Interactive cardiovascular and thoracic surgery最新文献

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Ruxolitinib withdrawal complicating emergency aortic root replacement 紧急主动脉根部置换术并发鲁索利替尼停药
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-30 DOI: 10.1093/icvts/ivac143
M. Szpytma, D. Gimpel, G. Crouch, J. Bennetts
{"title":"Ruxolitinib withdrawal complicating emergency aortic root replacement","authors":"M. Szpytma, D. Gimpel, G. Crouch, J. Bennetts","doi":"10.1093/icvts/ivac143","DOIUrl":"https://doi.org/10.1093/icvts/ivac143","url":null,"abstract":"Abstract Ruxolitinib, a Janus kinase inhibitor, is associated with severe withdrawal phenomena. Adequate tapering is often underemphasized in surgical emergencies and can complicate the postoperative course. We present a case of acute ruxolitinib withdrawal in a gentleman undergoing emergency cardiac surgery","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87888701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Very-long-term outcomes of mechanical valves in mitral position focusing on valve-related complications 二尖瓣位置机械瓣膜的长期预后,重点关注瓣膜相关并发症
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-30 DOI: 10.1093/icvts/ivac146
Gaku Uchino, H. Murakami, N. Mukohara, Hiroshi Tanaka, Yoshikatsu Nomura, S. Miyahara, Motoharu Kawashima, Jun Fujisue, Shuto Tonoki
{"title":"Very-long-term outcomes of mechanical valves in mitral position focusing on valve-related complications","authors":"Gaku Uchino, H. Murakami, N. Mukohara, Hiroshi Tanaka, Yoshikatsu Nomura, S. Miyahara, Motoharu Kawashima, Jun Fujisue, Shuto Tonoki","doi":"10.1093/icvts/ivac146","DOIUrl":"https://doi.org/10.1093/icvts/ivac146","url":null,"abstract":"Abstract OBJECTIVES This study aimed to examine very-long-term outcomes of a mechanical valve at the mitral position. METHODS This study included all patients who underwent mitral valve replacement (MVR) using a mechanical valve including urgent operation at the Department of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, from January 1987 to December 2015. RESULTS Five hundred and eighty-three patients (277 men [47.51%]; age, 61 [54–67] years) were included in this study. The implanted valve models were as follows: SJM, 221 (37.91%); ATS, 35 (6.00%); On-X, 68 (11.66%); and Carbomedics 194, (33.28%).The median clinical follow-up duration was 13.3 (7.4–19.6) years. The survival rates at 10, 15, 20 and 25 years were 81.42%, 69.27%, 56.34% and 45.03%, respectively. Thromboembolism was observed in 38 patients, and the linearized ratio for each event was 0.626%/patient-year [95% confidence interval (CI), 0.443–0.859%]. Intracranial haemorrhage and gastrointestinal bleeding were observed in 26 and 9 patients, and the linearized ratio for each event was 0.425%/patient-year (95% CI, 0.277–0.006%) and 0.145%/patient-year (95% CI, 0.067–0.276%), respectively. Major paravalvular leak was observed in 32 patients, and the linearized ratio was 0.532%/patient-year (95% CI, 0.364%–0.751%). The cumulative incidence rate of major paravalvular leak at 10, 15, 20 and 25 years was 3.7%, 5.6%, 6.4% and 10.4%, respectively. Multivariable Cox regression analysis revealed that repeated MVR and male gender were associated with major paravalvular leak. CONCLUSIONS Male gender and repeated MVR were risk factors for paravalvular leak after mechanical MVR. Paravalvular leak could have occurred regardless of postoperative period even at 25 years after implantation. Lifelong clinical follow-up is considered necessary.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84848683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Repair with a pulmonary neovalve in tetralogy of Fallot: does this avoid ventricular dysfunction? 法洛四联症的肺新瓣膜修复:能避免心室功能障碍吗?
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-30 DOI: 10.1093/icvts/ivac155
Albert F. Guerrero, Ivonne G. Pineda-Rodríguez, A. M. Palacio, C. Obando, Tomás Chalela, Jaime Camacho, Carlos Villa, J. Umaña, Néstor Sandoval-Reyes
{"title":"Repair with a pulmonary neovalve in tetralogy of Fallot: does this avoid ventricular dysfunction?","authors":"Albert F. Guerrero, Ivonne G. Pineda-Rodríguez, A. M. Palacio, C. Obando, Tomás Chalela, Jaime Camacho, Carlos Villa, J. Umaña, Néstor Sandoval-Reyes","doi":"10.1093/icvts/ivac155","DOIUrl":"https://doi.org/10.1093/icvts/ivac155","url":null,"abstract":"Abstract OBJECTIVES Given the anatomical variations of tetralogy of Fallot (TOF), different surgical techniques can be used to achieve correction. Transannular patches (TAPs) are the most commonly used technique; they are associated with right ventricular dysfunction, the incidence of which can be reduced through pulmonary valve preservation. METHODS Between January 2010 and July 2019, we performed 274 surgical corrections of tetralogy of Fallot at Fundación Cardioinfantil; 63 patients (23%) underwent repair with a TAP in addition to a pulmonary neovalve (Group I), 66 patients (24.1%) received a TAP without a pulmonary valve (Group II) and 145 patients (52.9%) had a repair with valve preservation (Group III). We analysed patient’s characteristics before, during and after surgery at a 30-day follow-up. RESULTS We found that patients in Group III were older (P = 0.04). Group II had the lowest level of O2 saturation before surgery (82%, P = 0.001). Cardiopulmonary bypass and aortic cross-clamp times were longer in Group I (P < 0.001). Right ventricular dysfunction was less frequent in Group III (15.9%, P = 0.011). Severe residual pulmonary regurgitation was more common in Group II (21.9%, P = 0.001). CONCLUSIONS Preservation of the pulmonary valve is an important factor for immediate postoperative management of tetralogy of Fallot. Patients who were repaired with a TAP with or without a pulmonary neovalve had a higher incidence of right ventricular dysfunction than those with pulmonary valve preservation.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87324157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Utility of the surgical Apgar score for predicting the short- and long-term outcomes in non-small-cell lung cancer patients who undergo surgery 应用手术Apgar评分预测非小细胞肺癌手术患者的短期和长期预后
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-30 DOI: 10.1093/icvts/ivac150
Akihiro Nagoya, R. Kanzaki, K. Kimura, Eriko Fukui, T. Kanou, N. Ose, S. Funaki, M. Minami, M. Fujii, Y. Shintani
{"title":"Utility of the surgical Apgar score for predicting the short- and long-term outcomes in non-small-cell lung cancer patients who undergo surgery","authors":"Akihiro Nagoya, R. Kanzaki, K. Kimura, Eriko Fukui, T. Kanou, N. Ose, S. Funaki, M. Minami, M. Fujii, Y. Shintani","doi":"10.1093/icvts/ivac150","DOIUrl":"https://doi.org/10.1093/icvts/ivac150","url":null,"abstract":"Abstract OBJECTIVES The surgical Apgar score (SAS) is a simple score that predicts postoperative complications based on 3 intraoperative valuables. The present study evaluated the association between the SAS and postoperative outcomes in non-small-cell lung cancer patients who underwent surgery. METHODS A total of 585 patients who underwent lung resection were enrolled in the present study. We calculated the SAS of each patient and investigated its influence on the short- and long-term outcomes. RESULTS Postoperative complications of any grade were detected in 164 cases (28%). The morbidity rate increased with decreasing SAS. When all the patients were divided into 2 groups (SAS <7 vs ≥7), postoperative complications were observed more frequently in the SAS <7 group than in the SAS ≥7 group (41% vs 25%, P < 0.001). In the multivariate analysis, the SAS was an independent risk factor for postoperative complications (odds ratio: 1.64 [1.03–2.61], P = 0.036). In terms of long-term outcomes, the 5-year disease-free survival (54.1% vs 73.2%, P < 0.001) and overall survival (73.8% vs 83.0%, P = 0.031) were significantly worse in the SAS <7 group than in the SAS ≥7 group. In a multivariate analysis, however, the SAS was not found to be an independent prognostic factor for either disease-free survival (hazard ratio: 1.39 [0.97–2.00], P = 0.075) or overall survival (hazard ratio: 0.90 [0.57–1.42], P = 0.642). CONCLUSIONS The SAS reflected preoperative and intraoperative characteristics and was able to stratify the morbidity rate, suggesting it to be a useful predictor of short-term outcomes in non-small-cell lung cancer patients who undergo surgery.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81554363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The correction of the diastasis of the rectus abdominis muscle concomitant with a moulded silicone implant insertion in a patient with medial pectus excavatum 内侧漏斗胸患者腹直肌移位伴硅胶模塑植入的矫正
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-30 DOI: 10.1093/icvts/ivac147
J. Anger, J. M. D. de Campos
{"title":"The correction of the diastasis of the rectus abdominis muscle concomitant with a moulded silicone implant insertion in a patient with medial pectus excavatum","authors":"J. Anger, J. M. D. de Campos","doi":"10.1093/icvts/ivac147","DOIUrl":"https://doi.org/10.1093/icvts/ivac147","url":null,"abstract":"Abstract The association of the diastasis of the rectus abdominis muscle and the medial pectus excavatum was reported. We have been using soft silicone block, sculpted intraoperatively, to correct pectus excavatum. The horizontal access used, 2 cm at a subxiphoid position, allows us to expose the sternum and the rectus abdominis muscles (RAMs). We report a case, male, 31 years presenting medial pectus excavatum and supraumbilical diastasis of the rectus abdominis muscle with a width of 35 mm at the costal arches, and 27 mm at 6 cm from the xiphoid process edge. The muscle borders presented a curved lateral deviation up to the insertion in the costal arches. The necessary space for the implant was dissected and the block was sculpted. The medial and superior aponeurosis borders of the RAM were incised at 6 cm from the xiphoid, and the posterior border of the RAM was released. The aponeurosis borders were brought together, promoting a medial and anterior positioning of the RAM. The inferior border of the implant was attached to the raw superior borders of the RAM. The result was considered satisfactory, and a magnetic resonance image 14 months after showed continuity of the implant and the muscles, promoting a uniform body contour. Registry: CAAE63181616.7.0000.0071.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"45 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72583860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A single-centre, retrospective study of mid-term outcomes of aortic arch repair using a standardized resection and patch augmentation technique 一项采用标准化切除和补片增强技术修复主动脉弓中期结果的单中心回顾性研究
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-28 DOI: 10.1093/icvts/ivac135
A. Patukale, F. Shikata, Shilpa S Marathe, Pervez Patel, S. Marathe, T. Colen, P. Venugopal, J. Suna, K. Betts, T. Karl, Janelle Johnson, K. Versluis, N. Alphonso
{"title":"A single-centre, retrospective study of mid-term outcomes of aortic arch repair using a standardized resection and patch augmentation technique","authors":"A. Patukale, F. Shikata, Shilpa S Marathe, Pervez Patel, S. Marathe, T. Colen, P. Venugopal, J. Suna, K. Betts, T. Karl, Janelle Johnson, K. Versluis, N. Alphonso","doi":"10.1093/icvts/ivac135","DOIUrl":"https://doi.org/10.1093/icvts/ivac135","url":null,"abstract":"Abstract OBJECTIVES The aim of this study was to evaluate the mid-term outcomes after the repair of aortic arch using a standard patch augmentation technique. METHODS The study included all patients who underwent repair of a hypoplastic/interrupted aortic arch (IAA) in a single institute from June 2012 to December 2019 by a standardized patch augmentation (irrespective of concomitant intra-cardiac lesions). End points evaluated were reintervention for arch obstruction and persistent/new-onset hypertension. RESULTS The study included 149 patients [hypoplastic aortic arch, n = 92 (62%), IAA, n = 9 (6%), Norwood procedure, n = 48 (32%)]. The patch material used for augmentation of the aortic arch included pulmonary homograft (n = 120, 81%), homograft pericardium (n = 18, 12%), CardioCel® (n = 9, 6%) and glutaraldehyde-treated autologous pericardium (n = 2, 1%). The median age and weight at surgery were 7 days [interquartile range (IQR) 5–17 days] and 3.5 kg (IQR 3–3.9 kg), respectively. The median follow-up was 3.27 years (IQR 1.28, 5.08), range (0.02, 8.76). Freedom from reintervention at 1, 3 and 5 years was 95% [95% confidence interval (CI) = 89%, 98%], 93% (95% CI = 86%, 96%) and 93% (95% CI = 86%, 96%) respectively. One patient (0.6%) had persistent hypertension 8 years after correction for interrupted arch with truncus arteriosus. CONCLUSIONS Repair of hypoplastic/IAA by transection and excision of all ductal tissue and standardized patch augmentation provide good mid-term durability. The freedom from reintervention at 5 years is >90%. The incidence of persistent systemic hypertension following arch reconstruction is low. The technique is reproducible and applicable irrespective of underlying arch anatomy.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80848958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neochord DS1000 system versus conventional mitral valve repair for correction of mitral regurgitation due to prolapse of the posterior leaflet Neochord DS1000系统与传统二尖瓣修复术对后小叶脱垂导致的二尖瓣返流的矫正
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-27 DOI: 10.1093/icvts/ivac139
T. David
{"title":"Neochord DS1000 system versus conventional mitral valve repair for correction of mitral regurgitation due to prolapse of the posterior leaflet","authors":"T. David","doi":"10.1093/icvts/ivac139","DOIUrl":"https://doi.org/10.1093/icvts/ivac139","url":null,"abstract":"In this issue of the Interactive CardioVascular and Thoracic Surgery, D’Onofrio and colleagues [1] from the University of Padua compared the perioperative and 5-year outcomes of correction of mitral regurgitation (MR) due to posterior leaflet prolapse with Neochord DS1100 (NeoChord, Inc. St. Louis Park, MN, USA) versus conventional mitral valve repair. Patients were enrolled from 2010 to 2018 and after exclusions, the authors had 281 patients available for the study: 169 had Neochord and 112 had surgical repair, suggesting the authors’ preference for Neochord to treat posterior leaflet prolapse. To compensate for discrepancies procedure selection, the authors used a propensity score analysis using preoperative clinical variables believed to affect outcome. They identified 88 pairs of patients with similar clinical profiles except for functional class which was worse in the Neochord group. The patients in this study were younger than in most reports on longitudinal outcomes of mitral valve repair [2, 3]. The chose patients’ survival as the primary endpoint of the study but since a propensity score analysis was used to compensate for differences in age and comorbidities, this does not seem rational. The secondary endpoints of reoperation on the mitral valve and freedom from moderate or severe MR are far more pertinent in this type of comparing procedures to treat MR. Before discharge from hospital, 8 patients in the Neochord and 1 patient in the surgical repair group had moderate or severe MR. The 5-year survival was similar, as one would expect, but the freedom from recurrent MR was only 57.6% in the Neochord group and 84.6% in the surgical repair group, and the freedom from reoperation was 78.9% in the first group and 92% in the second. Neochord DS1100 gained European market approval in 2016 and FDA approval for a randomized clinical trial in the USA in the same year [4]. I have not been able to find any publication on that randomized trial, likely because it is still enrolling patients in spite of the fact that 6 years have passed since its FDA approval [4]. Hopefully, this randomized clinical trial will help us to determine the usefulness of this device. Based on D’Onofrio and colleagues [1] experience and on that of others [3], I am not sure this device should be used in any patient who can have conventional mitral valve repair. There are, however, patients with posterior leaflet prolapse with intractable heart failure that would not tolerate a median sternotomy or even a right mini-thoracotomy with cardiopulmonary bypass and, perhaps, they should be considered for this device but only after excluding the feasibility of a transcatheter Mitraclip (Abbott Laboratories, Chicago, IL, USA), which is likely to provide better and safer outcomes [5]. I have been practicing cardiac surgery for over 4 decades and prospectively followed certain groups of my patients. Mitral valve surgery is one of them, and I have over 3000 mitral valve repairs in my dat","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86207187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Effect of preoperative radiotherapy on overall survival in N2 non-small-cell lung cancer: a propensity score-matched analysis of Surveillance, Epidemiology, and End Results database 术前放疗对N2期非小细胞肺癌总生存率的影响:监测、流行病学和最终结果数据库的倾向评分匹配分析
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-27 DOI: 10.1093/icvts/ivab321
Yunan Wang, Yunliang Cao, Mengjia Wu, Yanyi Lu, Bo He, Lei Zhou, Wei Hu
{"title":"Effect of preoperative radiotherapy on overall survival in N2 non-small-cell lung cancer: a propensity score-matched analysis of Surveillance, Epidemiology, and End Results database","authors":"Yunan Wang, Yunliang Cao, Mengjia Wu, Yanyi Lu, Bo He, Lei Zhou, Wei Hu","doi":"10.1093/icvts/ivab321","DOIUrl":"https://doi.org/10.1093/icvts/ivab321","url":null,"abstract":"Abstract OBJECTIVES The aim of this study was to investigate the effect of preoperative radiotherapy (PrORT) on the overall survival (OS) of patients with stage ipsilateral mediastinal lymph node metastasis (N2) non-small-cell lung cancer. METHODS A total of 1390 patients with stage N2 non-small-cell lung cancer between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results database. The efficacy of PrORT combined with surgery was compared with that of surgery alone on OS. Propensity score matching (PSM) was performed to balance the baseline characteristics of patients who received (n = 239) and did not receive (n = 1151) PrORT. We compared the OS of the 2 groups using the Kaplan–Meier method and log-rank were used to compare the OS between the 2 groups test before and after PSM and to analyse subgroups of patients with squamous cell carcinoma (SCC) and adenocarcinoma. RESULTS In whole group analysis before PSM, the median OS was superior in the PrORT group than in the surgery alone group (44.0 [34.4–56.6] vs 39.0 [34.5–43.5] months). There was a significant difference in OS [hazard ratio (HR): 0.819; 95% confidence interval (CI): 0.677–0.991; P = 0.029]. Nevertheless, no statistically significant difference was found in OS between the 2 groups after PSM (HR: 0.856; 95% CI: 0.654–1.122; P = 0.260). Among subgroup analysis of the SCC group before PSM revealed that patients who received PrORT had significantly higher median OS than those who did not receive PrORT (52.0 [40.0–NA] vs 27.0 [22.0–32.0] months; HR: 0.591, 95% CI: 0.442–0.792, P = 0.000) and the differences in OS existed after PSM (P = 0.043). However, no significant difference was found in OS before and after matching in the adenocarcinoma group (P = 0.827 and P = 0.801, respectively). CONCLUSIONS PrORT demonstrated an OS benefit for patients with stage N2 lung SCC; however, further prospective randomized clinical trials are warranted to confirm this finding.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"187 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77591795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical translation of surgical simulated closure of a ventricular septum defect 室间隔缺损手术模拟闭合的临床翻译
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-23 DOI: 10.1093/icvts/ivac122
Qi Li, N. Hussein, Yunyi Zhang, Yibing Fang, Yue Wang, Q. An, O. Honjo, S. Luo
{"title":"Clinical translation of surgical simulated closure of a ventricular septum defect","authors":"Qi Li, N. Hussein, Yunyi Zhang, Yibing Fang, Yue Wang, Q. An, O. Honjo, S. Luo","doi":"10.1093/icvts/ivac122","DOIUrl":"https://doi.org/10.1093/icvts/ivac122","url":null,"abstract":"Abstract OBJECTIVES To demonstrate that improvement in technical performance of congenital heart surgical trainees during ventricular septum defect (VSD) closure simulation translates to better patient outcomes. METHODS Seven trainees were divided into 2 groups. Experienced-fellows group included 4 senior trainees who had performed >5 VSD closures. Residents group consisted of 3 residents who had never performed a VSD closure. Experienced-fellows completed 3 VSD closures on real patients as a pretest. Both groups participated in a 4-week simulation requiring each participant to complete 2 VSD closures on three-dimensional printed models per week. One month later, all trainees returned for a post-test operation in real patients. All performances were recorded, blinded and scored independently by 2 cardiac surgeons using the validated Hands-On Surgical Training–Congenital Heart Surgery (HOST-CHS). Predefined surgical outcomes were analysed. RESULTS The median HOST-CHS score increased significantly from week 1 to 4 [50 (39, 58) vs 73 (65, 74), P < 0.001] during simulation. The improvement in the simulation of experienced-fellows successfully transferred to skill acquisition [HOST-CHS score 72.5 (71, 74) vs 54 (51, 60), P < 0.001], with better patients outcomes including shorter total cross-clamp time [pretest: 86 (70, 99) vs post-test: 60 (53, 64) min, P = 0.006] and reduced incidence of major patch leak requiring multiple pump runs [pretest: 4/11 vs post-test: 0/9, P = 0.043]. After simulation, the technical performance and surgical outcomes of Residents were comparable to Experienced-fellows in real patients, except for significantly longer cross-clamp time [Residents: 76.5 (71.7, 86.8) vs Experienced-fellows: 60 (53, 64) min, P = 0.002]. CONCLUSIONS Deliberate practice using simulation translates to better performance and surgical outcomes in real patients. Residents who had never completed a VSD closure could perform the procedures just as safely and effectively as their senior colleagues following simulation.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"323 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75469979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Robotic coronary revascularization in Europe, state of art and future of EACTS-endorsed Robotic Cardiothoracic Surgery Taskforce 欧洲的机器人冠状动脉血管重建术,eacts认可的机器人心胸外科工作组的技术现状和未来
4区 医学
Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-18 DOI: 10.1093/icvts/ivac108
Matto Pettinari, M. Gianoli, M. Palmen, Š. Černý, B. Onan, Sandeep Singh, P. Segers, C. Bolcal, C. Alhan, E. Navarra, H. de Praetere, J. Vojáček, T. Cebotaru, P. Modi, F. Doguet, U. Franke, A. Ouda, L. Melly, G. Malapert, L. Labrousse, A. Agnino, T. Philipsen, J. Jansens, T. Folliguet, D. Pereda, F. Musumeci, P. Suwalski, K. Cathenis, F. Van Praet, J. Bonatti, W. Oosterlinck
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引用次数: 1
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