Conclusions
In this review of 293 consecutive patients undergoing cardiac surgery
with CPB pump times ≥300 minutes, we observed reasonable mid-term
survival rates, with over 60% surviving to 1-year, despite high rates
of early operative mortality and morbidity. A CPB time of 446 minutes
may be useful as a marker of predicting 50% operative mortality. With
appropriate management including use of mechanical circulatory support
when needed, cardiac operations requiring very-prolonged CPB times can
be salvageable and should not be considered futile.