Coronary SurgeryThursday, October 15, 2026
High-Risk Cardiac Surgery Outcomes Improve With NICOM+CCUS-Guided Postop Fluid Management - Physicians Weekly
1 min read·By E. Nolan Beckett, MD·Source: Physicians Weekly
From The Cardiac Wire
Continuous thermodilution in 51 patients with anomalous aortic origin of a coronary artery showed that the high-risk anatomic triad (intramural segment, acute take-off, slit-like ostium) produces measurably reduced hyperemic flow (179 vs 290 mL/min) and elevated microvascular resistance at rest and under stress.
That matters because surgical unroofing has been justified almost entirely by anatomy and sudden-death registries, never by randomized data.
A flow-based threshold would give AAOCA surgery something it has lacked: a physiologic trigger.
Editor’s take pending for this article; this is the section commentary excerpt.
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High-Risk Cardiac Surgery Outcomes Improve With NICOM+CCUS-Guided Postop Fluid Management Physicians Weekly
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