General Thoracic and Cardiovascular Surgery最新文献

{"title":"Association between recovery from desaturation after stair climbing and postoperative complications in lung resection.","authors":"Kensuke Takei, Hayato Konno, Shinya Katsumata, Koki Maeda, Hideaki Kojima, Mitsuhiro Isaka, Keita Mori, Yasuhisa Ohde","doi":"10.1007/s11748-024-02059-1","DOIUrl":"10.1007/s11748-024-02059-1","url":null,"abstract":"<p><strong>Objective: </strong>The stair-climbing test (SCT) is used as a surrogate for cardiopulmonary exercise testing, which measures maximal oxygen uptake, and considered a useful method for assessing exercise capacity in thoracic surgery. This study aims to investigate whether the recovery time of percutaneous oxygen saturation (SpO₂) after stair climbing is a predictor of postoperative complications after lobectomy.</p><p><strong>Methods: </strong>We retrospectively identified 54 patients who performed SCT and underwent lobectomy between January 2015 and February 2023 at Shizuoka Cancer Center. The SpO₂ recovery time was defined as the time required to recover from the minimum to resting value after stair climbing. The association between SpO₂ recovery time and early postoperative pulmonary complications within 30 days after surgery was analyzed.</p><p><strong>Results: </strong>Eleven patients (20.4%) had postoperative pulmonary complications (≥ Clavien-Dindo Classification Grade 2). The cutoff value of SpO₂ recovery time obtained from the receiver operating characteristic curve analysis was 90 s [sensitivity, 81.8%; specificity, 72.1%; AUC, 0.77 (95% confidence interval, 0.64-0.90)]. The occurrence of postoperative pulmonary complications was 42.9% in the delayed recovery time (DRT; SpO₂ recovery time ≥ 90 s) group and 6.1% in the non-DRT (SpO₂ recovery time < 90 s) group (p = 0.002). DRT was a predictor of postoperative pulmonary complications (odds ratio, 11.60; 95% CI 2.19-61.80).</p><p><strong>Conclusions: </strong>DRT of SpO₂ after stair climbing is a predictor of postoperative pulmonary complications following lobectomy in borderline patients who require exercise capacity assessment. SpO₂ monitoring after stair climbing may be useful as one of the preoperative assessments in patients undergoing lobectomy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"171-179"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616239","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}

{"title":"Hypercoagulable state and effect of low-molecular-weight heparin prophylaxis on coagulation after lung cancer resection: results from thrombo-elastography.","authors":"Xiaoxiao Yang, Yongsheng Cai, Lihui Ke, Bo Wei","doi":"10.1007/s11748-024-02062-6","DOIUrl":"10.1007/s11748-024-02062-6","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients undergoing surgery are at increased risk for Venous thromboembolism (VTE). We monitored changes in perioperative coagulation status through Thrombo-elastography (TEG), and monitored the anticoagulant effect of low molecular weight heparin through TEG for the first time.</p><p><strong>Methods: </strong>From July 2019 to January 2020, 207 patients receiving curative surgery were retrospectively screened. and 23 patients were excluded because they did not meet the inclusion criteria. Blood samples were required at three time points (prior to, the first and third day after surgery). Some patients were administrated nadroparin calcium daily from the first day after surgery. Repeated measures ANOVA and Chi-square test were used to analyze the coagulation states variation. To balance the confounders, propensity score matching (PSM) was used to determine the differences of coagulation states between patients with or without Low-molecular-weight heparin (LMWH) prophylaxis.</p><p><strong>Results: </strong>In 184 patients, TEG parameters displayed significant procoagulant changes after lung surgery but conventional coagulation tests exhibited paradoxical trends. There were 6.5% (12/184) of patients identified as hypercoagulability before surgery. According to TEG results, the proportion of patients with hypercoagulability rose from 21.7% to 25% postoperatively, but more were classified into platelet or mixed hypercoagulability at third day compared with that at first day (3.8% vs 14.1%, P < 0.001). By PSM analysis, there were no significant differences in the proportion of hypercoagulable patients postoperatively between chemoprophylactic and nonprophylactic group.</p><p><strong>Conclusions: </strong>TEG was eligible to distinguish changing states of hypercoagulability postoperatively and indicate the role of platelet in blood hypercoagulability. Administration of postoperative LMWH prophylaxis showed little mitigation on hypercoagulable states.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"180-189"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation vs cardiopulmonary bypass in lung transplantation: an updated meta-analysis.","authors":"Rachid Eduardo Noleto da Nobrega Oliveira, Felipe S Passos, Bernardo Mulinari Pessoa","doi":"10.1007/s11748-024-02114-x","DOIUrl":"10.1007/s11748-024-02114-x","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs). DerSimonian and Laird random-effects model was applied for all endpoints. I² statistics was used to assess heterogeneity.</p><p><strong>Results: </strong>Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25-0.90), hemodialysis (OR 0.62, 95% CI 0.43-0.88), severe graft rejection (OR 0.43, 95% CI 0.23-0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I² = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46-0.86). Additionally, ECMO reduced the length of hospital stay (MD - 5.69 days, 95% CI - 9.31 to - 2.08) and ICU stay (MD - 6.02 days, 95% CI - 8.32 to - 3.71). However, ECMO was associated with longer total ischemic time (MD 61.07 min, 95% CI 3.51 to 118.62). No significant differences were observed for stroke, thromboembolic events, atrial fibrillation, or 30-day and 3-year mortality.</p><p><strong>Conclusions: </strong>ECMO offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.</p><p><strong>Trial registry: </strong>International Prospective Register of Systematic Reviews; N°: CRD42024604049; URL: https://www.crd.york.ac.uk/prospero/ .</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"137-146"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871888","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}

{"title":"Aortic floating thrombus in patients with COVID-19: a report of eight cases.","authors":"K Soumer, M Mallouki, N Azabou, H Horchani, S Nsiri, M Bousnina, A Jemel","doi":"10.1007/s11748-024-02072-4","DOIUrl":"10.1007/s11748-024-02072-4","url":null,"abstract":"<p><strong>Background: </strong>Thromboembolic events of COVID-19 are due to hyperinflammatory process associated with hypercoagulable state. The aim of the study was to determine characteristics and clinical outcomes of patients with COVID-19 who presented with aortic thrombus.</p><p><strong>Methods: </strong>We retrospectively conducted a single-center, descriptive study over a period of 1 year and 7 months, between June 2021 and December 2022, involving eight patients with documented SARS-CoV-2 infection associated with aortic thrombus revealed by acute limb ischemia.</p><p><strong>Results: </strong>The mean age of patients was 67 years with a median of 64, 5 ± 14. Of the eight included patients, six were men and two were women. Aortic thrombus was diagnosed in all cases. Six patients developed one episode of acute limb ischemia and one patient had recurrent upper and lower ischemia despite full anticoagulation whereas one patient had distal embolization with palpable pulses. In six patients, the thrombi were located in descending and abdominal aorta, while two patients presented with ascending aorta floating thrombus. Seven patients required urgent revascularization whereas medical treatment was recommended for one patient. The primary outcomes were successful in five cases, one patient had to be amputated above elbow, whereas two patients died due to a rapid deterioration of respiratory condition.</p><p><strong>Conclusion: </strong>Aortic thrombosis is a rare clinical presentation in SARS-CoV-2 infection but with potentially fatal embolic complication. Physicians should maintain a high degree of clinical suspicion to diagnose thromboembolic consequences of SARS-CoV-2 infection for timely management and avoiding morbidities like ischemic stroke and major amputations.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"164-170"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975492","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}

{"title":"Effects of temperature on transient neurologic dysfunction after total arch replacement.","authors":"Keitaro Nakanishi, Hiroshi Sato, Yutaka Iba, Ayaka Arihara, Shuhei Miura, Tsuyoshi Shibata, Jyunji Nakazawa, Tomohiro Nakajima, Takeo Hasegawa, Nobuyoshi Kawaharada","doi":"10.1007/s11748-024-02068-0","DOIUrl":"10.1007/s11748-024-02068-0","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between cooling status during aortic surgery with hypothermic circulatory arrest and postoperative neurologic dysfunction remains unknown. In the present study, we evaluated the effect of cooling status on transient neurologic dysfunction after total arch replacement.</p><p><strong>Methods: </strong>We studied patients who underwent elective total arch replacement with hypothermic circulatory arrest and antegrade selective cerebral perfusion from December 2011 to January 2021. Changes in tympanic temperature trends recorded during surgery were plotted. Several parameters, including the nadir temperature, cooling speed, and degree of cooling (cooling area, or the area under the curve of inverted temperature trends from cooling to rewarming as calculated by the integral method), were analyzed. The relationships between these variables and transient neurologic dysfunction were evaluated.</p><p><strong>Results: </strong>Transient neurologic dysfunction was observed in 33 (14.5%) of the 228 included patients. In the transient neurologic dysfunction group, the cooling area was larger (2417.3 vs. 1920.8 °C min; P < 0.001) and the cooling speed was higher (0.68 vs. 0.51 °C/min; P < 0.001) than in the non-transient neurologic dysfunction group. A multivariate logistic model revealed that both the cooling area (odds ratio = 1.13 per 100 °C min; P < 0.001) and cooling speed (odds ratio = 3.69 per °C/min; P = 0.041) were independent risk factors for transient neurologic dysfunction.</p><p><strong>Conclusions: </strong>Both the cooling area, which indicates the degree of cooling, and cooling speed had significant relationships with transient neurologic dysfunction after total arch replacement. Together, these findings indicate that overcooling and rapid cooling may contribute to brain injury.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"155-163"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893243","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}

{"title":"In vitro protamine addition for coagulation assessment using TEG 6s system during cardiopulmonary bypass: a pilot study.","authors":"Koichi Yoshinaga, Yusuke Iizuka, Yoshihiko Chiba, Yusuke Sasabuchi, Masamitsu Sanui","doi":"10.1007/s11748-024-02061-7","DOIUrl":"10.1007/s11748-024-02061-7","url":null,"abstract":"<p><strong>Objective: </strong>Systemic heparinization during cardiopulmonary bypass (CPB) can significantly affect thromboelastography (TEG). This study investigated the feasibility of adding protamine in vitro to allow assessment of coagulation status using the TEG 6s system during CPB.</p><p><strong>Methods: </strong>In this prospective observational study, 21 patients undergoing elective cardiac valve surgery were evaluated. During CPB, protamine was added in vitro to the heparinized blood of these patients at a concentration of 0.05 mg/mL and analyzed with the TEG 6s (Pre). The TEG parameters were compared to those analyzed after CPB withdrawal and systemic protamine administration (Post).</p><p><strong>Results: </strong>The citrated kaolin maximal amplitude (CK-MA) and the citrated functional fibrinogen maximal amplitude (CFF-MA) exhibited strong correlations between Pre and Post measurements (r = 0.790 and 0.974, respectively, P < 0.001 for both), despite significant mean differences (-2.23 mm for CK-MA and -0.68 mm for CFF-MA). Bland-Altman analysis showed a clinically acceptable agreement between Pre and Post measurement of CK-MA and CFF-MA (the percentage error was 10.6% and 12.2%, respectively). In contrast, the citrated kaolin reaction time (CK-R) showed no significant correlation between Pre and Post measurements (r = 0.328, P = 0.146), with a mean difference of 1.42 min (95% CI: -0.45 to 3.29).</p><p><strong>Conclusions: </strong>In vitro protamine addition allows assessment of coagulation status during CPB using the TEG 6s system. CK-MA and CFF-MA measured during CPB using this method revealed a strong correlation and agreement with post-CPB measurements, suggesting that our method potentially facilitates early prediction of post-CPB coagulation status and decision-making on transfusion strategies.</p><p><strong>Clinical trial registration: </strong>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, registration number: UMIN000041097, date of registration: July 13, 2020, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046925 ) before the recruitment of participants.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"147-154"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626450","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}

{"title":"Comparison of postoperative pain between robotic and uniportal video-assisted thoracic surgery for anatomic lung resection in patients with stage I lung cancer.","authors":"Keita Tokuishi, Jun-Ichi Wakahara, Yuichiro Ueda, So Miyahara, Hiroyasu Nakashima, Yoshiko Masuda, Ryuichi Waseda, Takeshi Shiraishi, Toshihiko Sato","doi":"10.1007/s11748-025-02129-y","DOIUrl":"https://doi.org/10.1007/s11748-025-02129-y","url":null,"abstract":"<p><strong>Objective: </strong>Uniportal video-assisted thoracoscopic surgery (U-VATS) and robot-assisted thoracoscopic surgery (RATS) are widely used, minimally invasive procedures. The present study aimed to compare postoperative pain following U-VATS and RATS anatomical lung resection in patients with clinical stage I lung cancer.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the data from 133 patients with clinical stage I lung cancer who underwent U-VATS (n = 63), four-arm RATS (n = 70) lobectomy, or segmentectomy between August 2020 and August 2023. Early postoperative outcomes, pain scores through postoperative day 7, and duration of postoperative analgesic use 60 days after surgery were compared using propensity score-matched analysis.</p><p><strong>Results: </strong>In the propensity score-matched analysis, the U-VATS group had a shorter operative time than the RATS group (160 vs. 202 min, respectively; P < 0.001). However, no significant differences were observed in blood loss, chest tube duration, complications, post operative stay length, or number of dissected lymph nodes and stations. The U-VATS group exhibited significantly lower pain scores than the RATS group throughout the entire postoperative period, particularly on postoperative days 1, 2, 3, 4, 5, and 7(P = 0.006, 0.044, 0.032, 0.041, 0.007, and 0.024, respectively). The number of patients who used analgesics for at least 2 months was lower in the U-VATS group than in the RATS group (4 [8.2%] vs. 17 [34.0%], respectively; P = 0.002).</p><p><strong>Conclusion: </strong>U-VATS anatomical lung resection in patients with clinical stage I lung cancer has less postoperative pain than RATS.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515449","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}

{"title":"Postoperative outcomes of cardiovascular surgery managed by nurse practitioners.","authors":"Masato Saitoh, Takuma Yamasaki, Tomoaki Tanabe, Shuichi Tochigi, Daiki Hirayama, Kiyotaka Aoyama, Imun Tei","doi":"10.1007/s11748-025-02132-3","DOIUrl":"https://doi.org/10.1007/s11748-025-02132-3","url":null,"abstract":"<p><strong>Objective: </strong>The significant workload of cardiovascular surgeons in Japan has led to a growing interest in implementing nurse practitioners as a means to address this issue. This study seeks to evaluate the postoperative outcomes of cardiovascular surgeries in which nurse practitioners were involved at our institution.</p><p><strong>Methods: </strong>This study utilized a retrospective observational study design. This study included patients who underwent scheduled cardiovascular surgeries at our hospital between April 1, 2019, and March 31, 2024. Patients were divided into two groups for postoperative care management: the DR group (physician only) and the NP group (co-management by physician and nurse practitioner). The primary end point was the 30-day mortality. We compared the two groups.</p><p><strong>Results: </strong>A total of 394 patients were classified into two groups: DR group (n = 101) and NP group (n = 293). There was no significant difference in the 30-day mortality between the two groups. The NP group had significantly shorter hospital stay (NP 20.6 ± 11.1 vs. DR 24.0 ± 11.8; p = 0.01; effect size = 0.299), postoperative length of stay (NP 14.5 ± 8.9 vs. DR 18.0 ± 10.4; p = 0.001; effect size = 0.376), ICU stay (NP 5.2 ± 3.5 vs. DR 6.3 ± 4.5; p = 0.014; effect size = 0.284), and time until 50-m walking (NP 3.8 ± 3.5 vs. DR 5.1 ± 5.1; p = 0.004; effect size = 0.342). There were no significant differences in the incidence of postoperative complications between the two groups.</p><p><strong>Conclusions: </strong>Nurse practitioners have the potential to provide safe care equivalent to that of physicians, and it may contribute to reduced hospital stays and improved postoperative recovery in patients.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482653","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}

{"title":"WTAP-mediated m6A modification on BASP1 mRNA contributes to ferroptosis in AAA.","authors":"Zexiang Tian, Wei Li, Jian Wang, Shuzhen Li","doi":"10.1007/s11748-025-02130-5","DOIUrl":"https://doi.org/10.1007/s11748-025-02130-5","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) is a common aneurysm that is often associated with atherosclerosis and can lead to artery rupture and death. Brain abundant membrane attached signal protein 1 (BASP1) is related to a variety of pathophysiological processes, but its role in AAA has not been reported.</p><p><strong>Methods: </strong>Real-time quantitative polymerase chain reaction (qRT-PCR) and western blot were used to detect the expressions of BASP1 and Wilms' tumor 1-associated protein (WTAP). Angiotensin-II (Ang-II) was employed for inducing AAA models in vitro to explore the effects and mechanism of BASP1 in AAA. Cell viability, apoptosis, oxidative stress level, and Fe²⁺ level were measured by the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide (MTT), flow cytometry, and various kits, respectively. In terms of mechanism, the methylated RNA immunoprecipitation (MeRIP)-qPCR, the dual luciferase reporter assay, and the cytochrome experiments were utilized to evaluate the relationship between BASP1 and WTAP.</p><p><strong>Results: </strong>A highly expressed level of BASP1 was observed in aortic tissues of AAA patients and Ang-II could induce AAA models by treating vascular smooth muscle cells (VSMCs). In cellular function, BASP1 knockdown impaired AAA and ferroptosis resulted from Ang-II. Mechanically, WTAP mediated the N6-methyladenosine (m6A) modification and mRNA stability of BASP1. Meanwhile, WTAP was highly expressed in AAA tissues of patients and the effects of WTAP silence in AAA and ferroptosis were diminished by up-regulated BASP1.</p><p><strong>Conclusion: </strong>WTAP promotes cell viability and inhibits apoptosis and ferroptosis resulted from Ang-II in VSMCs by mediating the m6A level of BASP1.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448881","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}

{"title":"Risk factors for distal stent graft-induced new entry after frozen elephant trunk procedure in chronic aortic dissection.","authors":"Sho Akita, Yoshiyuki Tokuda, Yuji Narita, Sachie Terazawa, Tomo Yoshizumi, Hideki Ito, Masato Mutsuga","doi":"10.1007/s11748-025-02122-5","DOIUrl":"https://doi.org/10.1007/s11748-025-02122-5","url":null,"abstract":"<p><strong>Background: </strong>The frozen elephant trunk (FET) procedure has emerged as an effective single-stage treatment for complex aortic pathologies. However, it carries a risk of distal stent graft-induced new entry (dSINE) in patients with chronic aortic dissection (CAD). This study investigated risk factors associated with dSINE development.</p><p><strong>Methods: </strong>Between 2009 and 2021, 160 FET procedures were performed, including 48 cases of CAD (mean time from onset: 5.6 ± 3.8 years). After excluding five patients due to incomplete 6-month postoperative computed tomography (CT) data, 43 patients were included. A multivariable stepwise Cox proportional hazards regression analysis was conducted to identify predictors of dSINE.</p><p><strong>Results: </strong>During a mean follow-up period of 5.9 ± 3.9 years, dSINE occurred in 22 of 43 patients (51.1%). Univariate analysis identified three significant risk factors for dSINE: total aortic diameter (TAD) > 45 mm at the distal stent-graft level (HR 5.88, 95% CI 1.35-25.52, p = 0.018), True lumen (TL) perimeter-based diameter (HR 1.22, 95% CI 1.03-1.46; p = 0.021), and TL ovality (HR 1.31, 95% CI 1.04-1.65, p = 0.022). Multivariate analysis revealed TAD > 45 mm as an independent risk factor for dSINE (HR 4.60, 95% CI 1.01-20.85, p = 0.048). The 5-year freedom from dSINE was significantly higher in patients with TAD ≤ 45 mm compared to those with TAD > 45 mm (87.5% vs. 20.8%, p < 0.01).</p><p><strong>Conclusions: </strong>Although FET remains an important therapeutic option for CAD, dSINE represents a significant postoperative complication. TAD > 45 mm was identified as an independent risk factor. These findings may guide surgical planning for FET procedures.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255448","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}