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.

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.