Journal of Cardiothoracic Surgery最新文献

{"title":"Comments on \"Into the future: first robotic totally endoscopic coronary artery bypass in Southeast Asia\".","authors":"Safa Özçelik","doi":"10.1186/s13019-026-04752-z","DOIUrl":"10.1186/s13019-026-04752-z","url":null,"abstract":"<p><p>We read with great interest the report describing the first robotic totally endoscopic coronary artery bypass (TECAB) in Southeast Asia. While this achievement deserves recognition, we believe several aspects-including revascularization strategy, prolonged operative and recovery times, and the lack of intraoperative transit-time flow measurement-require further clarification to accurately interpret the clinical significance of this pioneering experience.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181490","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":"Robotic-assisted versus conventional coronary artery bypass grafting: a systematic review, meta-analysis, and trial sequential analysis of 39,918 patients.","authors":"Ahmed Abdelsamad, Ibrahim Khalil, Mohammed Hrebat, Taher Abuawwad, Momen Zetawi, Basem Mohamed Yassin, Samer Imad Amayre, Mahmoud Ali Khazbak, Nadjet Laouadi, Shaimaa Khatib, Hamza Motaz Atalla, Layth Adnan Manasra, Abdellatif Qaraqe, Baraa Mansour, Tarig Mohamed Abdelatief Abdeldaim, Tamer Ghazy","doi":"10.1186/s13019-026-04684-8","DOIUrl":"10.1186/s13019-026-04684-8","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted coronary artery bypass grafting (RA-CABG) is an evolving minimally invasive alternative to conventional CABG (C-CABG), but comparative evidence remains fragmented. We conducted a comprehensive systematic review, meta-analysis, and trial sequential analysis to compare outcomes between RA-CABG and C-CABG.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, we searched PubMed, Embase, Cochrane CENTRAL, and Web of Science through January 2026. Studies comparing RA-CABG to C-CABG reporting at least one outcome of interest were eligible. Random-effects meta-analyses using DerSimonian-Laird estimators were performed. Risk of bias was assessed using ROBINS-I. Trial sequential analysis evaluated the conclusiveness of cumulative evidence.</p><p><strong>Results: </strong>Nine studies comprising 39,918 patients (13,638 RA-CABG; 26,280 C-CABG) were included. All included studies were observational in design, and long-term outcome data were sparse. RA-CABG was associated with significantly lower mortality (OR 0.55, 95% CI 0.43-0.69; P < 0.001; I²=0%), atrial fibrillation (OR 0.53; P < 0.001), respiratory failure (OR 0.31; P < 0.001), blood transfusion (OR 0.28; P < 0.001), hospital length of stay (MD - 1.95 days; P < 0.001), and ICU stay (MD - 22.7 h; P < 0.001). Stroke showed a non-significant trend favoring RA-CABG (OR 0.76; P = 0.071). Trial sequential analysis confirmed conclusive evidence for mortality, atrial fibrillation, respiratory failure, and blood transfusion. Results were robust across sensitivity analyses.</p><p><strong>Conclusions: </strong>In this meta-analysis of observational studies, RA-CABG was associated with significantly improved short-term outcomes compared to C-CABG across multiple endpoints, with conclusive statistical evidence for four of seven binary outcomes. However, all included studies were observational, and these associations should be interpreted with caution given potential residual confounding and case-selection bias. Multicenter randomized trials with long-term follow-up are needed to confirm these findings.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168968","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":"Preoperative levels of biomarkers of coagulation to predict massive bleeding after surgical repair for acute type A aortic dissection: a retrospective cohort study.","authors":"Emilia Norén, Jacob Ede, Mårten Larsson, Shahab Nozohoor, Johan Sjögren, Karl Teurneau-Hermansson","doi":"10.1186/s13019-026-04692-8","DOIUrl":"10.1186/s13019-026-04692-8","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection is a highly emergent condition with a high mortality rate. The condition poses an imminent risk of serious complications such as coagulopathy with massive bleeding. This increases the risk of mortality even after surgical repair. Procoagulant drugs are routinely administered but some patients still suffer postoperative massive bleeding that can be fatal. The study aimed to investigate whether massive bleeding after surgical treatment for type A aortic dissection can be predicted preoperatively through routine coagulation tests such as APTT, PT (INR), fibrinogen, D-dimer, and platelets.</p><p><strong>Methods: </strong>The study was a retrospective, single-center, cohort study performed at a tertiary cardiac surgery unit. A total of 474 patients who underwent surgery for type A aortic dissection at our department between January 2005 and May 2023 were included in the study. Of these, 87 patients had massive postoperative bleeding after surgery for type A aortic dissection and were compared to 387 patients who did not have massive postoperative bleeding. Uni- and multivariable analyses were performed using logistic regression. The multivariable model included predictors of massive bleeding. Bleeding-related routine lab variables were then forced into the model.</p><p><strong>Results: </strong>Patients with massive bleeding (18%) had higher preoperative activated partial thromboplastin time (APTT) (33 s vs 29 s, p<0.01), and creatinine (97 µmol/L vs 87 µmol/L, p<0.01), as well as lower preoperative platelet counts (172 × 10⁹/L vs 187 × 10⁹/L, p=0.03) compared to patients without massive bleeding. Patients with massive bleeding also had longer duration of cardiopulmonary bypass (CPB) (221 min vs 170 min, p<0.01) and suffered more postoperative complications. Multivariable logistic regression identified preoperative APTT per mmol increment (OR 1.04 (95% CI 1.01-1.07, p=0.01), preoperative APTT > 34.5 s (OR 2.95 (95% CI 1.60-5.47), p<0.01), preoperative creatinine > 82.5 µmol/L (OR 2.16 (95% CI 1.15-4.06), p=0.02), hypertension (OR 1.83 (95% CI 1.01-3.32), p<0.05) and CPB time per 10 min increment (OR 1.09 (95% CI 1.05-1.13, p<0.01)) as independent predictors of massive bleeding.</p><p><strong>Conclusion: </strong>Preoperative APTT exceeding 34.5 s was independently associated with massive bleeding after type A aortic dissection repair and may, pending prospective validation, help identify patients who could potentially benefit from earlier hemostatic intervention.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171359","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":"Correction: Temporal epidemiological characteristics of acute aortic dissection incidence patterns in east China: a retrospective analysis of 1,038 patients.","authors":"Fei Sun, Haiyan Wang, Teng Cai, Lijun Gan, Yuntao Cheng, Fanhua Meng","doi":"10.1186/s13019-026-04683-9","DOIUrl":"10.1186/s13019-026-04683-9","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074618","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":"Correction: Network pharmacology and experimental evaluation of Sanwei Tanxiang Tangsan in doxorubicin-induced heart failure.","authors":"Aruna, Dulan, Davaadagva Damdinjav, Battulga Tungalag, GuiZhi, Hua Li","doi":"10.1186/s13019-026-04682-w","DOIUrl":"10.1186/s13019-026-04682-w","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074608","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":"SCTS Annual Meeting 2025: Abstracts.","authors":"","doi":"10.1186/s13019-026-03838-y","DOIUrl":"10.1186/s13019-026-03838-y","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 Suppl 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061180","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":"Correction: Outcome of transcarotid transcatheter aortic valve replacement with balloon expandable valve.","authors":"Chikashi Nakai, Nikhil Azhagiri, Junyi Liu, Mei Xing G Zuo, Saeed Tarabichi, Eduardo Danduch, Augustion DeLago, Sanjay Samy","doi":"10.1186/s13019-026-04681-x","DOIUrl":"10.1186/s13019-026-04681-x","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897397","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":"SNAI2/SLUG: a key regulator of endothelial-to-mesenchymal transition and vascular remodeling in cardiovascular diseases.","authors":"Tong Yang, Zihao Liu, Haoyu Ran, Cheng Zhang, Qingchen Wu, Jun Xu","doi":"10.1186/s13019-026-04287-3","DOIUrl":"10.1186/s13019-026-04287-3","url":null,"abstract":"<p><p>Snail family transcriptional repressor 2 (SNAI2), also known as SLUG, is a canonical driver of epithelial-mesenchymal transition (EMT). While its oncogenic roles are well-established, emerging evidence underscores its pivotal involvement in cardiovascular diseases (CVDs). This review systematically summarizes the multifaceted functions of SNAI2 in the cardiovascular system, highlighting its role in mediating endothelial-to-mesenchymal transition (EndMT) and vascular smooth muscle cell (VSMC) phenotypic reprogramming. We detail the involvement of SNAI2 across a spectrum of pathologies, including atherosclerosis, aortic aneurysm, valvular heart disease, myocardial fibrosis, and pulmonary arterial hypertension. By acting as a critical nexus in signaling networks such as TGF-β, Notch, and Wnt, SNAI2 regulates cellular fate and extracellular matrix remodeling under pathological stress. Finally, we discuss the potential of SNAI2 as a diagnostic biomarker and a novel therapeutic target, offering prospective insights for the clinical management of CVDs.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880439","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":"Right atrial thrombus and pulmonary embolism one year after ventricular septal defect patch repair: successful surgical management of a complicated case.","authors":"Osama Abouelfetouh Elshaer, Mahmoud Gomaa, Mohamed Elsayed Abdelfattah, Mohamed Kamal Salama, Mohammad Ali Hammad","doi":"10.1186/s13019-026-04582-z","DOIUrl":"10.1186/s13019-026-04582-z","url":null,"abstract":"<p><strong>Background: </strong>Right heart thrombi are rare but life-threatening, with particularly high mortality when accompanied by pulmonary embolism (PE). Cardiac surgery may predispose to in-situ thrombus formation via suture lines or patch material, yet thromboembolic risk and preventive strategies following Ventricular Septal Defect (VSD) repair remain unclear. Here, we report a case of a young patient with a massive right atrial (RA) thrombus with PE one year after VSD repair in the absence of any known hypercoagulable state.</p><p><strong>Case presentation: </strong>A 17-year-old male with a history of surgical VSD repair one year earlier, who was not taking any antithrombotic therapy prior to presentation, presented with acute dyspnea, tachycardia, and severe hypoxia. Transthoracic echocardiography revealed a large, freely mobile RA mass. Subsequent CT pulmonary angiography and cardiac magnetic resonance confirmed a massive right pulmonary artery embolus and characterized the RA mass as an intracardiac thrombus. Because of clinical deterioration despite therapeutic anticoagulation, he underwent a successful urgent cardiac surgery with RA mass excision and pulmonary embolectomy. Postoperative histopathology confirmed the mass to be a thrombus.</p><p><strong>Conclusions: </strong>Our case highlights a rare late RA thrombus with PE one year after surgical VSD repair, requiring urgent surgery. Further research is needed to clarify post-VSD closure surveillance and thromboprophylaxis strategies.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857438","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":"Ruptured pulmonary arteriovenous malformation causing hemothorax during pregnancy: a case report.","authors":"Xueqian Wang, Bing Liu, Lianghai Cao","doi":"10.1186/s13019-026-04630-8","DOIUrl":"10.1186/s13019-026-04630-8","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly. During pregnancy, physiological hemodynamic changes and hormonal fluctuations substantially increase the risk of PAVM rupture. Spontaneous hemothorax secondary to ruptured PAVM is extremely uncommon and often presents with nonspecific manifestations, frequently resulting in misdiagnosis and delayed treatment.</p><p><strong>Case presentation: </strong>A 33-year-old woman at 31^+ 6 weeks of gestation presented to the emergency department with a 30-minute history of sudden-onset left-sided chest pain radiating to the shoulder and back. Initial vital signs were relatively stable; however, progressive hypoxemia developed after admission. Following multidisciplinary consultation, using Triple-Rule-Out Computed Tomography Angiography (TRO-CTA) protocol demonstrated rupture of an aneurysmally dilated pulmonary arteriovenous malformation (PAVM) in the left lower lobe, complicated by hemothorax. Emergency transcatheter pulmonary artery embolization was successfully performed, resulting in rapid hemostasis and clinical stabilization. The pregnancy was subsequently continued, and a healthy neonate was delivered at 36 weeks of gestation.</p><p><strong>Conclusions: </strong>Pregnancy increases the risk of PAVM rupture and hemorrhage. Clinicians working in emergency settings should be aware of this rare but potentially fatal condition. Triple-Rule-Out Computed Tomography Angiography (TRO-CTA) is a valuable modality for both diagnosis and therapeutic planning, and transcatheter embolization represents an effective treatment option for this life-threatening complication.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"21 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030557","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}