Introduction
The development and evolution of cardiopulmonary bypass (CPB) has proven fundamental in the era of cardiac surgery, allowing maintenance of end-organ perfusion during a vast array of surgical procedures1. Since its development, improved technologies have aimed at reducing pump-related complications, which include improved oxygenators, pumps, defoaming agent, and heparin-bonded circuits2. Despite advancement in this technology over the past century, CPB continues to be a main source of morbidity during cardiac surgical procedures.
Prolonged CPB perfusion times have been associated with various complications such as acute renal injury3–5, prolonged mechanical ventilation6, and increased intensive care times7. Additionally, increased CPB times have also been associated with increased embolic burden in the brain following surgery8, and postoperative mortality9–11. For these reasons, it is paramount that efficient, expeditious operations be carried out when CPB is employed to ensure optimal outcomes. However, it is unknown if outcomes following very-long CPB runs should be considered futile. This study evaluated the outcomes of cardiac operations associated with very-long CPB times.