General Thoracic and Cardiovascular Surgery最新文献_第8页

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 : 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":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","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

Serum C-reactive protein and procalcitonin levels in patients with pneumonia and anastomotic leakage in the postoperative period after esophagectomy. 食管切除术后肺炎和吻合口漏患者的血清 C 反应蛋白和降钙素原水平。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-11-01 Epub Date: 2024-07-29 DOI: 10.1007/s11748-024-02065-3

Hirotaka Ishida, Toshiaki Fukutomi, Yusuke Taniyama, Chiaki Sato, Hiroshi Okamoto, Yohei Ozawa, Ryohei Ando, Yasuharu Shinozaki, Michiaki Unno, Takashi Kamei

{"title":"Serum C-reactive protein and procalcitonin levels in patients with pneumonia and anastomotic leakage in the postoperative period after esophagectomy.","authors":"Hirotaka Ishida, Toshiaki Fukutomi, Yusuke Taniyama, Chiaki Sato, Hiroshi Okamoto, Yohei Ozawa, Ryohei Ando, Yasuharu Shinozaki, Michiaki Unno, Takashi Kamei","doi":"10.1007/s11748-024-02065-3","DOIUrl":"10.1007/s11748-024-02065-3","url":null,"abstract":"Objective: Despite being a less-invasive procedure, esophagectomy can cause severe infectious complications, such as pneumonia and anastomotic leakage. Herein, we aimed to clarify the inflammatory characteristics of pneumonia/anastomotic leakage after esophagectomy by assessing the difference between the postoperative trends of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in patients with pneumonia/anastomotic leakage using the values on the consecutive postoperative day (POD).Methods: This study included 439 patients who underwent minimally invasive esophagectomy. Serum CRP and PCT levels were measured on PODs 1-7, 10, and 14. Pneumonia and anastomotic leakage were defined as Clavien-Dindo grades ≥ 2.Results: Pneumonia and anastomotic leakage occurred in 96 and 51 patients, respectively. The CRP and PCT levels peaked on POD 3 (11.6 ± 6.8 mg/dL) and POD 2 (0.69 ± 2.9 ng/mL), respectively. Between PODs 3 and 14, CRP levels were significantly higher in patients with pneumonia and anastomotic leakage than in those without complications (P < 0.001). Between PODs 3 and 14, PCT levels were significantly higher in patients with pneumonia; however, on most PODs, there were no significant differences in PCT levels between patients with and without anastomotic leakage.Conclusion: Inflammatory reactions caused by pneumonia may be more intense than those caused by anastomotic leakage after esophagectomy. Postoperative trends in serum CRP and PCT levels may vary depending on the complication type. Pneumonia and anastomotic leakage after esophagectomy can be potentially distinguished by the postoperative trend of PCT values before detailed examinations, such as computed tomography and endoscopy.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"746-751"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787790","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

Impact of the expanded indication of robot-assisted thoracic surgery for mediastinal tumors. 扩大机器人辅助胸腔手术治疗纵隔肿瘤适应症的影响。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-28 DOI: 10.1007/s11748-024-02093-z

Taketo Kato, Hiroki Watanabe, Yuta Kawasumi, Yuka Kadomatsu, Harushi Ueno, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa

{"title":"Impact of the expanded indication of robot-assisted thoracic surgery for mediastinal tumors.","authors":"Taketo Kato, Hiroki Watanabe, Yuta Kawasumi, Yuka Kadomatsu, Harushi Ueno, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.1007/s11748-024-02093-z","DOIUrl":"https://doi.org/10.1007/s11748-024-02093-z","url":null,"abstract":"Objective: Following the introduction of robot-assisted thoracoscopic surgery (RATS) as a health insurance-covered treatment in Japan, we investigated the current status and impact of the expansion of the indications for RATS for mediastinal tumors.Methods: Between 2018 and 2022, 209 cases of total mediastinal tumor resection were performed in our hospital. The study period was divided into the first half (January 2018 to June 2020) and the second half (July 2020 to December 2022), and perioperative parameters were compared between the two groups.Results: Ninety-six surgical procedures were performed in the first half and 113 in the second half. The percentage of RATS approach was significantly higher in the second half compared with the first half (P < 0.001). Indications for RATS in the second half compared with the first half were significantly increased in patients with stage II (P < 0.001) and stage III (P = 0.026) thymomas, tumor diameter ≥ 50 mm (P < 0.011), and patients undergoing extended thymectomy for myasthenia gravis (P < 0.009). In respect of short-term postoperative parameters, the estimated intraoperative blood loss (P < 0.035), postoperative drain duration (P < 0.037), and postoperative hospital stay (P < 0.011) were significantly lower in the second half than in the first half.Conclusions: RATS has recently been expanded for mediastinal tumors with improved short-term outcomes in our hospital after health insurance was applied in Japan. In the future, it will be necessary to discuss the further expansion of its indications by taking into account safety and long-term outcomes.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521559","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

Long-term pulmonary repair in rat lungs after sublobar resection: electrocautery versus stapler methods. 大鼠肺叶叶下切除术后的长期肺修复：电烧法与订书机法。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-28 DOI: 10.1007/s11748-024-02098-8

Shunichiro Matsuoka, Daisuke Hara, Daisuke Nakamura, Hirotaka Kumeda, Kentaro Miura, Mai Iwaya, Takashi Eguchi, Kazutoshi Hamanaka, Takeshi Uehara, Kimihiro Shimizu

{"title":"Long-term pulmonary repair in rat lungs after sublobar resection: electrocautery versus stapler methods.","authors":"Shunichiro Matsuoka, Daisuke Hara, Daisuke Nakamura, Hirotaka Kumeda, Kentaro Miura, Mai Iwaya, Takashi Eguchi, Kazutoshi Hamanaka, Takeshi Uehara, Kimihiro Shimizu","doi":"10.1007/s11748-024-02098-8","DOIUrl":"https://doi.org/10.1007/s11748-024-02098-8","url":null,"abstract":"Objective: We investigated and compared the long-term (6-month) histologic changes in a rat model of sublobar resection created using electrocautery or stapler techniques.Methods: Nine-week-old male rats were anesthetized and intubated; thoracotomy with sublobar resection was performed in the right middle lobe using electrocautery or stapler techniques. Histological examination was performed at 2, 4, 8, 12, and 24 weeks post-surgery to assess long-term effects on lung tissue repair and morphologic changes. Lung expansion and alveolar epithelial cell proliferation were evaluated by measuring the mean linear intercept and counting the number of alveolar type I and II cells.Results: The electrocautery group showed signs of lung self-repair at the resected area over time, with inflammatory cell infiltration followed by growth of vessels and bronchioles. Mesothelial cells covered the resected area by 2 weeks; elastic fibers gradually connected from both sides by 24 weeks. Lung expansion, measured by mean linear intercept, was initially small below the electrocautery resection area at 2 weeks but recovered from 4 to 24 weeks. The stapler group showed persistently small mean linear intercept over time. In the electrocautery group, the number of alveolar type II cells was higher just below the resection than in other areas from 2 to 24 weeks, followed by alveolar type I cells (4 to 24 weeks). The stapler group showed a transient alveolar type II cell increase at 2 weeks.Conclusions: Compared to the stapler technique, electrocautery may provide advantages for postoperative lung repair by promoting lung expansion and alveolar epithelial cell proliferation.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521560","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

Impact of GAP score on surgical prognosis of non-small-cell lung cancer with usual interstitial pneumonia. GAP 评分对非小细胞肺癌合并常见间质性肺炎手术预后的影响

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-23 DOI: 10.1007/s11748-024-02096-w

Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Hisashi Tomita, Shuko Nojiri, Kenji Suzuki

{"title":"Impact of GAP score on surgical prognosis of non-small-cell lung cancer with usual interstitial pneumonia.","authors":"Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Hisashi Tomita, Shuko Nojiri, Kenji Suzuki","doi":"10.1007/s11748-024-02096-w","DOIUrl":"https://doi.org/10.1007/s11748-024-02096-w","url":null,"abstract":"Objective: Post-surgical survival outcomes in patients with non-small-cell lung cancer (NSCLC) and idiopathic pulmonary fibrosis (IPF) are expected to be worse than those in patients with other idiopathic interstitial pneumonias (IIPs). However, these remain unclear regarding patients with NSCLC and IPF histologically diagnosed as usual interstitial pneumonia [IPF(UIP)]. We aimed to assess the surgical and survival outcomes and identify prognostic factors in patients with NSCLC and IPF(UIP).Methods: This retrospective cohort study included patients with pathological stage I-III NSCLC and UIP. Prognostic factors and their association with lung cancer deaths (LCDs) and non-LCDs (NLCDs) were investigated.Results: The overall survival of patients with UIP was significantly poorer than that of others with IIPs. The main causes of death were lung cancer (36%) and respiratory disease (44%). Multivariate analyses revealed the pathological stage of NSCLC ≥ II (hazard ratio [HR], 2.196; p = 0.009) and GAP stage ≥ II (HR, 2.821; p = 0.016) to be significant prognostic factors. NLCD incidence was significantly high in patients with GAP stage ≥ II. Recurrence occurred in 26 patients (36.1%); the period from recurrence to death was shorter in patients with IPF(UIP) than in patients without IPF(UIP).Conclusions: Patients with NSCLC and IPF(UIP) had poor prognosis after surgery. However, the prognosis varied greatly depending on the GAP stage. Considering the difficulty in managing post-surgical recurrence and high incidence of LCDs in patients with IPF(UIP), pursuing a radical resection is recommended in patients with GAP stage I. For patients with GAP stage ≥ II, comprehensive management of UIP is also necessary.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498606","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

Intraoperative rapid immunohistochemistry of microsatellite instability using non-contact alternating current electric field mixing. 利用非接触式交流电场混合技术对微卫星不稳定性进行术中快速免疫组化。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-23 DOI: 10.1007/s11748-024-02099-7

Kazuhiro Imai, Naoki Yanagawa, Hajime Saito, Hiroshi Nanjo, Yuki Wakamatsu, Shinogu Takashima, Tsubasa Matsuo, Shoji Kuriyama, Tamotsu Sugai, Yoshihiro Minamiya

{"title":"Intraoperative rapid immunohistochemistry of microsatellite instability using non-contact alternating current electric field mixing.","authors":"Kazuhiro Imai, Naoki Yanagawa, Hajime Saito, Hiroshi Nanjo, Yuki Wakamatsu, Shinogu Takashima, Tsubasa Matsuo, Shoji Kuriyama, Tamotsu Sugai, Yoshihiro Minamiya","doi":"10.1007/s11748-024-02099-7","DOIUrl":"https://doi.org/10.1007/s11748-024-02099-7","url":null,"abstract":"Objectives: Tumors caused by failure of the DNA-mismatch repair system generally show microsatellite instability (MSI). High-frequency MSI cancers have been shown to be susceptible to immuno-oncology therapies. The aim of this study was to evaluate the clinical reliability of a rapid immunohistochemistry (IHC) technique for intraoperatively assessing molecular status through detection of tumoral deficiencies in the expression of mismatch repair proteins (dMMR; MLH1, MSH2, MSH6, and PMS2).Methods: The rapid IHC method uses non-contact alternating current (AC) mixing to achieve more rapid/stable staining within a minimum of 13 min during surgery. Sixteen formalin-fixed paraffin-embedded (FFPE) tumor samples from 3 dMMR patients with Lynch syndrome and 6 FFPE samples from 6 dMMR-cancer patients were collected to establish an IHC protocol for MMR proteins. Next, 26 surgical patients treated and whose MSI status was determined using PCR-based tests were retrospectively analyzed. The concordance of dMMR diagnoses for thoracic tumors between the conventional (frozen section (FS)- and FFPE-IHCs) and rapid AC-mixing IHC with FSs were compared.Results: A rapid IHC protocol using primary antibodies against four MMR proteins (mixed 5-10 min) was established (entire process within 40 min). The concordance rate for MMR-IHC between the conventional and rapid IHC was 100%. dMMR diagnoses including an MSI-high pulmonary sarcoma patient entirely matched between FS- and FFPE-IHC.Conclusion: Rapid MMR-IHC could potentially serve as a clinical tool for intraoperative determination of tumor MSI/dMMR status. AC-mixing technology will contribute to improving pathological diagnostic capability through the development of an original and innovative rapid IHC.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498607","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

Surgical outcomes of minimally invasive thoracoscopic surgery for pulmonary mycosis complicated with hematopoietic malignancy. 微创胸腔镜手术治疗肺霉菌病并发造血恶性肿瘤的手术效果。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-23 DOI: 10.1007/s11748-024-02092-0

Reo Ohtsuka, Sakashi Fujimori, Souichiro Suzuki, Takahiro Karasaki, Shinichiro Kikunaga, Kazuki Ito, Yosuke Hamada, Shusei Mihara, Otoya Watanabe, Hisashi Yamamoto

{"title":"Surgical outcomes of minimally invasive thoracoscopic surgery for pulmonary mycosis complicated with hematopoietic malignancy.","authors":"Reo Ohtsuka, Sakashi Fujimori, Souichiro Suzuki, Takahiro Karasaki, Shinichiro Kikunaga, Kazuki Ito, Yosuke Hamada, Shusei Mihara, Otoya Watanabe, Hisashi Yamamoto","doi":"10.1007/s11748-024-02092-0","DOIUrl":"https://doi.org/10.1007/s11748-024-02092-0","url":null,"abstract":"Objective: Patients with hematopoietic malignancies (HM) are often immunocompromised and, therefore, susceptible to developing invasive fungal infections, including pulmonary mycosis. Surgical resection is indicated for localized pulmonary mycosis refractory to antifungal agents. This study investigated the feasibility and outcomes of minimally invasive surgery for pulmonary mycosis patients complicated with HM.Methods: We retrospectively reviewed 56 cases of surgically treated pulmonary mycosis among the 3994 lung resections performed in our department between 2011 and 2020, focusing on the 19 cases under treatment for HM.Results: All patients underwent 3-port video-assisted thoracoscopic surgery, including one patient converted to open surgery. The 30 day mortality rate was zero. The overall survival rate 1 year after surgery was 63.2%. No relapse of mycosis was observed, and the majority of the cause of death was the progression of HM. The rate of major postoperative complications was comparable between the patients with HM (3/19) and without HM (5/37), despite the patients with HM having a higher frequency of immunocompromised status than those without HM. Most patients who underwent surgery before hematopoietic stem cell transplantation (HSCT) had leukocytopenia, while all patients who underwent surgery after HSCT received immunosuppressants. Mucormycosis was observed in 13 out of 19 patients (68%) with HM, and it was significantly associated with preoperative pancytopenia and usage of immunosuppressants.Conclusion: Minimally invasive surgery was feasible for pulmonary mycosis complicated with HM despite the high frequency of immunosuppression. These findings will deepen our understanding of pulmonary mycosis associated with HM and may improve perioperative patient care.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498610","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

Long-term outcomes of transapical-transcatheter aortic valve replacement. 经心尖经导管主动脉瓣置换术的长期疗效。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-23 DOI: 10.1007/s11748-024-02095-x

Koichi Maeda, Kazuo Shimamura, Isamu Mizote, Daisuke Nakamura, Kizuku Yamashita, Ai Kawamura, Daisuke Yoshioka, Yasushi Sakata, Shigeru Miyagawa

{"title":"Long-term outcomes of transapical-transcatheter aortic valve replacement.","authors":"Koichi Maeda, Kazuo Shimamura, Isamu Mizote, Daisuke Nakamura, Kizuku Yamashita, Ai Kawamura, Daisuke Yoshioka, Yasushi Sakata, Shigeru Miyagawa","doi":"10.1007/s11748-024-02095-x","DOIUrl":"https://doi.org/10.1007/s11748-024-02095-x","url":null,"abstract":"Objective: Transapical-transcatheter aortic valve replacement is one of the main interventions indicated for patients where access via peripheral vessels is challenging. However, there have been no reports on the long-term outcomes of this intervention. Here, we report the long-term outcomes of this intervention.Methods: Among 178 patients who underwent transapical-transcatheter aortic valve replacement between October 2009 and July 2023, 173 patients who underwent this intervention for native aortic stenosis were included in this study, and early and long-term results were evaluated.Results: The mean age was 82.4 ± 6.4 years, 52.6% were women, mean body area was 1.46 ± 0.17 m2, and the Society of Thoracic Surgeons Predicted Risk of Mortality was 11.2 ± 9.9%. In-hospital mortality was observed in three patients (1.7%). Mean follow-up duration was 4.3 ± 2.8 years, and the survival rates at 1-, 3-, 5-, and 8-years were 84.9%, 67.1%, 47.0%, and 22.1%, respectively. Freedom from cardiovascular mortality at 1, 3, 5, and 8-years was 92.9%, 86.1%, 75.8%, and 53.5%, respectively. The freedom from disabling stroke rates at 1, 3, 5, and 8-years were 95.0%, 92.4%, 92.4%, and 90.8%, respectively. Multivariate analysis revealed that male (Hazard Ratio 1.85, 95%Confidence Interval 1.27-2.70, p = 0.0012) and hemodialysis (Hazard Ratio 1.64, 95%Confidence Interval 1.00-2.67, p = 0.049) were significant poor prognosis factors.Conclusions: Long-term outcomes of transapical-transcatheter aortic valve replacement were satisfactory. Despite the variety of available approaches, the role of transapical-transcatheter aortic valve replacement, which has low vascular impact, has not been completely lost.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498608","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

Risks factors of adverse clinical outcomes in asymptomatic mitral regurgitation patients with preserved ejection fraction: a systematic review and meta-analysis. 射血分数保留的无症状二尖瓣反流患者不良临床结局的风险因素：系统回顾和荟萃分析。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-16 DOI: 10.1007/s11748-024-02094-y

Wilbert Huang, Alvin Frederich, Cynthia Arista, Capella Kezia, Muhammad Irfan Fathoni, Alya Roosrahima Khairunnisa, Lisa Milena Anabela, Siti Shofiah Syahruddin, Samuel Flindy, Alizha Rochana Putri

{"title":"Risks factors of adverse clinical outcomes in asymptomatic mitral regurgitation patients with preserved ejection fraction: a systematic review and meta-analysis.","authors":"Wilbert Huang, Alvin Frederich, Cynthia Arista, Capella Kezia, Muhammad Irfan Fathoni, Alya Roosrahima Khairunnisa, Lisa Milena Anabela, Siti Shofiah Syahruddin, Samuel Flindy, Alizha Rochana Putri","doi":"10.1007/s11748-024-02094-y","DOIUrl":"https://doi.org/10.1007/s11748-024-02094-y","url":null,"abstract":"Introduction and objective: Indication for mitral valve (MV) surgery in asymptomatic mitral regurgitation (MR) patients with preserved ejection fraction (EF) remains unclear. This study aims to identify risk factors of adverse clinical outcomes in asymptomatic MR patients with preserved EF for early indication of MV surgery.Methods: 3 databases were systematically searched to include studies with asymptomatic MR patients with preserved EF. Risk factors of adverse clinical outcomes (composite outcome of MACE and MV surgery indication), mortality, and left ventricular dysfunction (LVD) are pooled with a meta-analysis of random effect model.Results: A total of 39 observational studies with 9135 asymptomatic moderate to severe MR patients are included. We identified 21 statistically significant risk factors for adverse outcomes. Increased natriuretic peptide, presence of atrial fibrillation, LV GLS > 20%, LVEDD > 35 mm, LVESD > 22 mm, and LAVI > 55 ml/mm2, ERO > 55mm2, and regurgitation volume > 60 ml (HR 2.21, 2.07, 4.23, 2.98, 4.05, 1.84, 4.02, 3.30, respectively; p-value < 0.05; I2 0-87%) are associated with greater risk of adverse clinical outcome. Risk factors associated with postoperative LVD are the increase of LVEDD, LVESD, and RVSP. Risk factors associated with mortality are increasing STS score and LV GLS.Conclusion: Several clinical parameters and risk factors can be used to stratify asymptomatic MR patients with preserved ejection fraction who could benefit from early indication for MV surgery.","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462755","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

Acknowledgment to reviewers. 感谢审稿人。

IF 1.1 4区医学

General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-14 DOI: 10.1007/s11748-024-02091-1

引用次数: 0