Journal of Cardiovascular Development and Disease最新文献

{"title":"A Platform Integrating Biophysical and Biochemical Stimuli to Enhance Differentiation and Maturation of Cardiomyocyte Subtypes Derived from Human Induced Pluripotent Stem Cells.","authors":"Zhonggang Feng, Kota Sawada, Iori Ando, Riku Yoshinari, Daisuke Sato, Tadashi Kosawada","doi":"10.3390/jcdd12020056","DOIUrl":"10.3390/jcdd12020056","url":null,"abstract":"<p><p>To enhance the differentiation and maturation of cardiomyocytes derived from human induced pluripotent stem cells, we developed a bioreactor system that simultaneously imposes biophysical and biochemical stimuli on these committed cardiomyocytes. The cells were cultured within biohydrogels composed of the extracellular matrix extracted from goat ventricles and purchased rat-origin collagen, which were housed in the elastic PDMS culture chambers of the bioreactor. Elastic and flexible electrodes composed of PEDOT/PSS, latex, and graphene flakes were embedded in the hydrogels and chamber walls, allowing cyclic stretch and electrical pulses to be simultaneously and coordinately applied to the cultured cells. Furthermore, a dynamic analysis method employing the transverse forced oscillation theory of a cantilever was used to analyze and discriminate the subtype-specific beating behavior of the cardiomyocytes. It was found that myosin light chain 2v (<i>MLC2v</i>), a ventricular cell marker, was primarily upregulated in cells aggregated on the (+) electrode side, while cardiomyocytes with faint <i>MLC2v</i> but strong cardiac troponin T (<i>cTNT</i>) expression aggregated at the ground electrode (GND) side. mRNA analysis using rtPCR and the gel beating dynamics further suggested a subtype deviation on the different electrode sides. This study demonstrated the potential of our bioreactor system in enhancing cardiac differentiation and maturation, and it showed an intriguing phenomenon of cardiomyocyte subtype aggregation on different electrodes, which may be developed into a new method to enhance the maturation and separation of cardiomyocyte subtypes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491964","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":"Predictors of Visceral Infectious Aneurysms in Patients with Infective Endocarditis and Systemic Embolization.","authors":"Monique Boukobza, Emila Ilic-Habensus, Xavier Duval, Jean-Pierre Laissy","doi":"10.3390/jcdd12020057","DOIUrl":"10.3390/jcdd12020057","url":null,"abstract":"<p><strong>Background: </strong>To study whether infective endocarditis patients (IE-patients) with visceral embolic events (VEEs) at admission are at greater risk of developing visceral infectious aneurysms (VIAs) in left-sided infective endocarditis (LSIE) patients.</p><p><strong>Methods: </strong>We compared the data of prospectively collected 474 consecutive LSIE-patients (2005-2020) with and without VIAs. A whole-body-CTA was part of the initial work-up for all patients.</p><p><strong>Results: </strong>A total of 24 patients (5.1%) with VIA were included, of whom 19 (79.2%) had at least one VEE, compared to a proportion of 34% (<i>p</i> < 0.001) in IE-patients without VIAs. Both groups also differed in terms of vegetation size (>15 mm: 48% vs. 18%, <i>p</i> < 0.001), microorganisms, <i>Streptococcus</i> spp. (68.5% vs. 42%, <i>p</i> = 0.003), rare microorganisms (36% vs. 8.3%, <i>p</i> < 0.001) and concomitant extra-visceral infectious aneurysms (42% vs. 12.8%, <i>p</i> < 0.001). Cardiac surgery was performed in 21 patients (87.5%) and in-hospital mortality occurred in 2 (8%).</p><p><strong>Conclusions: </strong>This study shows a different profile of VIA-LSIE patients compared to LSIE-patients without. <i>Streptococcus</i> species were the most frequent causal agents. Our study indicates that the presence of VEEs in LSIE-patients could suggest an increased risk of VIA. This study also shows the need for further abdominal-CTA in all cases of left sided IE to detect asymptomatic visceral aneurysms.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492221","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":"Outcomes of K-Clip Implantation for Functional Tricuspid Regurgitation Accompanied with Persistent Atrial Fibrillation.","authors":"Da-Wei Lin, Ling-Wei Zou, Jia-Xin Miao, Jia-Ning Fan, Min-Fang Meng, Yi-Ming Qi, Zhi Zhan, Wen-Zhi Pan, Da-Xin Zhou, Xiao-Chun Zhang, Jun-Bo Ge","doi":"10.3390/jcdd12020055","DOIUrl":"10.3390/jcdd12020055","url":null,"abstract":"<p><p><b>Background:</b> Atrial fibrillation (AF) has been identified as a risk factor for functional tricuspid regurgitation (FTR) in the absence of other known etiologies, although limited interventional options are available. K-Clip™, a novel transcatheter tricuspid annuloplasty device, is a clip-based annular plication approach for FTR. To date, no studies have investigated the short-term outcomes of K-Clip™ for patients with severe FTR associated with AF. Therefore, the aim of this study was to explore the feasibility and effectiveness of transcatheter annular repair with K-Clip™ for FTR in patients with persistent AF. <b>Methods:</b> Patients with FTR and persistent AF who underwent transcatheter annular repair with K-Clip™ at nine centers in China during the inclusion period were included (This study derived from Confirmatory Clinical Study of Treating Tricuspid Regurgitation With K-Clip™ Transcatheter Annuloplasty System [TriStar study}). Baseline data, imaging results, and follow-up data were collected. <b>Results:</b> All 52 patients (23 men, 74.02 ± 7.03 years) received successful intervention, and the mean operation time and radian exposure were 2.64 ± 1.09 h and 133.33 ± 743.06 mGy, respectively. No death cases and a low major adverse event occurrence rate were reported in 30 days. A significant decrease in FTR was documented, and TR remained severe in only two patients (3.8%). The regurgitation volume decreased significantly, accompanied by a notable reduction in the effective regurgitation orifice area and tricuspid annulus diameter, which subsequently led to the reversal of right heart remodeling. Furthermore, a decrease in pulmonary artery systolic pressure and an increase in cardiac output were documented. <b>Conclusions:</b> Transcatheter annular repair with K-Clip™ showed favorable short-term prognosis and significant improvement in FTR in patients with severe FTR associated with persistent AF. K-Clip™ could be a novel option for that group of patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492219","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 Endothelial Dysfunction and Vasomotor Dysregulation in Myocardial Bridging.","authors":"Takumi Toya","doi":"10.3390/jcdd12020054","DOIUrl":"10.3390/jcdd12020054","url":null,"abstract":"<p><p>Myocardial bridging (MB), a congenital variant where a coronary artery segment is tunneled within the myocardium, is increasingly recognized as a contributor to coronary endothelial and vasomotor dysfunction. Beyond the hallmark systolic compression observed on angiography, MB disrupts endothelial integrity, impairs the release of vasoactive substances, and induces vasomotor abnormalities. These effects exacerbate ischemic symptoms and predispose to atherosclerosis in the proximal segment, particularly in conditions such as ischemia/myocardial infarction with nonobstructive coronary arteries. Recent studies underscore MB's association with coronary vasospasm, microvascular endothelial dysfunction, and adverse cardiovascular outcomes, including sudden cardiac death. These findings highlight the interplay between MB's structural anomalies and functional impairments, with factors such as the bridge's length, depth, and orientation influencing its hemodynamic significance. Advances in imaging and coronary physiology assessment, including acetylcholine testing and stress diastolic fractional flow reserve/iFR/RFR, have enhanced diagnostic precision. This review explores the multifaceted impact of MB on coronary physiology, emphasizing its role in endothelial dysfunction and vasomotor regulation. Recognizing MB's contribution to cardiovascular disease is essential for accurate diagnosis and tailored management strategies aimed at mitigating ischemic risk and improving patient outcomes.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492083","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":"Atrial Fibrillation Prediction Model Following Aortic Valve Replacement Surgery.","authors":"Nora Knez, Tomislav Kopjar, Tomislav Tokic, Hrvoje Gasparovic","doi":"10.3390/jcdd12020052","DOIUrl":"10.3390/jcdd12020052","url":null,"abstract":"<p><p>(1) Background: Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery. It leads to increased perioperative morbidity and costs. Our study aimed to determine the incidence of new-onset POAF in patients undergoing isolated aortic valve replacement (AVR) and develop a multivariate model to identify its predictors. (2) Methods: We conducted a retrospective study including all consecutive patients who underwent isolated AVR at our institution between January 2010 and December 2022. Patients younger than 18, with a history of atrial fibrillation, previous cardiac surgery, or those who underwent concomitant procedures were excluded. Patients were dichotomized into POAF and No POAF groups. Multivariate logistic regression with backward elimination was utilized for predictive modeling. (3) Results: This study included 1108 patients, of which 297 (27%) developed POAF. The final multivariate model identified age, larger valve size, cardiopulmonary bypass time, delayed sternal closure, ventilation time, and intensive care unit stay as predictors of POAF. The model exhibited fair predictive ability (AUC = 0.678, <i>p</i> < 0.001), with the Hosmer-Lemeshow test confirming good model fit (<i>p</i> = 0.655). The overall correct classification percentage was 65.6%. (4) Conclusions: A POAF prediction model offers personalized risk estimates, allowing for tailored management strategies with the potential to enhance patient outcomes and optimize healthcare costs.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492014","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":"Longitudinal Displacement for Left Ventricular Function Assessment.","authors":"Marina Leitman, Vladimir Tyomkin","doi":"10.3390/jcdd12020053","DOIUrl":"10.3390/jcdd12020053","url":null,"abstract":"<p><strong>Background: </strong>Quantitative evaluation of myocardial function traditionally relies on parameters such as ejection fraction and strain. Strain, reflecting the relative change in the length of a myocardial segment over the cardiac cycle, has been extensively studied in various cardiac pathologies over the past two decades. However, the absolute length change, or longitudinal displacement, of myocardial segments during the cardiac cycle has received limited attention. This study aims to evaluate longitudinal displacement in two separate groups: healthy athletes and patients with left ventricular dysfunction, providing new insights into myocardial function assessment.</p><p><strong>Methods: </strong>Echocardiographic examinations were performed on 30 healthy football players and 30 patients with left ventricular dysfunction using speckle-tracking imaging analysis. Global and regional peak longitudinal displacement values were calculated and compared with corresponding global and regional peak longitudinal strain measurements. A manual alternative for calculating global longitudinal strain was also proposed.</p><p><strong>Results: </strong>An inverse correlation was found between regional longitudinal displacement and regional longitudinal strain. Longitudinal displacement was maximal in the basal segments and lowest in the apex of the left ventricle, exhibiting a reversed basal-to-apical gradient (17.6 ± 3.5 mm vs. 11.5 ± 2.9 mm vs. 4.22 ± 1.7 mm in basal, mid, and apical segments, respectively; <i>p</i> < 0.000001). Maximal longitudinal displacement was observed in the inferior and posterior walls of the left ventricle. In the 30 patients with left ventricular dysfunction, global longitudinal displacement was significantly lower than in healthy individuals (4.4 ± 1.7 mm vs. 11.7 ± 1.5 mm, <i>p</i> < 0.000001). Global longitudinal displacement and global longitudinal strain showed a strong negative correlation (r = -0.72, <i>p</i> < 0.000001). Manually calculated global longitudinal strain demonstrated good agreement with speckle-tracking-based global longitudinal strain.</p><p><strong>Conclusions: </strong>Peak longitudinal displacement can be used to evaluate both regional and global myocardial function, similarly to peak longitudinal strain. Unlike strain, longitudinal displacement exhibits a reversed basal-to-apical gradient, with the highest values at the base of the left ventricle and the lowest at the apex. Global and regional longitudinal displacement is significantly reduced in patients with left ventricular dysfunction. Global longitudinal strain can be manually calculated using displacement measurements. Further studies are needed to evaluate peak longitudinal displacement in various cardiac pathologies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492214","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":"Beyond the Lumen: Molecular Imaging to Unmask Vulnerable Coronary Plaques.","authors":"Geoffrey Currie, Hosen Kiat","doi":"10.3390/jcdd12020051","DOIUrl":"10.3390/jcdd12020051","url":null,"abstract":"<p><p>Vulnerable coronary atherosclerotic plaque involves a dynamic pathophysiologic process within and surrounding an atheromatous plaque in coronary artery intima. The process drastically increases the risk of plaque rupture and is clinically responsible for most cases of acute coronary syndromes, myocardial infarctions, and sudden cardiac deaths. Early detection of vulnerable plaque is crucial for clinicians to implement appropriate risk-mitigation treatment strategies, offer timely interventions, and prevent potentially life-threatening events. There is an imperative clinical need to develop practical diagnostic pathways that utilize non-invasive means to risk-stratify symptomatic patients. Since the early 1990s, the identification of vulnerable plaque in clinical practice has primarily relied on invasive imaging techniques. In the last two decades, CT coronary angiogram (CTCA) has rapidly evolved into the prevalent non-invasive diagnostic modality for assessing coronary anatomy. There are now validated plaque appearances on CTCA correlating with plaque vulnerability. It is worth noting that in clinical practice, most CTCA reports omit mention of vulnerable plaque details because spatial resolution (0.3-0.5 mm) is often insufficient to reliably detect some crucial features of vulnerable plaques, such as thin fibrous caps. Additionally, accurately identifying vulnerable plaque features requires substantial expertise and time, which many cardiologists or radiologists may lack in routine reporting. Cardiac magnetic resonance imaging (cMRI) is also non-invasive and allows simultaneous anatomic and functional assessment of coronary plaques. Despite several decades of research and development, routine clinical application of cMRI in coronary plaque imaging remains hampered by complex imaging protocols, inconsistent image quality, and cost. Molecular imaging with radiotracers, specifically positron emission tomography (PET) with sodium fluoride (Na¹⁸F PET), have demonstrated significant potential as a sensitive and specific imaging procedure for diagnosing vulnerable coronary artery plaque. The study protocol is robust and brief, requiring minimal patient preparation. Compared to CTCA and cMRI, the diagnostic accuracy of this test is less dependent on the experience and expertise of the readers. Furthermore, validated automated quantitative algorithms complement the visual interpretation of the study, enhancing confidence in the diagnosis. This combination of factors makes Na¹⁸F PET a promising tool in cardiology for identifying high-risk coronary plaques.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492032","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 Heart Failure Team on Inpatient Rapid Sequencing of Heart Failure Therapy.","authors":"Zhongrui Zhou, Khalid Kardas, Ying Xuan Gue, Ali Najm, Anas Tirawi, Rachel Goode, Robert Frodsham, Rory Kavanagh, Archana Rao, Rebecca Dobson, David Wright, Matthew Kahn","doi":"10.3390/jcdd12020050","DOIUrl":"10.3390/jcdd12020050","url":null,"abstract":"<p><p>The management of heart failure (HF) has undergone a paradigm shift from conventional stepwise methods of initiation and the up-titration of HF therapy towards an early, more intensive initiation of pharmacotherapy to improve the prognosis. The aim of this study was to compare the outcomes of patients at the Liverpool Heart and Chest Hospital (LHCH), with new diagnosis of HF, who were reviewed by the inpatient heart failure team (HFT), compared to patients that were not reviewed. A retrospective review of the electronic records of patients admitted with a new diagnosis of HF to the LHCH from May to December 2023 was performed. Admission drugs were similar, apart from betablockers, which were more frequent in the non-HFT group (58% vs. 24.2%; <i>p</i> = 0.002). The length of inpatient stay was longer in the HFT group (median 5.5 days vs. 3 days; <i>p</i> = 0.001) and more likely to be on all four pillars of HF medical therapy (96.8% vs. 0; <i>p</i> < 0.001) within 30 days of discharge. The 30-day and 6-month mortality outcomes were not significantly different. Patients reviewed by the HFT were significantly more likely to receive the four pillars of HF therapy within 30 days of their diagnosis compared to their counterparts at the expense of a longer length of stay.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492201","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 CT Angiography in the Emergency Department: State of the Art and Future Perspectives.","authors":"Antonio De Vita, Marcello Covino, Sara Pontecorvo, Giacomo Buonamassa, Angelo Giuseppe Marino, Riccardo Marano, Luigi Natale, Giovanna Liuzzo, Francesco Burzotta, Francesco Franceschi","doi":"10.3390/jcdd12020048","DOIUrl":"10.3390/jcdd12020048","url":null,"abstract":"<p><p>About 5% of annual access to emergency departments (EDs) and up to 25-30% of hospital admissions involve patients with symptoms suggestive of acute coronary syndrome (ACS). The process of evaluating and treating these patients is highly challenging for clinicians because failing to correctly identify an ACS can result in fatal or life-threatening consequences. However, about 50-60% of these patients who are admitted to the hospital because of chest pain are found to have no ACS. Coronary computed tomographic angiography (CCTA) has emerged as a proposed new frontline test for managing acute chest pain in the ED, particularly for patients with low-to-intermediate risk. This narrative review explores the potential of adopting an early CCTA-based approach in the ED, its significance in the era of high-sensitivity troponins, its application to high-risk patients and its prognostic value concerning atherosclerotic burden and high-risk plaque features. Additionally, we address clinical and technical issues related to CCTA use for triaging acute chest pain in the ED, as well as the role of functional testing. Finally, we aim to provide insight into future perspectives for the clinical application of CCTA in the ED.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492079","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":"Mixed Reality (Holography)-Guided Minimally Invasive Cardiac Surgery-A Novel Comparative Feasibility Study.","authors":"Winn Maung Maung Aye, Laszlo Kiraly, Senthil S Kumar, Ayyadarshan Kasivishvanaath, Yujia Gao, Theodoros Kofidis","doi":"10.3390/jcdd12020049","DOIUrl":"10.3390/jcdd12020049","url":null,"abstract":"<p><p>The operative field and exposure in minimally invasive cardiac surgery (MICS) are limited. Meticulous preoperative planning and intraoperative visualization are crucial. We present our initial experience with HoloLens^® 2 as an intraoperative guide during MICS procedures: aortic valve replacement (AVR) via right anterior small thoracotomy, coronary artery bypass graft surgery (CABG) via left anterior small thoracotomy (LAST), and pulmonary valve replacement (PVR) via LAST. Three-dimensional (3D) segmentations were performed using the patient's computer tomography (CT) data subsequently rendered into a 3D hologram on the HoloLens^® 2. The holographic image was then superimposed on the patient lying on the operating table, using the xiphoid and the clavicle as landmarks, and was used as a real-time anatomical image guide for the surgery. The incision site marking made using HoloLens^® 2 differed by one intercostal space from the marking made using a conventional surgeon's mental reconstructed image from the patient's preoperative imaging and was found to be a more appropriate site of entry into the chest for the structure of interest. The transparent visor of the HoloLens^® 2 provided unobstructed views of the operating field. A mixed reality (MR) device could contribute to preoperative surgical planning and intraoperative real-time image guidance, which facilitates the understanding of anatomical relationships. MR has the potential to improve surgical precision, decrease risk, and enhance patient safety.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11856421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492216","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}