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

{"title":"The MIST Trial: Five Take-Home Points.","authors":"Marc Ruel","doi":"10.1177/15569845261481829","DOIUrl":"https://doi.org/10.1177/15569845261481829","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261481829"},"PeriodicalIF":1.7,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069499","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 Preoperative Anemia: Review of Best Practices in Cardiac Surgery.","authors":"Stephen D Waterford, Alexander Gregory, Joshua Nicholas, Rawn Salenger","doi":"10.1177/15569845261475667","DOIUrl":"https://doi.org/10.1177/15569845261475667","url":null,"abstract":"<p><p>Up to 40% of cardiac surgery patients present with preoperative anemia, which is associated with significant risks and management challenges. This review highlights the increased perioperative risk attributable to preoperative anemia as well as recommended optimization strategies. This includes screening for anemia and iron deficiency as well as the appropriate use of intravenous iron replacement, vitamin B12, folic acid, and erythrocyte stimulating agents. The mechanism of action, optimal dosing, and anticipated time to response are also described. The benefits of proactive treatment of preoperative anemia within the context of a comprehensive patient blood management program are also explored. Finally, a discussion is provided on how to overcome common barriers in the treatment of preoperative anemia.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261475667"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900235","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":"CT-Based Annular Measurements as a Predictor for Perceval Valve Size Selection.","authors":"Mahesh Ramchandani, Sebastian Arzt, Arudo Hiraoka, Slobodan Mićović, Hiroshi Niinami, Theodor Fischlein, Simon Moten, Jiangang Wang, William Kent, Carlo Savini, Elisa Mikus, Dina De Bock, Robert Gallegos, Farhad Bakhtiary, Miriam Silaschi, Minoru Tabata, Naoki Murata, Ilaria Piergentili, Seung Hyun Lee","doi":"10.1177/15569845261472983","DOIUrl":"https://doi.org/10.1177/15569845261472983","url":null,"abstract":"<p><strong>Objective: </strong>This multicenter study evaluates the accuracy of preoperative multidetector computed tomography (MDCT) measurements in predicting the appropriate Perceval (CORCYM Srl, Milan, Italy) prosthesis size, developing a chart to support surgeons in identifying the correct valve size.</p><p><strong>Methods: </strong>A multicenter retrospective study was conducted across 15 centers in 10 different countries. Inclusion criteria included preoperative MDCT imaging, meeting standardized technical specifications, and early postoperative clinical and hemodynamic outcomes, meeting the expected outcomes of a correctly sized valve. The K-means and receiver operating characteristic (ROC) analysis were applied to evaluate the sizing chart on 70% of the population, and their accuracy was verified on the remaining 30%.</p><p><strong>Results: </strong>There were 338 patients (mean age = 72.8 ± 7.9 years, 50.6% male) analyzed for this study, with a distribution of implanted bioprosthetic valve sizes of small in 21.6%, medium in 39.6%, large in 26.0%, and extra-large in 12.7%. The perimeter-derived diameter was found to be the MDCT-derived anatomical parameter with best overall correlation with the prosthesis size, and the K-means method outperformed the ROC curve-based classification, with an accuracy of prediction at almost 70%.</p><p><strong>Conclusions: </strong>The analysis of CT-based annular measurements as a predictive tool for Perceval valve sizing represents a meaningful step forward in contemporary cardiac surgery. In our retrospective, multicenter, real-world cohort, preoperative aortic annulus dimensions obtained via MDCT showed a moderate predictive accuracy for tricuspid aortic valves, and intraoperative assessment remains essential. Future larger studies, improved MDCT quality, and artificial intelligence tools may help refine and improve predictive performance, also in bicuspid anatomies.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261472983"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900256","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":"A Simple and Effective Exposure Technique for Femoral Artery Access in Minimally Invasive Cardiac Surgery: The \"Suture Wound Retractor\".","authors":"Hiromichi Sonoda, Akira Shiose","doi":"10.1177/15569845261474540","DOIUrl":"https://doi.org/10.1177/15569845261474540","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261474540"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900226","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":"Surgical Ablation for Atrial Fibrillation During Minimally Invasive Mitral Valve Surgery: Risk Dependencies and Long-Term Survival.","authors":"Mariusz Kowalewski, Giuseppe Maria Raffa, Jakub Batko, Michał Święczkowski, Emil Julian Dąbrowski, Karol Gostomczyk, Łukasz Kuźma, Wojciech Wańha, Radosław Litwinowicz, Tomasz Urbanowicz, Fabrizio D'Ascenzo, Marek Jasiński, Kazimierz Widenka, Marek Deja, Krzysztof Bartuś, Tomasz Hirnle, Wojciech Wojakowski, Michele Pilato, Francesco Musumeci, Roberto Lorusso, Calogera Pisano, Zdzisław Tobota, Bohdan J Maruszewski, Piotr Suwalski","doi":"10.1177/15569845261472462","DOIUrl":"https://doi.org/10.1177/15569845261472462","url":null,"abstract":"<p><strong>Objective: </strong>Atrial fibrillation (AF) is a common finding among patients with mitral valve disease, with a growing body of evidence showing survival benefits associated with surgical ablation (SA). However, a lack of data persists regarding the safety and survival after SA concomitant to minimally invasive mitral valve surgery (MIMVS).</p><p><strong>Methods: </strong>We retrospectively collected data from the Polish National Registry of Cardiac Surgery Procedures (Krajowy Rejestr Operacji Kardiochirurgicznych), searching for all adult patients with AF who underwent MIMVS between 2006 and 2021. Initially, 1,545 patients were identified; SA was performed on 512 patients (33.2%). Propensity score matching comparing MIMVS + SA versus MIMVS alone was performed.</p><p><strong>Results: </strong>Matching resulted in 365 pairs with similar baseline characteristics (median age = 65 years, interquartile range [IQR]: 58 to 70 years; median EuroSCORE II = 2.2%, IQR: 1.4 to 3.4). We observed no differences in 24 h mortality for MIMVS + SA versus MIMVS alone (0.3% vs 0.0%, <i>P</i> = 0.99). Although there was no difference in in-hospital complications, neurologic complications were reported less frequently in the SA group (2.7% vs 8.2%, <i>P</i> = 0.002). Unadjusted survival analysis favored MIMVS+SA (hazard ratio [HR] = 0.52, 95% confidence interval [CI]: 0.40 to 0.69, <i>P</i> < 0.001). However, after adjustment for baseline risk factors, the effect was no longer significant (HR = 0.85, 95% CI: 0.56 to 1.32, <i>P</i> = 0.48). When stratified on baseline CHA₂DS₂-VASc score, a gradient of benefit was seen, with patients at higher thromboembolic risk gaining the most benefits from concomitant SA.</p><p><strong>Conclusions: </strong>Patients with a higher thromboembolic risk gain the most benefits from concomitant SA. SA was associated with fewer neurologic complications.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261472462"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900230","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":"A Novel Bipolar Radiofrequency Clamp for Efficient Isolation of the Left Atrial Posterior Wall.","authors":"Jack Yi, Samantha J Procasky, M Cassandra Witt, Nicholas R Banull, Christian W Zemlin, Matthew R Schill, Ralph J Damiano","doi":"10.1177/15569845261477759","DOIUrl":"https://doi.org/10.1177/15569845261477759","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated a novel radiofrequency (RF) clamp that enables isolation of the entire left atrial posterior wall (LAPW) with a single application and was designed to reduce ablation time without sacrificing efficacy.</p><p><strong>Methods: </strong>Six Yorkshire pigs (47 ± 4 kg) underwent median sternotomy. A dual-generator RF clamp was used to create a lesion that isolated the LAPW with a single application. An additional lesion was created to isolate the left atrial appendage (LAA). Exit block testing was performed for all lesions. Hearts were perfused with triphenyl tetrazolium chloride (TTC), arrested, and explanted, and lesions were transversely sectioned at 5 mm intervals. Lesion transmurality was assessed with TTC staining and confirmed on histology when necessary. Ablation time and delivered energy were determined and compared with those from the previously tested single-generator version of this device.</p><p><strong>Results: </strong>Surgical ablation was successfully performed on all 6 animals. A total of 12 lesions, 6 LAPW and 6 LAA, were created, corresponding to 297 histological sections. Exit block was uniformly demonstrated (12 of 12). Transmurality was achieved in 100% of cross sections (297 of 297). LAPW ablation time was 37.9 ± 9.1 s, a 48% reduction compared with the single-generator clamp (72.5 ± 7.5 s, <i>P</i> < 0.001). The total energy delivered was 1,109 ± 343 J, similar to that of the single-generator clamp (1,231 ± 138 J, <i>P</i> = 0.45).</p><p><strong>Conclusions: </strong>The dual-generator, split-electrode RF clamp created transmural lesions with a single application while nearly halving ablation time compared with the previous single-generator clamp.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261477759"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900258","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":"Analysis of Ablation Curves to Predict Transmural Lesions Using an Epicardial Bipolar Irrigated Radiofrequency Clamp in Pigs and Humans.","authors":"Luca Aerts, Julie Norup Hertel, Ben J M Hermans, Justin G L Luermans, Sevasti-Maria Chaldoupi, Ronald Lans, Arnela Saljic, Jos G Maessen, Thomas Jespersen, Dominik Linz, Bart Maesen","doi":"10.1177/15569845261448874","DOIUrl":"https://doi.org/10.1177/15569845261448874","url":null,"abstract":"<p><strong>Objective: </strong>It is currently not known at what time point a lesion made with the bipolar irrigated radiofrequency clamp (Cardioblate™ Gemini-S, Medtronic, Galway, Ireland) is transmural. This study aimed to explore typical patterns of ablation curves to potentially predict the transmurality of ablation lesions created with the Gemini-S clamp during atrial fibrillation (AF) ablation.</p><p><strong>Methods: </strong>Ablations were performed on the atria and ventricles of 4 pigs. After ablation, the animals were sacrificed, and macroscopic evaluation was performed to identify the transmurality of the lesions. Typical patterns of ablation curves predicting transmurality were retrospectively identified. Second, a retrospective analysis of typical patterns in human ablation curves was performed to identify potential additional parameters associated with transmurality. Furthermore, the typical patterns identified in the pig experiments were retrospectively analyzed in human ablation curves.</p><p><strong>Results: </strong>Three typical patterns of transmurality were identified in the ablation curves in pigs. Type I was a sharp impedance rise, type II was 3 power drops of at least a 2-energy-level decline in 1 ablation cycle, and type III was a power drop (<11 s) with subsequent hovering of power levels between 15 and 25 W. In 11 hybrid AF ablation patients, 272 applications were performed via the left (41.9%) and right (58.1%) side. Of these ablations, 46.3% were classified as transmural based on the 3 typical patterns of transmurality identified in the pig experiments.</p><p><strong>Conclusions: </strong>Three typical patterns associated with transmurality have been identified using the Gemini-S clamp. These preliminary types need to be tested and validated in the clinical setting during hybrid AF ablation.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261448874"},"PeriodicalIF":1.7,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900263","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":"Comments on \"Axillary Versus Sternotomy Access in Minimally Invasive Mitral Valve Surgery: A Systematic Review and Meta-Analysis\".","authors":"Safa Özçelik","doi":"10.1177/15569845261474555","DOIUrl":"https://doi.org/10.1177/15569845261474555","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261474555"},"PeriodicalIF":1.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897319","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 for Personalized External Aortic Root Support (PEARS).","authors":"Alfred Kocher, Martin Winter, Severin Laengle, Alexandra Andreeva, Kira Osipenko, Doris Hutschala, Marek Ehrlich, Martin Andreas, Daniel Zimpfer, Emilio Osorio-Jaramillo","doi":"10.1177/15569845261477412","DOIUrl":"https://doi.org/10.1177/15569845261477412","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261477412"},"PeriodicalIF":1.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897295","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":"Alfred Kocher Technique: The New Kid on the Block.","authors":"Alfred A Kocher","doi":"10.1177/15569845261477423","DOIUrl":"https://doi.org/10.1177/15569845261477423","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261477423"},"PeriodicalIF":1.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897316","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}