European Journal of Cardio-Thoracic Surgery最新文献

{"title":"Incidental mediastinal masses detected on chest computed tomography scans during the COVID-19 pandemic.","authors":"Gaojun Lu, Peilong Zhang, Sara Ricciardi, Ruotian Wang, Chen Wang, Kun Qian, Giuseppe Cardillo, Yi Zhang","doi":"10.1093/ejcts/ezaf140","DOIUrl":"10.1093/ejcts/ezaf140","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of mediastinal masses in large-scale populations in China has been rarely reported. During COVID19 pandemic, many incidentalomas were reported due to the large amount of chest computed tomography scan performed in emergency setting.</p><p><strong>Methods: </strong>Retrospective analysis of emergency chest computed tomography scans (February 2020-February 2021) for COVID-19 screening, including mediastinal abnormalities (excluding lymph nodes, dysplasia, pneumomediastinum and other non-mass alterations), with computed tomography features, diagnostic workup and 1 year follow-up data were reviewed.</p><p><strong>Results: </strong>Of the 40 112 patients [mean age 54.5 (17.2) years; male-to-female ratio 1.02:1] screened for COVID-19, 293 (0.73%) had mediastinal masses of which 223 (0.56%) located in the anterior mediastinum. As participants aged, the prevalence tended to increase (P < 0.001). The prevalence was not different between the sexes (P = 0.635). An oval shape, anterior mediastinal location, and thymus involvement were the most common computed tomography characteristics. Surgery confirmed 11.3% (33 of 293) of nodal lesions, with a benign to malignant ratio of 51.4: 48.5. A computed tomography scan follow-up was conducted in 32.3% (84/260) of the patients, and in 82.1% (69/84) of cases the lesion was stable. Additionally, mediastinal masses were detected in 7.7% (20/260) of elderly patients who passed away soon after their primary disease worsened.</p><p><strong>Conclusions: </strong>In Chinese COVID-19 screening chest computed tomography, the prevalence of all mediastinal masses and anterior mediastinal masses was 0.73% and 0.56%, respectively. Findings support risk-stratified management: growing/suspicious lesions warrant intervention versus surveillance for stable masses. Standardized protocols and multidisciplinary consensus are critical.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":"67 4","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and risks of implantable cardioverter-defibrillators in children and young adults with congenital heart disease, primary electrical disease or paediatric cardiomyopathy†.","authors":"Andrei Fetcu, Thibault Schaeffer, Carolin Niedermaier, Jonas Palm, Takuya Osawa, Muneaki Matsubara, Paul Philipp Heinisch, Lena Friedrich, Carsten Lennerz, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono","doi":"10.1093/ejcts/ezaf134","DOIUrl":"10.1093/ejcts/ezaf134","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the benefits and potential risks of implantable cardioverter-defibrillators in paediatric and congenital heart disease (CHD) patients in the current era.</p><p><strong>Methods: </strong>All patients with CHD, paediatric cardiomyopathy or primary electrical disease, who underwent implantation of a defibrillator from 2001 to 2023, were examined. The occurrence of appropriate therapy, unplanned surgeries due to device complications, inappropriate shocks and associated risk factors were analysed.</p><p><strong>Results: </strong>A total of 214 patients were included, with 61% having CHD, 17% having paediatric cardiomyopathy and 22% having primary electrical disease. The most common diagnoses were transposition of the great arteries and tetralogy of Fallot (each 12%). The median age at implantation was 23 years (interquartile ranges 15-38), and the median follow-up was 5.7 years (95% confidence interval 4.9-7.3). A total of 196 patients met the criteria for outcome analysis, where appropriate therapy was observed in 41% (n = 80), occurring more often in patients with indications for secondary prevention than primary prevention (56% vs 26% at 5 years, P = 0.003). The cumulative incidence of inappropriate shocks was 13% (n = 26), with patients with CHD being more frequently affected. Unplanned surgeries were required in 36% (n = 71), predominantly due to lead-related issues in those with abdominal generator placement.</p><p><strong>Conclusions: </strong>The high rate of appropriate therapies underscores the critical importance of risk assessment in ICD selection, particularly to mitigate lead failures and unnecessary shocks. However, defibrillator therapy has a relevant rate of unplanned surgeries, with abdominal generators and epicardial/extracardiac leads being risk factors.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":"67 4","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and limitations of line pressure-targeted cerebral perfusion strategy in aortic arch surgery.","authors":"Joon Chul Jung, Hyoung Woo Chang, Jae Hang Lee, Kay-Hyun Park","doi":"10.1093/ejcts/ezaf131","DOIUrl":"10.1093/ejcts/ezaf131","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal flow rate for selective antegrade cerebral perfusion during aortic arch surgery is unknown. While 10-15 ml/kg/min is generally recommended, our centre has adopted a line pressure-targeted, relatively low-flow antegrade cerebral perfusion strategy. We aimed to evaluate the effect of flow rate on neurological outcomes.</p><p><strong>Methods: </strong>Patients without preoperative neurological deficits who underwent aortic arch surgery between January 2018 and May 2023 were enrolled. Under moderate hypothermia, an initial cerebral ischaemia period of 15-20 min was permitted. Following a brief retrograde cerebral perfusion, bilateral selective antegrade cerebral perfusion was performed using balloon-tipped perfusion catheters. The flow rate was determined using a line pressure of 200 mmHg. Risk factor analysis for postoperative permanent and temporary neurological deficits was conducted.</p><p><strong>Results: </strong>A total of 262 patients were included. The median selective antegrade cerebral perfusion flow rate was 5.7 ml/kg/min. Permanent neurological deficits occurred in 2 patients (0.8%), while temporary neurological deficits occurred in 30 patients (11.5%). The low antegrade cerebral perfusion flow rate was not a risk factor for permanent or temporary neurological deficits. Prolonged cerebral ischaemia time was the only significant risk factor for temporary neurological deficits.</p><p><strong>Conclusions: </strong>Under moderate hypothermia and with the assistance of retrograde cerebral perfusion, the line pressure-targeted, relatively low-flow selective antegrade cerebral perfusion strategy at our centre achieved favourable neurological outcomes. However, prolonged cerebral ischaemia time was a significant risk factor for temporary neurological deficits.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":"67 4","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and prediction of intensive care unit readmission after oesophagectomy for cancer‡.","authors":"Yuxin Yang, Hong Zhang, Boyao Yu, Bin He, Bin Li, Rong Hua, Yang Yang, Yi He, Yuanshan Yao, Chunguang Li, Zhigang Li","doi":"10.1093/ejcts/ezaf124","DOIUrl":"10.1093/ejcts/ezaf124","url":null,"abstract":"<p><strong>Objectives: </strong>Intensive care unit (ICU) readmission has been proposed as a metric for quality of surgical care. The current study investigated potential factors and developed a prediction model for ICU readmission in patients following oesophagectomy for cancer.</p><p><strong>Methods: </strong>A total of 3028 patients from January 2019 to December 2022 were retrospectively collated as training cohort, with 829 patients from January 2023 to August 2023 enrolled for validation, respectively. Univariable and multivariable analyses were performed to identify potential factors after which a nomogram based on results from multivariable analysis was constructed and validated.</p><p><strong>Results: </strong>In the training cohort, the rate of ICU readmission was 3.6% (110/3028). Readmitted patients were associated with more reoperations, higher 90-day mortality and prolonged postoperative stay (all P < 0.001). Multivariable analysis demonstrated that older age ≥75 years, neoadjuvant therapy, preoperative albuminaemia, diffusing lung capacity for carbon monoxide (DLCO)%, longer operative duration and retention of endotracheal intubation when entering ICU were independently associated with ICU readmission. Based on these results, a nomogram for predicting readmission was constructed and validated. The Hosmer-Lemeshow test showed the model in the training cohort was well calibrated (χ2 = 5.259, P = 0.73) and area under the receiver operating characteristic curve was 0.739 (95% confidence interval 0.691-0.787). Moreover, the application of the nomogram in the validation cohort showed an improved area under the receiver of 0.780 (95% confidence interval 0.703-0.857).</p><p><strong>Conclusions: </strong>ICU readmission after oesophagectomy although uncommon (3.6%) was associated with prolonged hospitalization and significant mortality. A nomogram based on 6 variables may assist intensivists to early identifying patients at high risk of readmission.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of pulmonary hydatid cysts: a single-centre analysis of 872 cases.","authors":"Yener Aydin, Ali Bilal Ulas, Kamber Kasali, Suat Eren, Aysenur Dostbil, Atilla Eroglu","doi":"10.1093/ejcts/ezaf114","DOIUrl":"10.1093/ejcts/ezaf114","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to investigate the importance of pulmonary parenchyma preservation, the results of cystotomy and the capitonnage technique and the efficacy of postoperative albendazole treatment.</p><p><strong>Methods: </strong>A retrospective study was conducted at a single centre between 2000 and 2024, encompassing 872 consecutive patients with pulmonary hydatid cysts.</p><p><strong>Results: </strong>Of the cases studied, 394 (45.2%) were female and 478 (54.8%) were male, with a mean age of 26.8 ± 19.7 years (range: 2-86 years). Isolated lung involvement was observed in 553 (63.4%) cases. In general, a single hydatid cyst was detected in 665 (76.3%) patients, and 466 (53.4%) of these had isolated lung involvement. In 452 cases (51.8%), only the right lung was affected, whereas 294 (33.7%) had left lung involvement, and 126 (14.5%) had bilateral lung involvement. An operation was performed in 807 (92.5%) cases. Cystotomy and capitonnage were performed in 782 (89.7%) patients. Thoracoscopic wedge resection was performed in 13 cases (1.5%), cystotomy alone in 5 cases (0.6%), lobectomy in 5 cases (0.6%) and enucleation with capitonnage in 2 cases (0.2%). Postoperative complications included atelectasis in 45 cases (5.6%), prolonged air leak in 8 cases (1.0%), empyema in 6 cases (0.7%), wound infection in 3 cases (0.4%) and bleeding in 2 cases (0.2%). Recurrence was observed in 4 (0.5%) surgically treated cases, and 1 case (0.1%) resulted in death in the postoperative period.</p><p><strong>Conclusions: </strong>The management of pulmonary hydatid cysts with cystotomy and capitonnage is feasible in the majority of patients and results in acceptable success and complication rates. Administration of albendazole postoperatively has been shown to be an effective method of preventing recurrence.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Irimie and Urbanski Aortic repair: Trade off between residual regurgitation and higher gradient.","authors":"Marek J Jasinski","doi":"10.1093/ejcts/ezaf094","DOIUrl":"10.1093/ejcts/ezaf094","url":null,"abstract":"","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical primer: an introduction into the principles of Bayesian statistical analyses in clinical trials.","authors":"Samuel Heuts, Michal J Kawczynski, Bart J J Velders, James M Brophy, Graeme L Hickey, Mariusz Kowalewski","doi":"10.1093/ejcts/ezaf139","DOIUrl":"10.1093/ejcts/ezaf139","url":null,"abstract":"<p><p>Trials in cardiac surgery are often hampered at the design level by small sample sizes and ethical considerations. The conventional analytical approach, combining frequentist statistics with null hypothesis significance testing, has known limitations and its associated P-values are often misinterpreted, leading to dichotomous conclusions of trial results. The Bayesian statistical framework may overcome these limitations through probabilistic reasoning and is subsequently introduced in this Primer. The Bayesian framework combines prior beliefs and currently obtained data (the likelihood), resulting in updated beliefs, also known as posterior distributions. These distributions subsequently facilitate probabilistic interpretations. Several previous cardiac surgery trials have been performed under a Bayesian framework and this Primer enhances the understanding of their basic concepts by linking results to graphical presentations. Furthermore, contemporary trials that were initially analysed under a frequentist framework, are re-analysed within a Bayesian framework to demonstrate several interpretative advantages.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":"67 4","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing three-dimensional anatomical understanding in complex thoracic surgery: a comparative study of OpVerse and Synapse 3D.","authors":"Yu-An Zheng, Yi-Ching Lee, Jing-Yuan Huang, Hsien-Yuan Hsieh, Yang-Sheng Chen, Xu-Heng Chiang, Ping-Hsuan Han, Mong-Wei Lin, Hsao-Hsun Hsu, Yi-Ping Hung, Jin-Shing Chen","doi":"10.1093/ejcts/ezaf069","DOIUrl":"10.1093/ejcts/ezaf069","url":null,"abstract":"<p><strong>Objectives: </strong>Virtual reality (VR) technology is increasingly employed in medical settings to provide innovative solutions for complex surgeries. In this study, we introduced and compared OpVerse, a multifunctional new VR platform developed for surgical simulations, with established software Synapse 3D to assess its efficacy in facilitating complex thoracic surgeries.</p><p><strong>Methods: </strong>Patient-specific VR digital twin thoracic models were created based on computed tomography scans of 9 patients with large thoracic neoplasms and 4 requiring tracheobronchial reconstruction. Twelve doctors as system testers were enlisted to evaluate the usability and user acceptance of OpVerse and Synapse 3D using the System Usability Scale (SUS) and the Technology Acceptance Model; they provided qualitative feedback through interviews.</p><p><strong>Results: </strong>OpVerse achieved higher scores than Synapse 3D in SUS (73.3 ± 14.6 vs 53.8 ± 11.6, P = 0.0006), as well as perceived usefulness (4.5 ± 0.4 vs 4.1 ± 0.5, P = 0.0134), perceived ease of use (4.2 ± 0.4 vs 3.8 ± 0.6, P = 0.0364) and attitude towards using and behavioural intention to use (4.6 ± 0.4 vs 3.6 ± 0.7, P = 0.0002) in Technology Acceptance Model, compared to Synapse 3D, indicating enhanced efficiency and user engagement with the new system. Participants favoured OpVerse for its immersive qualities, intuitive interface (particularly rotation and enhanced visual transparency effects) and ability to enhance comprehension of complex 3D anatomical structures.</p><p><strong>Conclusions: </strong>OpVerse, our streaming VR simulation platform, enables the manipulation and visualization of patient-specific digital twin thoracic models through features such as rotation, enhanced visual transparency effects and measurement. Preliminary results suggest that OpVerse may offer advantages in terms of immersion, ease of use and understanding of 3D anatomical structures compared to Synapse 3D.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis of adenocarcinoma with innumerable pure ground-glass nodules and/or part-solid nodules.","authors":"Hirofumi Takenaka, Kazuo Nakagawa, Masaya Yotsukura, Yukihiro Yoshida, Shun-Ichi Watanabe","doi":"10.1093/ejcts/ezaf130","DOIUrl":"10.1093/ejcts/ezaf130","url":null,"abstract":"<p><strong>Objectives: </strong>Although many studies have examined lung adenocarcinoma with multiple additional lesions with ground-glass opacity on high-resolution computed tomography including pure ground-glass nodules and part-solid nodules, no study has yet investigated patients who had resected adenocarcinoma with lesions of pure ground-glass nodule and/or part-solid nodule that were so numerous that it was impossible to resect all of them.</p><p><strong>Methods: </strong>Among 5076 patients with resected adenocarcinoma, 877 (17.3%) had additional lesions of pure ground-glass nodule and/or part-solid nodule. Numerous lesions for which it is impossible to resect all of them (innumerable lesions) were defined as follows: 10 or more lesions are seen in 3 or more different lobes and at least 1 lesion is located in the inner two-thirds of each lobe. Of these, 73 patients with innumerable pure ground-glass nodules and/or part-solid nodules, and with clinical N0 were investigated in terms of clinicopathological features and oncological outcomes.</p><p><strong>Results: </strong>For the main adenocarcinoma, 35 patients (47.9%) underwent sublobar resection. After the initial surgery, 23 patients (31.5%) showed the growth of residual lesions and this growth was often observed more than 2 years from the initial surgery. Surgery was selected for 19 (82.6%) of these 23 patients with lesions that had grown. The 5-year overall survival rate was 86.2%.</p><p><strong>Conclusions: </strong>The prognosis of patients with resected adenocarcinoma with innumerable pure ground-glass nodules and/or part-solid nodules was favourable. Due to the possibility of the growth of residual lesions, sublobar resection should be considered for the main tumour at the initial surgery.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":"67 4","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal perfusion during complex aortic arch procedure reduces kidney injury in newborn piglets at moderate hypothermia†.","authors":"Sabine Meier, Maja-Theresa Dieterlen, Kristin Klaeske, Susann Oßmann, Mia Bovet, Michael A Borger, Martin Kostelka, Marcel Vollroth","doi":"10.1093/ejcts/ezaf117","DOIUrl":"10.1093/ejcts/ezaf117","url":null,"abstract":"<p><strong>Objectives: </strong>Complex aortic arch procedures in newborns require the most optimal perfusion strategy to prevent acute kidney injury and its consequences from developing. We performed a randomized comparison of the selective anterograde cerebral perfusion (SACP) and SACP with additional distal perfusion (SACP+DP) with moderate hypothermia in a neonate piglet model to generate better insights into renal tissue-specific injury due to the different perfusion strategies in newborns.</p><p><strong>Methods: </strong>Newborn piglets (2.5-10 kg) were randomized to undergo cross-clamp for 60 min with either SACP (n = 9) or SACP+DP (n = 9) followed by 120 min of recovery. Renal biopsies were analysed for histomorphological changes and the induction of hypoxia-related factors. Kidney injury markers were analysed in piglet serum.</p><p><strong>Results: </strong>Histomorphological analyses of renal biopsies after 120-min recovery showed comparable glomeruli area (P = 0.06), glomerular capsule space length (P = 0.25), proximal tubules cell height (P = 0.09) and diameters of proximal tubules (P = 0.23) between SACP and SACP+DP. hypoxia-inducible factor 1α nuclear translocation, a marker for oxidative stress, was higher in the glomeruli (P < 0.01) and proximal tubules (P = 0.05) in the SACP group compared to the SACP+DP group. Serum concentrations of neutrophil gelatinase-associated lipocalin were higher in the SACP group (100.3 ± 40.8 ng/ml) compared to the SACP+DP group (67.4 ± 19.3 ng/ml, P = 0.03).</p><p><strong>Conclusions: </strong>Our neonate piglet study demonstrated higher oxidative stress in vulnerable nephron structures in renal tissue and higher serum neutrophil gelatinase-associated lipocalin concentrations with SACP compared to SACP+DP indicating that SACP+DP is more suitable to reduce renal insult induced by complex aortic arch procedures.</p>","PeriodicalId":11938,"journal":{"name":"European Journal of Cardio-Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}