General Thoracic and Cardiovascular Surgery最新文献

{"title":"Implications for prosthesis selection in dialysis patients undergoing aortic valve replacement.","authors":"Kyriakos Spiliopoulos, Andrew V Xanthopoulos, Konstantinos Sideris, Dimitrios Magouliotis, John Skoularigis","doi":"10.1007/s11748-024-02104-z","DOIUrl":"10.1007/s11748-024-02104-z","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"123-124"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618138","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":"Segmentectomy versus lobectomy: does FEV1.0 change accurately reflect the postoperative cardiopulmonary function?","authors":"Yusuke Fujibayashi, Masahiko Takata, Noriaki Tsubota, Yoshimasa Maniwa","doi":"10.1007/s11748-024-02052-8","DOIUrl":"10.1007/s11748-024-02052-8","url":null,"abstract":"<p><strong>Objective: </strong>The postoperative respiratory function has been compared between lobectomy and segmentectomy based on the resting spirometric change in many previous studies. However, spirometric change has only been assessed in static conditions, and it is unclear whether it accurately reflects the cardiopulmonary function.</p><p><strong>Methods: </strong>We used spirometry and a 6-min walk test to evaluate patients who underwent lobectomy and segmentectomy and examined the changes in heart rate (HR), respiratory rate (RR), and saturation of percutaneous oxygen (SpO₂) before and after walking between the two groups.</p><p><strong>Results: </strong>The present study included 24 patients who underwent segmentectomy and 21 who underwent lobectomy. There was no significant difference in the reduction of the median forced expiratory volume in 1 s (FEV1.0) after surgery. In the 6-min walk test, the increase in HR and RR after surgery has no significant differences between lobectomy and segmentectomy (HR: p = 0.372 and RR: p = 0.131). However, the two groups showed a significant difference in the reduction of SpO₂ (p < 0.001). In addition, correlation analysis found that the more the number of resected segments, the more the reduction of SpO₂ with a statistical significance (p = 0.002).</p><p><strong>Conclusions: </strong>Patients who received segmentectomy showed to suppress the reduction of SpO₂ with a statistical difference after the 6-min walk test in comparison to those who received lobectomy. These results suggest that segmentectomy has less impact on the cardiopulmonary function and the 6-min walk test is useful for evaluating the postoperative cardiopulmonary function.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"96-101"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418570","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":"Optimal timing of bridging annuloplasty and patch augmentation for heterotaxy syndrome associated with functional single ventricles.","authors":"Makoto Nakamura, Motonori Ishido, Masahiko Nishioka","doi":"10.1007/s11748-024-02057-3","DOIUrl":"10.1007/s11748-024-02057-3","url":null,"abstract":"<p><strong>Objective: </strong>Although the challenging prognosis of functional single ventricles with common atrioventricular valves due to complex morphology and uncontrollable regurgitation by valvuloplasty has been highlighted, reports on when and how these extremely complicated atrioventricular valves should be repaired are few. This study investigated the timing and risk factors for valve intervention in these patients.</p><p><strong>Methods: </strong>Between April 2006 and March 2023, 40 patients with heterotaxy syndrome associated with functional single ventricles underwent surgery. Valve intervention was performed in 14 of the 40 patients with moderate or severe atrioventricular valve regurgitation.</p><p><strong>Results: </strong>The timing of the first valve intervention varied, with four, five, three, and two patients undergoing valve intervention before the cavopulmonary shunt, simultaneously with the cavopulmonary shunt, before total cavopulmonary connection, and simultaneously with total cavopulmonary connection, respectively. Mechanical valve replacements were performed in three patients. Among the 14 patients undergoing valve intervention, four died. Three of the four patients underwent valvuloplasty before the cavopulmonary shunt, including two who could undergo the cavopulmonary shunt but died after the procedure. Eight of the fourteen patients completed total cavopulmonary connection. The cumulative survival rate was not significantly different between the 14 patients who underwent and 26 who did not undergo intervention (hazard ratio, 2.52; 95% confidence interval, 0.56-11.24; P = 0.23).</p><p><strong>Conclusion: </strong>Our surgical strategies provide a chance for the next staged repair of common atrioventricular valves in patients with both heterotaxy and valvular regurgitation. Including patch augmentation, advanced valve intervention is possible at or after the cavopulmonary shunt.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"73-79"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544730","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":"Pooled comparative analysis of transcatheter aortic valve replacement versus surgical aortic valve replacement in patients with left ventricular assist device.","authors":"Dimitrios E Magouliotis, Grigorios Giamouzis, Thanos Athanasiou, Kyriakos Spiliopoulos, Alexandros Briasoulis, John Skoularigis, Filippos Triposkiadis, Andrew Xanthopoulos","doi":"10.1007/s11748-024-02100-3","DOIUrl":"10.1007/s11748-024-02100-3","url":null,"abstract":"<p><p>A thorough literature search was conducted on patients with Left Ventricular Assist Device (LVAD) and aortic insufficiency undergoing transcatheter aortic valve replacement (TAVR). We identified all original research studies that compared the long-term outcomes of surgical transcatheter aortic valve replacement (SAVR) versus TAVR for patients with LVAD, published between 1990 and 2023. The primary endpoint was the composite of in-hospital mortality, stroke, transient ischemic attack, myocardial infarction (MI), pacemaker implantation, vascular complications and cardiac tamponade. Secondary endpoints were the median overall survival (OS), the incidence of acute kidney injury (AKI), any bleeding needing transfusions or reintervention and cost. A total of fourteen studies and 358 patients were included (TAVR: 242; SAVR: 116). The composite outcome, the incidence of AKI, the bleeding needing transfusion, along with cost were significantly higher in the SAVR group. In addition, there was no significant difference between TAVR and SAVR in terms of median OS. The median OS in the TAVR group was 18 months. Finally, the most common causes of death were progression of heart failure and pneumonia. The present meta-analysis indicates that TAVR is associated with enhanced outcomes compared to SAVR for patients with LVAD presenting aortic insufficiency. Further well-designed original studies with greater sample sizes are necessary to validate our findings.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"125-129"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498609","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":"Neck vessels geometry and diameter change in patients with acute type A aortic dissection.","authors":"Yuichiro Kitada, Homare Okamura, Kengo Teshima, Kei Akiyoshi, Yohei Nomura, Makiko Mieno, Hideo Adachi","doi":"10.1007/s11748-025-02121-6","DOIUrl":"https://doi.org/10.1007/s11748-025-02121-6","url":null,"abstract":"<p><strong>Objective: </strong>Branched prostheses are used to treat aortic arch with dissection. However, changes in the neck vessel geometry and diameter after dissection are not well known. We aimed to evaluate neck vessels geometry and changes in diameter with dissection.</p><p><strong>Methods: </strong>A total of 209 patients admitted to our hospital for acute type A aortic dissection, and we excluded patients with insufficient computed tomography image to evaluate neck vessels; as such 201 patients were included. We measured the neck vessels geometry with or without dissection, and additionally evaluated the pre- and postdissection neck vessel diameters in 16 patients for whom predissection computed tomography were available.</p><p><strong>Results: </strong>The average differences between the non-dissected and dissected vessels were 3.0 mm in proximal innominate artery (IA), 2.8 mm in distal IA, 2.5 mm in proximal left carotid artery (LCCA), 3.1 mm in distal LCCA, 2.7 mm in proximal left subclavian artery (LSA), and 1.9 mm in distal LSA. The average pre- and postdissection diameters of the neck vessels were as follows: IA: 15.1 ± 2.6 and 16.7 ± 3.2 mm (P = 0.002); LCCA: 10.7 ± 0.9 and 12.3 ± 1.2 mm (P = 0.054); and LSA: 12.4 ± 2.5 and 12.8 ± 2.1 mm (P = 0.32).</p><p><strong>Conclusion: </strong>In patients with acute type A aortic dissection, dissected neck vessels diameter is significantly larger than that of the non-dissected neck vessels diameter. However, the postdissection diameter changes in the neck vessels were mostly <2 mm.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037847","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":"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":"https://doi.org/10.1007/s11748-024-02105-y","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>After lobectomy, better residual lung expansion was associated with improved postoperative pulmonary function.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","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}

{"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":"https://doi.org/10.1007/s11748-024-02115-w","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Setting the SUVmax as cutoff value could predict pathologically less-invasive cancers in c-stage IA2-IA3 solid predominant lung adenocarcinoma.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-06","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}

{"title":"Prognostic significance of preoperative to postoperative serum carcinoembryonic antigen ratio after lobectomy for lung adenocarcinoma.","authors":"Go Kamimura, Masaya Aoki, Mihiro Iwamoto, Yusei Tsuneyoshi, Shoichiro Morizono, Tadashi Umehara, Aya Harada-Takeda, Koki Maeda, Toshiyuki Nagata, Kazuhiro Ueda","doi":"10.1007/s11748-024-02042-w","DOIUrl":"10.1007/s11748-024-02042-w","url":null,"abstract":"<p><strong>Introduction: </strong>Lung adenocarcinoma with a preoperatively elevated serum carcinoembryonic antigen (CEA) value has a relatively poor postoperative prognosis. Although surgical resection generally results in a reduction in the CEA value, the significance of the change in the CEA value on the prognostic outcome remains unclear.</p><p><strong>Methods: </strong>Our study included 133 patients who underwent lobectomy with curative intent for lung adenocarcinoma representing a preoperative CEA value > 5.0. Statistical analysis was performed using a receiver operating characteristic analysis and a stepwise Cox proportional hazards analysis.</p><p><strong>Results: </strong>Both the postoperative CEA value and postoperative-to-preoperative CEA ratio (CEA ratio) significantly affected the survival. Although the CEA ratio was not predictive of the survival in patients with postoperative CEA ≤ 6.2 ng/ml (n = 105), it was predictive in the remaining patients with postoperative CEA > 6.2 ng/ml (n = 28). Patients with postoperative CEA > 6.2 ng/ml and a CEA ratio ≥ 0.39 (n = 7) showed the worst survival outcome. According to the multivariate analysis, the CEA ratio and postoperative nodal status were significant predictors of the survival in overall patients.</p><p><strong>Conclusion: </strong>The CEA ratio may be a useful prognostic marker in patients who undergo lobectomy for lung adenocarcinoma and show postoperative CEA > 6.2 ng/ml. A high CEA ratio may indicate the presence of a subclinical residual tumor, which may lead to the development of subsequent recurrence.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"39-44"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157322","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":"Correction: Post-lung transplant outcomes of connective tissue disease-related interstitial lung diseases compared with idiopathic interstitial pneumonia: a single-center experience in Japan.","authors":"Miho Yamaguchi, Takafumi Yamaya, Mitsuaki Kawashima, Chihiro Konoeda, Hidenori Kage, Masaaki Sato","doi":"10.1007/s11748-024-02108-9","DOIUrl":"10.1007/s11748-024-02108-9","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"72"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768058","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":"Updated pathophysiological overview of functional MR (ventricular and atrial).","authors":"Jun Akashi, Yutaka Otsuji, Yosuke Nishimura, Robert A Levine, Masaharu Kataoka","doi":"10.1007/s11748-024-02047-5","DOIUrl":"10.1007/s11748-024-02047-5","url":null,"abstract":"<p><p>Basic mechanism of ventricular functional mitral regurgitation (FMR) is subvalvular tethering. Left ventricular (LV) dilatation, in association with mitral valve (MV) annular dilatation, causes outward displacement of papillary muscles (PMs), which abnormally pulls or tethers MV leaflets, resulting in MV tenting, reduction in leaflets coaptation and MR. Because surgical annuloplasty does shorten distance between anterior and posterior MV annuli to improve coaptation but does not address this subvalvular tethering, ventricular FMR frequently persists or recurs in the chronic stage after surgical annuloplasty. This high incidence of persistent/recurrent MR requires additional procedures to reduce subvalvular tethering. Although patients occasionally show marked improvements after annuloplasty with surgical tethering reduction procedures such as PM approximation, evidence to support benefits of such surgery is limited, requiring further trials. Recently, MV adaptation or MV leaflets tissue growth associated with LV dilatation attracts attention. Patients with larger MV leaflets with significant LV dilatation/dysfunction show less MV tethering and MR compared to those with smaller MV leaflets but with similar LV remodeling, suggesting the protective or beneficial role of MV leaflets tissue growth against LV remodeling. The MV leaflets tissue growth has the potential to lead to novel strategies of treatment for ventricular FMR. It is well known that atrial FMR is frequent in patients with left atrial dilatation, typically in those with isolated atrial fibrillation. The degree of atrial FMR is usually mild, even when it is present, and occasionally moderate, and severe atrial FMR is really rare. It is known that only severe regurgitation causes heart failure in primary MR, resulting in description on indications of surgery or intervention for only severe MR in current guidelines. Therefore, this atrial FMR up to moderate degree did not attract attention for a long time. However, recent studies have shown that patients with only moderate atrial FMR develop severe heart failure, suggesting more aggressive indication of MV surgery or intervention for \"moderate\" regurgitation in patients with atrial FMR. Therefore, atrial FMR is now recognized highly important. The unveiled malignant nature of atrial FMR arises many questions, including (1) why patients with only moderate atrial FMR develop heart failure? (2) do patients with mild atrial FMR develop heart failure or not?, and many others. Atrial FMR seems even more mysterious after the unveiling of its significance.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300461","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}