The Pulmonary Protection Trial

Pulmonary Dysfunction After Open Heart Surgery: Randomized Clinical Trial With Focus on Lung-protective Interventions

The purpose of this study is to investigate whether patients with a preoperative reduced pulmonary function have a better preserved oxygenation capacity after open heart surgery, using either pulmonary perfusion or pulmoplegia compared with TAVI and the control-group with standard ECC (Extra Corporal Circulation).

Inclusion Criteria:

1. Planned and urgent surgery on legally competent patients over 18 years:

   • Coronary Artery Bypass Graft Surgery
   • Aortic Valve Replacement
   • Coronary Artery Bypass Graft Surgery + Aortic Valve Replacement
   • Transcatheter Aortic-Valve Implantation

2. Spirometry FEV1 measurement show less than or equal to 80% of the anticipated. We expect that these patients provide the largest signal with lung protective interventions in relation to lung healthy patients.

Exclusion Criteria:

• Previous surgery on the heart or lungs
• Previous thoracic irradiation
• Preoperative heart failure (ejection fraction below 20%).
• Surgical demanding mitral regurgitation
• Unstable patients (heart rate above 100 and systolic blood pressure below 100 mmHg)
• Intubated patients
• Patients with an ongoing preoperative treatment with antibiotics for suspected pneumonia.
• Patients with renal insufficiency requiring hemodialysis
• Pregnant and lactating