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

{"title":"Do Right in the Left (Chest): Considering the Role of Adjunct Left Atrial Appendage Ligation During Lung Cancer Resection.","authors":"Zach M DeBoard, Nishith N Patel","doi":"10.1177/15569845241309635","DOIUrl":"https://doi.org/10.1177/15569845241309635","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241309635"},"PeriodicalIF":1.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467962","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":"Three-Dimensional Lung Reconstructions for Preoperative Planning of Uniportal Video-Assisted Thoracoscopic Segmentectomies Using Visible Patient Software.","authors":"Iris E W G Laven, Geert H J M Verkoulen, Koen C H A Verkoulen, Aimée J P M Franssen, Lori M van Roozendaal, Michiel H M Gronenschild, Karel W E Hulsewé, Yvonne L J Vissers, Erik R de Loos","doi":"10.1177/15569845251315450","DOIUrl":"https://doi.org/10.1177/15569845251315450","url":null,"abstract":"<p><p>In this article, we present the use of 3-dimensional (3D) lung reconstructions performed by Visible Patient software and share our experience with the first 5 patients who were scheduled for a segmentectomy. These reconstructions provided useful insights into more accurate lung nodule locations, resulting in a preoperative change in the surgical plan in 3 of the 5 patients. In addition, surgeons were better prepared for surgery with the preoperative knowledge of anatomical variations identified in 4 patients. These findings highlight the critical role of preoperative 3D lung reconstructions in determining the appropriate surgical indication and refining the surgical plan when thoracoscopic segmentectomy is initially indicated.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251315450"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457879","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":"The First International Consortium for Health Outcomes Measurement (ICHOM) Standard Dataset for Reporting Outcomes in Heart Valve Disease: Moving From Device- to Patient-Centered Outcomes.","authors":"Emmanuel Lansac, Kevin M Veen, Andria Joseph, Paula Blancarte Jaber, Frieda Sossi, Zofia Das-Gupta, Suleman Aktaa, J Rafael Sádaba, Vinod H Thourani, Gry Dahle, Wilson Y Szeto, Faisal Bakaeen, Elena Aikawa, Frederick J Schoen, Evaldas Girdauskas, Aubrey Almeida, Andreas Zuckermann, Bart Meuris, John Stott, Jolanda Kluin, Ruchika Meel, Wil Woan, Daniel Colgan, Hani Jneid, Husam Balkhy, Molly Szerlip, Ourania Preventza, Pinak Shah, Vera H Rigolin, Silvana Medica, Philip Holmes, Marta Sitges, Philippe Pibarot, Erwan Donal, Rebecca T Hahn, Johanna J M Takkenberg","doi":"10.1177/15569845241269309","DOIUrl":"https://doi.org/10.1177/15569845241269309","url":null,"abstract":"<p><strong>Objective: </strong>Globally significant variation in treatment and course of heart valve disease (HVD) exists, and outcome measurement is procedure focused instead of patient focused. This article describes the development of a patient-related (International Consortium for Health Outcomes Measurement) standard set of outcomes and case mix to be measured in patients with HVD.</p><p><strong>Methods: </strong>A multisociety working group was formed that included patient representatives and representatives from scientific cardiology and cardiothoracic surgery societies that publish current guidelines for HVD. The standard set was developed to monitor the patient's journey from diagnosis to treatment with either a surgical or transcatheter procedure. Candidate clinical and patient-reported outcome measures (PROMs) and case mix were identified through benchmark analyses and systematic reviews. Using an online modified Delphi process, the working group voted on final outcomes/case mix and corresponding definition.</p><p><strong>Results: </strong>Patients with aortic/mitral/tricuspid valve disease or root/ascending aorta >40 mm were included in the standard set. Patients entered the dataset when the diagnosis of HVD was established, allowing outcome measurement in the preprocedural, periprocedural, and postprocedural phases of patients' lives. The working group defined 5 outcome domains: vital status, patient-reported outcomes, progression of disease, cardiac function and durability, and complications of treatment. Subsequently, 16 outcome measures, including 2 patient-reported outcomes, were selected to be tracked in patients with HVD. Case-mix variables included demographic factors, demographic variables, echocardiographic variables, heart catheterization variables, and specific details on aortic/mitral/tricuspid valves and their specific interventions.</p><p><strong>Conclusions: </strong>Through a unique collaborative effort between patients and cardiology and cardiothoracic surgery societies, a standard set of measures for HVD was developed. This dataset focuses on outcome measurement regardless of treatment, moving from procedure- to patient-centered outcomes. Implementation of this dataset will facilitate global standardization of outcome measurement, allow meaningful comparison between health care systems and evaluation of clinical practice guidelines, and eventually improve patient care for those experiencing HVD worldwide.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241269309"},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448872","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":"Axillary Artery Versus Femoral or Central Arterial Cannulation in Minithoracotomy Mitral Surgery: Is There a Difference in Early Outcomes?","authors":"Jeffrey G Gaca, Brittany A Zwischenberger, Keith Carr, Andrew Wang, Donald D Glower","doi":"10.1177/15569845251315728","DOIUrl":"https://doi.org/10.1177/15569845251315728","url":null,"abstract":"<p><strong>Objective: </strong>Axillary artery cannulation techniques continue to improve and find application throughout cardiac surgery. Yet, early outcomes are poorly documented versus femoral or central arterial cannulation in right minithoracotomy mitral surgery.</p><p><strong>Methods: </strong>There were 3,044 consecutive adult patients undergoing mitral valve surgery via right thoracotomy from 1996 to 2022 examined from a prospectively maintained database. Propensity score matching was used to compare outcomes of axillary versus aortic cannulation in 241 matched pairs and axillary versus femoral cannulation in 356 matched pairs.</p><p><strong>Results: </strong>Arterial cannulation was axillary (770 of 3,044; 25%) versus femoral (149 of 3,044; 5%) or central aortic (2,125 of 3,044; 70%). Axillary versus aortic or femoral patients were older (<i>P</i> < 0.001), more often redo (<i>P</i> < 0.001), more urgent (<i>P</i> < 0.001), and had more mitral replacement (<i>P</i> < 0.001) and tricuspid procedures (<i>P</i> < 0.001). After propensity score matching, cannulation groups did not differ in patient characteristics or concurrent surgical procedures. For matched patients, axillary artery cannulation was not independently associated with operative mortality (<i>P</i> = 0.3), postoperative respiratory failure (<i>P</i> = 0.3), perioperative stroke (<i>P</i> = 0.7), renal insufficiency (<i>P</i> = 0.4), pump time (<i>P</i> = 0.6), clamp time (<i>P</i> = 0.2), transfusion (<i>P</i> = 0.5), perioperative length of stay (<i>P</i> = 0.7), or survival (<i>P</i> = 0.6). Axillary cannulation increased operative time by 14 ± 7 min (<i>P</i> = 0.04) versus aortic or femoral artery cannulation.</p><p><strong>Conclusions: </strong>Right axillary artery cannulation is a safe alternative for right minithoracotomy mitral surgery. Advantages may include avoidance of the aorta in reoperations or older patients, avoidance of peripheral atherosclerosis in older patients, and a low incidence of limb ischemia or wound infection. Disadvantages may include longer access time and an additional chest incision.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251315728"},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425239","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":"Combined Robotic Endoscopic Aortic Valve Replacement and Robotic Totally Endoscopic Coronary Bypass: Dual Case Report With 3-Year Follow-Up.","authors":"Hiroto Kitahara, Sarah Nisivaco, Yazan AlJamal, Husam H Balkhy","doi":"10.1177/15569845241313465","DOIUrl":"https://doi.org/10.1177/15569845241313465","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241313465"},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425261","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":"Atrial Fibrillation Surgery in the Era of Minimally Invasive Surgery: Biatrial Versus Left Atrial Maze.","authors":"Omar M Sharaf, Alexandra Murillo-Solera, Thomas M Beaver","doi":"10.1177/15569845251315746","DOIUrl":"https://doi.org/10.1177/15569845251315746","url":null,"abstract":"<p><strong>Objective: </strong>Atrial fibrillation management is rapidly evolving, particularly for patients who are intolerant to medical therapy. Several catheter-based, surgical, and hybrid approaches currently exist, each with unique benefits that may be harnessed to provide optimal outcomes for these patients. This review focuses on the use of a biatrial lesion set versus an isolated left atrial lesion set for ablation.</p><p><strong>Methods: </strong>Major representative articles for each ablation strategy were identified and included. Terms searched on PubMed, Google Scholar, and Scopus included \"atrial fibrillation ablation,\" \"atrial fibrillation surgery,\" and \"maze procedure,\" among others. Additional articles were included based on expert opinion.</p><p><strong>Results: </strong>The complete Cox maze biatrial lesion set has the highest efficacy but requires cardiopulmonary bypass. An isolated left atrial lesion set can also be performed, and these approaches are often less invasive but not as efficacious as the traditional complete maze operation.</p><p><strong>Conclusions: </strong>Although biatrial ablation may carry a higher risk of conduction abnormalities than isolated left atrial ablation in the setting of atrial fibrillation, biatrial ablation is more efficacious in maintaining sinus rhythm.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251315746"},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425235","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":"Combined Mitral and Aortic Valve Surgery Through a Right Minithoracotomy: A Single-Center Experience.","authors":"Mariafrancesca Fiorentino, Elisa Mikus, Alberto Tripodi, Diego Sangiorgi, Simone Calvi, Elena Tenti, Antonino Costantino, Carlo Savini","doi":"10.1177/15569845251314025","DOIUrl":"https://doi.org/10.1177/15569845251314025","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive combined mitral and aortic valve surgery is still uncommon. We report our experience performing multiple valve procedures through a right-sided minithoracotomy.</p><p><strong>Methods: </strong>We present an observational case series with a retrospective analysis of 38 patients who underwent double valve surgery through right anterior thoracotomy from November 2013 to November 2023.</p><p><strong>Results: </strong>The median age of our population was 72 years, and 61% were female patients. The median EuroSCORE II was 2.27. Three patients (7.9%) had redo operations. The median cardiopulmonary bypass (CPB) and cross-clamp times were 98 and 85 min, respectively. No conversion to full sternotomy was necessary. In-hospital mortality was 2.6% (1 patient); the patient died of septic shock and consequent multiorgan failure. Of the patients, 53% required transfusions with packed blood cells. Postoperative atrial fibrillation was observed in 12 patients (32%), and 2 patients (5.2%) required pacemaker implantation due to third-degree atrioventricular block. Also, 1 stroke (2.6%) and 1 rethoracotomy for bleeding were observed. The median ventilation time was 10 h. The median intensive care unit and postoperative length of stay were 2 days and 7.5 days, respectively. Survival at 1, 3, 5, and 10 years was 93.8%, 86.3%, 86.3%, and 77.2%, respectively, with a median follow-up time of 6.5 years. Freedom from reintervention at 1, 3, 5, and 10 years was 96.8%, 89.5%, 85.0%, and 69.5%, respectively, with a median follow-up time of 5.7 years.</p><p><strong>Conclusions: </strong>In our experience, a minimally invasive approach for combined aortic and mitral valve surgery is safe and feasible, with acceptable CPB and cross-clamp times and good outcomes. Therefore, it can be an attractive option for patients with double valve diseases.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251314025"},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425258","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":"Initial Experience of Left Atrial Appendage Ligation Using Penditure in a Minimally Invasive Cardiac Surgical Approach.","authors":"Olatoye Olutola, Yasir Abu-Omar, Gregory D Rushing","doi":"10.1177/15569845241311596","DOIUrl":"https://doi.org/10.1177/15569845241311596","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241311596"},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407311","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":"Innovations: A Growing Global Presence.","authors":"Niv Ad","doi":"10.1177/15569845251314608","DOIUrl":"https://doi.org/10.1177/15569845251314608","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251314608"},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407312","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 Surgical Repair for a Failed Transcatheter Left Atrial Appendage Occlusion Device.","authors":"Hiroyuki Tsukui, Mitsugu Ogawa, Michael H Culig","doi":"10.1177/15569845241311301","DOIUrl":"https://doi.org/10.1177/15569845241311301","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845241311301"},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407315","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}