Journal of Cardiothoracic Surgery最新文献

{"title":"Augmented reality-assisted infraclavicular first rib resection for arterial and venous thoracic outlet syndrome: a case series.","authors":"Ryogo Furuhata, Atsushi Tanji, Yuki Yamai, Taku Suzuki","doi":"10.1186/s13019-025-03665-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03665-7","url":null,"abstract":"<p><strong>Background: </strong>The infraclavicular approach is a surgical approach for vascular thoracic outlet syndrome (TOS). However, difficulty in accessing the posterior aspect of the first rib may cause insufficient decompression. To address this problem, we used augmented reality (AR) technology to intraoperatively visualize and determine the extent of rib resection. This study aimed to introduce AR-assisted infraclavicular first rib resection for arterial or venous TOS and report its clinical outcomes.</p><p><strong>Methods: </strong>AR-assisted rib resection was introduced in our unit in 2022. Using an infraclavicular approach, we performed first rib resection and scalenectomy with the assistance of endoscopy. We compared the edge of the intraoperatively resected rib with the resection area of the preoperative simulation displayed in the AR to determine the extent of the resection.</p><p><strong>Results: </strong>Six patients who underwent AR-assisted rib resection for arterial or venous TOS had excellent or good Derkash scores at 1 year postoperatively. Postoperative angiography revealed no subclavian vessel stenosis.</p><p><strong>Conclusions: </strong>AR technology enables intraoperative three-dimensional assessment of the location of major vessels and the extent of resection, which may contribute to improved outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"378"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345436","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":"A case of twin pregnancy with \"precious fetuses\" complicated by DeBakey type I aortic dissection.","authors":"Jianbo Xue, Yiming Ni, Jianbang He, Junsa Zhu","doi":"10.1186/s13019-025-03650-0","DOIUrl":"https://doi.org/10.1186/s13019-025-03650-0","url":null,"abstract":"<p><p>Aortic dissection during pregnancy is exceedingly rare yet life-threatening, presenting substantial risks to both the mother and fetus. Prompt diagnosis and intervention are critical for effective management. This report describes the case of a 37-year-old woman, pregnant with twins via assisted reproductive technology, who presented with sudden chest pain. Upon admission, she was diagnosed with a type I aortic dissection (DeBakey classification). Due to progressive fetal distress, an emergency cesarean section was performed, along with a simplified hysterectomy and aortic repair. Both the mother and infants were discharged in stable condition one month postoperatively. While the optimal treatment for acute type I aortic dissection in pregnancy remains controversial, this case demonstrates that aggressive surgical intervention, combined with careful perioperative management, can effectively safeguard the lives of the mother and fetus.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"380"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345404","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":"Relapsing polychondritis with catastrophic tracheal injury: extracorporeal membrane oxygenation and silicone Y-stenting for salvage therapy.","authors":"I-Chun Kuo, Pin-Li Chou, Yu-Ting Cheng, Jia-Shiuan Ju, Yu-Hsuan Tsai, Yun-Hen Liu, Chien-Hung Chiu","doi":"10.1186/s13019-025-03627-z","DOIUrl":"https://doi.org/10.1186/s13019-025-03627-z","url":null,"abstract":"<p><strong>Background: </strong>Airway injury is a life-threatening condition requiring immediate intervention. Tracheal perforation in patients with relapsing polychondritis (RP) and tracheobronchomalacia (TBM) is extremely rare, posing significant management challenges. Here, we describe the successful placement of a silicone Y-stent via rigid bronchoscopy under venovenous extracorporeal membrane oxygenation (ECMO) to address this complex clinical scenario.</p><p><strong>Case presentation: </strong>We present the case of a 29-year-old female with RP and tracheostomy tube dependence who developed tracheal rupture, resulting in acute respiratory failure. To stabilize her condition, venovenous ECMO was initiated, and a silicone Y-stent was successfully placed via rigid bronchoscopy. The patient achieved full recovery, and the stent was removed 10 months later, revealing complete airway healing.</p><p><strong>Conclusions: </strong>This case highlights the effectiveness of silicone Y stenting and venovenous ECMO as viable salvage strategies for severe airway injuries in RP patients. Our findings demonstrate the safety and feasibility of this approach in managing complex airway conditions, offering a potential treatment option for similar cases.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"384"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345437","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":"Combined with chemotherapy and radiotherapy is effective in improving prognosis: a case of primary mediastinal embryonal carcinoma.","authors":"JiaRong Yuan, SiYi Wang, ZiYi He, HaiTao Huang, GuangBin Li","doi":"10.1186/s13019-025-03619-z","DOIUrl":"https://doi.org/10.1186/s13019-025-03619-z","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"385"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345432","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":"Post-operative and long-term outcomes in dialysis and non-dialysis patients undergoing on-pump and off-pump CABG: a nationwide cohort analysis.","authors":"Chia-Hsun Lin, Chung-Kuan Wu, Vy-Khanh Nguyen, Chien-Wei Chuang, Mingchih Chen","doi":"10.1186/s13019-025-03615-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03615-3","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass grafting (CABG) is commonly recommended for patients with severe coronary artery disease (CAD). However, the current literature lacks consensus on whether on-pump or off-pump CABG provides superior outcomes between dialysis and non-dialysis patients.</p><p><strong>Methods: </strong>This nationwide retrospective cohort study analysed the demographic and comorbid data of 31,016 participants in Taiwan between January 1, 2006 and December 31, 2015. CAD patients who had undergone CABG were stratified by presence of dialysis and the procedure type into the following four groups: non-dialysis, on-pump; non-dialysis, off-pump; dialysis, on-pump; and dialysis, off pump. Study outcomes included postoperative complications and long-term follow-up.</p><p><strong>Results: </strong>Non-dialysis on-pump CABG patients experienced worse postoperative outcomes including higher mortality, longer hospital stays, and increased mechanical ventilation use, compared to non-dialysis off-pump CABG patients. Similar trends were observed between the dialysis on-pump CABG and off-pump CABG groups. Cox regression analysis revealed a lower risk of myocardial infarction (MI) and percutaneous coronary intervention (PCI) but higher mortality among non-dialysis on-pump CABG patients (hazard ratio [HR], 0.911, 0.828, and 1.530; 95% confidence interval [CI], 0.850-0.977, 0.761-0.901, and 1.445-1.621; respectively] compared to non-dialysis off-pump CABG patients. In the dialysis population, on-pump CABG patients showed a higher risk of MI and mortality but lower PCI risk than did dialysis off-pump patients (HR, 1.044, 1.262, and 0.724; 95% CI, 0.824-1.322, 1.107-1.439, and 0.582-0.902; respectively). Five-year Kaplan-Meier analysis revealed similar trends.</p><p><strong>Conclusions: </strong>Off-pump CABG was generally associated with better mortality outcomes in both non-dialysis and dialysis populations.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"379"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345379","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":"Pulmonary endarterectomy and lung resection achieving therapeutic success in rarely encountered large cavitary infarctions following pulmonary embolism: a case report.","authors":"Lubna Bakr, Milka Latinović, Joseph Daniel Sumner, Giuseppe Aresu","doi":"10.1186/s13019-025-03418-6","DOIUrl":"https://doi.org/10.1186/s13019-025-03418-6","url":null,"abstract":"<p><strong>Background: </strong>Cavitary infarction following pulmonary embolism is a rare condition associated with high mortality. Surgical intervention is mainly indicated in cases where medical therapy has failed. Although previous reports have shown promising results of surgical management, we have found only 15 cases reported in the literature where surgery was undertaken. To the best of our knowledge, we report the first case in which pulmonary endarterectomy combined with lung resection were successfully performed to manage this rare high-risk condition.</p><p><strong>Case presentation: </strong>44-year-old man presented with a 2-week history of cough, fever, nausea and vomiting, as well as significant weight loss. Investigations revealed cavitating lesions and acute pulmonary embolism for which he was initially started on antibiotics and anticoagulation, followed by surgery. This included right upper lobectomy, wedge resection from the right lower lobe, and pulmonary endarterectomy. He was discharged home in satisfactory condition on his 13th postoperative day.</p><p><strong>Conclusions: </strong>In this case, early surgery demonstrated both safety and efficacy in managing this high-risk rare condition. Involving the multi-disciplinary team and combining surgical intervention with appropriate antibiotics and anticoagulation regimes in a multi-modal approach is key to offer the best management to this group of sick patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"383"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345415","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":"Effects of mannitol on cardiac function and postoperative arrhythmias after coronary artery bypass grafting: a randomized controlled trial.","authors":"Masumeh Hemmati Maslakpak, Sohrab Negargar, Ali Farbod, Solmaz Fakhari, Ahmadali Khalili, Eisa Bilejani, Vahid Alinejad, Amir Faravan","doi":"10.1186/s13019-025-03640-2","DOIUrl":"https://doi.org/10.1186/s13019-025-03640-2","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative cardiac dysfunction and arrhythmias are significant complications following cardiac surgery, frequently resulting in increased mortality, longer hospital stays, higher healthcare costs, and diminished patient quality of life. This study investigates the effects of mannitol on cardiac function and the incidence of postoperative arrhythmias after coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>In a single-center, double-blind, randomized controlled trial, ninety patients undergoing elective on-pump CABG were randomly assigned (1:1) to receive either 200 mL of mannitol 20% (n = 45) or 200 mL of lactated Ringer's solution (n = 45) during cardiopulmonary bypass priming. Postoperative assessments included cardiac enzyme levels (creatine phosphokinase, creatine kinase-MB isoenzyme, and cardiac troponin I), incidence of arrhythmias (atrial fibrillation, ventricular fibrillation, ventricular tachycardia), and left ventricular ejection fraction. Statistical significance was defined as a p-value < 0.05.</p><p><strong>Results: </strong>No significant differences were observed between the mannitol and control groups in baseline demographics or clinical risk factors (p > 0.05). Left ventricular ejection fraction was similar between the groups (45.22 ± 9.82 in the mannitol group vs. 42.66 ± 7.94 in the control group; p = 0.178). Atrial fibrillation occurred in 9 of 45 patients (20%) in the mannitol group and 12 of 45 (26.7%) in the control group (p = 0.309). Ventricular tachycardia was observed in 2 of 45 (4.4%) vs. 4 of 45 (8.9%) patients, respectively (p = 0.338). Thirty-day mortality was 2 of 45 (4.4%) in the mannitol group and 1 of 45 (2.2%) in the control group (p = 0.50). Cardiac enzyme levels (CPK, CK-MB, and cTnI) showed no significant differences between groups (p > 0.05). However, ventricular fibrillation occurred in 2 of 45 patients (4.4%) in the mannitol group versus 8 of 45 (17.8%) in the control group, a statistically significant difference (p = 0.045).</p><p><strong>Conclusions: </strong>In conclusion, while mannitol was associated with a lower incidence of ventricular fibrillation, this is a single-center study with limited power to detect differences in other outcomes. Further studies with larger sample sizes are needed to confirm these findings.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"376"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345426","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 first case of diaphragm pacing system implantation in a patient with high cervical spinal cord injury in taiwan: a case report and literature review.","authors":"Yi-Hsiang Lai, Kuan-Hsun Lin, Hsu-Kai Huang, Tsai-Wang Huang, Yen-Shou Kuo","doi":"10.1186/s13019-025-03607-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03607-3","url":null,"abstract":"<p><strong>Introduction: </strong>This report presents the first case of a patient with high cervical spinal cord injury who underwent successful laparoscopic implantation of a diaphragm pacing system in Taiwan. It also compares the pros and cons of laparoscopic and thoracoscopic implantation and discusses postoperative care.</p><p><strong>Background: </strong>The diaphragm pacing system (DPS) represents a substantial advancement in respiratory support technology, particularly for patients with chronic respiratory insufficiency. It electrically stimulates the phrenic nerve, which in turn activates the diaphragm-the primary muscle involved in respiration [1]. This stimulation mimics the natural neural impulses that drive diaphragmatic contractions, thereby promoting inhalation and a more efficient lung ventilation. The DPS typically consists of implanted electrodes, an external pulse generator, and connecting leads [2]. It is mainly used in patients with high spinal cord injuries, amyotrophic lateral sclerosis, and central hypoventilation syndrome. These conditions often result in compromised neural control of the diaphragm, leading to severe respiratory insufficiency. By restoring diaphragm function, DPS can enhance the patients' quality of life, reduce dependence on mechanical ventilators, and lower the risk of ventilator-associated complications [3]. Despite its benefits, DPS is not without challenges. Patient selection and the surgical approach are critical to perform successful DPS implantation for the restoration of diaphragm function [4]. This report presents the first case of a patient with cervical spine injury who underwent successful laparoscopic implantation of DPS in Taiwan. Furthermore, it discusses postoperative ICU care and reviews the pros and cons of different surgical approaches to performing DPS implantation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"377"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345375","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":"Near-infrared intraoperative fluorescence imaging using indocyanine green in thoracic duct ligation surgery in patients with chylothorax.","authors":"Hongan Shao, Saiguang Ji, Yue Yao, Hong Liu","doi":"10.1186/s13019-025-03591-8","DOIUrl":"https://doi.org/10.1186/s13019-025-03591-8","url":null,"abstract":"<p><p>Surgery is an effective treatment for chylothorax, particularly in cases of high-output chylothorax. However, precisely locating the thoracic duct for ligation and observing the surgical outcomes intraoperatively remains a challenge for surgeons. In this study, we demonstrated the feasibility of using Near-infrared (NIR) fluorescence imaging for thoracic duct ligation following indocyanine green (ICG) injection. Five patients with chylothorax who underwent surgery at our center were retrospectively included in this study. Of these, two had postoperative chylothorax following esophageal cancer surgery, one had postoperative chylothorax following lung cancer surgery, and two had spontaneous chylothorax. All patients received inguinal lymph node injections of ICG and subsequently underwent thoracic duct ligation under NIR-guided video-assisted thoracoscopic surgery (VATS) after anesthesia. All patients underwent NIR-guided ICG injection followed by VATS thoracic duct ligation. Four patients were operated on via the right side and one via the left side. The mean operative time was 62 min, the mean SBR value was 4.19, the mean postoperative drainage was 229.6 ml/day, the mean duration of postoperative chest drainage was 6.2 days, and the mean hospital stay was 17.8 days. None of the patients experienced recurrence of chylothorax postoperatively or during follow-up. In conclusion, NIR combined with ICG injection is highly effective in exploring and exposing the thoracic duct, as well as in determining the surgical outcome of thoracic duct ligation in real time.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"381"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344959","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":"Surgical myectomy might inhibit ascending aortic dilation in obstructive hypertrophic cardiomyopathy: a serial cardiac magnetic resonance study.","authors":"Changpeng Song, Xinli Guo, Xinxin Zheng, Jie Lu, Jingang Cui, Shuiyun Wang, Xiaohong Huang","doi":"10.1186/s13019-025-03592-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03592-7","url":null,"abstract":"<p><strong>Background: </strong>The impact of septal myectomy on the progression of ascending aortic (AAo) dilation in patients with obstructive hypertrophic cardiomyopathy (HOCM) remains uncertain. This study aimed to investigate the relationship between septal myectomy and AAo dilation in HOCM patients.</p><p><strong>Methods: </strong>A total of 69 patients with HOCM were enrolled. All the participants underwent sequential cardiac magnetic resonance scans at a mean interval of 5.13 ± 2.04 years, with each scan being more than 3 years apart.</p><p><strong>Results: </strong>At baseline, 17 patients with HOCM (25%) exhibited AAo dilation (Indexed AAo dimension > 19 mm/m²). Age (OR 1.10, 95%CI: 1.01-1.019, P = 0.026) and female (OR 4.80, 95%CI: 1.05-21.93, P = 0.043) were independently associated with AAo dilation. In patients who underwent myectomy, the AAo dimension at follow-up was similar to that at baseline (32.47 ± 4.70 mm vs. 32.81 ± 5.06 mm, P = 0.197). Furthermore, the rate of AAo dilation was lower in patients with myectomy compared to those without myectomy (-0.06 ± 0.38 mm/year vs. 0.18 ± 0.43 mm/year, P = 0.016). Additionally, moderate or severe mitral regurgitation was significantly associated with AAo dilation rate (B = 0.273, P = 0.032).</p><p><strong>Conclusions: </strong>Myectomy in patients with HOCM was associated with the absence of progression of AAo dilatation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"382"},"PeriodicalIF":1.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345345","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}