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

{"title":"A Reinforcement Technique for Dissected Arch Vessels Using Hydrofit During Acute Type A Aortic Dissection Repair.","authors":"Shintaro Takago, Satoru Nishida, Kazunori Koyama","doi":"10.1177/15569845251327397","DOIUrl":"10.1177/15569845251327397","url":null,"abstract":"<p><p>Acute type A aortic dissection is a fatal condition that presents with arch vessel dissection necessitating emergency surgical intervention and reconstruction. During surgical treatment of acute type A aortic dissection, thorough analysis is required to prevent complications while reconstructing these fragile dissected arch vessels. This study describes the surgical treatment of 8 patients with dissected arch vessels who underwent reinforcement technique for anastomosis mediated by Hydrofit® (Sanyo Chemical Industries, Kyoto, Japan). The arch vessels were anastomosed with a prosthetic graft. Following the application of Hydrofit to the suture line on the adventitia, no intraoperative bleeding was detected at the reconstruction site of the dissected arch vessels. Postoperative computed tomography revealed no new anastomotic tear or pseudoaneurysm. We highly recommend the use of this reinforcement technique with Hydrofit for the management and reconstruction of vessels involved in acute type A aortic dissection. We observed a fast and uneventful recovery, suggesting promising postoperative results.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"201-204"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991787","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":"Endoscopic Valve-in-MAC: Mitral Valve Replacement With Transcatheter Bioprosthesis Implantation via Right Minithoracotomy.","authors":"Tommaso Gasbarri, Rosa Giusti","doi":"10.1177/15569845251320937","DOIUrl":"10.1177/15569845251320937","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"123"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006684","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 Robotic MIDCAB With Hybrid PCI for Multivessel Coronary Disease Involving the Left Main: Results of 62 Cases.","authors":"Noritsugu Naito, Homam Ibrahim, Cezar Staniloae, Louai Razzouk, Michael Dorsey, Eugene Grossi, Didier F Loulmet","doi":"10.1177/15569845251324200","DOIUrl":"10.1177/15569845251324200","url":null,"abstract":"<p><strong>Objective: </strong>Hybrid coronary revascularization is a clinical strategy that uses a combination of surgical revascularization and percutaneous coronary intervention (PCI). Data on the hybrid approach for coronary artery disease involving the left main (LM) are scarce. We analyzed our cohort of hybrid coronary revascularizations with minimally invasive direct coronary artery bypass (MIDCAB) using robotic left internal mammary artery harvesting and PCI for multivessel disease with and without LM involvement.</p><p><strong>Methods: </strong>Between January 2013 and December 2020, 105 patients consecutively underwent robotic MIDCAB. Of those, 62 patients (59.1%) had multivessel coronary artery disease and underwent revascularization via the hybrid approach using robotic MIDCAB and PCI. Patients were then stratified into 2 groups for comparison: LM disease (<i>n</i> = 22, 35.5%) and non-LM disease (<i>n</i> = 40, 64.5%).</p><p><strong>Results: </strong>The SYNTAX scores were significantly lower in the non-LM group compared with the LM group (19.06 ± 6.41 vs 24.86 ± 7.04, <i>P</i> = 0.002). There were no other significant differences in demographics between the groups. There were no 30-day mortalities in either group. Freedom from major adverse cardiac and cerebrovascular events at 5 years was 72.2% in the non-LM group and 61.0% in the LM group (<i>P</i> = 0.89). There were no significant differences in 5-year overall survival (94.1% vs 83.3%, <i>P</i> = 0.074) or freedom from coronary reintervention (83.4% vs 75.4%, <i>P</i> = 0.699).</p><p><strong>Conclusions: </strong>Hybrid robotic MIDCAB for patients with and without LM disease can be performed with acceptable results in selected patients. However, it is not possible to draw definitive conclusions regarding safety and efficacy compared with conventional coronary artery bypass grafting.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"158-166"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998501","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":"Endoscopic Visualization and the Cardiac Surgeon.","authors":"Johannes Spilka, Ludwig Müller","doi":"10.1177/15569845251326598","DOIUrl":"10.1177/15569845251326598","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"120-122"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018571","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":"Sutureless Valve Outcomes in Isolated Aortic Valve Replacement by Surgical Approach: Results from a Prospective International Real-World Registry.","authors":"Giovanni Concistré, Max Baghai, Giuseppe Santarpino, Alistair Royse, Maximilian Scherner, Giovanni Troise, Mattia Glauber, Marco Solinas","doi":"10.1177/15569845251326526","DOIUrl":"10.1177/15569845251326526","url":null,"abstract":"<p><strong>Objective: </strong>Perceval sutureless valve (Corcym, Saluggia, Italy) has been in clinical use for more than 15 years. The aim of this study is to report clinical and hemodynamic performance from a real-world registry in patients who underwent aortic valve replacement (AVR) with a Perceval, comparing outcomes of minimally invasive (MICS) versus full sternotomy (FS) settings.</p><p><strong>Methods: </strong>This prospective international registry enrolled 1,652 patients implanted with a sutureless aortic valve in 55 institutions from 2011 to 2021. Patients with isolated AVR were analyzed by MICS and FS approaches. Preoperative covariates were adjusted with propensity score matching 2:1, reaching a final cohort of 857 isolated AVR patients with 558 patients in MICS and 299 in FS groups.</p><p><strong>Results: </strong>Successful first implantation was 98.0% for both approaches (<i>P</i> > 0.999). As expected, surgical timings were significantly longer in MICS versus FS (<i>P</i> = 0.004 and <i>P</i> < 0.001), but intensive care unit and hospital lengths of stay were significantly lower in the MICS cohort, resulting in about 0.5 days and 1.5 days less spent in the intensive care unit and hospital, respectively. The surgical approach did not show any effect on early or late survival, disabling stroke, leaks greater than 2, pacemaker rate, or hemodynamics.</p><p><strong>Conclusions: </strong>Our propensity-matched analysis demonstrates the noninferiority of MICS with regard to hard endpoints and better outcomes for secondary endpoints such as reduced length of intensive care and in-hospital stay.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"180-187"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728749","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":"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":"133-147"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448872","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":"Beating Roman Arch Technique in Minimally Invasive Mitral Valve Re-Repair.","authors":"Muhammad Ibrahim Azmi, Zuraini Mohd Noor, Shahrul Amry Hashim","doi":"10.1177/15569845251320953","DOIUrl":"10.1177/15569845251320953","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"124"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968656","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":"Endoscopic Mitral Valve Tumor Removal and Mitral Valve Repair.","authors":"Dimos Karangelis, Konstantinos Lolakos, Henri Bartolozzi, Antonios Pitsis","doi":"10.1177/15569845251320639","DOIUrl":"10.1177/15569845251320639","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"125-126"},"PeriodicalIF":1.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989774","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":"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":"80-86"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","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":"Advancing the Treatment Paradigm for Multivessel Coronary Artery Disease: Hybrid Coronary Revascularization.","authors":"Parth M Patel, Ryon L Arrington, Amalia Jonsson, Jane W Wei, Jose Binongo, Chandan Devireddy, William Nicholson, Wissam Jaber, Stephane Rinfret, Michael E Halkos","doi":"10.1177/15569845241311292","DOIUrl":"10.1177/15569845241311292","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to examine the longitudinal safety and efficacy of hybrid coronary revascularization (HCR) in a large cohort of patients with multivessel coronary artery disease (CAD).</p><p><strong>Methods: </strong>From 2009 to 2020, 561 consecutive patients (median age 64.0 years, predicted risk of mortality 1.3% ± 1.8%, 403 with 2-vessel disease and 158 with 3-vessel disease) underwent a planned HCR procedure with a robot-assisted off-pump left internal mammary artery to left anterior descending (LIMA-LAD) coronary artery bypass graft (CABG) combined with percutaneous coronary intervention (PCI) of non-LAD vessels. Multivariable regression analysis was used to identify risk factors for short-term and longer-term outcomes.</p><p><strong>Results: </strong>Operative mortality and stroke occurred in 4 (0.7%) and 5 patients (0.9%), respectively. Postoperative angiography revealed LIMA patency in 415 of 425 patients (98%). Median follow-up was 4.5 years and was 93% complete. Repeat revascularization occurred in 44 patients (8%) at a median of 2.7 years. Freedom from repeat revascularization and survival at 5 years was similar between patients with 2-vessel and 3-vessel disease (<i>P</i> = 0.73 and <i>P</i> = 0.19, respectively). Completely revascularized patients had 5-year survival of 91% versus 64% for incompletely revascularized patients (hazard ratio = 3.8, <i>P</i> < 0.001). Age (<i>P</i> = 0.03), renal failure (<i>P</i> < 0.001), and history of myocardial infarction (<i>P</i> = 0.01) were risk factors for late adverse events.</p><p><strong>Conclusions: </strong>HCR is a safe and effective minimally invasive alternative to conventional CABG or multivessel PCI with a low incidence of late repeat revascularization and mortality. HCR can be safely applied to carefully selected patients with either 2-vessel or 3-vessel CAD; however, incomplete revascularization may result in lower long-term survival.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"57-64"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079647","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}