of H₂ had a protective effect on the kidneys of pigs after cardiac surgery, especially in terms of normalization of plasma biomarkers to control levels.

Background and Objectives: The use of the HeartMate 3 (HM3) ventricular assist device (VAD) as a bridge to transplant is rising notably in pediatric patients with end-stage heart disease. This study reports a single-centre experience with the HM3 device in pediatric patients. Materials and Methods: We conducted a retrospective clinical data review (including procedural, perioperative and follow-up parameters) of pediatric patients (n = 5, aged 10–16 years) supported with HM3 VAD at our institution between January 2022 and October 2025. Results: During this period, five pediatric patients (median age of 13 years [range 10–16, IQR 10–14.5]; median weight of 41.5 kg [24–75 IQR 32–62]) underwent HM 3 implantation. The Pedimacs profiles ranged from 1 to 2. Two patients with Pedimacs profile 1 received a temporary left ventricular assist device preoperatively for hemodynamic stabilization. The median intensive care unit stay was 47 days (range 21–54, IQR 28–50.5). Right ventricular dysfunction occurred in four patients and was managed conservatively in three, while one required intraoperative implantation of a temporary CentriMag right ventricular assist device. Two patients remain on device support, while three patients were successfully bridged to heart transplantation. No mortality was observed, and none of the patients experienced pump-related complications. Conclusions: The use of the HeartMate 3 is a safe and effective treatment strategy for successful bridging to heart transplantation. Right ventricular dysfunction is a common and clinically significant complication, but it can be effectively managed with appropriate measures.

Background and Objectives: Surgical revascularisation of patients with atherosclerosis of the ascending aorta remains a challenge. Different surgical strategies have been described in coronary surgical patients to offer alternative revascularisation strategies other than the conventional surgical revascularisation in patients unsuitable for it. The aim of this study is to compare the real-world outcomes between two groups of patients who underwent off-pump surgery (left internal mammary artery graft to the left anterior descending artery) or a hybrid with a percutaneous revascularisation procedure at a later stage. Materials and Methods: This is a single-centre retrospective observational study. Between the years 2010 and 2021, 91/6863 patients (1.33%) were diagnosed with severe atherosclerosis of the ascending aorta. All the patients were treated with off-pump revascularisation (91 patients), and the cardiologist would decide at a later stage whether the rest of the vessels would be treated with percutaneous revascularisation (25 patients). Results: There was no statistical difference in the various preoperative characteristics, except for coronary artery left main disease (30.30% vs. 64%; p = 0.0043). The two groups had no statistical differences in the perioperative characteristics and postoperative complications. The 1-, 5-, and 10-year mortality rates in the two groups were 6.1% vs. 0%, 59% vs. 80%, and 93.9% vs. 100%, respectively (off-pump vs. hybrid with percutaneous revascularisation procedure, p = 0.1958). Conclusions: Both strategies have high long-term comparable mortality. The off-pump surgery and the HCR procedure at a later stage may be solutions for these high-risk patients, but the target treatment should be complete HCR revascularisation during the index hospitalization.