Journal of Cardiothoracic Surgery最新文献

{"title":"miR-1307-5p mediates endothelial dysfunction and inflammation induced by acute coronary syndrome by targeting PIM3.","authors":"ChangMing Jin, BaoBin Sun, XiaoHong Li, Hao Chen, Tao Zhang","doi":"10.1186/s13019-026-04258-8","DOIUrl":"https://doi.org/10.1186/s13019-026-04258-8","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the clinical value of miR-1307-5p in acute coronary syndrome (ACS) patients and its role in human umbilical vein endothelial cells (HUVECs).</p><p><strong>Methods: </strong>Enrollment consisted of 124 ACS cases and 124 controls. Reverse transcription quantitative real-time PCR (RT-qPCR) was used to measure the miR-1307-5p and proviral integration site for Moloney murine leukemia virus 3 (PIM3) levels in serum samples, and the receiver operating characteristic (ROC) curve was utilized to assess the diagnostic utility of miR-1307-5p. ACS cell model was established using hypoxia/reoxygenation (H/R). enzyme-linked immunosorbent assay (ELISA) was employed to detect the von Willebrand factor (vWF), heart-type fatty acid-binding protein (H-FABP), tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-8 in serum and HUVECs. Apoptosis was analyzed by flow cytometry, while cell viability was evaluated through Cell Counting Kit-8 (CCK8) assay. The interaction between miR-1307-5p and PIM3 was validated via dual-luciferase reporter (DLR) and RNA immunoprecipitation (RIP) experiments.</p><p><strong>Results: </strong>miR-1307-5p is significantly downregulated in ACS patients' serum and effectively distinguishes controls from ACS patients. It also shows negative correlations with vWF, H-FABP, TNF-α, IL-6, and IL-8. miR-1307-5p directly targets PIM3. Upregulating miR-1307-5p enhances HUVEC viability and suppresses apoptosis. Furthermore, this intervention alleviates endothelial injury and reduces inflammation. Notably, PIM3 overexpression reversed these protective effects of miR-1307-5p.</p><p><strong>Conclusion: </strong>Reduced serum miR-1307-5p expression holds promise as a potential diagnostic biomarker for ACS. Upregulation of miR-1307-5p alleviates endothelial dysfunction and inflammation by targeting PIM3, suggesting that the miR-1307-5p/PIM3 axis represents a potential therapeutic target for ACS.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864040","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}

{"title":"Intraoperative continuous noninvasive hemoglobin monitoring in patients undergoing thoracic surgery.","authors":"Mona Mohamed Mogahed, Taha Saad Alnoamani, Mohamed Shafik Elkahwagy","doi":"10.1186/s13019-026-04253-z","DOIUrl":"https://doi.org/10.1186/s13019-026-04253-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the agreement between noninvasive hemoglobin (SpHb) and invasive hemoglobin (InvHb) monitoring in guiding blood transfusions during thoracic procedures.</p><p><strong>Methods: </strong>This study was not interventional but assessed the agreement between SpHb and InvHb monitoring in guiding blood transfusions during thoracic procedures. Data were collected from 80 patients ≥ 18 years older who were candidates for thoracic surgeries. Continuous SpHb monitoring was conducted. Simultaneous (InvHb) samples were collected for validation at predefined perioperative intervals: preoperative baseline, immediately after induction, 1, 2, 3, and 4 h after incision, at the end of surgery, and in the recovery room. Agreement was assessed using Bland-Altman analysis, and correlation was evaluated using Pearson coefficients. The primary outcome measure was the correlation between SpHb and InvHb.</p><p><strong>Results: </strong>There was a significant positive correlation between SpHb and InvHb at preoperative period, immediately after induction of anesthesia, 1 h, 2 h, 3 h, 4 h after start of surgery, at the end of surgery and after recovery of the patient (Pearson's r = 0.949772, 0.940262, 0.915292, 0.981438, 0.989623, 0.984838, 0.965235 and 0.933264). Bland-Altman analysis between SpHb and InvHb demonstrated low bias with good limits of agreement at the same interval points [Mean bias (limits of agreement): 0.56 (-0.3 to 1.4), 0.54 (-0.38 to 1.5), 0.67 (-0.37 to 1.7), 0.52 (-0.14 to 1.8), 0.48 (0.12 to 1.1), 0.6 (-0.001 to 1.2) g/dl].</p><p><strong>Conclusion: </strong>In patients undergoing thoracic surgery, there is a strong correlation and acceptable agreement between SpHb monitoring using Masimo pulse co-oximetry and invasive hemoglobin measurements.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864049","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}

{"title":"Vascular implications of non-pulsatile flow extracorporeal life support.","authors":"Alex Bartlett, Antonio Gachineiro","doi":"10.1186/s13019-026-04136-3","DOIUrl":"https://doi.org/10.1186/s13019-026-04136-3","url":null,"abstract":"<p><p>Extracorporeal life support has become a widely integrated tool in treating refractor cardiopulmonary failure. Under normal physiologic conditions, arterial blood flow is inherently pulsatile, and cyclic shear stress plays a pivotal role in maintaining endothelial homeostasis and vascular integrity. In contrast, contemporary ECMO systems generate continuous, non-pulsatile flow, representing a fundamental deviation from native hemodynamics. While non-pulsatile ECMO pumps remain the clinical standard for their reliability and ease of use, their non-physiologic approach to augmenting perfusion is increasingly recognized as a detriment to vascular health. Continuous-flow disrupts numerous signaling and regenerative pathways integral to endothelial proliferation. Through culminative dysregulation of nitric oxide expression, pathological angiogenesis, and accelerated denudation of von Willibrand Factor, patients experience heightened risk of hemorrhagic complications, while thrombotic and embolic events arise through other distinct mechanisms. This review aims to centralize current evidence regarding vascular health to identify causative agents of endothelial insult associated with non-pulsatile VA-ECMO. We further summarize experimental and clinical studies discussing the impact of altered shear forces and their contribution to endothelial dysregulation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856472","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}

{"title":"Endovascular management of asymptomatic large descending thoracic aortic aneurysm long after coarctation of aorta repair: a case report.","authors":"Prabhnoor Nagra, Matthew Neely, Arunabh Sinha, Garrett Wolfram, Joel Corvera, Blair MacPhail, Raed Abdulkareem, Raghunandan Motaganahalli","doi":"10.1186/s13019-026-04102-z","DOIUrl":"https://doi.org/10.1186/s13019-026-04102-z","url":null,"abstract":"<p><strong>Background: </strong>Coarctation of the aorta represents 6-8% of congenital heart defects. Surgical repair is often done in infancy, but late complications such as aneurysm formation may be present decades later. Late aneurysm after childhood coarctation repair remains a recognized complication, but surveillance lapses and complex arch branch involvement can delay detection and complicate repair planning. We present a case of a large descending thoracic aortic aneurysm found incidentally over 60 years after initial coarctation repair, a latency period exceeding many reported cases [5].</p><p><strong>Case presentation: </strong>A 62-year-old woman with a history of coarctation repairs at 5 months of age and at 10 years of age presented asymptomatically for echocardiogram evaluation of a cardiac murmur. Computed tomography angiography (CTA) revealed a 7.3 cm saccular aneurysm (length 8.2 cm, width 6.5 cm, depth 7.3 cm) of the distal aortic arch and proximal descending aorta, with the left subclavian artery previously ligated and the left carotid artery originating from the aneurysm sac. She underwent a hybrid repair performed in a single setting: right common carotid-to-left common carotid bypass via retro-pharyngeal tunneling followed by thoracic endovascular aortic repair (TEVAR) with overlapping stent grafts. Angiography confirmed complete exclusion of the aneurysm without endoleak. Follow-up revealed no complications, and the patient remained asymptomatic.</p><p><strong>Conclusions: </strong>This case underscores the importance of lifelong surveillance in patients with repaired congenital heart disease, even in the absence of symptoms. Evolution of technology with endovascular repair has provided less invasive options for management of complex aneurysms resulting after repair of aortic coarctation. This case report demonstrates surveillance gaps after repair of thoracic aortic coarctation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856420","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}

{"title":"Correction: Exclusion of the left atrial appendage in Chinese population with perclip system: 1-year follow-up outcome results from a prospective, multi-center, open-label, single-arm device trial.","authors":"Haoyang Li, Jingyuan Huo, Hongfei Xu, Jingya Fan, Firyuza Husanova, Canbo Li, Xiao Tian, Heng Zhang, Xin Chen, Xiaofan Chen, Yanjia Gu, Yun Mou, Jing Li, Shuai Yuan, Liang Ma, Yiming Ni, Weidong Li","doi":"10.1186/s13019-026-04243-1","DOIUrl":"https://doi.org/10.1186/s13019-026-04243-1","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856461","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}

{"title":"Independent lung ventilation using dual ventilators for unilateral reexpansion pulmonary edema after mediastinal tumor resection: a case report.","authors":"Yu Zhou, HongZhang Ding, Qing Yang, Teng Zheng, YuYu Gu, Feng Chen, Jinbao Li","doi":"10.1186/s13019-026-04247-x","DOIUrl":"https://doi.org/10.1186/s13019-026-04247-x","url":null,"abstract":"<p><strong>Background: </strong>Reexpansion pulmonary edema following pulmonary and mediastinal surgery presents a complex clinical challenge. Independent lung ventilation (ILV), which facilitates the application of distinct positive end-expiratory pressures (PEEP) and tidal volumes to each lung, may serve as an alternative therapeutic approach for managing reexpansion pulmonary edema.</p><p><strong>Case presentation: </strong>A 58-year-old female patient presented with a giant space-occupying lesion measuring 17.1*11.2*19.2 cm in the left lung and underwent mediastinal tumor resection under general anesthesia. Intraoperatively, following the resection of the tumor and the invaded upper lobe of the left lung, the left lung was manually reopened, resulting in the development of reexpansion pulmonary edema (RPE). To prevent exudate from the left lung from infiltrating the right lung and to avoid barotrauma to the right lung due to excessive airway pressure, a dual ventilator mechanical ventilation strategy was employed. This approach utilized a double-lumen endotracheal tube, allowing for differential ventilation modes tailored to each lung.</p><p><strong>Conclusion: </strong>The mechanical ventilation treatment involving double-lumen bronchial intubation with various ventilation modes serves as an effective ventilatory support for managing reexpansion pulmonary edema.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856452","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}

{"title":"Staged hybrid repair of a symptomatic post-traumatic aortic aneurysmatic lesion in a patient with late diagnosed connective tissue disorder.","authors":"Georg Jung, Jeannine Bucheli, Renate Schönenberger-Berzins, Marianne Rohrbach, Qendresa Parduzi, David Schibilsky, Peter Matt, Maani Hakimi","doi":"10.1186/s13019-026-04238-y","DOIUrl":"https://doi.org/10.1186/s13019-026-04238-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic post-traumatic thoracic aortic aneurysms may remain undiagnosed for years. In patients with genetically mediated aortopathies, open surgery is traditionally favored, whereas endovascular approaches remain controversial due to concerns regarding durability and long-term complications. We report a staged hybrid repair of a huge symptomatic post-traumatic thoracic aortic aneurysm in a patient with a subsequently identified variant in the TGF[Formula: see text]3 gene. The focus of this case lies in the interdisciplinary staged strategy combining open arch repair and thoracic endovascular aortic repair, guided by interdisciplinary decision making spinal cord protection strategies.</p><p><strong>Case presentation: </strong>A 41-year-old female was diagnosed with a 125 mm descending thoracic aortic post traumatic aneurysm with compression of adjacent structures. Additional visceral and cerebral aneurysms raised suspicion of a systemic connective tissue disorder. A staged hybrid approach was selected. Stage 1: frozen elephant trunk with arch reconstruction. Stage 2 comprised thoracic endovascular aortic repair following selective transposition of a directly originating left vertebral artery, guided by motor and somatosensory evoked potential monitoring and intraoperative balloon occlusion testing. Subsequent whole-genome sequencing identified a heterozygous variant in transforming growth factor beta 3.</p><p><strong>Conclusions: </strong>This case highlights the importance of early multidisciplinary planning and individualized staged hybrid strategies in complex thoracic aortic aneurysms, particularly when connective tissue disease is suspected but not yet genetically confirmed. Integration of open and endovascular techniques, combined with tailored spinal cord protection measures, can enable effective and durable repair while minimizing neurological risk in selected high-risk patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838060","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}

{"title":"The SGLT2 inhibitor dapagliflozin alleviates ventricular remodeling and apoptosis after myocardial infarction by inhibiting the TGF-β1 and MAPK pathways.","authors":"Zhen Zhu, Ying Zhang, Zhong Fang, Xin Li, Chao Ma, Qingqing Liu, Qingling Zhang, Wenjing Zhu, Huixian Su, Xiaodong Xu","doi":"10.1186/s13019-026-03951-y","DOIUrl":"https://doi.org/10.1186/s13019-026-03951-y","url":null,"abstract":"<p><strong>Background: </strong>Heart failure and ventricular remodeling are the major cardiac injuries after myocardial infarction (MI). Sodium‒glucose cotransporter 2 (SGLT2) inhibitors have been shown to be effective at alleviating heart failure and improving patient outcomes and quality of life. However, whether SGLT2 has the same effect on myocardial infarction is unclear. The aim of this study was to elucidate the efficacy and underlying mechanisms of dapagliflozin on the outcome of myocardial infarction.</p><p><strong>Methods: </strong>A porcine model of myocardial infarction was established via percutaneous coronary intervention with a balloon-dilated catheter and treated with dapagliflozin (DPG), an SGLT2 inhibitor, for 8 weeks. The biochemical indices of pig blood were determined. M-mode echocardiography was performed to determine cardiac structure and function. HE staining, Masson staining and TUNEL were used to detect myocardial fibrosis and apoptosis. The expression of target proteins in signal transduction pathways was determined by Western blotting.</p><p><strong>Results: </strong>DPG treatment ameliorated myocardial hypertrophy and fibrosis and increased collagen synthesis and apoptosis induced by myocardial infarction in pigs. Moreover, DPG inhibited the activation of the TGF-β1 and MAPK signaling pathways.</p><p><strong>Conclusion: </strong>DPG can effectively reduce ventricular remodeling and myocardial cell apoptosis after myocardial infarction. DPG inhibits the TGF-β1 and MAPK pathways.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838100","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}

{"title":"Minimally invasive thoracoscopic surgical ablation and hybrid ablation in AF patients: results from a single-arm systematic review and meta-analysis.","authors":"Fouad Hanna, Ali Dway, Hamza A Abdul-Hafez, Yousef M Husseiny, Ahmed Youssef Hassan, Mazen Negmeldin A Yassin, Basel Saber Hussein Ayoub, Hadeel Jameel Ayesh, Omneya Kandil, Abdelrahman Elgendy, Nada G Hamam, Abdelrahman El-Helbawy","doi":"10.1186/s13019-026-04135-4","DOIUrl":"https://doi.org/10.1186/s13019-026-04135-4","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most frequent cardiac arrhythmia in adults, with presentations from asymptomatic to severe cardiovascular morbidities. Cardiac ablation treats patients resistant to antiarrhythmic drugs (AAD) using approaches such as bilateral surgical ablation, which permits targeting of superior vena cava lesions but entails longer procedures and higher complication risk, and hybrid ablation that combines epicardial and endocardial techniques.</p><p><strong>Method: </strong>We performed a meta-analysis per PRISMA guidelines, including observational and interventional single-arm studies of patients undergoing bilateral surgical or hybrid ablation in single- and double-setting subgroups. Studies were selected by predefined criteria, and data were extracted independently by 12 investigators. Searches covered multiple databases up to March 29, 2025.</p><p><strong>Result: </strong>Thirty-two studies with 1,871 patients were evaluated. Overall complication rates were 0.11 (95% CI: 0.08-0.14) for surgical ablation and 0.13 (95% CI: 0.095-0.17) for hybrid ablation, with no significant subgroup difference (p = 0.093). Arrhythmia-free rates were 0.81 (95% CI: 0.69-0.89) for surgical and 0.76 (95% CI: 0.70-0.85) for hybrid ablation (p = 0.305). Mean operative times were 160.9 min (95% CI: 135 - 186.9) for surgical and 192.65 min (95% CI: 109.3-275.9) for hybrid ablation (p = 0.069). Bleeding rates were 0.03 (95% CI: 0.02-0.04) and 0.049 (95% CI: 0.03-0.07), respectively (p = 0.06). Mortality, stroke, conversion to sternotomy, and hospital length of stay showed no significant differences.</p><p><strong>Conclusion: </strong>Surgical ablation yielded a slightly higher arrhythmia-free rate and fewer total complications, while hybrid ablation had shorter operative time; subgroup (single vs. double setting) differences were not significant.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838368","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}

{"title":"Transcatheter edge-to-edge repair and left ventricular assist devices for secondary mitral regurgitation in advanced heart failure: a scoping review.","authors":"Rida Shakeel, Tuba Basit, Sohaib Aftab Ahmad Chaudhry, Huzaifa Sabir Nawaz, Amal Tahir, Syeda Masooma Jafri, Diksha Ladhani, Rachna Katyara, Muhammad Hussain, Muhammad Khalid Afridi, Raghabendra Kumar Mahato, Muhammad Aqib Faizan","doi":"10.1186/s13019-026-04245-z","DOIUrl":"https://doi.org/10.1186/s13019-026-04245-z","url":null,"abstract":"<p><strong>Background: </strong>Secondary mitral regurgitation (SMR) worsens outcomes in advanced heart failure. Transcatheter edge-to-edge repair (TEER) and left ventricular assist device (LVAD) implantation represent advanced treatment options for patients with persistent symptoms despite guideline-directed medical therapy (GDMT).</p><p><strong>Methods: </strong>A scoping review using a PICO framework identified contemporary studies published up to 2025 involving adults with advanced heart failure (NYHA III-IV, INTERMACS 1-7) and ≥moderate SMR. Outcomes included mortality, heart failure hospitalizations, functional status, mitral regurgitation reduction, ventricular remodeling, complications, and quality of life.</p><p><strong>Results: </strong>Nine studies including over 2,000 patients were analyzed (mean age 60-72 years; LVEF 15-33%). TEER was associated with lower mortality and fewer heart failure hospitalizations compared with GDMT in selected patients. LVAD recipients generally had more advanced disease (predominantly INTERMACS 1-3) with higher early mortality but substantial functional improvement. TEER achieved MR ≤ 2 + in 84-99% of patients with low procedural complication rates (1-9%), whereas LVAD therapy demonstrated greater functional improvement but higher device-related complications.</p><p><strong>Conclusion: </strong>TEER is associated with improved outcomes in selected patients with advanced heart failure and SMR, while LVAD therapy remains essential for patients with end-stage disease requiring durable circulatory support.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838103","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}