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

{"title":"Supra-Annular Perceval Bentall: From Concept to Patient.","authors":"S Chris Malaisrie, Borut Gersak, Beth Whippo, Matthew Snyder","doi":"10.1177/15569845261469838","DOIUrl":"https://doi.org/10.1177/15569845261469838","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate a supra-annular implantation of a composite valve-graft (CVG) constructed from a sutureless aortic valve within a Dacron graft for aortic root replacement. The anatomic rationale, preclinical validation, and clinical outcomes of this novel technique are described.</p><p><strong>Methods: </strong>The anatomic rational for sizing of the valve and graft was examined by ex vivo implantation of a Perceval Plus XL valve (Corcym, Milan, Italy) within a 28 mm Valsalva Dacron graft (Terumo Aortic, Inchinnan, UK). Hydrodynamic in vitro testing with a ViVitro pulse duplicator system (ViVitro, Victoria, BC, Canada) validated the integrity of the CVG. The CVG was implanted supra-annular to the native aortic annulus in a clinical setting.</p><p><strong>Results: </strong>A Perceval XL valve within a 28 mm Valsalva Dacron graft provided 8% oversize of the valve inflow ring within the graft collar. In vitro testing showed valve stability within the Dacron graft under physiologic conditions. The first SUpra-annular PERceval Bentall (SUPERB) was performed in a 75-year-old male patient with concomitant aortic stenosis and aortic root aneurysm. The CVG was constructed by (1) suturing the graft to the aortic annulus, (2) construction of coronary buttons, and (3) deployment of the sutureless valve with the Dacron graft in a supra-annular position.</p><p><strong>Conclusions: </strong>SUPERB uses a Perceval XL valve within a 28 mm Valsalva Dacron graft for aortic root replacement. Positioning of the sutureless valve within the Dacron graft and supra-annular to the native aortic annulus decouples valve sizing from the restrictions of native aortic annular dimensions. This approach simplifies CVG sizing and potentially mitigates patient-prosthetic mismatch.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261469838"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678337","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 Use of del Nido Cardioplegia in Adults and Pediatric Patients Undergoing Minimally Invasive Endoscopic Cardiac Surgery.","authors":"Antonios Samothrakis, Fotios A Mitropoulos, Theodora M Stougiannou, Efstratios Georgakarakos, Dimos Karangelis","doi":"10.1177/15569845261469790","DOIUrl":"https://doi.org/10.1177/15569845261469790","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive cardiac surgery (MICS) offers faster recovery and improved patient satisfaction compared with sternotomy, but limited exposure makes myocardial protection challenging. Use of del Nido cardioplegia (DNC), originally developed for pediatrics, is increasing in adults due to its single-dose administration and prolonged arrest.</p><p><strong>Methods: </strong>Following PRISMA guidelines, PubMed was searched for studies published between September 1, 2015, and September 30, 2025, evaluating DNC in MICS or sternotomy-sparing cardiac surgery. Seven studies met inclusion criteria, including retrospective propensity-matched cohorts, 1 prospective randomized single-center trial, and 1 network meta-analysis.</p><p><strong>Results: </strong>DNC was consistently linked to lower cardioplegia volume, fewer repeat doses, and shorter cross-clamp and bypass times compared with blood or histidine-tryptophan-ketoglutarate (HTK) solutions. Some studies reported reduced postoperative enzyme release, particularly with ischemic times <100 min. Safety outcomes, including mortality, complications, and recovery, were comparable across groups. Meta-analytic evidence suggested procedural efficiency advantages, while Custodiol ranked highest overall.</p><p><strong>Conclusions: </strong>DNC appears to be a safe alternative in MICS, offering workflow-related procedural efficiency while maintaining comparable myocardial protection. However, current evidence is mostly retrospective and single center. Large, multicenter, randomized trials are needed to establish its role versus HTK and Custodiol in sternotomy-sparing procedures.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261469790"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678357","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":"Robotic Internal Mammary Artery Harvesting in a Porcine Model Using the hinotori™ Robotic Surgical System.","authors":"Xander Jacquemyn, Christoph Wandhöfer, Wouter Oosterlinck","doi":"10.1177/15569845261458287","DOIUrl":"https://doi.org/10.1177/15569845261458287","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261458287"},"PeriodicalIF":1.7,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520248","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":"ISMICS 2024 Presidential Address: A Piece Is Missing in the Jigsaw.","authors":"Nikolaos Bonaros","doi":"10.1177/15569845261457443","DOIUrl":"https://doi.org/10.1177/15569845261457443","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261457443"},"PeriodicalIF":1.7,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520245","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 Coronary Artery Bypass Versus Percutaneous Coronary Intervention in Patients With Coronary Artery Disease: A Meta-Analysis.","authors":"Mohamed Doma, Edmundo Damiani Bertoli, Gustavo Rovari, Adham Ramadan, Luena Seferasi, Mangesh Kritya, Ghazal Sanadgol, Ibrahim Kamel, Shanmukh Sai Pavan Lingamsetty, Yehia Karara, Lucas Cael Azevedo Ramos Bendaham, Motahar Hosseini, Arnar Geirsson, Chase R Brown, Andrew M Goldsweig","doi":"10.1177/15569845261457424","DOIUrl":"https://doi.org/10.1177/15569845261457424","url":null,"abstract":"<p><strong>Objective: </strong>As alternatives to conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG) and percutaneous coronary intervention (PCI) offer less invasive treatments for coronary artery disease (CAD). However, data comparing outcomes of R-CABG versus PCI are limited.</p><p><strong>Methods: </strong>Databases were systematically searched for studies comparing R-CABG versus PCI. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), both overall and stratified by left main or multivessel (LM+MV) or isolated left anterior descending artery (LAD) disease. Kaplan-Meier curves were digitally extracted to reconstruct individual participant data (IPD), from which hazard ratios (HRs) were estimated for survival analyses.</p><p><strong>Results: </strong>Six retrospective studies, including 1,896 patients (R-CABG: 894, 47.1%), were analyzed. The mean age was 63.8 ± 11.3 years, and 78.7% were male patients. Follow-up ranged from 2 to 8 years. Overall, R-CABG was associated with a lower odds of target vessel revascularization (TVR; OR = 0.50, 95% CI: 0.27 to 0.93, <i>P</i> = 0.03) and myocardial infarction (MI; OR = 0.44, 95% CI: 0.26 to 0.76, <i>P</i> < 0.01), with no significant difference in all-cause mortality. Among patients with LM+MV disease, R-CABG reduced TVR and MI. In LAD lesions, R-CABG significantly lowered the likelihood of MI (OR = 0.18, 95% CI: 0.04 to 0.71) as well as major adverse cardiovascular events (MACE; OR = 0.51, 95% CI: 0.28 to 0.93). Time-to-event analysis from reconstructed IPD demonstrated significantly improved freedom from reintervention (HR = 0.31, 95% CI: 0.16 to 0.60) and MACE (HR = 0.24, 95% CI: 0.15 to 0.60) with R-CABG, whereas no significant difference was found for all-cause mortality.</p><p><strong>Conclusions: </strong>R-CABG was associated with less TVR and MI compared with PCI in CAD patients, with no difference in all-cause mortality.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261457424"},"PeriodicalIF":1.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308096","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 Cardiac Surgery in Carney-Stratakis Syndrome: A New Frontier in Tumor Resection.","authors":"Muhammad Adeel Sami, Hafsa Zareen","doi":"10.1177/15569845261457636","DOIUrl":"https://doi.org/10.1177/15569845261457636","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261457636"},"PeriodicalIF":1.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308109","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 Creation of Digital Twins in Cardiovascular Interventions Requires . . . Good Data!","authors":"Andreas Sarantopoulos, Nikolaos Schizas","doi":"10.1177/15569845261457091","DOIUrl":"https://doi.org/10.1177/15569845261457091","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845261457091"},"PeriodicalIF":1.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264574","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 Antiplatelet Management Before and After CABG.","authors":"Abeline R Watkins, Nadia A Clarizia, Pierre Voisine, Marc Ruel","doi":"10.1177/15569845261449187","DOIUrl":"10.1177/15569845261449187","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"195-201"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Totally Endoscopic Mitral Valve Surgery in Octogenarians: Age Is Just a Number!","authors":"Riya Bhasin, Sarah Nisivaco, Hiroto Kitahara, Yazan AlJamal, Husam H Balkhy","doi":"10.1177/15569845261452666","DOIUrl":"10.1177/15569845261452666","url":null,"abstract":"<p><strong>Objective: </strong>Octogenarians are sometimes excluded from mitral valve (MV) surgery due to increased morbidity and mortality. Sternal-sparing approaches (e.g., robotic MV surgery) have the potential to reduce these risks. We reviewed the outcomes of robotic totally endoscopic MV surgery in octogenarians.</p><p><strong>Methods: </strong>Of 600 patients undergoing elective robotic totally endoscopic MV surgery at our institution (September 2013 to December 2024), 40 patients were octogenarians. Early and midterm clinical and echocardiographic outcomes were analyzed. All procedures were performed using the da Vinci Si or Xi (Intuitive Surgical, Sunnyvale, CA, USA) with an endoscopic approach and an 8 to 10 mm working port.</p><p><strong>Results: </strong>The mean age was 83 ± 2.7 years, and 55% were female patients. The mean Society of Thoracic Surgeons risk was 4.4% ± 2.1%, 36 patients (90%) underwent MV repair, and 65% had concomitant procedures. Two patients had previous heart surgery. Cardiac arrest methods included endoballoon (62.5%), fibrillating heart (35%), or cross-clamp (2.5%). There was 1 (2.5%) conversion to sternotomy. The incidence of new postoperative atrial fibrillation was 15%, and 3 patients (7.5%) returned to the operating room for bleeding. There were no postoperative myocardial infarctions, strokes, or early mortalities. Mean intensive care unit and hospital length of stay were 1.5 ± 0.8 and 3.5 ± 1.5 days, respectively. Return to full activity occurred at a mean of 13 ± 9 days. Early postoperative echocardiography revealed 95% none to mild mitral regurgitation (MR). Clinical follow-up was complete in 100% of patients at a mean of 37 months. All-cause mortality occurred in 9 patients, and 1 was a cardiac-related death. At midterm echocardiography follow-up (mean 36 months), 90% had none to mild MR.</p><p><strong>Conclusions: </strong>These findings add to the growing evidence supporting the safety and efficacy of robotic totally endoscopic MV surgery and specifically recognize its benefits in older patients.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"250-255"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149696","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":"Incidence of Permanent Pacemaker Implantation Following Tricuspid Valve Surgeries: A Systematic Review and Meta-Analysis.","authors":"Seyed Shervin Shafiei, Saeid Hosseini, Samuel Heuts, Abolfazl Hosseinnataj, Peyman Sardari Nia","doi":"10.1177/15569845261455899","DOIUrl":"10.1177/15569845261455899","url":null,"abstract":"<p><strong>Objective: </strong>Tricuspid valve (TV) surgery is increasingly performed. Still, the risk of permanent pacemaker (PPM) implantation following TV surgery is a serious concern. Therefore, the present systematic review and meta-analysis is aimed to determine the incidence of PPM implantation following TV surgeries in various surgical settings.</p><p><strong>Methods: </strong>This study was preregistered in PROSPERO (CRD42024585421). A methodical search was performed across various international electronic databases. Random-effects models were used to illustrate the aggregated incidence of PPM implantation following different types of TV surgeries. Meta-regression and subgroup analysis were applied to evaluate the statistically significant effect of modifiers.</p><p><strong>Results: </strong>Twelve studies were included; a total of 18,437 patients underwent TV surgery. The incidence of PPM implantation following overall TV surgery was 12.1% (<i>P</i> < 0.001), isolated TV surgery was 11.1% (<i>P</i> < 0.001), TV + mitral valve (MV) surgery was 12.3% (<i>P</i> < 0.001), TV + aortic valve (AV) surgery was 10.9% (<i>P</i> = 0.001), and TV + MV + AV surgery was 17.3% (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>PPM implantation is a common complication that can arise after TV surgery, especially when multiple valves are involved. Although substantial variability across studies makes it difficult to pinpoint exact risks, the overall message is clear: there is a need to focus on preoperative patient counseling and develop standardized research to improve our ability to predict and prevent these complications.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"217-230"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}