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

{"title":"Totally Endoscopic Ascending Aortic Replacement and Mitral Valve Repair.","authors":"Timotheos G Kelpis, Antonios A Pitsis","doi":"10.1177/15569845261425664","DOIUrl":"https://doi.org/10.1177/15569845261425664","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":"21 2","pages":"179-180"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251097","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":"Minimally Invasive Approach for Mitral Valve Surgery Is Associated With Increased Risk of Postoperative Diaphragm Dysfunction.","authors":"Sameer K Singh, Marco Tagliafierro, Darina Kirilina, Paul A Kurlansky, Michael Argenziano, Syed Tasnim Raza","doi":"10.1177/15569845261436390","DOIUrl":"10.1177/15569845261436390","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive mitral valve (MIMV) surgery has increased in prevalence due to reduced postoperative pain, length of stay, and improved cosmesis. However, there is a lack of data describing the risk and impact of postoperative diaphragm dysfunction (DD) after MIMV.</p><p><strong>Methods: </strong>Consecutive patients at a single institution undergoing isolated mitral valve surgery either via full sternotomy (FS) or MIMV (right thoracotomy) between 2015 and 2024 were included. The diagnosis of DD was based on postoperative diaphragm elevation on chest X-ray and confirmation via ultrasound Sniff test. Factors associated with postoperative DD were identified, and postoperative outcomes were compared between groups.</p><p><strong>Results: </strong>The incidence of postoperative DD was 3.0% (<i>n</i> = 35) among the 1,155 patients undergoing MV surgery. The incidence of DD was 1.8% after FS and 9.3% after MIMV (<i>P</i> < 0.001). Among MIMV patients, all suffered from right DD. After controlling for age, body mass index, and pulmonary comorbidities, MIMV was independently associated with postoperative DD compared with FS (odds ratio = 5.1, 95% CI: 2.4 to 11.0, <i>P</i> < 0.001). Although patients with and without DD had similar postoperative outcomes, those patients older than 70 years with DD had longer postoperative ventilation times (<i>P</i> = 0.03) and hospital length of stay (<i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>MIMV via right thoracotomy is associated with increased risk of postoperative DD and increased ventilation times and hospital length of stay for elderly patients. Further studies are needed to elucidate the causes for diaphragm injury to minimize this complication.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"144-149"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948306","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":"10.1177/15569845261425653","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"177-178"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","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":"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":"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":"150-158"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770433","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":"The 10 Commandments of Cryo Nerve Block.","authors":"Curtis C Quinn, Lizabeth A O'Connor","doi":"10.1177/15569845261433541","DOIUrl":"10.1177/15569845261433541","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"101-105"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","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":"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":"166-172"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","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":"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":"122-128"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165405","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":"Outcomes of Aortic Valve Repair: A Systematic Review and Meta-Analysis Using Reconstructed Individual Patient Data.","authors":"Rui J Cerqueira, João Q Mascarenhas, Maria Rodrigues, Joana O Miranda, Michal J Kawczynski, Jan Vojacek, Bardia Arabkhani, Elham Bidar, Adelino Leite-Moreira, Francisca Saraiva, Samuel Heuts","doi":"10.1177/15569845261438464","DOIUrl":"10.1177/15569845261438464","url":null,"abstract":"<p><strong>Objective: </strong>The progressive dissemination of isolated aortic valve repair (AVRep) and valve-sparing root (VSR) procedures has resulted in a cumulative expansion of the available literature. This work aims to synthesize the current knowledge and identify predictors of mortality and reintervention in patients undergoing such valve-preserving procedures.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in 2 databases (last search January 2025). Studies with ≥200 adult patients undergoing AVRep or VSR with a minimum mean follow-up ≥5 years were included. Short-term outcomes were summarized using weighted descriptive statistics. Forest plots, funnel plots, and the Newcastle-Ottawa Scale were used to evaluate the risk of bias. Long-term survival and freedom from reoperation were analyzed through reconstructing individual patient data from Kaplan-Meier curves, and a mixed-effects Cox frailty model was used to identify study-level predictors of these endpoints.</p><p><strong>Results: </strong>There were 48 studies included, encompassing 20,914 patients with a mean weighted age of 52.42 (50.28 to 54.57) years. Early outcomes included hospital mortality (1.34% [1.04% to 1.73%]), bleeding (3.77% [2.76% to 5.13%]), myocardial ischemia (0.44% [0.26% to 0.77%]), pacemaker implantation (1.00% [0.63% to 1.59%]), neurologic events (1.27% [0.91% to 1.78%]), and postoperative residual aortic regurgitation (3.48% [1.90% to 6.29%]). Pooled survival at 1, 5, 10, and 20 years of follow-up was 96.8%, 92.5%, 83.8%, and 67%, respectively; freedom from reoperation at the same time points was 97.9%, 93.9%, 88.2%, and 77.5%, respectively. Factors such as older age, female sex, aortic dissection, and isolated valve repair were associated with higher mortality.</p><p><strong>Conclusions: </strong>These findings suggest that AVRep and VSR are associated with low early mortality and morbidity and excellent long-term outcomes. However, heterogeneity in definitions and endpoints across studies underlines the need for standardized definitions and conduction of properly designed randomized trials.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"111-121"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874147","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":"Using Augmented Reality to Guide Complex Chest Wall Resection With Simplified Single-Patch Reconstruction.","authors":"Alexander Pohlman, Madison Lozanoski, Bilal Odeh, Zaid M Abdelsattar","doi":"10.1177/15569845251410549","DOIUrl":"10.1177/15569845251410549","url":null,"abstract":"","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"173-174"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100157","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":"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":"129-137"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","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}