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

{"title":"Cryoanalgesia in Thoracic Surgery.","authors":"Lauren Drake, Benny Weksler","doi":"10.1177/15569845261436009","DOIUrl":"https://doi.org/10.1177/15569845261436009","url":null,"abstract":"<p><p>Cryoanalgesia is a technique for reducing postoperative pain that involves freezing peripheral nerves while preserving their ability to regain function over time. The technique has been used for decades, and randomized trials have shown a reduction in pain and opioid use in some patients undergoing thoracotomy and pectus excavatum repair. In these trials, outcomes were highly dependent on the control groups. Randomized studies of patients undergoing minimally invasive thoracic surgery have failed to show the same results. Furthermore, several studies have reported chronic pain and neuropathic-type pain in patients treated with cryoanalgesia. In this review, we discuss the electrophysiologic and histopathologic basis of cryoanalgesia, highlight randomized trials of cryoanalgesia in thoracic surgery, and outline potential pitfalls, such as chronic pain, to offer insight into which patients may benefit most from cryoanalgesia and potential future directions of study.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261436009"},"PeriodicalIF":1.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837032","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":"Does Robot-Assisted Hybrid Coronary Revascularization Matter? Insights From a Single-Center Experience in Patient Quality of Life.","authors":"Salman W Bafageeh, Hani I Barnawi, Mohammed A Ashour, Marah M Alsulami, Yara Aljefri, Ibrahim Zabani, Hisham Khalil, Omer Elamin, Ahmed Jamjoom, Uthman AlUthman","doi":"10.1177/15569845261441274","DOIUrl":"https://doi.org/10.1177/15569845261441274","url":null,"abstract":"<p><strong>Objective: </strong>Coronary artery disease (CAD) significantly affects patient quality of life (QoL). Robot-assisted hybrid coronary revascularization (RHCR) emerged as a minimally invasive alternative to conventional coronary artery bypass grafting (CABG), offering enhanced recovery and improved QoL outcomes. This study evaluates the QoL outcomes of RHCR compared with conventional CABG preoperatively and 4 weeks and 6 months postoperatively using the validated 36-Item Short Form (SF-36) questionnaire.</p><p><strong>Methods: </strong>This prospective study included 96 patients (48 RHCR, 48 CABG) with multivessel CAD treated at King Faisal Specialist Hospital between July 2018 and December 2020. QoL was assessed using the SF-36 questionnaire across 8 domains with scores obtained preoperatively and at 4 weeks and 6 months after surgery. Statistical analyses were conducted to compare changes between groups.</p><p><strong>Results: </strong>The RHCR group consistently reported higher scores for physical functioning and role limitations due to physical health, mental health, social functioning, and general health at all time points. At 4 weeks, RHCR patients experienced significantly better scores in physical functioning (75.4 vs 62.6, <i>P</i> < 0.001), social functioning (72.5 vs 64.2, <i>P</i> = 0.003), and bodily pain (76.8 vs 54.0, <i>P</i> < 0.001). At 6 months, RHCR maintained superiority in physical functioning (94.7 vs 88.0, <i>P</i> < 0.001), general health (84.1 vs 78.1, <i>P</i> = 0.020), and mental health (83.5 vs 75.4, <i>P</i> = 0.002).</p><p><strong>Conclusions: </strong>RHCR is associated with greater improvements in QoL compared with conventional CABG, particularly in domains related to physical functioning, role limitations due to physical health, and general health perception.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261441274"},"PeriodicalIF":1.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770269","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":"Nationwide Short-Term and Midterm Clinical Outcome Comparison of Hybrid Coronary Revascularization Versus Off-Pump Coronary Artery Bypass Surgery.","authors":"Monica Gianoli, Anne R de Jong, Ferenc van der Hulst, Maaike M Roefs, Sandeep Singh, Patrique Segers, Pim van der Harst, Willem J L Suyker, Kirolos A Jacob","doi":"10.1177/15569845261437076","DOIUrl":"https://doi.org/10.1177/15569845261437076","url":null,"abstract":"<p><strong>Objective: </strong>Hybrid coronary revascularization (HCR) has emerged as a minimally invasive alternative to conventional coronary artery bypass techniques for patients with multivessel coronary artery disease. This study aimed to compare the clinical outcomes of HCR versus off-pump coronary artery bypass (OPCAB) in patients with multivessel disease in The Netherlands.</p><p><strong>Methods: </strong>This study analyzed 117 HCR patients and 313 OPCAB patients after propensity score matching. The primary outcome was the incidence of major adverse cardiac and cerebrovascular events (MACCE) at 30 days after the procedure. Secondary outcomes included mortality, myocardial infarction, repeat revascularization, and ischemic cerebrovascular accidents. Midterm survival and repeat target vessel revascularization (TVR) were evaluated over a median follow-up of 36 months.</p><p><strong>Results: </strong>At 30 days, MACCE rates were similar between the HCR group (5.1%) and the OPCAB group (4.1%; <i>P</i> = 0.62). Secondary outcomes were also comparable between the groups. The incidence of myocardial infarction in the HCR group was numerically higher (3.4% vs 1.6%), but this difference was not statistically significant (<i>P</i> = 0.17). Midterm survival rates showed no significant difference between the groups, although numerically the HCR showed a higher rate of TVR (5.1% vs 4.1%, <i>P</i> = 0.62). No significant differences were found in blood transfusion requirements or postoperative hospital stay duration.</p><p><strong>Conclusions: </strong>HCR demonstrated comparable short-term and midterm outcomes to OPCAB, suggesting it is a viable alternative for multivessel coronary artery disease treatment. However, further research is necessary to assess long-term effectiveness and to identify specific patient populations who may benefit most from HCR.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261437076"},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770433","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":"Comparison of Surgical Outcomes and Long-Term Follow-Up in One-Stage Versus Two-Stage Hybrid Coronary Revascularization With DES.","authors":"Magdalena Synak, Justyna Jankowska-Sanetra, Wiktoria Stankiewicz, Marta Mazur, Krzysztof Kępa, Witold Gerber, Krzysztof Milewski, Paweł Kaźmierczak, Paweł Eugeniusz Buszman, Andrzej Bochenek, Marek Cisowski, Piotr Paweł Buszman, Krzysztof Sanetra","doi":"10.1177/15569845261425652","DOIUrl":"https://doi.org/10.1177/15569845261425652","url":null,"abstract":"<p><strong>Objective: </strong>To compare perioperative outcomes in patients who receive complete revascularization in one-stage or two-stage hybrid coronary revascularization (HCR) with initial angioplasty.</p><p><strong>Methods: </strong>The research is a retrospective subanalysis of the HYBRID-COR feasibility study. Thirty patients who underwent one-stage HCR (endoscopic atraumatic coronary artery bypass grafting [EACAB] and percutaneous coronary intervention [PCI]; group 1) were compared with 121 patients who underwent EACAB procedure as a final stage of HCR (group 2). Observations of bleeding, transfusion requirements, kidney injury, and other complications were conducted. Long-term outcomes were evaluated.</p><p><strong>Results: </strong>Median (interquartile range [IQR]) perioperative drainage was higher in group 1 (750.0 [422.5 to 1,112.5] mL vs 400.0 [252.5 to 650.0] mL, <i>P</i> = 0.004), as was mechanical ventilation time (430.0 [300.0 to 600.0] min vs 300.0 [225.0 to 410.0] min, <i>P</i> = 0.001). Patients in group 1 required pleurocentesis more often (36.7% vs 13.2%, <i>P</i> = 0.003), as well as blood transfusions (26.7% vs 9%, <i>P</i> = 0.009). No significant differences were found for kidney injury incidence (20% vs 14.9%, <i>P</i> = 0.493). Two deaths (1.6%) and 1 myocardial infarction (0.8%) were noted in group 2 in the perioperative period. In a median long-term follow-up of 1,378.5 (758.0 to 2,033.0) days, no significant differences were noted in major adverse cardiac and cerebrovascular events, mortality, myocardial infarction occurrence, repeat revascularization, or incidence of stroke.</p><p><strong>Conclusions: </strong>PCI-first HCR is associated with less postoperative drainage, shorter mechanical ventilation time, fewer pleurocenteses, and less transfusion requirements when compared with one-stage HCR. The heart team decision is essential in choosing individual strategy, as the risk of postponing complete revascularization and temporary dual antiplatelet therapy withdrawal must be evaluated. Further studies are required, particularly on long-term outcomes.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261425652"},"PeriodicalIF":1.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770329","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":"Cryoanalgesia for Pain Management in Thoracic Surgery.","authors":"Niv Ad","doi":"10.1177/15569845261435621","DOIUrl":"https://doi.org/10.1177/15569845261435621","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261435621"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716778","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 Difficult Endoscopic Vein Harvesting Cases.","authors":"Sadiq Siddiqui, Henri Bartolozzi, Fabio Bartolozzi, Alan Soo, Ronan Kelly","doi":"10.1177/15569845261425662","DOIUrl":"https://doi.org/10.1177/15569845261425662","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261425662"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716796","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":"Totally Thoracoscopic Left Atrial Appendage Exclusion After Prior Cardiac Surgery: An Absolute Contraindication?","authors":"Hareshdeva Devan Nair, Farhan Khan, John Smithells, Zach M DeBoard","doi":"10.1177/15569845261425653","DOIUrl":"https://doi.org/10.1177/15569845261425653","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261425653"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716909","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 10 Commandments of Cryo Nerve Block.","authors":"Curtis C Quinn, Lizabeth A O'Connor","doi":"10.1177/15569845261433541","DOIUrl":"https://doi.org/10.1177/15569845261433541","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261433541"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716787","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":"Chest Tube Learning Synthesis and Evaluation Assistant (CheLSEA): A Prospective Observational Trial of an Intelligent Decision Support System.","authors":"Nikita Arora, William Klement, Nathalie Japkowicz, Daniel G Jones, Donna E Maziak, Andrew J E Seely, Sudhir R Sundaresan, Patrick J Villeneuve, Sebastien Gilbert","doi":"10.1177/15569845261425605","DOIUrl":"https://doi.org/10.1177/15569845261425605","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the performance of an artificial intelligence predictive clinical decision support system (CheLSEA) in generating chest tube management recommendations.</p><p><strong>Methods: </strong>From October 2020 to May 2021, 50 adult elective pulmonary resection patients with at least 24 h of chest tube drainage were enrolled in a single-arm, double-anonymized, observational study to evaluate CheLSEA's performance compared with standard chest tube care. Clinical status, digital pleural drainage data, and chest X-ray data were collected prospectively. For each query, CheLSEA generated a recommendation for chest tube removal or maintenance. If maintenance was recommended, CheLSEA generated a removal time prediction.</p><p><strong>Results: </strong>Most patients were female (29 of 47, 62%), smokers (39 of 47, 83%), with a median age of 73 (interquartile range [IQR]: 66 to 77) years, who underwent minimally invasive (44 of 47, 94%) lobectomy (41 of 47, 87%) for primary non-small cell lung cancer (35 of 47, 75%). CheLSEA was queried 174 times, 21% (36 of 174) of which triggered the CheLSEA safeguard system, mostly due to grade 3 or increasing subcutaneous emphysema (20 of 36, 56%). CheLSEA recommended chest tube removal in 9% of remaining requests (12 of 138), 83% of which were safe (10 of 12) and 17% of which were premature by ≤6 h (2 of 12). The remaining 126 queries were answered with chest tube maintenance recommendations up to the optimal removal time (97 of 126, 77%) or shortly thereafter (29 of 126, 23%; median = 17 h, IQR: 17 to 22). When predicting chest tube removal time, 93% of responses (82 of 88) were accurate.</p><p><strong>Conclusions: </strong>CheLSEA provides safe chest tube management recommendations and can potentially enhance care by reliably emulating expert-level clinical guidance.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261425605"},"PeriodicalIF":1.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716732","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":"Comparison of Mechanical Properties of Patient-Specific Direct 3D-Printed Aortic Valve for Simulation Trainings: A Comparative Study.","authors":"Shokoufeh Cheheili Sobbi, Anastasiia Pavlykova-Chertovska, Silke Dreesen, Jos Maesen, Peyman Sardari Nia","doi":"10.1177/15569845251408924","DOIUrl":"https://doi.org/10.1177/15569845251408924","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the mechanical properties of 3-dimensional (3D)-printed patient-specific aortic models for surgical simulation. The objective was to analyze the effects of postcuring time and color pigments on material stiffness, flexibility, toughness, and durability and to identify the most suitable material and processing conditions to enhance the biomechanical realism of 3D-printed aortae.</p><p><strong>Methods: </strong>Direct 3D printing was used to fabricate patient-specific aortic models. Samples were prepared with different postcuring times (5, 10, 15, and 20 min) and with or without color pigments (pink and orange). Uniaxial tensile testing was conducted to analyze the mechanical properties, including tensile strength, stiffness, flexibility, and strain at failure, using stress-strain curves.</p><p><strong>Results: </strong>Uncolored samples with a postcuring time of 15 min demonstrated the best mechanical properties for simulation training, offering a balance between flexibility, stiffness, and toughness. Colored samples exhibited lower tensile strength, reduced toughness, and increased stiffness as compared with uncolored samples.</p><p><strong>Conclusions: </strong>Material selection and postprocessing play a crucial role in the biomechanical accuracy of 3D-printed patient-specific aortic models. Uncolored samples with a 15 min postcuring time are optimal for surgical simulation. Future research should focus on refining postprocessing techniques and directly comparing 3D-printed models with human aortic tissue to improve realism and validation.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251408924"},"PeriodicalIF":1.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165405","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}