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

{"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}

{"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":"10.1177/15569845241309635","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"10-12"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","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":"Novel Treatment of Palmar Hyperhidrosis With Robotic Hybrid Cryoablation Sympathectomy.","authors":"Taoyuan Beninato, Kristen Kent, Pauline H Go","doi":"10.1177/15569845241298256","DOIUrl":"10.1177/15569845241298256","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":"20 1","pages":"106-108"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604773","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":"Acute Postinfarction Ventricular Septal Defect Repair Through the Left Minithoracotomy.","authors":"Oleksandr Babliak, Dmytro Babliak, Yevhenii Melnyk, Katerina Revenko, Oleksii Stohov","doi":"10.1177/15569845241311598","DOIUrl":"10.1177/15569845241311598","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"104-105"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189137","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":"10.1177/15569845241311596","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"19-21"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","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":"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":"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":"87-95"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","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}