General Thoracic and Cardiovascular Surgery最新文献_第6页

Postoperative outcomes of cardiovascular surgery managed by nurse practitioners. 由执业护士管理的心血管手术的术后结果。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-23 DOI: 10.1007/s11748-025-02132-3

Masato Saitoh, Takuma Yamasaki, Tomoaki Tanabe, Shuichi Tochigi, Daiki Hirayama, Kiyotaka Aoyama, Imun Tei

{"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":"Objective: 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.Methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

Aortic wall degeneration late after ascending aortic wrapping. 升主动脉包裹后晚期主动脉壁变性。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-23 DOI: 10.1007/s11748-025-02133-2

Haruna Araki, Tadashi Kitamura, Shinzo Torii, Toshiaki Mishima, Masaomi Fukuzumi, Kagami Miyaji

引用次数: 0

Guidelines for preoperative pulmonary function assessment in patients with lung cancer who will undergo surgery (The Japanese Association for Chest Surgery). 肺癌手术患者术前肺功能评估指南（日本胸外科协会）。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-19 DOI: 10.1007/s11748-025-02120-7

Yasuhisa Ohde, Kazuhiro Ueda, Jiro Okami, Hajime Saito, Toshihiko Sato, Eiji Yatsuyanagi, Masanori Tsuchida, Takahiro Mimae, Hiroyuki Adachi, Tomoyuki Hishida, Hisashi Saji, Ichiro Yoshino

{"title":"Guidelines for preoperative pulmonary function assessment in patients with lung cancer who will undergo surgery (The Japanese Association for Chest Surgery).","authors":"Yasuhisa Ohde, Kazuhiro Ueda, Jiro Okami, Hajime Saito, Toshihiko Sato, Eiji Yatsuyanagi, Masanori Tsuchida, Takahiro Mimae, Hiroyuki Adachi, Tomoyuki Hishida, Hisashi Saji, Ichiro Yoshino","doi":"10.1007/s11748-025-02120-7","DOIUrl":"https://doi.org/10.1007/s11748-025-02120-7","url":null,"abstract":"This article translates the guidelines for preoperative pulmonary function assessment in patients with lung cancer who will undergo surgery, established by the Japanese Association of Chest Surgery on May 17, 2021, from Japanese to English. The last version of these guidelines was created on April 5, 2011. Over the past decade, changes in clinical practice have occurred that do not align with the current guidelines, prompting a revision in conjunction with the introduction of new evidence this time. This guideline was developed with reference to the internationally adopted GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system. Extraction of evidence, systematic review, and quality assessment are entrusted to each guideline review committee and the Pulmonary Function Assessment Working Group. Committee members are also responsible for determining the selection of evidence and the extraction period, with a particular emphasis on adopting items considered to be of special importance. The recommended assessment and management is categorized into a general overview, pulmonary function assessment, cardiopulmonary exercise test, pulmonary function assessment for lung cancer with interstitial pneumonia, preoperative smoking cessation, and pulmonary rehabilitation. These are described by the strength of recommendation, the strength of evidence, and the consensus rate.","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":"143448879","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

WTAP-mediated m6A modification on BASP1 mRNA contributes to ferroptosis in AAA. wtap介导的m6A对BASP1 mRNA的修饰有助于AAA的铁下垂。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-19 DOI: 10.1007/s11748-025-02130-5

Zexiang Tian, Wei Li, Jian Wang, Shuzhen Li

{"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":"Background: 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.Methods: 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.Results: 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.Conclusion: WTAP promotes cell viability and inhibits apoptosis and ferroptosis resulted from Ang-II in VSMCs by mediating the m6A level of BASP1.","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}

引用次数: 0

Risk factors for distal stent graft-induced new entry after frozen elephant trunk procedure in chronic aortic dissection. 慢性主动脉夹层冷冻象鼻手术后远端支架移植诱导新血管进入的危险因素。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-06 DOI: 10.1007/s11748-025-02122-5

Sho Akita, Yoshiyuki Tokuda, Yuji Narita, Sachie Terazawa, Tomo Yoshizumi, Hideki Ito, Masato Mutsuga

{"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":"Background: 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.Methods: 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.Results: 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).Conclusions: 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.","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}

引用次数: 0

No survival benefit of primary tumor resection for non-small cell lung cancer patients with unexpectedly detected pleural disseminated nodules in the era of targeted therapy. 在靶向治疗时代，对意外发现胸膜播散性结节的非小细胞肺癌患者进行原发肿瘤切除术无生存益处。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-01 Epub Date: 2024-07-20 DOI: 10.1007/s11748-024-02055-5

Yukio Watanabe, Kazuya Takamochi, Takuo Hayashi, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Hisashi Tomita, Kenji Suzuki

{"title":"No survival benefit of primary tumor resection for non-small cell lung cancer patients with unexpectedly detected pleural disseminated nodules in the era of targeted therapy.","authors":"Yukio Watanabe, Kazuya Takamochi, Takuo Hayashi, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Hisashi Tomita, Kenji Suzuki","doi":"10.1007/s11748-024-02055-5","DOIUrl":"10.1007/s11748-024-02055-5","url":null,"abstract":"Objectives: Non-small cell lung cancer (NSCLC) patients with pleural dissemination are generally contraindicated for surgery. This study aimed to investigate the survival benefits of primary tumor resection for NSCLC patients with unexpectedly detected pleural disseminated nodules during thoracotomy in the era of targeted therapy.Methods: Of the 4984 patients with NSCLC who underwent surgery without induction therapy between 2000 and 2021, we retrospectively evaluated 90 (1.8%) patients with unexpectedly detected pleural disseminated nodule. Survival analyses were performed with Kaplan-Meier methods and Cox proportional hazards regression.Results: Among the evaluated patients, 58 were male, the median age was 67, and 77 (86%) were diagnosed with adenocarcinoma. Exploratory thoracotomy was performed in 21 (23%), and primary tumor resection was performed in 69 (77%) patients, including pneumonectomy in four, lobectomy in 39, and sublobar resection in 26. Epidermal growth factor receptor gene mutation and anaplastic lymphoma kinase rearrangement were detected in 33 (37%) and 4 (4%) cases, respectively. Among them, 31 patients received targeted therapy. The overall survival (OS) was not significantly different between patients with primary tumor resection and exploratory thoracotomy (5-year OS rate: 30.2% vs. 27.8%, p = 0.81). Multivariable analysis revealed that sex (p = 0.02) and targeted therapy (p < 0.01) were independent prognostic factors for OS. Survival outcomes in patients who received targeted therapy were significantly better regardless of primary tumor resection.Conclusions: Primary tumor resection might not affect the survival in NSCLC patients with unexpectedly detected pleural disseminated nodules in the era of targeted therapy.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"102-109"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731062","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

Correction: Thoracic and cardiovascular surgeries in Japan during 2021 : Annual report by the Japanese Association for Thoracic Surgery. 更正：2021年日本的胸部和心血管手术：日本胸外科协会的年度报告。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-01 DOI: 10.1007/s11748-024-02113-y

Naoki Yoshimura, Yukio Sato, Hiroya Takeuchi, Tomonobu Abe, Shunsuke Endo, Yasutaka Hirata, Michiko Ishida, Hisashi Iwata, Takashi Kamei, Nobuyoshi Kawaharada, Shunsuke Kawamoto, Kohji Kohno, Hiraku Kumamaru, Kenji Minatoya, Noboru Motomura, Rie Nakahara, Morihito Okada, Hisashi Saji, Aya Saito, Masanori Tsuchida, Kenji Suzuki, Hirofumi Takemura, Tsuyoshi Taketani, Yasushi Toh, Wataru Tatsuishi, Hiroyuki Yamamoto, Takushi Yasuda, Masayuki Watanabe, Goro Matsumiya, Yoshiki Sawa, Hideyuki Shimizu, Masayuki Chida

引用次数: 0

Comparison of segmentectomy and wedge resection for cT1cN0M0 non-small cell lung cancer. 分段切除术和楔形切除术治疗 cT1cN0M0 非小细胞肺癌的比较。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-01 Epub Date: 2024-07-08 DOI: 10.1007/s11748-024-02058-2

Satoshi Takamori, Makoto Endo, Jun Suzuki, Hikaru Watanabe, Satoshi Shiono

{"title":"Comparison of segmentectomy and wedge resection for cT1cN0M0 non-small cell lung cancer.","authors":"Satoshi Takamori, Makoto Endo, Jun Suzuki, Hikaru Watanabe, Satoshi Shiono","doi":"10.1007/s11748-024-02058-2","DOIUrl":"10.1007/s11748-024-02058-2","url":null,"abstract":"Objective: Sublobar resection is considered a standard surgical procedure for early non-small cell lung cancer, although the survival of patients undergoing sublobar resection for clinical T1cN0M0 non-small cell lung cancer remains unclear. This study aimed to compare survival between segmentectomy and wedge resection for clinical T1cN0M0 non-small cell lung cancer.Methods: This retrospective study included patients who had undergone curative surgery for cT1cN0M0 stage IA3 non-small cell lung cancer. The overall and recurrence-free survival rates of 91 patients who underwent segmentectomy or wedge resection were compared.Results: Thirty-nine (42.9%) and 52 patients (57.1%) were included in the segmentectomy and wedge resection groups, respectively. The median length of follow-up was 6.0 years (95% confidence interval 4.2 - - years) (Kaplan-Meier estimate). The 5 year overall survival rates were not significantly different between the segmentectomy and wedge resection groups (67.7% vs 52.0%, P = 0.132). The 5 year recurrence-free survival rate was worse in the wedge resection group than in the segmentectomy group (66.6% vs 46.9%, P = 0.047). In univariable analysis, spread through air spaces (hazard ratio, 5.889; 95% confidence interval, 2.357-14.715; P < 0.001) was an important prognostic factor for recurrence-free survival in the wedge resection group.Conclusions: The overall survival of patients who underwent segmentectomy for clinical T1cN0M0 non-small cell lung cancer was not significantly different from that of patients who underwent wedge resection. However, patients with cT1cN0M0 non-small cell lung cancer who underwent wedge resection tended to have a worse recurrence-free survival prognosis than those who underwent segmentectomy.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"110-117"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554568","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

Minimally invasive cardiac surgeries in 2021: annual report by Japanese society of minimally invasive cardiac surgery. 2021 年微创心脏外科手术：日本微创心脏外科学会年度报告。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2025-02-01 Epub Date: 2024-07-31 DOI: 10.1007/s11748-024-02066-2

Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Minoru Tabata, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Taichi Sakaguchi

{"title":"Minimally invasive cardiac surgeries in 2021: annual report by Japanese society of minimally invasive cardiac surgery.","authors":"Tomoki Shimokawa, Hiraku Kumamaru, Noboru Motomura, Hiroyuki Nishi, Hiroyuki Nakajima, Hiroyuki Kamiya, Minoru Tabata, Kazuma Okamoto, Soh Hosoba, Yoshikatsu Saiki, Taichi Sakaguchi","doi":"10.1007/s11748-024-02066-2","DOIUrl":"10.1007/s11748-024-02066-2","url":null,"abstract":"Purpose: Although minimally invasive cardiac surgery (MICS) procedures are widely performed throughout Japan, nationwide data regarding treated cases are limited. Up-to-date results for cardiovascular surgery are vital for quality control in clinical practice. Presented here is the 2021 annual report based on data from the Japan Cardiovascular Surgery Database (JCVSD).Methods: Records noted in the JCVSD of patients who underwent mitral valve surgery, aortic valve replacement (AVR), coronary artery bypass grafting (CABG), atrial septum defect (ASD) closure, or cardiac tumor resection via right or left minithoracotomy, as well as thoracoscopic- or port-assisted, or robotic-assisted approaches, in 2021 were examined. Perioperative parameters including mortality and morbidity was evaluated.Results: The 30-day and in-hospital mortalities for isolated mitral valve repair (n = 1211) were 0.1% and 0.2%, respectively, while those for all mitral valve repair (n = 2017) were 0.05% and 0.2%, respectively. More than 100 facilities were found to perform fewer than five MICS mitral valve surgery cases per year. As for MICS-AVR, 30-day and in-hospital mortalities for isolated AVR (n = 818) were 0.5% and 0.5%, respectively, while those for all AVR (n = 987) were 0.6% and 1.1%, respectively. Additionally, those for MICS-CABG (n = 400) were 0.8% and 0.5%, respectively. Those for ASD (n = 183) and cardiac tumor (n = 96), were 0.5% and 0.5%, respectively, and 0% and 1.0%, respectively.Conclusion: This is the first report of MICS results of procedures performed in Japan based on the 2021 JCVSD data. Additional results obtained with a similar data collection method are expected and details on MICS are being collected starting 2024.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"88-95"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859525","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 : 2025-02-01 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":"https://doi.org/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":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","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