General Thoracic and Cardiovascular Surgery最新文献

Determining optimal pretreatment in cardiac surgery: an experimental study. 确定心脏手术的最佳预处理：一项实验研究。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2024-11-14 DOI: 10.1007/s11748-024-02102-1

Masahiro Fujii, Hiromasa Yamashita, Yasuhiro Kawase, Ryuzo Bessho, Yosuke Ishii

{"title":"Determining optimal pretreatment in cardiac surgery: an experimental study.","authors":"Masahiro Fujii, Hiromasa Yamashita, Yasuhiro Kawase, Ryuzo Bessho, Yosuke Ishii","doi":"10.1007/s11748-024-02102-1","DOIUrl":"10.1007/s11748-024-02102-1","url":null,"abstract":"Objectives: Heart failure patients with reduced ejection fraction are currently treated with four drug combinations: angiotensin receptor/neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors, resulting in improved survival outcomes. Herein, we examined whether myocardial protection by esaxerenone or sacubitril/valsartan may present a counter-effect to the harm caused by cardioplegic arrest.Methods: Male Wistar rats fed a normal diet were orally administered esaxerenone (3 mg/kg; Esax) or sacubitril/valsartan (68 mg/kg; SaV) once a day for 2 weeks from 6 weeks of age. Age-matched, untreated male Wistar rats served as controls (Control). Isolated rat hearts were aerobically Langendorff-perfused and subjected to 2 min of St Thomas' Hospital 2 cardioplegia (STH2) infusion and 28 min of normothermic global ischemia followed by 60 min of reperfusion. The recovery of function was measured during 60 min of reperfusion. Additionally, troponin T levels were measured after reperfusion as myocardial injury.Results: The final recovery of left ventricular developed pressure (presented as the percentage of preischemic value) in the Control, Esax, and SaV groups was 50.7 ± 6.2%, 68.5 ± 7.4%*, and 69.3 ± 14.3%*, respectively (*p < 0.05 vs. Control). Troponin T (ng per gram wet weight) levels in the Control, Esax, and SaV groups were 166.8 ± 78.1, 77.0 ± 14.6*, and 74.2 ± 36.6*, respectively (*p < 0.05 vs. Control).Conclusion: Oral administration of esaxerenone or sacubitril/valsartan to rats 2 weeks prior to surgery enhanced the myocardial protection afforded by STH2 and may attenuate the myocardial injury caused by hyperkalemic cardioplegic arrest.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"585-591"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in serum KL-6 levels following lung transplantation for interstitial lung diseases. 间质性肺疾病肺移植后血清KL-6水平变化趋势

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-02-24 DOI: 10.1007/s11748-025-02117-2

Kazuhisa Matsumoto, Akihiro Ohsumi, Tomohiro Handa, Daisuke Nakajima, Satona Tanaka, Satoshi Hamada, Kohei Ikezoe, Kiminobu Tanizawa, Toyohiro Hirai, Hiroshi Date

{"title":"Trends in serum KL-6 levels following lung transplantation for interstitial lung diseases.","authors":"Kazuhisa Matsumoto, Akihiro Ohsumi, Tomohiro Handa, Daisuke Nakajima, Satona Tanaka, Satoshi Hamada, Kohei Ikezoe, Kiminobu Tanizawa, Toyohiro Hirai, Hiroshi Date","doi":"10.1007/s11748-025-02117-2","DOIUrl":"10.1007/s11748-025-02117-2","url":null,"abstract":"Objective: To assess the changes in Krebs von den Lungen-6 (KL-6) levels pre- and post-lung transplantation for interstitial lung disease and to determine the connection between changes in KL-6 levels and chronic lung allograft dysfunction.Methods: Eighty-two lung transplantation procedures were performed in interstitial lung disease patients between January 2008 and December 2019. We compared changes in KL-6 levels before and after transplantation in two groups: unilateral and bilateral lung transplant groups. Additionally, KL-6 levels just before or at the onset of chronic lung allograft dysfunction were compared to the lowest post-transplant levels.Results: In total, 28 female and 49 male patients (median age: 54 years; range 22-64; 42 and 35 patients underwent unilateral and bilateral lung transplantations, respectively) were enrolled. The post-transplant observation period ranged from 8 to 163 (median: 64.2) months. KL-6 levels decreased in 76 patients (98.7%). Notably, the KL-6 level was lower in the bilateral lung transplantation group than in the unilateral lung transplantation group. Moreover, KL-6 levels were higher just before or at the onset of chronic lung allograft dysfunction than the lowest post-transplant levels. These levels were significantly higher than the highest post-transplant levels observed in the non-chronic lung allograft dysfunction group.Conclusions: Our findings suggest that KL-6 levels decrease in interstitial lung disease patients following lung transplantation, with a greater reduction in KL-6 levels observed in bilateral lung transplantation compared to unilateral lung transplantation. Elevated serum KL-6 levels were associated with chronic lung allograft dysfunction, highlighting its utility as a diagnostic biomarker.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"629-636"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influence of HLA mismatch between donors and recipients on postoperative outcomes in cadaveric lung transplantation. 供体和受体HLA不匹配对尸体肺移植术后预后的影响。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2024-12-09 DOI: 10.1007/s11748-024-02109-8

Hidenao Kayawake, Ichiro Sakanoue, Satona Tanaka, Yojiro Yutaka, Yoshihiro Nishino, Akira Matsumoto, Taiki Ryo, Taichi Matsubara, Daisuke Nakajima, Hiroshi Date

{"title":"Influence of HLA mismatch between donors and recipients on postoperative outcomes in cadaveric lung transplantation.","authors":"Hidenao Kayawake, Ichiro Sakanoue, Satona Tanaka, Yojiro Yutaka, Yoshihiro Nishino, Akira Matsumoto, Taiki Ryo, Taichi Matsubara, Daisuke Nakajima, Hiroshi Date","doi":"10.1007/s11748-024-02109-8","DOIUrl":"10.1007/s11748-024-02109-8","url":null,"abstract":"Objectives: Generally, HLA matching between donors and recipients is not performed in lung transplantation (LTx). Therefore, whether HLA mismatch between donors and recipients (D/R mismatch) influences postoperative outcomes after LTx remains uncertain. In this study, we investigated the influence of D/R mismatch on postoperative outcomes after cadaveric LTx (CLT).Methods: A total of 140 CLT procedures were performed between 2012 and 2020. After excluding 5 recipients with preformed DSA and 1 recipient undergoing re-LTx, 134 recipients were enrolled in this retrospective study. The postoperative outcomes were compared between recipients with higher and lower D/R mismatches.Results: The median D/R mismatch (A/B/DR loci) was 4.0 (range, 1-6). When dividing these 134 recipients into two groups (H group [D/R mismatch ≥ 5, n = 57] and L group [D/R mismatch ≤ 4, n = 77]), there were no significant differences in the patient backgrounds. The lengths of hospital and intensive care unit stays were similar (p = 0.215 and p = 0.37, respectively). Although the overall survival was not significantly better in the H group than in the L group (p = 0.062), chronic lung allograft dysfunction-free survival was significantly better in the H group than in the L group (p = 0.027). Conversely, there was no significant difference in the cumulative incidence of de novo donor-specific anti-HLA antibodies (dnDSAs) between the two groups (p = 0.716).Conclusions: No significant difference in dnDSA development was observed between patients with higher and lower D/R HLA mismatches. Given the favorable outcomes in the high HLA mismatch group, CLTs can be performed safely in recipients with high D/R HLA mismatches.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"609-615"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of residual lung expansion on pulmonary function after lobectomy. 肺叶切除术后残余肺扩张对肺功能的影响。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-01-08 DOI: 10.1007/s11748-024-02105-y

Takamasa Shibazaki, Shohei Mori, Yu Suyama, Satoshi Arakawa, Yo Tsukamoto, Daiki Kato, Tomonari Kinoshita, Takeo Nakada, Takashi Ohtsuka

{"title":"Effect of residual lung expansion on pulmonary function after lobectomy.","authors":"Takamasa Shibazaki, Shohei Mori, Yu Suyama, Satoshi Arakawa, Yo Tsukamoto, Daiki Kato, Tomonari Kinoshita, Takeo Nakada, Takashi Ohtsuka","doi":"10.1007/s11748-024-02105-y","DOIUrl":"10.1007/s11748-024-02105-y","url":null,"abstract":"Objectives: Pulmonary function after lobectomy is often higher than what is predicted. This occurrence could be related to postoperative expansion of the residual lung. The study aim was to determine if residual lung expansion affects pulmonary function after lobectomy.Methods: The participants in this retrospective study were 142 patients who had undergone lobectomy via video-assisted thoracic surgery. Computed tomography and pulmonary function tests were performed preoperatively and 1 year postoperatively. Three-dimensional computed tomography volumetry was performed to assess lung volumes preoperatively and postoperatively, and the predicted postoperative forced expiratory volume in 1 s was calculated. The residual lung expansion ratio was defined as the postoperative-to-preoperative residual lung volume ratio, and the postoperative forced expiratory volume in 1 s ratio was defined as the measured-to-predicted postoperative forced expiratory volume in 1 s ratio. The effect of the residual lung expansion ratio on the postoperative forced expiratory volume in 1 s ratio as well as the factors affecting the postoperative forced expiratory volume in 1 s ratio were evaluated.Results: The median residual lung expansion ratio was 1.17 (interquartile range: 1.10-1.24), and the median postoperative forced expiratory volume in 1 s ratio was 1.13 (interquartile range: 1.04-1.21). The residual lung expansion ratio significantly affected postoperative forced expiratory volume in 1 s ratio (p < 0.001).Conclusion: After lobectomy, better residual lung expansion was associated with improved postoperative pulmonary function.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"602-608"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating air leakage from staple line reinforcements in anatomical pulmonary resection (AIRSTOP): a prospective randomized controlled trial protocol. 评估解剖性肺切除术（AIRSTOP）中钉线增强物的漏气：一项前瞻性随机对照试验方案。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2024-12-26 DOI: 10.1007/s11748-024-02111-0

Jotaro Yusa, Kazuhisa Tanaka, Kohei Takahashi, Yuki Shiko, Takeshi Sugawara, Ichiro Yoshino, Hidemi Suzuki

{"title":"Evaluating air leakage from staple line reinforcements in anatomical pulmonary resection (AIRSTOP): a prospective randomized controlled trial protocol.","authors":"Jotaro Yusa, Kazuhisa Tanaka, Kohei Takahashi, Yuki Shiko, Takeshi Sugawara, Ichiro Yoshino, Hidemi Suzuki","doi":"10.1007/s11748-024-02111-0","DOIUrl":"10.1007/s11748-024-02111-0","url":null,"abstract":"Background: Air leakage during pulmonary resection is a major complication in thoracic surgery. It frequently occurs at sites of adhesion dissection, due to lung manipulation, and along the staple lines of automatic suturing devices, particularly in cases of pulmonary fragility such as those of emphysema and interstitial pneumonia. Persistent postoperative air leakage prolongs chest tube indwelling and extends hospitalization time. Staplers with absorbable tissue reinforcements have been introduced for pulmonary resection to prevent intraoperative stapler-related air leakage. This phase II prospective, open-label, randomized, parallel-group trial aims to validate the efficacy of staplers with or without absorbable tissue reinforcements in controlling stapler-related air leakage during anatomical pulmonary resections.Methods: Overall, 120 patients will be randomized into two groups: one that will undergo conventional anatomical pulmonary resection and the other in which staplers with absorbable tissue reinforcements will be used. The primary endpoint will be intraoperative stapler-related air leakage. Data will be analyzed between 2024 and 2025.Discussion: This trial will validate the effectiveness and safety of staple line reinforcements in controlling intraoperative air leakage during anatomical pulmonary resections, potentially leading to optimized strategies for patients with conditions such as emphysema and interstitial pneumonia.Trial registration: This trial has been registered with the Japan Registry of Clinical Trials 1032220620 ( https://jrct.niph.go.jp/latest-detail/jRCTs031230224 ).","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"616-621"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proposal for novel definition of radiologically less-invasive clinical stage IA solid predominant lung adenocarcinoma using the maximum standardized uptake value. 建议使用最大标准化摄取值来定义放射学上低侵袭性临床IA期实性显性肺腺癌。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-01-06 DOI: 10.1007/s11748-024-02115-w

Yukio Watanabe, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Kazuya Takamochi, Kenji Suzuki

{"title":"Proposal for novel definition of radiologically less-invasive clinical stage IA solid predominant lung adenocarcinoma using the maximum standardized uptake value.","authors":"Yukio Watanabe, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s11748-024-02115-w","DOIUrl":"10.1007/s11748-024-02115-w","url":null,"abstract":"Objective: This study aimed to evaluate the possibility of defining new imaging criteria to predict less-invasive clinical (c)-stage IA2-IA3 solid predominant lung adenocarcinoma using the maximum standardized uptake value (SUVmax) as the cutoff value.Methods: Consecutive 364 patients who underwent anatomical resection with mediastinal lymphadenectomy and positron emission tomography for c-stage IA2-IA3 solid predominant lung adenocarcinoma with a tumor diameter < 3 cm were retrospectively evaluated. Less-invasive cancer was defined as the absence of nodal involvement, lymphovascular or pleural invasion, or spread through air spaces. The SUVmax cutoff value was determined based on the specificity of the receiver operating characteristic curve.Results: 228 were pure-solid tumors, and 136 were part-solid tumors. 212 were c-stage IA2 and 152 were c-stage IA3. When the SUVmax was set at a cutoff value of 2.2, sensitivity and specificity were 33.0% and 97.6%, respectively, and it was possible to secure the sensitivity by more than 30% with high specificity among the solid predominant tumors. When the SUVmax was set at a cutoff value of 2.2, sensitivity and specificity were 40.7% and 95.7%, respectively, in whole tumor diameter ≤ 2 cm, and 27.0% and 99.0%, respectively in whole tumor diameter between 2 and 3 cm. When the SUVmax was set at a cutoff value of 2.2, sensitivity and specificity were 45.8% and 96.6%, respectively, in part-solid tumors, and 17.8% and 97.8%, respectively in pure-solid tumors.Conclusion: Setting the SUVmax as cutoff value could predict pathologically less-invasive cancers in c-stage IA2-IA3 solid predominant lung adenocarcinoma.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"622-628"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of thoracic endovascular aortic repair for complicated type B acute aortic dissection from a multicenter Japanese post-market surveillance study. 来自日本一项多中心上市后监测研究的复杂B型急性主动脉夹层的胸血管内主动脉修复结果

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-02-01 DOI: 10.1007/s11748-025-02123-4

Yoshimasa Seike, Sophie B Green, Keita Mori, Kimberly Reid, Hitoshi Matsuda

{"title":"Outcomes of thoracic endovascular aortic repair for complicated type B acute aortic dissection from a multicenter Japanese post-market surveillance study.","authors":"Yoshimasa Seike, Sophie B Green, Keita Mori, Kimberly Reid, Hitoshi Matsuda","doi":"10.1007/s11748-025-02123-4","DOIUrl":"10.1007/s11748-025-02123-4","url":null,"abstract":"Objectives: A primary goal of thoracic endovascular aortic repair (TEVAR) for type B acute aortic dissection (BAAD) is exclusion of the primary entry tear with a suitable stent graft (SG) to reestablish true lumen flow and promote aortic remodeling. This study aimed to determine the safety and efficacy of a conformable thoracic SG in a Japanese population with complicated BAAD.Methods: Between 2016 and 2017, 43 patients with complicated BAAD were enrolled in this prospective, nonrandomized, multicenter post-market surveillance study at 27 sites in Japan. All patients underwent TEVAR using the Gore TAG Conformable Thoracic Endoprosthesis (CTAG) (W.L. Gore and Associates, Flagstaff, AZ).Results: The most common TEVAR indication for complicated BAAD was malperfusion (41.9%; 24 out of 43) and aortic rupture was observed in 32.5% of patients (14 out of 43). All SG implants were successfully completed and there was no patient with surgical conversion. Thirty-day mortality was 7.0% (3 out of 43) and one patient (2.3%) experienced spinal cord ischemia during hospitalization. Entry tear exclusion was achieved in 91.3% of patients at 1 month, and 95.7% at 24 months. Through 24 months after TEVAR, no retrograde type A aortic dissection was observed and distal stent graft induced new entry was observed in two patients (4.7%).Conclusion: TEVAR utilizing the CTAG device for complicated BAAD in Japan demonstrated a low incidence of perioperative mortality and complications. Complications directly attributed to the SG including RTAD and dSINE were uncommon and the midterm outcomes were deemed satisfactory.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"592-600"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of a Tissuetunneler guide for an automatic suture device in robot-assisted thoracic surgery. 在机器人辅助胸外科手术中使用组织隧道引导器自动缝合装置。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-05-20 DOI: 10.1007/s11748-025-02141-2

Tomohiko Matsuzaki, Hiroto Onozawa, Atsushi Wada, Naohiro Aruga, Masayuki Iwazaki, Ryota Masuda

引用次数: 0

The effect of spironolactone in reducing the risk of postoperative atrial fibrillation in patients undergoing coronary artery bypass graft surgery: randomized single-blind placebo-controlled study. 螺内酯降低冠状动脉旁路移植手术患者术后心房颤动风险的效果：随机单盲安慰剂对照研究。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2024-11-01 DOI: 10.1007/s11748-024-02101-2

Ava Farzaneh, Mehdi Moradi, Gholamreza Safarpoor, Armin Karamian

{"title":"The effect of spironolactone in reducing the risk of postoperative atrial fibrillation in patients undergoing coronary artery bypass graft surgery: randomized single-blind placebo-controlled study.","authors":"Ava Farzaneh, Mehdi Moradi, Gholamreza Safarpoor, Armin Karamian","doi":"10.1007/s11748-024-02101-2","DOIUrl":"10.1007/s11748-024-02101-2","url":null,"abstract":"Background: Postoperative atrial fibrillation (POAF), one of the most common cardiac arrhythmias following coronary artery bypass graft (CABG) surgery is associated with unfavorable outcomes.Objectives: This study investigated the effect of spironolactone administered two weeks before surgery on the incidence of POAF in patients undergoing CABG.Methods: This randomized single-blind placebo-controlled study was conducted on 130 CABG patients. All patients were randomly divided into intervention and control groups including 65 cases for each group. In the intervention group, patients received 50 mg of spironolactone orally daily for 2 weeks before surgery, and in the control group patients received placebo daily from 2 weeks before surgery. All patients were continuously monitored for the occurrence of POAF for two weeks postoperatively.Results: The mean age of the patients in the intervention and control groups was 61.7 ± 5.4 and 60 ± 6.7 years, respectively. The incidence of POAF in the intervention and control groups was 7.7% and 20%, respectively (Odds Ratio = 0.33, P = 0.042). All demographic and clinical variables were similar in patients with and without POAF (all P > 0.05).Conclusions: Our findings revealed that in comparison to placebo, the use of spironolactone is associated with reduced incidence of POAF in CABG candidates.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"579-584"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commando procedure in cardiac surgery: a narrative review. 心脏外科突击手术：述评。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-08-01 Epub Date: 2025-06-25 DOI: 10.1007/s11748-025-02168-5

Hanyun Yi, Yongnan Li, Qiming Zhao, Xiangyang Wu

{"title":"Commando procedure in cardiac surgery: a narrative review.","authors":"Hanyun Yi, Yongnan Li, Qiming Zhao, Xiangyang Wu","doi":"10.1007/s11748-025-02168-5","DOIUrl":"10.1007/s11748-025-02168-5","url":null,"abstract":"Objective: The Commando procedure is a technically demanding, high-risk cardiac operation. This review synthesizes advancements in the Commando procedure, with emphasis on technical modifications, broadening clinical applications, and associated clinical outcomes.Methods: The study employed a systematic literature search in PubMed, utilizing the term \"Commando Procedure,\" covering all publication dates, yielding 178 identified articles. The inclusion criteria favored peer-reviewed studies that offered detailed surgical accounts, case series with a minimum of five patients, outcome evaluations, or technical innovations-e.g., novel patching or suture techniques. The editorials and studies devoid of procedural details or quantitative results were excluded. Editorials and studies devoid of procedural details or quantitative results were excluded.Results: The review details the expanded clinical applications, technical improvements, and outcome trends of the Commando procedure. Initially crafted to manage aortic annular dilation, the technique now covers a broader spectrum of complex multivalvular diseases. The correlation between recent procedural standardization and broader clinical adoption is evident in improved survival rates. However, unresolved challenges remain. However, unresolved challenges remain.Conclusion: In recent years, we have witnessed a proliferation of procedural modifications and adaptations of the Commando technique, tailored to address anatomically distinct pathologies across heterogeneous clinical scenarios.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"567-578"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0