Journal of Cardiothoracic Surgery最新文献

{"title":"Indications, contributing factors, and short-term outcomes of pneumonectomy: an 8-year retrospective study in a resource-limited setting.","authors":"Mekonnen Feyissa Senbu, Dereje Gulilat, Hiwot Tadesse Habtamu","doi":"10.1186/s13019-024-03268-8","DOIUrl":"10.1186/s13019-024-03268-8","url":null,"abstract":"<p><strong>Background: </strong>Pneumonectomy, the surgical removal of an entire lung, was first performed in 1933 by Evarts A. Graham for lung carcinoma. Today, pneumonectomy is primarily indicated for non-small cell lung cancer (NSCLC) worldwide. However, it carries a higher risk of morbidity and mortality compared to less extensive lung resections.</p><p><strong>Objectives: </strong>This study aims to investigate the indications for pneumonectomy and its short-term outcomes among patients who underwent the procedure between 2016 and 2023.</p><p><strong>Methods and materials: </strong>A retrospective study was conducted on 112 patients who underwent pneumonectomy. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Univariate, bivariate, and multivariate analyses were performed to address the study's objectives. The Pearson chi-square test, crude odds ratio (COR), and adjusted odds ratio (AOR) were calculated for categorical variables where appropriate. To identify factors associated with pneumonectomy, a binary logistic regression model was used, and odds ratios with 95% confidence intervals were calculated. A p-value of < 0.25 was used as a threshold for including variables in the multivariate analysis, while a p-value of < 0.05 was considered statistically significant in the final model.</p><p><strong>Results: </strong>The majority of patients were aged between 20 and 30 years, with 54 patients (48.2%) in this age group, and a male-to-female ratio of 1.6:1. The primary indication for pneumonectomy was inflammatory conditions, accounting for 62.5% (70 patients), followed by carcinoid tumors at 32.1% (36 patients). Lung cancer was the diagnosis in 5.4% (6 patients) of cases. Factors significantly associated with pneumonectomy included a history of tuberculosis treatment (AOR 40.3; 95% CI: 3.01, 540.2), intraoperative blood loss > 500 mL (AOR 9.07; 95% CI: 1.04, 79.13), and surgical duration > 180 min (AOR 37.9; 95% CI: 1.82, 792.3). The morbidity rate was 25%, while the mortality rate was 5.4%.</p><p><strong>Conclusion and recommendations: </strong>In our setting, pneumonectomy is most commonly performed for inflammatory conditions. Significant factors associated with the procedure include a history of tuberculosis treatment, intraoperative blood loss > 500 mL, and surgical duration > 180 min. To reduce the need for pneumonectomy, strategies should focus on tuberculosis prevention, screening, and proper patient evaluation and diagnosis before treatment, to prevent extensive lung damage that often necessitates this procedure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"120"},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255699","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":"Anomalous origin of the left main coronary artery in a 62‑year‑old woman: a case report and review of the literature.","authors":"Mohammad Safariyan, Najmeh Mohammadrafie, Soheila Pourmasumi, Vahid Mohammadi, Xiao Xu, Alaa Hamza Hermis, Mohammed Musaed Al-Jabri, Farkhondeh Jafarian, Mohammad Ali Zakeri","doi":"10.1186/s13019-024-03217-5","DOIUrl":"10.1186/s13019-024-03217-5","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormalities of the coronary arteries, including abnormal origins, are often detected in heart patients who undergo coronary angiography. Although only a small percentage of these abnormalities lead to serious complications, the consequences can be extremely fatal.</p><p><strong>Case presentation: </strong>We report the case of a 62-year-old woman who presented with chest pain. The patient has a history of hypertension and complains of chest pain that worsens with walking and improves with rest. A basic electrocardiogram (ECG) showed sinus rhythm with no signs of arrhythmia or ischemic changes. Coronary angiography revealed an anomalous left coronary artery originating from the right sinus of Valsalva (RSoV).</p><p><strong>Conclusions: </strong>We report a rare case of an anomalous left coronary artery originating from the RSoV without specific clinical symptoms. The patient presented with unstable angina, and after further investigation, this anomaly was diagnosed. Investigating these abnormalities, especially in young individuals with cardiac symptoms, should be prioritized. Cardiologists should also be aware of this rare condition that can have fatal consequences.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"119"},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255600","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":"Early and late clinical outcomes and cost-effectiveness of aortic valve replacement using the Inspiris Resilia bioprosthesis : A systematic review and meta-analysis.","authors":"Ahmed Ahmed, Tarek A Abdel Aziz, Mohannad M R AlAsaad, Motaz Majthoob, Kamaleldin Ahmed Altahmody","doi":"10.1186/s13019-024-03269-7","DOIUrl":"10.1186/s13019-024-03269-7","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to critically revise the published literature on clinical outcomes and cost-effectiveness of Inspiris Resilia valve.</p><p><strong>Methods: </strong>This work was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Full text research articles discussing clinical or cost-effectiveness aspects of Inspiris Resilia bioprosthesis published in English were included in this analysis. Studies were excluded if they weren't exclusively conducted on patients submitted to surgical aortic valve replacement using the Inspiris Resilia bioprosthesis.</p><p><strong>Results: </strong>The technical success rate was almost perfect in all studies. Reported complications included severe prosthesis-patient mismatch, reoperation, endocarditis, and paravalvular leak. In almost all studies, there were significant improvement of NYHA at the end of follow up as compared to baseline. In all studies, there were significant improvement of one or more hemodynamic parameters at the end of follow up as compared to baseline.</p><p><strong>Conclusions: </strong>Surgical aortic valve replacement using Inspiris Resilia tissue valve appears to be safe and effective with low rate of aortic valve and systemic complications and mortality. Its performance appears to be equal to or better than many other bioprosthetic valves. As compared to mechanical valves, its use is suggested to be more cost-effective.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"117"},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255698","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":"Anomalous origin of a right pulmonary artery identified with echocardiography combined with CT: a case in a juvenile patient.","authors":"Yan-Ling Li, Ping Xie, Jia Wei, Zhao-Xia Guo","doi":"10.1186/s13019-024-03297-3","DOIUrl":"10.1186/s13019-024-03297-3","url":null,"abstract":"<p><p>An anomalous origin of the pulmonary artery (AOPA) from the ascending aorta is a relatively rare but important cardiac malformation that frequently involves the right pulmonary artery (RPA). Its clinical manifestations depend mainly on the associated significant pulmonary hypertension, with an extremely high mortality rate in the first year of life. Here, we present a rare survival case of an 11-year-old child with the disease, who was hospitalized due to intermittent abdominal pain, but without any apparent signs of chest tightness or shortness of breath. The low oxygen saturation as discovered during the physical examination. Subsequent examination with transthoracic echocardiography (TTE) and pulmonary artery computed tomography angiography (CTA) revealed this unexpected congenital malformation. Although the estimated mean pulmonary artery pressure (MAP) from the TTE was 51 mmHg, which seemed to contraindicate corrective cardiac surgery, the limitations of TTE were considered. Consequently, after multidisciplinary consultation, surgical intervention was ultimately decided upon, resulting in a favorable prognosis for the patient. This case provides a new insight for clinicians in the diagnosis and treatment of complex congenital heart diseases.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"118"},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255586","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":"Biomarkers to predict the outcomes of surgical intervention for aortic dissection.","authors":"Abanob G Hanna, Fabian Jimenez Contreras, Omar M Sharaf, Griffin P Stinson, Philip J Hess","doi":"10.1186/s13019-024-03226-4","DOIUrl":"10.1186/s13019-024-03226-4","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic dissections and repairs are associated with high rates of mortality. The aim of this review is to summarize the literature concerning the prognostic ability of various preoperative biomarkers for patients undergoing surgical repair of the thoracic and abdominal aorta to elucidate whether these biomarkers could improve the selection of surgical candidates.</p><p><strong>Methods: </strong>Relevant biomarkers were selected if they had predictive value in inflammatory disease processes and/or cardiovascular disease. Full-text articles available in English on PubMed that related these biomarkers to the prognosis of aortic repair following aortic dissection were examined.</p><p><strong>Results: </strong>For patients who underwent repair for type A dissection, a preoperative elevated SII was associated with inferior 30-day survival (hazard ratio: 3.532, 95% confidence interval: 1.719-7.255, p = 0.001) and increased rates of adverse cardiovascular events. Elevated preoperative IL-6 and D-dimer levels were independently associated with single-organ dysfunction, multiorgan dysfunction, and death. The use of a combination of markers was a stronger predictor. The areas under the curve (AUCs) for the specified IL-6 and D-dimer cutoff values were 0.901 and 0.817, respectively, whereas the AUC reached 0.936 when IL-6 was combined with D-dimer. For patients who underwent thoracic endovascular aortic repair (TEVAR) for type B dissection, an elevated postoperative systemic immune-inflammation index (SII) was an independent risk factor for aorta-related complications, graft failure, and significantly inferior freedom from aortic-related mortality. A combination of elevated preoperative and postoperative SII values was again predictive of in-hospital adverse outcomes and follow-up complications, including endoleaks, branch artery stenosis, distal aortic expansion, aortic rupture, and death (p = 0.0016). An elevated preoperative neutrophil‒leukocyte ratio (NLR) is associated with an increased incidence of early postoperative adverse events and poor survival.</p><p><strong>Conclusions: </strong>Inflammatory markers seem to have predictive ability for postoperative outcomes after aortic repair in type A dissections. Further studies should compare these biomarkers to determine the best predictive marker for individual disease states and surgeries.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"116"},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255601","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":"CircHIPK2 recruits SRSF1 to increase TXNIP mRNA stability and promotes autophagy-dependent ferroptosis and apoptosis in myocardial ischemia-reperfusion injury.","authors":"Zhu Zhang, Jinqi Hao, Qinghong Qiao, Junting Song, Yanqin Yu","doi":"10.1186/s13019-024-03325-2","DOIUrl":"10.1186/s13019-024-03325-2","url":null,"abstract":"<p><strong>Background: </strong>Myocardial ischemia/reperfusion injury (MIRI) secondary to acute myocardial infarction (AMI) can lead to cardiomyocyte death and impaired cardiac function. Studies have confirmed that circular RNAs (circRNAs) play an important role in MIRI. In this study, the role and mechanism of circHIPK2 in MIRI were evaluated.</p><p><strong>Methods: </strong>Human cardiac myocytes (HCM) were cultured under Hypoxia/Reoxygenation (H/R) condition to establish a MIRI model in vitro. Expression of circHIPK2, SRSF1 and TXNIP was assessed using RT-qPCR. Protein levels of autophagy markers (LC3II/LC3I, Beclin1, p62) and ferroptosis markers (GPX4, FTH1, ACSL4) were detected by Western blot. Cell viability and apoptosis were assessed by CCK-8 and flow cytometry. Levels of oxidative stress markers (MDA, SOD) and inflammatory factors (IL-6, IL-1β, TNF-α) were tested by ELISA assay. Iron concentration was measured with an iron detection kit. Location of circHIPK2 in cells was detected by RNA-nucleosome separation assay. RIP and ChIP assays verified the relationship between circHIPK2, SRSF1 and TXNIP. TXNIP mRNA stability was dertermined by actinomycin D. Infarct area was examined by TTC staining in myocardial ischemia/reperfusion (I/R) mouse model. HE staining evaluated myocardial injury.</p><p><strong>Results: </strong>CircHIPK2 was increased in H/R-induced HCM cells. CircHIPK2 downregulation suppressed oxidative stress, inflammatory factors and autophagy-dependent ferroptosis in HCM cells induced by H/R. Additionally circHIPK2 recruited SRSF1 to target TXNIP and stabilized TXNIP mRNA expression. We further demonstrated that TXNIP upregulation overturned the therapeutic effects of circHIPK2 silencing on H/R model cells. In vivo, downregulation of circHIPK2 improved myocardial dysfunction caused by I/R.</p><p><strong>Conclusion: </strong>Our results demonstrate that circHIPK2 contributes to MIRI through inducing oxidative stress and autophagy-dependent ferroptosis via SRSF1/TXNIP axis, offering new insights into MIRI treatment.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"115"},"PeriodicalIF":1.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189568","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":"Long-term outcomes of drainless anatomical lung resection surgery for pulmonary malignancies.","authors":"Ting-Fang Kuo, Mong-Wei Lin, Ke-Cheng Chen, Shuenn-Wen Kuo, Pei-Ming Huang, Jang-Ming Lee","doi":"10.1186/s13019-024-03303-8","DOIUrl":"10.1186/s13019-024-03303-8","url":null,"abstract":"<p><strong>Objective: </strong>Drainless minimally invasive anatomical lung resection surgery for pulmonary malignancies is safe and feasible in terms of early postoperative outcomes. However, the quality of surgery in the long term remains uncertain. This study aimed to investigate the perioperative outcomes, 3-year overall, and disease-free survival rates of patients who underwent minimally invasive anatomical lung resection surgery with the drainless technique for pulmonary malignancies.</p><p><strong>Methods: </strong>Fifty-eight patients who underwent drainless minimally invasive anatomical lung resection surgery for pulmonary malignancies (36 -lobectomy; 22 -segmentectomy) between November 2017 and June 2022 by a single surgeon were enrolled. Patients' characteristics and perioperative, early postoperative, and long-term data were collected. The lymph node dissection stations and number, resection margin, 3-year overall and disease-free survival rates were assessed.</p><p><strong>Results: </strong>The median age was 64 years. Forty-four patients were females (76%) and forty-seven patients were non-smokers (81%). The median five-factor modified frailty index was 1. Most patients had primary lung cancer; four (7%), 43 (74%), seven (12%), and three (5%) had stage 0, I, II, and III, respectively. The median lymph node dissection stations was four, and the number was 17. The resection margin was free in 98% of the cases. The 3-year overall survival rate was 98.3% in all patients, and 97.2% and 100% in the lobectomy and segmentectomy subgroups, respectively. The 3-year disease-free survival rate was 85.3% in all patients and 80.5% and 92.9% in the lobectomy and segmentectomy subgroups, respectively.</p><p><strong>Conclusion: </strong>The drainless technique is safe and feasible for minimally invasive anatomical lung resection surgery for pulmonary malignancies in terms of early postoperative and long-term outcomes. However, further randomized controlled studies are warranted.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"114"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122902","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":"Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery.","authors":"Hao Xu, Xun Wu, Songjing Zhao, Zhenfan Wang, Guanchao Jiang, Yun Li, Jian Zhou","doi":"10.1186/s13019-024-03130-x","DOIUrl":"10.1186/s13019-024-03130-x","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative tracheobronchial injury is a rare but serious complication of lung surgery. With the increasing number of segmentectomies, surgeons need to locate finer and less easily identified segmental bronchi or even subsegmental bronchi. However, there is no simple or feasible method for visualizing the bronchus during surgery.</p><p><strong>Case presentation: </strong>Herein, we report a case in which indocyanine green (ICG) inhalation was used to visualize the pulmonary bronchus during video-assisted thoracoscopic surgery. The patient was a woman with a GGO located in the anterior segment of the right upper lobe, and thoracoscopic segmentectomy was scheduled. ICG (3.75 mg/ml) was inhaled into the lung on the operative side after single-lung ventilation for 5 min. During surgery, the anterior segmental bronchus was difficult to locate accurately. Under the overlay imaging window of the NIF imaging system, the bronchus was shown in green, indicating the bronchi in contrast to the surrounding lung tissue. We dissected the bronchi with the assistance of fluorescence imaging and were surprised to find that the bifurcation of the anterior and apical bronchi could be clearly identified by navigation via the inhaled ICG and NIF system. Segmentectomy was successfully performed, and no adverse events were recorded.</p><p><strong>Conclusion: </strong>This case showed that ICG nebulization is feasible and safe for visualizing the pulmonary bronchus during thoracoscopic surgery. This method has great application potential for reducing intraoperative tracheobronchial injury.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"113"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074533","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 enhanced chest CT with three-dimensional reconstruction combined with preoperative olive oil administration on the incidence of postoperative chylothorax: a retrospective study.","authors":"Xindong Luo, Di Lu, Ziqiang Wang, Jingyi Wang, Ruozhu Dong, Yaping Wang, Wei Cao, Dacheng Jin, Zhaohao Lin, Haochi Li, Pengcheng Du, Yunjiu Gou, Pengcheng Dong, Yayuan Yang","doi":"10.1186/s13019-024-03319-0","DOIUrl":"10.1186/s13019-024-03319-0","url":null,"abstract":"<p><strong>Background: </strong>Chylothorax is a rare but potentially life-threatening complication after esophageal cancer resection. This study aims to investigate the impact of a strategy combining preoperative three-dimensional (3D) reconstruction of contrast-enhanced chest CT with olive oil ingestion on the incidence of chylothorax following esophageal cancer resection.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 357 patients who underwent esophageal cancer resection in the Department of Thoracic Surgery at Gansu Provincial People's Hospital from January 2019 to June 2024. Among them, 179 patients who underwent preoperative 3D reconstruction of contrast-enhanced chest CT combined with oral olive oil administration were assigned to the 3D reconstruction group, while 158 patients who did not receive these interventions served as the control group. The primary outcome measures included the incidence of chylous leakage and related perioperative outcomes.</p><p><strong>Results: </strong>All patients in both groups underwent surgeries successfully without any perioperative deaths. Compared to the control group, the 3D reconstruction group exhibited a significant decrease in the incidence of postoperative chylothorax (0% versus 8.2%, P < 0.001). The visualization rate of the thoracic duct during surgery was higher in the 3D reconstruction group compared to the control group (93.85% vs. 48.73%). Furthermore, patients in the 3D reconstruction group had less intraoperative bleeding (P = 0.003), shorter postoperative hospital stays (P = 0.003), and reduced chest drainage in the first three postoperative days (P < 0.001).</p><p><strong>Conclusion: </strong>This study reveals that preoperative three-dimensional reconstruction of chest using enhanced CT allows for the anticipation of thoracic duct anatomy. Additionally, the combination of preoperative oral olive oil administration significantly enhances the intraoperative visualization of the thoracic duct. This integrated strategy effectively reduces the incidence of postoperative chylothorax, demonstrating promising clinical application prospects.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"112"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074528","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 behavior change theory-based nursing interventions on cardiac function recovery and quality of life among cardiac surgery patients with cardiopulmonary bypass.","authors":"Youwei Zhao, Wei Wei, Zhiyuan Wang, Yanbo Dong, Zhenyu Su, Shichao Guo","doi":"10.1186/s13019-024-03219-3","DOIUrl":"10.1186/s13019-024-03219-3","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the impact of nursing interventions, guided by behavior change theory, on the recovery of cardiac function and quality of life in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>A total of 120 patients scheduled for CPB in the Department of Cardiology at our hospital, from February 2021 to May 2023, were enrolled. According to the study protocol, patients were randomly assigned to either a control group (n = 60) or an observation group (n = 60) post-surgery. The control group received routine nursing care, while the observation group received nursing interventions based on behavior change theory, including health education, psychological support, and behavioral incentives. Informed consent was obtained from all patients. General patient data were collected from clinical records. Cardiac function was assessed using echocardiography. The wall motion score index (WMSI) and 6-minute walk distance (6MWD) were evaluated post-care. Serum levels of inflammatory cytokines TNF-α, IL-6, and IL-10 were measured via ELISA. Quality of life was assessed using the WHOQOL-BREF questionnaire, while anxiety and depression levels were evaluated using the HAM-A and HAM-D scales, respectively.</p><p><strong>Results: </strong>The baseline clinical characteristics and biochemical data of both groups were comparable (P > 0.05). The observation group showed a significantly higher left ventricular ejection fraction (LVEF) compared to the control group (P < 0.05), while both left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were significantly lower (P < 0.05). Additionally, the observation group had a significantly lower WMSI score and a longer 6MWD (P < 0.05). Regarding inflammatory markers, TNF-α and IL-6 levels were significantly reduced in the observation group, while IL-10 levels were significantly elevated compared to the control group (P < 0.05). In terms of quality of life, the observation group reported significantly higher scores in physical health, mental health, social relationships, and environmental factors (P < 0.05). Moreover, anxiety and depression levels were significantly lower in the observation group, as evidenced by reduced HAM-A and HAM-D scores (P < 0.05).</p><p><strong>Conclusion: </strong>Nursing care guided by behavior change theory significantly improves cardiac function and overall quality of life in patients recovering from cardiac surgery with CPB. This approach enhances LVEF, reduces left intraventricular diameter, lowers inflammatory cytokine levels, and improves mental health and social functioning. These findings underscore the importance of behavior change theory-based nursing interventions in optimizing postoperative recovery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"109"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074525","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}