Conclusions
In this review of 293 consecutive patients undergoing cardiac surgery with CPB pump times ≥300 minutes, we observed reasonable mid-term survival rates, with over 60% surviving to 1-year, despite high rates of early operative mortality and morbidity. A CPB time of 446 minutes may be useful as a marker of predicting 50% operative mortality. With appropriate management including use of mechanical circulatory support when needed, cardiac operations requiring very-prolonged CPB times can be salvageable and should not be considered futile.