{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T08:05:40Z","timestamp":1779437140729,"version":"3.53.1"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Science and Technology Department of Sichuan Province","award":["2024YFFK0253"],"award-info":[{"award-number":["2024YFFK0253"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"abstract":"<jats:p>Vasoplegic shock syndrome (VS) occurs in up to 20% of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and is associated with increased morbidity rates and poor prognosis. Here, we report a case of severe refractory VS with high aortic-radial pressure gradient following cardiac surgery. A 46-year-old female underwent metal mitral valve replacement, tricuspid valve plasty, and left atrial thrombectomy exhibited refractory peripheral hypotension during rewarming on CPB. Central aortic pressure measurement revealed a significant aortic-radial pressure gradient. By increasing perfusion flow and the administration of vasoactive medications, the aortic pressure gradually normalized but VS still existed, and then weaning from CPB under the guidance of transesophageal echocardiography (TEE). After the patient was transferred to the cardiac intensive care unit (CICU), pulse indicator continuous cardiac output (PICCO) was implanted to guide the maintenance of cardiac function, volume expansion and stable hemodynamics, and the dosage of vasoactive medications was gradually reduced. The patient was discharged on postoperative day 10. A significant aortic-radial pressure gradient was considered an early sign of VS. Early recognition, combined with advanced hemodynamic monitoring and assessment of oxygen metabolism indicators, is crucial for optimizing perioperative management and improving outcomes in patients undergoing CPB.<\/jats:p>","DOI":"10.1177\/02676591261454556","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:36:51Z","timestamp":1779237411000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe aortic-radial pressure gradient and vasoplegic shock syndrome after cardiopulmonary bypass: A case report and literature review"],"prefix":"10.1177","author":[{"given":"Xunjie","family":"Li","sequence":"first","affiliation":[{"name":"West China Hospital of Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Long","sequence":"additional","affiliation":[{"name":"West China Hospital of Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4069-0136","authenticated-orcid":false,"given":"Ronghua","family":"Zhou","sequence":"additional","affiliation":[{"name":"West China Hospital of Sichuan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2019.12.013"},{"issue":"3","key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.athoracsur.2017.09.039","article-title":"Characterizing predictors and severity of vasoplegia syndrome after heart transplantation","volume":"105","author":"Chan JL","year":"2018","unstructured":"Chan JL, Kobashigawa JA, Aintablian TL, et al. Characterizing predictors and severity of vasoplegia syndrome after heart transplantation. Ann Thorac Surg 2018; 105(3): 770\u2013777. https:\/\/doi.org\/10.1016\/j.athoracsur.2017.09.039","journal-title":"Ann Thorac Surg"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.14797\/mdcvj.1245"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-017-0789-6"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-022-02320-2"},{"issue":"2","key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1213\/ANE.0000000000001096","article-title":"Risk factors involved in central-to-radial arterial pressure gradient during cardiac surgery","volume":"122","author":"Fuda G","year":"2016","unstructured":"Fuda G, Denault A, Deschamps A, et al. Risk factors involved in central-to-radial arterial pressure gradient during cardiac surgery. Anesth Analg 2016; 122(2): 624\u2013632. https:\/\/doi.org\/10.1213\/ANE.0000000000001096","journal-title":"Anesth Analg"},{"issue":"7","key":"e_1_3_3_8_2","doi-asserted-by":"crossref","first-page":"e68890","DOI":"10.1371\/journal.pone.0068890","article-title":"Central-radial artery pressure gradient after cardiopulmonary bypass is associated with cardiac function and may affect therapeutic direction","volume":"8","author":"Sun J","year":"2013","unstructured":"Sun J, Ding Z, Qian Y, et al. Central-radial artery pressure gradient after cardiopulmonary bypass is associated with cardiac function and may affect therapeutic direction. PLoS One 2013; 8(7): e68890. https:\/\/doi.org\/10.1371\/journal.pone.0068890","journal-title":"PLoS One"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0391398818784791"},{"issue":"2","key":"e_1_3_3_10_2","first-page":"310","article-title":"Peripheral arterial blood pressure versus central crterial blood pressure monitoring in critically ill patients after cardio-pulmonary bypass","volume":"33","author":"Ahmad RA","year":"2017","unstructured":"Ahmad RA, Ahmad S, Naveed A, et al. Peripheral arterial blood pressure versus central crterial blood pressure monitoring in critically ill patients after cardio-pulmonary bypass. Pakistan J Med Sci 2017; 33(2): 310\u2013314. https:\/\/doi.org\/10.12669\/pjms.332.12220","journal-title":"Pakistan J Med Sci"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjon.2021.07.031"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.15805"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2743-8"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/2050312120935466"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v5.i1.47"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261454556","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591261454556","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591261454556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:17:36Z","timestamp":1779434256000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591261454556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":14,"alternative-id":["10.1177\/02676591261454556"],"URL":"https:\/\/doi.org\/10.1177\/02676591261454556","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"article-number":"02676591261454556"}}