Interactive cardiovascular and thoracic surgery最新文献_第9页

Early postoperative pain after subxiphoid uniportal thoracoscopic major lung resection: a prospective, single- blinded, randomized controlled trial 剑突下单门胸腔镜大肺切除术后早期疼痛:一项前瞻性、单盲、随机对照试验

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-17 DOI: 10.1093/icvts/ivac133

Zhigang Chen, Lei Jiang, Hua Zheng, Wentian Zhang, Xin Lv, Amr Abdellateef

{"title":"Early postoperative pain after subxiphoid uniportal thoracoscopic major lung resection: a prospective, single- blinded, randomized controlled trial","authors":"Zhigang Chen, Lei Jiang, Hua Zheng, Wentian Zhang, Xin Lv, Amr Abdellateef","doi":"10.1093/icvts/ivac133","DOIUrl":"https://doi.org/10.1093/icvts/ivac133","url":null,"abstract":"Abstract OBJECTIVES Preoperative selection bias led to the inability to generalize the proposed benefit of subxiphoid uniportal video-assisted thoracoscopic surgery (SVATS) as having less postoperative pain than uniportal intercostal VATS. So, we conducted this prospective, single-blinded, randomized controlled trial to investigate the hypothesis that SVATS may have less early postoperative pain than UVATS in patients who undergo major lung resection for early-stage lung cancer. METHODSA total of 262 patients were randomly allocated between 2 groups (each with 131 patients), the first being the UVATS group and the second being the SVATS group. The values indicated on the numerical rating scale (NRS) of pain were collected at 24 h and 48 h during rest and during coughing. In addition, different perioperative variables were analysed and compared between the 2 groups. RESULTS Multiple linear regression analysis showed that the type of surgical approach was a significant predictor of the postoperative NRS values. The postoperative NRS pain values were significantly lower in the SVATS group after 24 h during rest and coughing and after 48 h during coughing. Postoperatively, patients in the SVATS group got out of bed significantly earlier [16.37 (2.54) vs 18.05 (3.29) h, p < 0.001]. The SVATS group showed a significantly higher rate of intraoperative arrhythmia [20 (15.3%) vs 3 (2.3%) patients, p = 0.03]. CONCLUSIONS SVATS major pulmonary resection in early-stage lung cancer is associated with less early postoperative pain than the UVATS approach. Operating on patients with cardiac problems using the SVATS approach is still a limiting factor for randomization due to the potential compression on the heart with resulting arrhythmia. Clinical trial registration The trial was registered under clinical trials.gov Identifier: NCT03331588. https://clinicaltrials.gov/ct2/show/NCT03331588.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86672708","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

Associated factors and short-term mortality of early versus late acute kidney injury following on-pump cardiac surgery 无泵心脏手术后早期与晚期急性肾损伤的相关因素和短期死亡率

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-16 DOI: 10.1093/icvts/ivac118

Shengnan Li, Ming Liu, Xiang Liu, Dong Yang, N. Dong, Fei Li

{"title":"Associated factors and short-term mortality of early versus late acute kidney injury following on-pump cardiac surgery","authors":"Shengnan Li, Ming Liu, Xiang Liu, Dong Yang, N. Dong, Fei Li","doi":"10.1093/icvts/ivac118","DOIUrl":"https://doi.org/10.1093/icvts/ivac118","url":null,"abstract":"Abstract OBJECTIVES Acute kidney injury (AKI) is common following cardiac surgery. The aim was to investigate the characteristics of AKI that occurred within 48 h and during 48 h to 7 days after cardiac surgery. METHODS Patient data were extracted from Medical Information Mart for Intensive Care III database. AKI was defined according to the Kidney Disease Improving Global Outcomes guideline and divided into early (within 48 h) and late (during 48 h to 7 days) AKI. Multivariable logistic regression models were established to investigate risk factors for AKI. Cox proportional hazards model was used to analyse 90-day survival. RESULTS AKI occurred in 51.2% (2741/5356) patients within the first 7 days following cardiac surgery, with the peak occurrence at 36–48 h. The incidence of early and late AKI was 41.9% and 9.2%, respectively. Patients with late AKI were older and had more comorbidities compared to early AKI patients. Risk factors associated with early AKI included age, body mass index, congestive heart failure and diabetes. While late AKI was related to atrial fibrillation, estimated glomerular filtration rate, sepsis, norepinephrine, mechanical ventilation and packed red blood cell transfusion. In Cox proportional model, both late and early AKIs were independently associated with 90-day mortality, and patients with early AKI had better survival than those with late AKI. CONCLUSIONS AKI that occurred earlier was distinguishable from AKI that occurred later after cardiac surgery. Time frame should be taken into consideration.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76487412","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

Surgical reconstruction of a giant left ventricular aneurysm with prior unloading using a microaxial pump 用微轴流泵预先卸载巨大左心室动脉瘤的手术重建

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-16 DOI: 10.1093/icvts/ivac137

Marta L Medina Estrada, M. Silaschi, E. Charitos, H. Treede

引用次数: 0

Giant subaortic left ventricular diverticulum with aortic regurgitation and stenosis 巨大的主动脉下左室憩室伴主动脉瓣返流和狭窄

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-16 DOI: 10.1093/icvts/ivac121

R. Hu, Zhiwei Wang, Jin‐ling Chen, Zhiyong Wu

引用次数: 0

An ACTH-secreting tumour hidden in a congenitally hypoplastic left lung 藏于先天性左肺发育不全的促肾上腺皮质激素肿瘤

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-16 DOI: 10.1093/icvts/ivac130

Xueyu Chen, Yajie Zhang, Jules Lin, Hecheng Li

引用次数: 0

False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection 急性非a非b主动脉夹层假腔/真腔壁压力比升高

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-13 DOI: 10.1093/icvts/ivac138

N. Kimura, Masanori Nakamura, Reiya Takagi, M. Mieno, A. Yamaguchi, M. Czerny, F. Beyersdorf, F. Kari, B. Rylski

{"title":"False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection","authors":"N. Kimura, Masanori Nakamura, Reiya Takagi, M. Mieno, A. Yamaguchi, M. Czerny, F. Beyersdorf, F. Kari, B. Rylski","doi":"10.1093/icvts/ivac138","DOIUrl":"https://doi.org/10.1093/icvts/ivac138","url":null,"abstract":"Abstract OBJECTIVES We aimed to determine whether non-A non-B aortic dissection (AD) differs in morphologic and haemodynamic properties from type B AD. METHODS We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B AD by means of computational fluid dynamics. Wall pressure and wall shear stress (WSS) in both the true lumen (TL) and false lumen (FL) at early, mid- and late systole were evaluated. Morphology, WSS and the FL/TL wall pressure ratio were compared between groups. RESULTS Nineteen patients (type B, n = 7; non-A non-B, n = 12) were included. The median age (51 [46, 67] vs 53 [50, 63] years; P = 0.71) and a complicated course (14% vs 33%; P = 0.6) did not differ between the type B group and the non-A non-B group. However, the median entry tear width was increased in the non-A non-B group (9.7 [7.3, 12.7] vs 16.3 [11.9, 24.9] mm; P = 0.010). Streamlines showed, in patients with non-A non-B AD, blood from the TL flowed into the FL via the entry tear. Prevalence of a FL/TL wall pressure ratio >1.0 (type B versus non-A non-B) at early, mid- and late systole was 57% vs 83% (P = 0.31), 43% vs 83% (P = 0.13) and 57% vs 75% (P = 0.62), respectively. WSS did not differ between the groups. CONCLUSIONS The increased FL/TL wall pressure ratio observed during systole in non-A non-B AD may beget a complicated presentation.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89109134","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

Role of fluorodeoxyglucose-positron emission tomography in predicting the pathological response and prognosis after neoadjuvant chemoradiotherapy for locally advanced non-small-cell lung cancer 氟脱氧葡萄糖-正电子发射断层扫描在预测局部晚期非小细胞肺癌新辅助放化疗后病理反应和预后中的作用

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-11 DOI: 10.1093/icvts/ivac113

M. Tanahashi, E. Suzuki, N. Yoshii, Takuya Watanabe, H. Tsuchida, Shogo Yobita, Kensuke Iguchi, Suiha Uchiyama, Minori Nakamura

{"title":"Role of fluorodeoxyglucose-positron emission tomography in predicting the pathological response and prognosis after neoadjuvant chemoradiotherapy for locally advanced non-small-cell lung cancer","authors":"M. Tanahashi, E. Suzuki, N. Yoshii, Takuya Watanabe, H. Tsuchida, Shogo Yobita, Kensuke Iguchi, Suiha Uchiyama, Minori Nakamura","doi":"10.1093/icvts/ivac113","DOIUrl":"https://doi.org/10.1093/icvts/ivac113","url":null,"abstract":"Abstract OBJECTIVES The present study compared the utility of fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) for predicting the pathological response and prognosis following neoadjuvant therapy for locally advanced non-small-cell lung cancer (NSCLC). METHODS This retrospective analysis included 72 patients in whom adjacent structures showed involvement and/or cN2 NSCLC who received induction chemoradiotherapy (ICRT) and subsequent surgery at our hospital from 2008 to 2019. FDG-PET and CT were performed in all patients before and after ICRT using the same scanner with similar techniques. We calculated the reduction in the maximum standardized uptake value in FDG-PET (ΔSUVmax) and tumour size on CT (ΔCT-size) before and after ICRT and investigated the relationship between the pathological response and prognosis. RESULTS The disease response was classified as a major pathological response in 43 patients, and a minor response in 29 patients. ΔSUVmax 60% and ΔCT-size 30% were identified as the optimal cut-off values for predicting a major pathological response. ΔSUVmax was superior to ΔCT-size in terms of sensitivity, specificity, positive predictive value and negative predictive value. Furthermore, ΔSUVmax was superior to ΔCT-size for predicting the prognosis. CONCLUSIONS Based on the results of the present study, FDG-PET appeared to have greater utility than CT in predicting the pathological response following ICRT and the postoperative prognosis in patients with locally advanced NSCLC.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72481521","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

Reporting of patient safety incidents in minimally invasive thoracic surgery: a national registered thoracic surgeons experience for improvement of patient safety 微创胸外科患者安全事件报告:国家注册胸外科医生提高患者安全的经验

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Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-11 DOI: 10.1093/icvts/ivac129

B. Bottet, C. Rivera, M. Dahan, P. Falcoz, S. Jaillard, J. Baste, A. Seguin-Givelet, Richard Bertrand de la Tour, Francois Bellenot, A. Rind, D. Gossot, P. Thomas, X. D'Journo

{"title":"Reporting of patient safety incidents in minimally invasive thoracic surgery: a national registered thoracic surgeons experience for improvement of patient safety","authors":"B. Bottet, C. Rivera, M. Dahan, P. Falcoz, S. Jaillard, J. Baste, A. Seguin-Givelet, Richard Bertrand de la Tour, Francois Bellenot, A. Rind, D. Gossot, P. Thomas, X. D'Journo","doi":"10.1093/icvts/ivac129","DOIUrl":"https://doi.org/10.1093/icvts/ivac129","url":null,"abstract":"Abstract OBJECTIVES The reporting of patient safety incidents (PSIs) occurring in minimally invasive thoracic surgery (MITS) is crucial. However, previous reports focused mainly on catastrophic events whereas minor events are often underreported. METHODS All voluntary reports of MITS-related PSIs were retrospectively extracted from the French REX database for ‘in-depth analysis’. From 2008 to 2019, we retrospectively analysed and graded events according to the WHO classification of PSIs: near miss events, no harm incidents and harmful incidents. Causes and corrective measures were analysed according to the human-technology-organization triad. RESULTS Of the 5145 cardiothoracic surgery PSIs declared, 407 were related to MITS. Among them, MITS was performed for primary lung cancer in 317 (78%) and consisted in a lobectomy in 249 (61%) patients. PSIs were: near miss events in 42 (10%) patients, no harm incidents in 81 (20%) patients and harmful incidents in 284 (70%) patients (mild: n = 163, 40%; moderate: n = 78, 19%; severe: n = 36, 9%; and deaths: n = 7, 2%). Human factors represented the most important cause of PSIs with 267/407 (65.6%) cases, including mainly vascular injuries (n = 90; 22%) and non-vascular injuries (n = 43; 11%). Pulmonary arteries were the most affected site with 57/91 cases (62%). In all, there were 7 deaths (2%), 53 patients required second surgery (13%) and 30 required additional lung resection (7%). CONCLUSIONS The majority of reported MITS -related PSIs were non-catastrophic. Human factors were the main cause of PSIs. Systematic reporting and analysis of these PSIs will allow surgeon and his team to avoid a large proportion of them.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"139 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79872086","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

Long-term paracorporeal pulsatile mechanical circulatory support in adolescent and adult patients 青少年和成人患者的长期体外搏动机械循环支持

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-09 DOI: 10.1093/icvts/ivac107

J. Kremer, A. El-Dor, W. Sommer, U. Tochtermann, G. Warnecke, M. Karck, A. Ruhparwar, A. Meyer

{"title":"Long-term paracorporeal pulsatile mechanical circulatory support in adolescent and adult patients","authors":"J. Kremer, A. El-Dor, W. Sommer, U. Tochtermann, G. Warnecke, M. Karck, A. Ruhparwar, A. Meyer","doi":"10.1093/icvts/ivac107","DOIUrl":"https://doi.org/10.1093/icvts/ivac107","url":null,"abstract":"Abstract OBJECTIVES Our goal was to analyse adverse events in adolescent and adult patients with the Berlin Heart EXCOR and to assess the outcome of a subsequent heart transplant (HTX). METHODS From 2006 to 2020, a total of 58 patients (12–64 years old) received a biventricular assist device (BIVAD) at our institution and were included in this study. RESULTS The causes of biventricular heart failure were nonischaemic cardiomyopathy (62.1%), ischaemic cardiomyopathy (22.4%) and myocarditis (15.5%). The median INTERMACS score was I (I—III). The median age was 49 years (interquartile range, 34–55 years), and 82.8% were male. Causes of death were multiorgan failure (25.0%), septic shock (17.9%), cerebral haemorrhage (14.3%), bleeding (14.3%) and embolic events (14.3%). Major bleeding was more frequent in the patients who died while on BIVADs (60.7 vs 6.7%, P < 0.001). Wound infections were more prevalent in HTX recipients (n = 21, 70.0%). After BIVAD thrombosis, 104 chamber exchanges were performed in 28 patients (48.3%). HTXs were performed in 52.6% of the patients after a BIVAD support time of 316 ± 240 days. The mean time to follow-up of 30 HTX recipients was 1722 ± 1368 days. One-, 6- and 12-month survival after an HTX were 96.7%, 90.0% and 76.7%, respectively. Long-term survival after 5 and 10 years was 69.7%. CONCLUSIONS Pump thrombosis, infections and bleeding after receiving a BIVAD did not preclude a successful HTX. Although only 50% of patients with BIVADs were successfully given a transplant, long-term survival after an HTX in patients with BIVAD was noninferior compared to that of other recipients.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79334482","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

Effects of cardiopulmonary bypass on immunoglobulin G antibody titres after SARS-CoV2 vaccination 体外循环对SARS-CoV2疫苗接种后免疫球蛋白G抗体效价的影响

4区医学

Interactive cardiovascular and thoracic surgery Pub Date : 2022-05-06 DOI: 10.1093/icvts/ivac123

Ryosuke Hayashi, Y. Takami, H. Fujigaki, Kentaro Amano, Yusuke Sakurai, Kiyotoshi Akita, Koji Yamana, A. Maekawa, Kuniaki Saito, Y. Takagi

{"title":"Effects of cardiopulmonary bypass on immunoglobulin G antibody titres after SARS-CoV2 vaccination","authors":"Ryosuke Hayashi, Y. Takami, H. Fujigaki, Kentaro Amano, Yusuke Sakurai, Kiyotoshi Akita, Koji Yamana, A. Maekawa, Kuniaki Saito, Y. Takagi","doi":"10.1093/icvts/ivac123","DOIUrl":"https://doi.org/10.1093/icvts/ivac123","url":null,"abstract":"Abstract OBJECTIVES Patients with cardiovascular disease are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Although SARS-CoV2 vaccination may be effective, its impact on surgical patients is not well studied. We investigated the effects of cardiovascular surgery, especially under cardiopulmonary bypass (CPB), on the antibody titres after SARS-CoV2 vaccination. METHODS A prospective observational study was designed for patients undergoing surgery between July and November 2021. The immunoglobulin G against the receptor-binding domain was measured and antibody preserved rate (APR) was calculated from perioperative titres comparison. RESULTS Enrolled 63 study patients were divided into 39 undergoing surgery with CPB (Group CPB) and 24 without CPB (Group None). Preoperative vaccines were BNT162b2 (Pfizer/BioNTech) (n = 58, 92%) and mRNA-1273 (Moderna) (n = 5, 8%). While immunoglobulin G against the receptor-binding domain titres did not significantly decrease after surgery in Group None, they decreased significantly in Group CPB from 21.80 [11.15, 37.85] to 11.95 [6.80, 18.18] U/ml (P < 0.001) a day after surgery, 11.40 [7.85, 22.65] U/ml (P < 0.001) 14 days after surgery and 7.60 [4.80, 17.60] U/ml (P < 0.001) a month after surgery. The APRs a day after the surgery were significantly lower in Group CPB (0.46 [0.41, 0.60]) than in Group None (0.80 [0.68, 0.87]) (P < 0.001). CONCLUSIONS The SARS-CoV2 antibody titres significantly decreased with lower APRs immediately after surgery under CPB. Based on our informative results, careful considerations of vaccination schedule might be required for surgery under CPB.","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86827929","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