Interactive cardiovascular and thoracic surgery最新文献

{"title":"Nothing changes if nothing changes.","authors":"Michael Salna, Brett R Anderson, Emile Bacha, Paul Kurlansky","doi":"10.1093/icvts/ivac217","DOIUrl":"https://doi.org/10.1093/icvts/ivac217","url":null,"abstract":"A musician would not play a concert piece without repeatedly practicing each measure flawlessly. Similarly, the first time a professional basketball player takes a three-pointer is not during a televised playoff game. That shot is taken after countless iterations of microimprovements in their stance, jump, and wrist motion on the practice court. These performance-based professionals practice until their default is near perfection, and then they continue to be coached throughout their professional career. With an arguably steeper learning curve, why are surgeons not afforded this luxury of preparation and ongoing mentorship? The clock cannot be stopped in the operating room and, unlike hitting a wrong note on the piano, every misplaced stitch or cut may have irreversible consequences, which may not be apparent at the time. Learning cardiac surgery is stressful. The stakes are high, crossclamp and bypss times are precious and the cognitive burden can be immense. To further complicate matters, as outcome measures become increasingly scrutinized and operative costs rise in the face of declining reimbursement, stress falls not only upon the trainee but upon the attending surgeon as well. Despite these rigours, cardiac surgery is still fundamentally taught within a mentor-mentee apprenticeship training model that largely ends after fellowship. It may be more sophisticated nowadays, but a cardiac surgeon teaches residents the same way a violin master would teach an apprentice to build a violin in the 15thcentury Florence or a stone mason an apprentice during the building of a great cathedral. Why has it not changed? Every case is a playoff game for surgeons. Every day we must perform technically and physically demanding tasks, aspiring to nothing short of excellence. Nathan et al. [1] previously demonstrated that technical performance in paediatric cardiac surgery was strongly associated with outcomes—to the point where optimal technical performance can overcome adverse intraoperative events. By extension, poor performance is associated with shortand long-term mortality and reintervention [2, 3]. So, if technique is so important, surely there are objective measures to assess technical performance in trainees? Hussein et al. performed a systematic review of 54 studies evaluating the use of competency-based assessments in the evaluation of technical skills in cardiothoracic surgery. Cardiac surgery was the most common specialty using objective assessment methods with coronary anastomosis being the most frequently tested task (28%). Thirty studies (56%) assessed objective changes in technical performance (the others validated the assessment tools) and 97% of them found improvement in their trainees. Despite this obvious benefit, it was surprising that only 21 (39%) of the 54 studies incorporated assessment methods into their training curricula. Clearly, there is a mismatch between our acknowledgement of the importance of simulation and technical preparatio","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9403298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40424192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel use of reverse double switch operation in failed left ventricular recruitment pathway.","authors":"Jorge O Barretta,&nbsp;Sofía Grinenco,&nbsp;Juan M Osuna,&nbsp;Natalia S Napoli","doi":"10.1093/icvts/ivac173","DOIUrl":"https://doi.org/10.1093/icvts/ivac173","url":null,"abstract":"<p><p>In spite of great advances in staged left ventricle recruitment strategy, some patients do not achieve biventricular circulation nor are candidates for reversal to single-ventricle palliation. We present a case of a successful reverse double switch operation in a patient with failure of left ventricle recruitment and pulmonary hypertension. This strategy provided a one-and-a-half repair with a sub-pulmonary hypoplastic left ventricle that improved the patient's clinical status, becoming a novel alternative in this particular subset of patients.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/4c/ivac173.PMC9351613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40594072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does surgical fixation improve pain and quality of life in patients with non-flail rib fractures? A best evidence topic review.","authors":"Samad Raza,&nbsp;Jazmin Eckhaus","doi":"10.1093/icvts/ivac214","DOIUrl":"https://doi.org/10.1093/icvts/ivac214","url":null,"abstract":"<p><p>A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'does surgical stabilization of rib fractures improve pain and quality of life in patients with non-flail rib fractures?'. Altogether >300 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Whilst several non-randomized cohort studies demonstrate superior pain and quality of life outcomes with surgical fixation as compared to conservative management, this is not replicated by the findings of a recent randomized trial which found worse pain, but early return to work in those treated with surgical stabilization of rib fractures. Given this, clinicians will need to carefully consider the indications for treating painful non-flail rib fractures as surgical fixation represents a reasonable treatment option in only appropriately selected candidates.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/39/ivac214.PMC9415186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40434264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coil embolization to treat pulmonary sequestration in the right upper lobe.","authors":"Yujiao Deng,&nbsp;Xin Fang,&nbsp;Bing Wu","doi":"10.1093/icvts/ivac178","DOIUrl":"https://doi.org/10.1093/icvts/ivac178","url":null,"abstract":"<p><p>Although there have been a few case reports of pulmonary sequestration, it is primarily located in the lower lobe and left lung, rarely in the right upper lobe. Here, we report a case presented with haemoptysis. Computed tomography images revealed flake ground-glass shadows in the right upper lobe. Computed tomography angiography demonstrated an artery supplied the affected lesions stemmed from the aortic arch. We diagnosed and treated her with bronchial artery angiography with coil embolization. No complications were found after operation until now. Thus, CTA could help identify the abnormal blood vessels, and interventional therapy may be an effective alternative to surgery of pulmonary sequestration.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"35 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9562055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery bypass grafting in infants and young children: default or alternative choice?","authors":"Bahaaldin Alsoufi","doi":"10.1093/icvts/ivac168","DOIUrl":"https://doi.org/10.1093/icvts/ivac168","url":null,"abstract":"","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40463038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-expansion pulmonary oedema.","authors":"Mohammad Behgam Shadmehr","doi":"10.1093/icvts/ivac170","DOIUrl":"https://doi.org/10.1093/icvts/ivac170","url":null,"abstract":"the of a 44-year-old who a thoracotomy for a loculated right empyema thoracis from a transdiaphragmatic rupture of a right subphrenic abscess. After draining 3000ml of pus, decortication and lung re-expansion, a large amount of serosanguineous fluid in the patient’s endotracheal tube. the cause of their patient of abscess fluid (pus) or through small bronchial parenchymal as opposed to re-expansion pulmonary oedema. My","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/6a/ivac170.PMC9272060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40395334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histology of the tricuspid valve annulus and right atrioventricular muscle distance.","authors":"Kokoro Yamane,&nbsp;Yosuke Takahashi,&nbsp;Hiromichi Fujii,&nbsp;Akimasa Morisaki,&nbsp;Yoshito Sakon,&nbsp;Noriaki Kishimoto,&nbsp;Takumi Kawase,&nbsp;Masahiko Ohsawa,&nbsp;Toshihiko Shibata","doi":"10.1093/icvts/ivac175","DOIUrl":"https://doi.org/10.1093/icvts/ivac175","url":null,"abstract":"<p><strong>Objectives: </strong>Histologically, the mitral valve annulus comprises a collection of collagen fibres. However, the existence of collagen fibres in the tricuspid valve annulus has not been elucidated. Our goal was to clarify the histology of the tricuspid annulus.</p><p><strong>Methods: </strong>Fifty human hearts without heart disease that were autopsied at Osaka City University Hospital between January 2009 and December 2017 were examined. The tricuspid valve was sectioned at 12 sites around the annulus, and the atrioventricular junction distance was measured.</p><p><strong>Results: </strong>None of the tricuspid valve annulus samples had a continuous aggregation of collagen fibres that could be called an annulus. The interventricular space between the right atria and ventricles was composed of adipose tissue only on the anterosuperior and inferior sides, and no adipose tissue was found on the septal side. Comparing the atrioventricular muscle distance of the anterosuperior and inferior sides, the distance at the inferior side was statistically significantly larger than that of the anterosuperior side in 47 cases (P < 0.0001).</p><p><strong>Conclusions: </strong>There was no continuous circumferential aggregation of collagen fibres in the right atrioventricular junction. The distance between the right atrial and ventricular myocardium was greater at the inferior side than that at the anterosuperior side, which might lead to more inferior annular dilation versus anterosuperior dilation. These anatomical features will be fundamental for future discussions of the suturing method used in prosthetic ring annuloplasty for tricuspid regurgitation.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9318885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40481165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of transit-time flow measurement on early postoperative outcomes in total arterial coronary revascularization with internal thoracic arteries: a propensity score analysis on 910 patients.","authors":"Mojgan Laali, Nathalie Nardone, Pierre Demondion, Cosimo D'Alessandro, Paul Guedeney, Eleodoro Barreda, Guillaume Lebreton, Pascal Leprince","doi":"10.1093/icvts/ivac065","DOIUrl":"10.1093/icvts/ivac065","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the impact of transit-time flow measurement (TTFM) on early postoperative outcomes in total arterial coronary revascularization.</p><p><strong>Methods: </strong>A single-centre retrospective analysis was conducted on 910 patients undergoing isolated total arterial coronary artery bypass grafting with internal thoracic arteries (ITAs) at our institution, between January 2017 and February 2020. Complete arterial revascularization with bilateral ITAs with a Y-configuration, or single ITA, was planned for all patients. According to the surgeon preference, TTFM was assessed in 430 patients (TTFM group). They were compared with 480 patients without TTFM assessment (no TTFM group). Primary end point was the occurrence of in-hospital major cardiac adverse events (MACE). A propensity score analysis with an inverse probability weighting approach was performed to control for selection bias.</p><p><strong>Results: </strong>TTFM was associated with longer cardiopulmonary bypass times (76.0 [62.0; 91.2] vs 79.0 [65.0; 94.0] min, P = 0.042). Six (1.4%) patients in the TTFM group versus no patient in the no TTFM group underwent intraoperative graft revision because of unsatisfying flow values (P = 0.011). MACE were significantly lower in the TTFM group (14, 3.3%) than in the no TTFM group (33, 6.9%, P = 0.014). At crude regression, TTFM was protective against MACE occurrence (odds ratios 0.46, 95% confidence interval 0.23-0.85, P = 0.016). Inverse probability weighting adjustment did not significantly displace P-values and odds ratios for MACE occurrence in the TTFM group 0.44, 95% confidence interval 0.28-0.69, P < 0.001.</p><p><strong>Conclusions: </strong>Even if associated with longer cardiopulmonary bypass times, intraoperative graft flow measurement with TTFM reduces MACE occurrence and it should be recommended for graft evaluation in arterial coronary artery bypass grafting surgery.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":"123 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80147784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-stage repair for ascending aortic aneurysm, artery stenosis and occlusion of neck vessels caused by Takayasu arteritis.","authors":"Yosuke Nakai,&nbsp;Yusuke Nishikawa,&nbsp;Takayuki Saito,&nbsp;Hisao Suda","doi":"10.1093/icvts/ivac180","DOIUrl":"https://doi.org/10.1093/icvts/ivac180","url":null,"abstract":"<p><p>Takayasu arteritis results in a variety of vascular symptoms, and there are some cases in which progressive vascular lesions require surgical intervention. We present a case with ascending aortic aneurysm, right common carotid artery stenosis, left common carotid artery occlusion and left subclavian artery stenosis caused by Takayasu arteritis that was successfully treated with total arch replacement and ascending aorta to right internal carotid artery bypass.</p>","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/c9/ivac180.PMC9336583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SUVmax-Δ makes the difference.","authors":"Clemens Aigner,&nbsp;Hubertus Hautzel,&nbsp;Till Ploenes","doi":"10.1093/icvts/ivac169","DOIUrl":"https://doi.org/10.1093/icvts/ivac169","url":null,"abstract":"","PeriodicalId":13621,"journal":{"name":"Interactive cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40395595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}