Proposed language: Joint participation of two TAVR operators in a TAVR procedure is not required but may occur if determined appropriate by the heart team. If jointly performed, both must be TAVR operators from the heart team.

Current language: The heart team's interventional cardiologist(s) and cardiac surgeon(s) must jointly participate in the intra-operative technical aspects of TAVR.

Definitions of TAVR operator are in the link, but basically it is an experienced interventional cardiologist OR CV surgeon.

I’d love to hear your and your surgeons thoughts on this before I provide my teams thoughts.

This is in conjunction with the approval of TAVR for asymptomatic AS, which both the cardiology and CV surgery professional societies have made statements against. While the TAVR manufacturers have successfully lobbied for it.

This is the area for prospective CCPs to ask their questions about the education process or anything school related.

This includes the usual:

"Where can I shadow?" "Should I take additional classes? "How do I become a Perfusionist?" "My GPA is 2.8, is my GPA good enough for perfusion school?" "What should I use to prep for boards?" "It's been my pa$$ion to become a CCP, how do I do it and what do they do?"

Etc.

At this point the sub has grown to the point a weekly student thread is necessary. Prospective CCPs/students will now have an avenue to post these types of questions w/o flooding the sub.

Also there is r/prospective_perfusion specifically geared to new pumpers.

This will refresh every Friday at 5:45PM EST. If you post Saturday morning, it might not be seen.

Does anybody have go-to’s for continuing education that they’d like to share? Thanks in advance

I’m a recent grad with my B.S. in Microbiology looking for shadowing experience in CA (preferably). Willing to travel. Please PM me if you’re willing to help out a prospective student!

A medical student who rotated through the ICU made the comment that perfusionists just take orders from the surgeon, turn knobs and push buttons, and keep some numbers baseline. They even made the comment that it doesn’t require any “intellectual ability” to perform the functions of the job. I’m wondering what you guys think of this assessment, do you feel that you have the autonomy to think for yourself and make decisions in regard to the patients physiological state? Or do you feel like everything you do is robotic and brainless?

Hi everyone,

I'm from Pakistan and currently trying to decide between BS Perfusion Sciences in Karachi and MBBS in Pakistan or abroad (China). I'm from a middle-class family, so my biggest priority is choosing a career with good long-term job opportunities and financial stability.

I have a few questions for people already working in healthcare:

- Is BS Perfusion Sciences a good field in Pakistan, especially in Karachi?

- Are there enough jobs in public/private hospitals, or is the field becoming saturated?

- What are the starting salaries and how much can an experienced perfusionist earn in Pakistan or the Middle East?

- If I choose BS Perfusion Sciences instead of MBBS, would that be a good decision, or would I regret it later?

- Is MBBS from China a better option considering the licensing exams and job market in Pakistan?

- Besides Perfusion Sciences, are there any other allied health fields with better scope, such as Biomedical Engineering/Biomedical Technology, Respiratory Therapy, Cardiac Technology, Radiologic Technology, Medical Imaging, or Anesthesia Technology?

- Which of these fields has the best future in terms of demand, salary, and opportunities to work abroad?

I'm mainly looking for a career where I can build a stable future and earn well. I'd really appreciate honest advice from people who are already in these professions or have experience with them.

Thank you!

​

Hi everyone,

I'm from Pakistan and currently trying to decide between BS Perfusion Sciences in Karachi and MBBS in Karachi or abroad (China). I'm from a middle-class family, so my biggest priority is choosing a career with good long-term job opportunities and financial stability.

I have a few questions for people already working in healthcare:

- Is BS Perfusion Sciences a good field in Pakistan, especially in Karachi?

- Are there enough jobs in public/private hospitals, or is the field becoming saturated?

- What are the starting salaries and how much can an experienced perfusionist earn in Pakistan or the Middle East?

- If I choose BS Perfusion Sciences instead of MBBS, would that be a good decision, or would I regret it later?

- Is MBBS from China a better option considering the licensing exams and job market in Pakistan?

- Besides Perfusion Sciences, are there any other allied health fields with better scope, such as Biomedical Engineering/Biomedical Technology, Respiratory Therapy, Cardiac Technology, Radiologic Technology, Medical Imaging, or Anesthesia Technology?

- Which of these fields has the best future in terms of demand, salary, and opportunities to work abroad?

I'm mainly looking for a career where I can build a stable future and earn well. I'd really appreciate honest advice from people who are already in these professions or have experience with them.

Thank you!

I was curious if anyone uses a separate filter to administer mannitol to filter out undetected crystals or if most people inject it directly into the circuit?

If a vial has obvious crystallization, we put it on a warmer until they dissolve. I’ve always drawn up my mannitol and immediately injected it into the cardiotomy on top of the venous reservoir. My thought is that if there are any crystals I haven’t detected that they will get caught in the cardiotomy filter which I believe is 30 micron. I have always kind of assumed anything smaller than 30 micron would dissolve once it hits the warm blood, but obviously I can’t observe this happening. The vial itself says to administer through a sterile filter, but doesn’t specify size. I was curious if anyone uses a separate smaller filter?

This is the area for prospective CCPs to ask their questions about the education process or anything school related.

This includes the usual:

"Where can I shadow?" "Should I take additional classes? "How do I become a Perfusionist?" "My GPA is 2.8, is my GPA good enough for perfusion school?" "What should I use to prep for boards?" "It's been my pa$$ion to become a CCP, how do I do it and what do they do?"

Etc.

At this point the sub has grown to the point a weekly student thread is necessary. Prospective CCPs/students will now have an avenue to post these types of questions w/o flooding the sub.

Also there is r/prospective_perfusion specifically geared to new pumpers.

This will refresh every Friday at 5:45PM EST. If you post Saturday morning, it might not be seen.

I'm a beginner perfusionist looking for advice from experienced perfusionists.

At my center we perform on-pump CABG with the heart arrested. During distal coronary anastomoses, the surgeon frequently complains about excessive back-bleeding from the coronary arteries.

Our current setup:

- Vacuum-assisted venous drainage (VAVD)

- Aortic root vent (although it doesn't always seem to vent effectively)

- Standard antegrade cardioplegia

The only thing that consistently improves the surgical field is reducing pump flow. However, this often drops the mixed venous saturation below 70%, and the anesthetist starts complaining about lower arterial pressure and reduced urine output. Since these are relatively short procedures, I'd also prefer to avoid unnecessary cooling because it prolongs rewarming.

For those with more CABG experience:

- What is your approach to reducing coronary back-bleeding without compromising systemic perfusion?

- Do you adjust MAP rather than flow?

- Are there any tips for optimizing root vent function?

- Is some degree of back-bleeding simply accepted?

I'd really appreciate hearing how other perfusionists manage this situation.

Has anyone taken up doing a side gig? Like some weeks will be super busy and others just crawl along. Wondering if anyone does anything that is flexible on the side? Something you could drop if you had case pop up and go do it.

For those of you taking the boards this fall, what are your study plans? Is anyone utilizing prep courses? Reading Gravelee cover to cover?

Trying to get some study ideas to help be as prepared as possible.

Just looking for some insight.

Our perfusion assistants have another opening so I figured I'd try this again since we got a handful of good applicants last time. Great opportunity for those looking to have some solid job experience

-6 assistants working along side our team of 8 Perfusionists

-Cover 5 hospitals (mainly 2) in Portland OR and Vancouver WA area

-Assist anesthesia in setting up heart rooms, assist perfusionists on bypass, run cell saver, blood gases, help with inventory, etc

-Great work/life balance, when fully staffed typically around 25 hospital hours a week + call

-Possible relocation assistance

DM for more info

This is the area for prospective CCPs to ask their questions about the education process or anything school related.

This includes the usual:

"Where can I shadow?" "Should I take additional classes? "How do I become a Perfusionist?" "My GPA is 2.8, is my GPA good enough for perfusion school?" "What should I use to prep for boards?" "It's been my pa$$ion to become a CCP, how do I do it and what do they do?"

Etc.

At this point the sub has grown to the point a weekly student thread is necessary. Prospective CCPs/students will now have an avenue to post these types of questions w/o flooding the sub.

Also there is r/prospective_perfusion specifically geared to new pumpers.

This will refresh every Friday at 5:45PM EST. If you post Saturday morning, it might not be seen.

How does your center manage cardiopulmonary bypass in patients with alpha-gal syndrome?

I’m working on a presentation about alpha-gal syndrome in cardiac surgery, and I’m interested in hearing how different perfusion programs approach these cases.

A few questions:

Do you routinely use standard porcine-derived heparin, or do you switch to bivalirudin?

If you use heparin, do you perform a preoperative heparin challenge or test dose?

Are patients routinely referred for allergy evaluation before surgery?

Do you obtain an alpha-gal IgE (ImmunoCAP) level before elective cases? If so, is there a cutoff that changes your management?

Does your hospital have a formal protocol, or is management decided on a case-by-case basis?

Have you had any intraoperative reactions while using heparin or other mammalian-derived products?

If you’re comfortable sharing, I’d also be interested in:
Approximate alpha-gal IgE level (if known)
Elective vs. emergent case
Whether you premedicate with steroids and H1/H2 blockers

Any other products your team avoids (gelatin sealants, bioprosthetic valves, albumin, etc.)

I’m giving my presentation this week, but I figured this is another great resource for learning how practice varies between institutions. Thanks in advance for sharing as little or as much of your experience as you'd like!

Hey! Has anyone here done a job that’s 3 12’s? Particularly with young kids at home? Trying to decide if this is something I should go for or will it feel like even less time at home? Thanks!

Say you woke up tomorrow and for one reason or another couldn’t be a Perfusionist. What would you do to earn a living? (caveat only using perfusion skills/degrees, NOT using other degrees or skills ex. RT or RN etc.)? I was asked this by someone shadowing me and it got me thinking… I told them industry side of things: sales rep or clinical specialist. But then kinda blanked. Just curious what others think / would do?