{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:06:13Z","timestamp":1779890773337,"version":"3.53.1"},"reference-count":17,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aortic manipulation and prolonged ischemia during cardiopulmonary bypass remain major drivers of perioperative complications. Optimizing clamping strategies is crucial to minimize iatrogenic blood loss and improve recovery profiles within a Patient Blood Management (PBM) framework. Objectives: This study aimed to evaluate the impact of two different aortic clamping strategies\u2014single cross-clamping versus side-clamping\u2014on early hematologic outcomes within a Patient Blood Management (PBM) framework in patients undergoing on-pump coronary artery bypass grafting (CABG). Methods: In this retrospective cohort study, 265 patients who underwent elective isolated 3-vessel on-pump CABG between January 2019 and April 2025 were analyzed. Patients were divided into two groups: the Side-Clamp group (n = 132), where proximal anastomoses were performed under partial occlusion after releasing the main cross-clamp, and the Single Cross-Clamp group (n = 133), where all anastomoses were completed during a single arrest period. The primary outcomes were postoperative hemoglobin (Hb) drop and 24-h chest tube drainage. Results: The side-clamp technique was associated with significantly shorter cardioplegic arrest times (34.5 \u00b1 3.7 vs. 52.0 \u00b1 3.9 min; p &lt; 0.001). Key findings revealed that the postoperative hemoglobin drop was significantly lower in the side-clamp group (1.9 \u00b1 0.4 g\/dL vs. 2.1 \u00b1 0.4 g\/dL; p = 0.005). Notably, the side-clamp group also exhibited significantly lower 24-h chest tube drainage (123.4 \u00b1 28.3 mL vs. 131.0 \u00b1 27.4 mL; p = 0.027). Multivariate linear regression analysis, adjusting for age, sex, and CPB time, confirmed the side-clamp technique as an independent predictor of superior hemoglobin preservation (\u03b2 = \u22120.115, p = 0.009). No significant differences were observed regarding the incidence of postoperative AF (13.6% vs. 15.8%; p = 0.748) or 30-day mortality. Conclusions: The side-clamp strategy is associated with modest but statistically significant reductions in postoperative hemoglobin decline and 24-h chest tube drainage. While these differences did not translate into a significant reduction in RBC transfusion or early mortality, the side-clamp technique represents a useful technical component within a broader Patient Blood Management strategy in routine on-pump CABG practice.<\/jats:p>","DOI":"10.3390\/jcm15114124","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:31:56Z","timestamp":1779885116000},"page":"4124","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Side-Clamping Versus Single Cross-Clamping in On-Pump CABG: Impact on Early Hematologic Outcomes and Blood Conservation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8612-3607","authenticated-orcid":false,"given":"Hakan","family":"\u00d6nta\u015f","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Balikesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asiye Asl\u0131","family":"G\u00f6z\u00fca\u00e7\u0131k R\u00fczgar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Balikesir Atat\u00fcrk City Hospital, Bal\u0131kesir 10100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020). 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