The Journal of cardiovascular surgery最新文献

{"title":"A national cross-sectional survey on time-trends for endovascular repair of genetically-triggered aortic disease and connective tissue disorders over two decades.","authors":"Mario D'Oria, Sandro Lepidi, Rocco Giudice, Jacob Budtz-Lilly, Ciro Ferrer","doi":"10.23736/S0021-9509.24.12941-2","DOIUrl":"10.23736/S0021-9509.24.12941-2","url":null,"abstract":"<p><strong>Background: </strong>By this survey, we aim to gain national-based information regarding trends in endovascular repair (ER) for the treatment of aortic disease in patients with genetically-triggered aortic disease (GTAD) and connective tissue disorder (CTD) over the last two decades.</p><p><strong>Methods: </strong>All Italian vascular surgery centers (N.=80) were invited to participate in an anonymous electronic cross-sectional survey on ER for GTAD/CTD.</p><p><strong>Results: </strong>Overall, 29 institutions completed the survey, thereby yielding a 36% response rate. The percentage of responding institutions rises to 64% if only regional hubs were considered (23/36). The median number of index procedures per center was 6.2, and a steady increase in the overall number of interventions over time was also noted. Most patients were males (73%) with a median age of 48 years. The most common endovascular procedure was TEVAR (N.=101), followed by F/BEVAR (N.=43) and EVAR (N.=37). The overall technical success rate was 83.4% while major adverse events and mortality at thirty days were reported at 18.2% and 9.9%, respectively. An additional 5.0% mortality rate was noted for an overall one-year mortality of 14.9%, while 3.7% of all treated patients were diagnosed with a type 1 endoleak.</p><p><strong>Conclusions: </strong>This national cross-sectional survey, investigating trends in ER of GTADs and CTDs over two decades, highlights a consistent increase in the use of endovascular techniques for their treatment. Early mortality was acceptably low, yet influenced by the urgency of presentation. At one-year follow-up, a 5% additional death rate was noted, and the reintervention rate remained below one in ten.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"351-357"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major vein anomalies and abdominal aortic surgery.","authors":"Ognjen Kostić, David Matejević, Andrija Roganović, Lazar B Davidović","doi":"10.23736/S0021-9509.24.13123-0","DOIUrl":"10.23736/S0021-9509.24.13123-0","url":null,"abstract":"","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"414-415"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The specificities of the common femoral artery anatomy, calcification and endovascular treatment.","authors":"Bahaa Nasr, Maxime Raux, Maxime Dubosq-Lebaz, Camil-Cassien Bamde, Raphaël Coscas, Yann Gouëffic","doi":"10.23736/S0021-9509.24.13129-1","DOIUrl":"10.23736/S0021-9509.24.13129-1","url":null,"abstract":"<p><p>Atherosclerotic lesions of the femoral artery bifurcation are one of the most complex lesion subsets commonly encountered in peripheral artery disease. Common femoral endarterectomy remains the standard of care in this location due to the bulky, eccentric, heavily calcified nature of the plaques, the frequent involvement of the femoral bifurcation, and the risk of compromising future femoral approaches. Recent studies have reported high rates of technical success and low rates of complications with endovascular treatment of the femoral artery bifurcation. This is related to improvements of endovascular equipment and the technical skills of operators. The aim of this manuscript was to provide a comprehensive review of the peculiarities of common femoral artery anatomy, calcification and treatment.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"330-338"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate ischemic mitral regurgitation in ischemic heart disease: to operate or not? A meta-analysis.","authors":"Razan A Alsuayri, Abdullah K Alassiri, Ahmed K Awad, Mohammed N Faleh, Rasha T Baqays, Massimo Porqueddu","doi":"10.23736/S0021-9509.24.12851-0","DOIUrl":"10.23736/S0021-9509.24.12851-0","url":null,"abstract":"<p><strong>Introduction: </strong>Deciding whether to perform coronary artery bypass grafting (CABG) alone or in combination with mitral valve repair is a common dilemma encountered by surgeons when treating patients with ischemic mitral regurgitation, a common condition related to coronary artery disease. Although ischemic mitral regurgitation after CABG has been linked to unfavorable results, the benefits of including mitral valve repair are still unknown. This discrepancy led us to undertake a systematic review and meta-analysis to determine whether combining CABG with mitral valve surgery leads to better clinical results than CABG alone.</p><p><strong>Evidence acquisition: </strong>Studies comparing the results of CABG versus CABG with mitral valve replacement were searched in the databases of PubMed and Google Scholar. There were six randomized clinical trials included in this study.</p><p><strong>Evidence synthesis: </strong>We analyzed 852 patients' data. There were no significant variations between patients who acquired CABG alone or CABG+(MVR) in terms of their risk of death at one year, stroke, atrial fibrillation, or hospitalization for heart failure. For recurrent/residual mitral regurgitation; it revealed an RR=5.42, 95% CI, 0.77 to 37.98, and a P value of =0.065. According to the analysis of study heterogeneity, no apparent heterogeneity was identified in the outcomes of death after one year, stroke, atrial fibrillation, or hospitalization for heart failure. However, the outcome of recurrent or residual mitral regurgitation showed significant variation (I²=66%).</p><p><strong>Conclusions: </strong>Patients who underwent CABG alone versus CABG plus MVR did not differ significantly from one another. However, the comparison of CABG alone with CABG plus MVR underlines the need for customized treatment plans based on the unique characteristics of each patient.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"390-397"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating biomarkers in acute aortic dissection versus acute myocardial infarction: a systematic review.","authors":"Maria L Galhano, Filipa Jácome, Jennifer Y Huynh, Marina Dias-Neto","doi":"10.23736/S0021-9509.24.13062-5","DOIUrl":"10.23736/S0021-9509.24.13062-5","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review aimed to discuss the current knowledge of possibly useful circulatory biomarkers (other than D-dimers) in the diagnosis of patients with an acute aortic dissection (AAD), to distinguish these patients from patients with Acute Myocardial Infarction (AMI).</p><p><strong>Evidence acquisition: </strong>This study followed the PRISMA guidelines. The databases PubMed, EMBASE and Scopus were systematically searched from inception to May 2023. Studies were included if they presented measurements of biomarker(s) in the blood/plasma/serum samples from adult patients with AAD versus AMI. Articles were excluded if aortic dissection was subacute or chronic (>14 days), if they lack a control group (AMI), or if they were animal studies, revisions, or editorials. The main outcome was the identification of biomarkers that exhibited diagnostic potential to differentiate patients with AAD versus AMI.</p><p><strong>Evidence synthesis: </strong>The research query resulted in 1342 articles after the removal of duplicates, from which seven were included in the systematic review. The biomarkers identified included general blood assessment, metabolomics, products of the degradation of fibrin, extracellular matrix markers and an ischemia-associated molecule. Most studies lack diagnostic validity such as sensitivity and specificity. In six studies, the concentration of a total of six biomarkers showed significative differences between AAD and AMI group.</p><p><strong>Conclusions: </strong>A great heterogeneity of molecules has been studied as putative diagnostic markers of AAD versus AMI. Studies of better quality are needed, presenting the diagnostic validity of the molecules under analysis and the putative synergic diagnostic value of the molecules identified so far.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"383-389"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of common femoral artery steno-occlusive disease: a comprehensive review of anatomical and hemodynamic considerations.","authors":"Adam T Geale, Hany Zayed, Pablo Lamata, Jordi Alastruey, Rachel E Clough","doi":"10.23736/S0021-9509.24.13073-X","DOIUrl":"10.23736/S0021-9509.24.13073-X","url":null,"abstract":"<p><p>Open surgical repair, often in the form of endarterectomy, is still the gold standard for steno-occlusive disease in the common femoral artery, despite the success of lower-risk endovascular alternatives in other peripheral arterial regions. Stenting in the common femoral artery is not widely adopted due to the proximity of the artery to the mobile hip joint, and the perceived risk this has on the stent structure due to kinking. The purpose of this review was to assess how hip movement contributes to the anatomical and biomechanical challenges proposed in the common femoral artery, and how these challenges impact the hemodynamics with both open surgical and endovascular stent treatments. The findings demonstrated that the common femoral artery is a fixed arterial segment which does not bend or twist as previously perceived. However, high degrees of bending and twisting are evident in the vessels directly proximal and distal to the common femoral artery. Mechanical testing suggests that the latest generation braided Nitinol stents could be well-suited to these challenges. Both endarterectomy and stenting provide good hemodynamic results regarding limb perfusion. However, other hemodynamic parameters, such as wall shear stress, may not be optimized with either modality, increasing the risk of chronic restenosis. As a high proportion of common femoral artery disease extends into the adjacent arterial segments, further research is warranted to ascertain the optimum hemodynamic stent configuration, as a lower-risk alternative to open surgery.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"313-323"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off versus on pump myocardial revascularization in patients with severe asymptomatic carotid stenosis.","authors":"Dragan Opacic, Agron Ibishi, Anca A Irimie, Darko Radakovic, Georges El Hachem, Mohammad Sharaf, Rayan Cheaban, Claudio Velasquez-Silva, Marcus-André Deutsch, René Schramm, Sabine Bleiziffer, André Renner, Jan F Gummert, Sebastian V Rojas","doi":"10.23736/S0021-9509.24.13031-5","DOIUrl":"https://doi.org/10.23736/S0021-9509.24.13031-5","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease is a global cause of morbidity and mortality, often managed by coronary artery bypass grafting (CABG). This study addresses a critical decision-making dilemma in CABG procedures for patients with severe asymptomatic carotid stenosis, comparing off-pump and on-pump techniques.</p><p><strong>Methods: </strong>We conducted a retrospective single-center analysis, employing propensity scored matched-pair methodology to compare perioperative outcomes in patients with asymptomatic severe carotid stenosis undergoing off-pump or on-pump CABG. The primary endpoint was the occurrence of perioperative stroke. Secondary endpoints included postoperative delirium, intrahospital mortality, intensive care unit stay, length of hospitalization and long-term survival.</p><p><strong>Results: </strong>The study involved 243 patients with asymptomatic severe carotid stenosis operated between July 2009 and October 2018, subsequently propensity score matched into two groups of 78 patients each (off-pump and on-pump). The incidence of perioperative stroke was significantly higher in the On-Pump group compared to the off-pump group (10.3% vs. 1.3%, P=0.03). However, secondary endpoints, such as intrahospital mortality and length of hospitalization, showed no significant differences between the two groups. Long-term survival rates were also comparable.</p><p><strong>Conclusions: </strong>Our findings indicate that off-pump CABG significantly reduces the risk of perioperative stroke in patients with severe asymptomatic carotid stenosis compared to on-pump CABG, without compromising long-term outcomes. These results support the preference for off-pump CABG in this high-risk patient population, highlighting the need for tailored surgical approaches based on individual patient risk profiles.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":"65 4","pages":"398-405"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open surgery of common femoral artery occlusive disease: a contemporary review.","authors":"Nicola Troisi, Giulia Bertagna, Valerio Artini, Giovanni B Torsello, Raffaella Berchiolli","doi":"10.23736/S0021-9509.24.13098-4","DOIUrl":"10.23736/S0021-9509.24.13098-4","url":null,"abstract":"<p><strong>Introduction: </strong>Endovascular therapy has gradually gaining more importance for the treatment of common femoral artery (CFA) occlusive disease due to satisfactory perioperative outcomes. However, endovascular interventions seem to provide acceptable outcomes only in the short-term period. Endarterectomy still remains the gold standard with well-established mid- and long-term outcomes. The aim of this study was to analyze all appropriate studies about mid- and long-term outcomes of CFA endarterectomy, regardless of the type of technique used in the framework of a narrative contemporary review.</p><p><strong>Evidence acquisition: </strong>This narrative review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The main inclusion criterion was the availability of data on isolated CFA endarterectomy including mid (1-5 years) and long (6-10 years) term results.</p><p><strong>Evidence synthesis: </strong>Four studies have been selected. In the mid-term period CFA endarterectomy showed an excellent primary patency rate regardless the clinical presentation (up to 95% and 100% in intermittent claudication and chronic limb-threatening ischemia). About the type of reconstruction, a statistically significant difference was found between patchplasty and direct suture in terms of primary patency (97% vs. 89.9%, P=0.02). In the long-term period the overall primary patency rate was about 95%, regardless of the clinical condition (P=0.04). Overall long-term limb salvage rate ranged from 87% to 92%, with a relatively significant difference between intermittent claudication (100%), and chronic limb-threatening ischemia (82%) (P=0.01).</p><p><strong>Conclusions: </strong>Considering long-term clinical outcomes and the subsequent durability, surgical treatment is still the cornerstone for CFA occlusive disease, regardless of the type of technique used for both endarterectomy and arterial reconstruction. Due to its reduced invasiveness, high-risk patients may benefit from an endovascular-first approach.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"324-329"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of common femoral artery occlusive disease: the current gap in the evidence and future perspectives.","authors":"Sarah J Messeder, Liam Musto, Athanasios Saratzis","doi":"10.23736/S0021-9509.24.13107-2","DOIUrl":"10.23736/S0021-9509.24.13107-2","url":null,"abstract":"<p><p>The common femoral artery (CFA) is the most common site affected by peripheral artery disease. Due its various anatomical and morphological features, common femoral endarterectomy has long since been the preferred treatment option. However, there are complications associated with common femoral endarterectomy including, but not limited to, surgical site infections, hematoma formation, bleeding, and nerve injury. Unfortunately, this has been further complicated by the ageing population and increasing epidemic of obesity and diabetes mellitus. Within vascular surgery, there has been a rise in use of endovascular techniques for peripheral artery disease. Endovascular repair of the CFA is safe and feasible. One clear advantage is that they can be performed under local or regional anesthesia, thus reducing morbidity. This narrative review seeks to describe the current gap in the evidence and future perspectives in the management of common femoral artery occlusive disease.</p>","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"346-350"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common femoral artery: a paradigm shift to the vascular surgeon's comfort zone?","authors":"Lukla Biasi, Sanjay Patel, Hany Zayed","doi":"10.23736/S0021-9509.24.13140-0","DOIUrl":"10.23736/S0021-9509.24.13140-0","url":null,"abstract":"","PeriodicalId":101333,"journal":{"name":"The Journal of cardiovascular surgery","volume":" ","pages":"311-312"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}