Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery最新文献

{"title":"Innovations in Heart Transplantation: Partial Heart Transplantation and Xenotransplantation.","authors":"Zachary T Silvano, Vincent S Alexander, Sreeja Choppara, Andrew D Vogel, Herra Javed, John Treffalls, T Konrad Rajab","doi":"10.1177/15569845251375442","DOIUrl":"https://doi.org/10.1177/15569845251375442","url":null,"abstract":"<p><p>Despite efforts to improve donor heart allocation policies, geographic disparities, logistical challenges and patient criteria limit organ availability. However, recent surgical innovations offer potential solutions. These include partial heart transplantation and xenotransplantation. Partial heart transplantation is a new procedure with the potential to address several clinical challenges in treating congenital heart defects. Cardiac xenotransplantation involves the transplantation of genetically modified porcine hearts into humans, offering a potential solution to the shortage of donor organs. Although immunologic barriers and ethical concerns remain, ongoing research aims to mitigate the risks and optimize outcomes, providing hope for patients in need. These innovative surgical approaches offer promising avenues for addressing the critical shortage of donor hearts and with ongoing research, may hold the potential to revolutionize heart transplantation, and improve outcomes for patients facing terminal heart failure.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375442"},"PeriodicalIF":1.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transaortic Partial Septectomy via Right Anterior Minithoracotomy for Hypertrophic Obstructive Cardiomyopathy.","authors":"Oleksandr Babliak, Dmytro Babliak, Serhii Yatsuk","doi":"10.1177/15569845251382589","DOIUrl":"https://doi.org/10.1177/15569845251382589","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251382589"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Subclavian Vein Cannulation in Venovenous Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Study.","authors":"Sagar B Dave, Jose B Trinidad, Chris Zalesky, Christina Creel-Bulos, Eric Leiendecker, Deepa M Patel, Casey Frost Miller, Melissa Morris, Josh Chan, Mani Daneshmand, Craig S Jabaley, Jeffrey Javidfar","doi":"10.1177/15569845251375502","DOIUrl":"https://doi.org/10.1177/15569845251375502","url":null,"abstract":"<p><strong>Objective: </strong>Venovenous (VV) extracorporeal membrane oxygenation (ECMO) cannulation may pose venous access challenges. Subclavian vein (SCV) cannulation is an alternative site. This study hypothesizes that SCV access is a safe alternative in VV ECMO.</p><p><strong>Methods: </strong>This is a single-center, retrospective study of peripheral VV ECMO that was stratified by SCV cannulation. Each site was considered as a separate cannulation event. Descriptive statistics, groupwise comparisons, and mixed-effects logistic regression were used. Primary endpoints included cannulation-specific complications and ECMO-related adverse events.</p><p><strong>Results: </strong>From 2020 to 2023, 157 patients were supported with VV ECMO. The cohort was 57% male patients with a median age of 44 (34 to 56) years and a median body mass index of 34 (28 to 44) kg/m². Thirty-five percent of patients (<i>n</i> = 55) had an SCV cannula during their ECMO course. Both groups had similar pre-ECMO variables, except for higher rates of COVID-19 (69% [<i>n</i> = 38] vs 49% [<i>n</i> = 49], <i>P</i> = 0.016) in the SCV cohort. There was no unadjusted survival difference (<i>P</i> = 0.8). There were 392 unique cannulation events. SCV cannulations were more commonly employed for additional cannulas and transitioning to single-site dual-lumen cannulation (<i>P</i> < 0.001). There was an increased cannulation-associated pneumothorax rate in the SCV arm (<i>P</i> < 0.001) when compared with all non-SCV sites. Mixed-effects logistic regression showed no site-related differences in adverse events or complication rates.</p><p><strong>Conclusions: </strong>Between the SCV and non-SCV groups, there was no difference in site-related adverse events or complications. This study supports the use of SCV cannulation as a viable alternative in patients supported with VV ECMO.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375502"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Surgery: Robotic, Augmented Reality, and 3D-Printed Approaches to Complex Giant Hiatal Hernia With Mesenteroaxial Volvulus.","authors":"Luigi Marano, Sergii Girnyi, Tomasz Cwalinski, Marek Strzemski, Karol Polom, Mateusz Wilcowski, Jaroslaw Skokowski","doi":"10.1177/15569845251382590","DOIUrl":"https://doi.org/10.1177/15569845251382590","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251382590"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Thoracoscopic Localization and Ligation of Triple System Thoracic Duct With Indocyanine Green Lymphangiography.","authors":"Natacha Wathieu, Haley Leesley, Abbas Abbas","doi":"10.1177/15569845251375599","DOIUrl":"https://doi.org/10.1177/15569845251375599","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375599"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foldax LifePolymer and A Novel Polymeric Heart Valve: Pathway to Clinical Evaluation.","authors":"Andy C Kiser, Isaac George, Brent D Wilson, Brian Whisenant, Steven J Yakubov, Martin B Leon","doi":"10.1177/15569845251375566","DOIUrl":"https://doi.org/10.1177/15569845251375566","url":null,"abstract":"<p><strong>Objective: </strong>An optimal valve replacement prosthesis demands durable leaflet technology, superior hemodynamic performance, and ease of use. Preclinical evaluation of polymer leaflets has historically demonstrated mechanical failure related to biodegradation. We present the preclinical evaluation of the novel TRIA™ polymer valve (Foldax, Salt Lake City, UT, USA) and a case report of TRIA mitral valve replacement.</p><p><strong>Methods: </strong>A uniquely formulated, biostable, and biocompatible polymer (LifePolymer™ [LP], Foldax) has been designed to meet the functional demands of cardiac hemodynamics. Preclinical in vitro evaluation included biocompatibility testing, thrombogenicity testing, and toxicologic assessment followed by evaluation in the arteriovenous shunt of nonhuman primates and in the aortic position in sheep. Clinical evaluation of early human aortic and mitral implantation included computed tomography imaging and echocardiographic examination.</p><p><strong>Results: </strong>In vitro studies of LP demonstrated no evidence of toxicity or tissue injury, no cytological injury in cell culture, and no intracutaneous sensitization. LP proved to be nonhemolytic by direct and extract methods, and complement activation was insignificant. Genotoxicity analysis proved LP to be nonmutagenic. All standard toxicologic assessments were within the margin of safety. Biostability was confirmed without polymer degradation or excessive comparative thrombogenicity. Ovine 6-month aortic valve explantation showed no leaflet calcification and minimal fibrinous depositions. An early human case example shows no evidence of leaflet thrombus formation at 6 months and a mean mitral gradient of 3 mm Hg at 12 months.</p><p><strong>Conclusions: </strong>LP has met the requirements for a prosthetic polymer human heart valve. The surgical TRIA Mitral Valve has demonstrated promising early human clinical success, potentially facilitating a lifetime valve replacement strategy.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375566"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Multifocal Benign Acquired Bronchoesophageal Fistulas.","authors":"Valeda Yong, Sameer Patel, Gerard Criner, Whitney Burrows, Nathaniel Marchetti, Roh Yanagida, Kewal Krishan, Parag Desai, Charles Bakhos","doi":"10.1177/15569845251382592","DOIUrl":"https://doi.org/10.1177/15569845251382592","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251382592"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Y-Graft Versus In Situ Bilateral Internal Mammary Arteries in Endoscopic Coronary Artery Bypass Grafting.","authors":"Theresia Feline Husen, Silke van Genechten, Jade Claessens, Loren Packlé, Samuel Heuts, Jos G Maessen, Alaaddin Yilmaz","doi":"10.1177/15569845251377059","DOIUrl":"https://doi.org/10.1177/15569845251377059","url":null,"abstract":"<p><strong>Objective: </strong>The clinical outcomes of bilateral internal mammary arteries (BIMA) in situ were compared with Y-grafts in endoscopic coronary artery bypass grafting (endo-CABG), a less-invasive alternative to conventional CABG, providing reduced trauma and faster recovery.</p><p><strong>Methods: </strong>A retrospective single-center study was performed from January 2016 until February 2023 on endo-CABG patients, dividing them into in situ BIMA graft or Y-graft recipients. As endo-CABG was performed in all patients requiring surgical revascularization, this represents an unselected cohort. The primary outcome comprised freedom from major adverse cardiac and cerebrovascular events (MACCE). The secondary outcomes were target lesion revascularization (TLR) and 1-year overall survival.</p><p><strong>Results: </strong>A total of 1,328 endo-CABG patients (BIMA in situ, <i>n</i> = 693; Y-graft, <i>n</i> = 634) were included. Overall, characteristics of both groups were comparable, except that Y-graft patients had more comorbidities (diabetes mellitus and myocardial infarction), which was reflected in the EuroSCORE II. Furthermore, most Y-graft patients had triple-vessel disease and a higher number of bypasses required. The 1-year MACCE-free survival did not differ significantly between the groups (91.9% vs 89%; univariable hazard ratio [HR] = 1.42, 95% CI: 0.96 to 2.11, <i>P</i> = 0.079; multivariable HR = 1.07, 95% CI: 0.70 to 1.63, <i>P</i> = 0.771), as did the 1-year survival rate (95.7% vs 93.2%; univariable HR = 1.67, 95% CI: 1.01 to 2.75, <i>P</i> = 0.046; multivariable HR =1.34, 95% CI: 0.77 to 2.33, <i>P</i> = 0.297). TLR did not differ significantly between groups (univariable HR = 0.68, 95% CI: 0.22 to 2.08, <i>P</i> = 0.499) or after adjustment (multivariable HR = 0.31, 95% CI: 0.08 to 1.24, <i>P</i> = 0.100).</p><p><strong>Conclusions: </strong>Creating a Y-graft for distal lesions and in cases in which more than 2 anastomoses are required serves as a favorable alternative without a difference between in situ and Y-grafts in 1-year MACCE-free survival.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251377059"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Mitral Valve Repair With Adjustable Chords.","authors":"Oleksandr Babliak, Dmytro Babliak, Serhii Yatsuk","doi":"10.1177/15569845251382595","DOIUrl":"https://doi.org/10.1177/15569845251382595","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251382595"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shaping the Future of Partial Heart Transplantation: Innovations and Emerging Applications.","authors":"Seth E M Wolf, John A Kucera, Michael Mensah-Mamfo, John K Cook, Danielle R Pitchon, Lindsey M Reynolds, Akosua D Odei, Richard E Overman, Pranava Sinha, Yves d'Udekem, Joseph W Turek, Douglas M Overbey","doi":"10.1177/15569845251375996","DOIUrl":"https://doi.org/10.1177/15569845251375996","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251375996"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}