Journal of Cardiothoracic Surgery最新文献

{"title":"Ketamine as part of multi-modal analgesia may reduce opioid requirements following cardiac surgery: a retrospective observational cohort study.","authors":"James Hall, Juri Chung, Michael Khilkin, George Elkomos-Botros","doi":"10.1186/s13019-025-03405-x","DOIUrl":"https://doi.org/10.1186/s13019-025-03405-x","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain control in cardiac surgery is often managed with opioid medications. Insufficient analgesia can result in complications including splinting, pneumonia, and delay of appropriate rehabilitation. Given the risks and adverse effects of opioids including sedation, respiratory depression, delirium, and decreased gastrointestinal motility, hyperalgesia and potential for addiction, strategies for opioid reduction are likely to improve outcomes, therefore multimodal opioid sparing pain regimens are preferred. Recently, there is increased evidence that low dose Ketamine, an N-methyl-D-Aspartate (NMDA) receptor antagonist, is safe and effective for analgesia in postoperative patients and may be appropriate to this setting.</p><p><strong>Methods: </strong>This is a single center, retrospective, observational, cohort study over a one year period involving postoperative adult cardiac surgery comparing those who received a single dose of postoperative ketamine, 0.3 mg/kg over 30 min, with those who did not receive any ketamine. Other analgesic protocols were similar between groups and did not include additional ketamine. A total of 120 patient charts were reviewed, of which 96 met inclusion criteria, 32 in the ketamine group and 64 in the standard care group. Charts were reviewed for opioid and other pain medication requirements during the postoperative period and on discharge, and for secondary outcomes: hospital length of stay, ICU length of stay, in-hospital and 30-day mortality, 30-day readmission, and rates of delirium, emergence reactions, and need for escalated respiratory support.</p><p><strong>Results: </strong>The group who received postoperative ketamine required 28.8 morphine milligram equivalents (MME) less postoperative opioid (90.1 mg vs 118.9 mg, p = 0.167), and was prescribed an average of 15.8 MME less on discharge (p < 0.001). Intraoperatively, both groups received 1000 mg acetaminophen, 2 mg intravenous morphine and 100 mcg fentanyl, 26 MME, by protocol. No ketamine was administered intraoperatively or preoperatively. The groups differed in respect to operation type and controlling for this parameter failed to achieve significance in needs during admission (p = 0.215), but remained significant on discharge (p = 0.02). The non-ketamine group received more ketorolac (15.5 vs 10.1, p = 0.06). The ketamine group required less acetaminophen but more gabapentin. There was no difference in hospital or ICU length of stay. There was no delirium or mortality in either group. Respiratory depression occurred in 15 patients who all subsequently received ketamine. No patient developed respiratory depression after ketamine.</p><p><strong>Conclusions: </strong>Ketamine may be a reasonable choice for postoperative cardiac surgery analgesia and may reduce the need for opioids on discharge, and possibly during admission.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"178"},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780084","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":"Observation of bronchial anatomy and variation of the middle lobe of the right lung based on three-dimensional reconstruction of lung CT.","authors":"Bin Zhao, Wenbo Wu, Guochen Duan","doi":"10.1186/s13019-025-03402-0","DOIUrl":"10.1186/s13019-025-03402-0","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the anatomical types and variations of lung segments and subsegment bronchi based on CT 3D reconstruction technology, and to provide anatomical theoretical support for thoracic surgeons in terms of surgical techniques.</p><p><strong>Methods: </strong>The 3D CT reconstructed images of 541 patients were retrospectively analyzed. We explored the anatomical structure of the bronchi in the middle lobe of the right lung, sorted out the variations, and classified them in detail according to different bronchial types.</p><p><strong>Results: </strong>In the CT 3D reconstruction of 541 patients, the bronchial anatomical types of the right middle lobe were divided into two types. There were 530 cases (98.0%) of two-branched type and 11 cases (2.0%) of three-branched type, and no four-branched type was found in the data of this paper. In addition, the spatial relationship between B₄ and B₅, and the spatial relationship between subsegmental bronchi B_4a, B_4b, B_5a, and B_5b are analyzed. The most common anatomical type and spatial relationship of the right middle lobe bronchi in the two-branched type were B₄ and B₅ in the external-internal relationship, B_4a and B_4b in the external-internal relationship, and B_5a and B_5b in the upper and lower relationship, and this subtype was 416 cases (76.9%). In addition, 23 cases (3.9%) were found to have a spatial relationship between B₄ and B₅ in the right middle lobe similar to the lingual bronchial subtype in the left upper lobe.</p><p><strong>Conclusion: </strong>We used a large number of CT 3D reconstructed images to explore the anatomical types and variations of the bronchi in the middle lobe of the right lung. Thoracic surgeons can use our data to guide increasingly delicate lobectomy and segmentectomy.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"172"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772510","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":"Application of modified neck drainage in the management of cervical anastomotic fistula in esophageal cancer patients.","authors":"Song Wu, Zhe Zhang, Zhonghua Qin","doi":"10.1186/s13019-025-03401-1","DOIUrl":"10.1186/s13019-025-03401-1","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic fistula is a rare but life-threatening complication of esophageal cancer, and its treatment remains challenging.We aimed to evaluate the clinical efficacy of modified cervical drainage in the management of cervical anastomotic fistula in patients after esophageal cancer surgery.</p><p><strong>Methods: </strong>From June 2017 to December 2021, 25 esophageal cancer patients who developed cervical anastomotic fistula were enrolled in the study. Among them, 14 patients were treated with modified cervical drainage, which served as the observation group, while the remaining 11 patients underwent open incision and drainage, which served as the control group. The treatment outcomes of the two groups were compared and analyzed.</p><p><strong>Results: </strong>The observation group had a significantly shorter healing time, fewer dressing changes, shorter hospital stay, and lower hospitalization costs compared to the control group (P < 0.05). The incidence of complications in the neck was not significantly different between the two groups (P > 0.05). All patients resumed a normal diet without experiencing fever, coughing or other discomfort, and were discharged after a smooth recovery.</p><p><strong>Conclusions: </strong>Modified neck drainage, as a treatment method for cervical anastomotic leakage in esophageal cancer patients, has preliminarily demonstrated potential in promoting patient recovery. However, its efficacy still requires further validation and confirmation through studies with larger sample sizes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"173"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772496","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":"Real-time blood gas management: evaluating quantum perfusion system's accuracy against a standard blood gas analysis in CPB.","authors":"Bahi Hyasat, Amjad Bani Hani, Ali Al Saraireh, Rana Al Kirmeen, Dina Sabha, Saif Yamin, Islam Massad, Ayman Hammoudeh","doi":"10.1186/s13019-025-03409-7","DOIUrl":"10.1186/s13019-025-03409-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Continuous blood gas monitoring (CBGM) during cardiopulmonary bypass (CPB) is essential for maintaining optimal patient outcomes, enabling rapid responses to critical fluctuations in blood gas parameters. This non-inferiority study evaluates the Quantum Perfusion System by Spectrum Medical, which features continuous online blood gas monitoring through Quantum workstation (QWS) and Quantum ventilation module (QVM) without the use of cuvettes, against the standard blood gas analysis (BGA) analyzer to assess real-time clinical accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included a sample of 40 patients, monitored continuously with the QPS and compared at intervals against standard BGA measurements. The patients undergoing on elective CPB procedures, specifically for coronary artery bypass grafting (CABG), mitral valve replacement (MVR), and aortic valve replacement (AVR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pre-alignment deviations for all parameters were within CLIA thresholds, confirming baseline reliability. For hemoglobin, the pre-alignment deviation was 1.9%, which decreased to 0.7% post-alignment, both within the CLIA threshold of ± 5%, with a Bland-Altman mean difference of 0.0988 g/dL (limits: 0.0963 to 0.1012 g/dL). Hematocrit showed a pre-alignment deviation of 2.1%, reduced to 0.2% post-alignment, both within the CLIA threshold of ± 5%, with a Bland-Altman mean difference of 0.3009% (limits: 0.2956 to 0.3063%). For PaO₂, the pre-alignment deviation was 3.9%, reduced to 0.4% post-alignment, both within the CLIA threshold of ± 10%, with a Bland-Altman mean difference of 4.0490 mmHg (limits: 3.9976 to 4.1004 mmHg). PCO₂ demonstrated a pre-alignment deviation of 4.2%, reduced to 0.19% post-alignment, both within the CLIA threshold of ± 10%, with a Bland-Altman mean difference of 0.3790 mmHg (limits: 0.3751 to 0.3829 mmHg). SvO₂ showed a pre-alignment deviation of 3%, which decreased to 0.8% post-alignment, both within the CLIA threshold of ± 5%, with a Bland-Altman mean difference of 0.7782% (limits: 0.7706 to 0.7858%). Finally, for SaO₂, the pre-alignment deviation was 2.6%, reduced to 0.1% post-alignment, both within the CLIA threshold of ± 5%, with a Bland-Altman mean difference of 0.9614% (limits: 0.9594 to 0.9634%). The Passing-Bablok regression analysis confirmed strong agreement, with slopes close to 1.0100 and intercepts near zero for all parameters. These results validate the QPS as a reliable and non-inferior tool for real-time blood gas monitoring during cardiopulmonary bypass, adhering to CLIA standards and ensuring clinical accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings support the accuracy of the Quantum Perfusion System compared to the BGA standard, demonstrating the system's capability to provide accurate, continuous blood gas monitoring during CPB. However, further studies are necessary to strengthen and confirm these results across broader and more varied clinica","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"176"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772512","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":"LncRNA FAM66C predicts poor prognosis in patients with lung adenocarcinoma and regulates cell proliferation and metastasis via miR-339-3p.","authors":"Xi Chen, Wenhui Xu, Yuan Shen, Anning Qi, Huiling Qin","doi":"10.1186/s13019-025-03374-1","DOIUrl":"10.1186/s13019-025-03374-1","url":null,"abstract":"<p><strong>Background: </strong>As one of the tumors with the highest fatality rates in the world, LUAD has a high risk of concealment, recurrence, and metastasis, which has turned into a significant issue in the medical community. To find possible treatment targets for LUAD, the study investigated the relationship between FAM66C and the prognosis of LUAD as well as the mechanism by which it interacts with miR-339-3p.</p><p><strong>Methods: </strong>Tissue samples and clinicopathological data were collected from 117 LUAD patients. Polymerase chain reaction assay was used to find FAM66C and miR-339-3p expression in LUAD tissues. Utilizing CCK-8, Transwell, and flow cytometry, the relationship between LUAD cell proliferation, migration, apoptosis, and FAM66C expression was assessed. The dual luciferase reporter gene assay was utilized to investigate the interaction between miR-339-3p and FAM66C. The prognostic potential and connection of FAM66C with clinicopathology were evaluated using the Chi-square test, Kaplan-Meier, and multivariate Cox regression analysis.</p><p><strong>Results: </strong>FAM66C expression was drastically reduced and miR-339-3p expression was upregulated in LUAD cells and tissues. There was a negative correlation between FAM66C and miR-339-3p. FAM66C inhibits the expression of miR-339-3p, and miR-339-3p can reverse the inhibitory impact of FAM66C on LUAD cells. FAM66c expression was substantially associated with clinical TNM stage and lymph node metastases When FAM66C expression is low, the prognosis of LUAD patients is bad.</p><p><strong>Conclusions: </strong>In conclusion, lower FAM66C expression can be utilized to predict the poor prognosis of LUAD, and FAM66C is negatively linked with miR-339-3p, which can influence cancer cell development by modulating miR-339-3p expression.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"175"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772499","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":"A rare case of right atrial perforation and pericardial tamponade following leakage of bone cement.","authors":"Renlang Liu, Zhirong Wang, Zhiwei Zhang, Hong You, Qi Ai, Wancun Jin, Qin Wu","doi":"10.1186/s13019-025-03403-z","DOIUrl":"10.1186/s13019-025-03403-z","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous vertebroplasty is commonly used to treats vertebral fractures, tumors, and osteolytic vertebral metastases. However, cement leakage during the procedure can lead to severe complications, including cardiac perforation. This report presents a case of right atrial perforation and pulmonary embolism caused by cement leakage, emphasizing the clinical significance of these events and discussing the treatment strategy.</p><p><strong>Case presentation: </strong>A 57-year-old female was admitted to the hospital with a slipped lumbar vertebra and back pain, for which she underwent percutaneous vertebroplasty. On the 10th postoperative day, the patient suddenly developed chest tightness and shortness of breath, accompanied by a gradual decline in hemoglobin levels. After several imaging studies, a diagnosis of right atrial perforation caused by bone cement was confirmed. The patient subsequently underwent open cardiac foreign body removal and made a full recovery, with no residual cardiac dysfunction.</p><p><strong>Conclusion: </strong>This case highlights the rare but serious complication of right atrial perforation caused by bone cement leakage during percutaneous vertebroplasty. The report emphasizes the importance of early identification of bone cement-related complications. While conservative management may suffice for pulmonary embolism, urgent surgical treatment is required for cardiac cement embolism to prevent further complications.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"174"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772492","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":"Reducing access complications in an interdisciplinary structural heart program.","authors":"Dinah Maria Berres, Markus Schlömicher, Boris Dickmann, Thomas Buck, Justus Thomas Strauch, Farhan Ahmad, Horatiu Coman, Peter Lukas Haldenwang","doi":"10.1186/s13019-025-03407-9","DOIUrl":"10.1186/s13019-025-03407-9","url":null,"abstract":"<p><strong>Background: </strong>Vascular (VC) and cardiac structural complications (CSC) are frequent complications following transcatheter aortic valve implantation (TAVI). Aim of this single-center retrospective study was to evaluate strategies for minimizing periprocedural access complications as part of an interdisciplinary structural heart program.</p><p><strong>Methods: </strong>Included were all patients who underwent TAVI between 09/2022 and 08/2023 at our institution. All procedures were performed by a heart team, consisting of a cardiovascular surgeon with peripheral vascular and interventional experience and an interventional cardiologist on site. Valvular type and size, access route and backup strategies were assessed by the heart team according to the preoperative CT-imaging. Baseline characteristics, periprocedural data, complications and 30-day outcomes were analyzed concerning the access route using Mann-Whitney-U-test or Fisher´s exact test.</p><p><strong>Results: </strong>Analyzed were 167 consecutive patients (81 (76-85) years; 53.3% male). 48 (28.7%) of these had severe peripheral artery disease. 130 (77.8%) procedures were performed via a percutaneous transfemoral approach, 13 (7.8%) via a femoral cut-down and 4 (2.4%) via a transaxillary access. For 20 procedures (11.9%) a transapical access was used. 106 patients (72%) with transvascular and all patients with transapical access received a balloon-expanding valve, whereas 41 (28%) patients with transvascular access received a self-expanding prosthesis. No coronary occlusion was seen. Annular rupture occurred in one patient (0.6%), valve displacement in two patients (1.2%). Totally 5 (3%) access femoral arteries were stented and 8 (4.8%) needed a surgical reconstruction. 30-day mortality was 2.99%.</p><p><strong>Conclusions: </strong>On site interventional and cardiovascular surgical expertise may minimize VC and CSC following TAVI.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"177"},"PeriodicalIF":1.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772515","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":"Multidisciplinary management of thoracic aortic injury with hemodynamically unstable pelvic fracture in the elderly.","authors":"Lei Wang, Huamin Ge, Ziyi Wang, Haiping Zhao, Yufang Zhang, Shouyin Jiang, Shanxiang Xu","doi":"10.1186/s13019-025-03391-0","DOIUrl":"10.1186/s13019-025-03391-0","url":null,"abstract":"<p><p>Blunt thoracic aortic injury (BTAI) is a critical clinical emergency often presenting as severe trauma. The early diagnosis and treatment of BTAI pose significant challenges in its management, especially when patients experience early-stage hemodynamic instability. Presently, in the context of multiple traumas, there is an absence of clearly-defined and comprehensive guidelines capable of accurately determining the optimal timing and sequence of interventions for aortic injuries. This issue is particularly prominent when aortic injuries are complicated by abdominal vascular injuries, which exacerbate hemodynamic instability. This study aims to present two distinct cases of patients with BTAI complicated by pelvic vascular injuries, resulting in hemodynamic instability. These cases were treated at different trauma centers. The successful treatment strategies included the implantation of covered stents for aortic repair and arterial embolization for pelvic vascular injuries. By sharing these cases, we intend to enhance the understanding of the complex management of such combined - injury situations. We underscore that comprehensive aortic computed tomography angiography (CTA) is of crucial importance in the early detection of aortic injuries and other major vascular injuries in high-energy trauma scenarios. Although regional trauma centers have demonstrated positive impacts on patient outcomes, the retrospective nature of this study and its limited sample size necessitate further large-scale research to validate our findings and proposed management strategies.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"171"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764055","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":"Deciphering myocardial fibrosis: a comprehensive bibliometric analysis of mechanism over the period 1992-2023.","authors":"Jiaojiao Zhang, Wenhui Wang, Zhen Wang, Meiqi Zhou, Shengbing Wu","doi":"10.1186/s13019-025-03404-y","DOIUrl":"10.1186/s13019-025-03404-y","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is a critical link in preventing the progression of heart disease. This study conducted a bibliometric analysis of its mechanism to identify trends and hotspots, aiming to provide valuable references for heart disease prevention and treatment.</p><p><strong>Methods: </strong>This research relies on the Web of Science Core Collection, capturing all related publications on the mechanism of myocardial fibrosis up to November 11, 2023. For the bibliometric analysis, CiteSpace 6.2.R5 (64-bit) and VOSviewer 1.6.19 software tools were utilized.</p><p><strong>Results: </strong>The mechanism of myocardial fibrosis research involves 14,931 authors from 2,370 institutions in 71 countries/regions, resulting in 2,431 published studies. Nattel Stanley is the most prolific author, while Francogianis Ng is noted for the highest co-publication frequency. The United States leads in countries/regions, with the University of California System being the top institution. Cardiovascular Research is a primary outlet for new studies, and Circulation is a key reference in this research community. Current research primarily examines how myocardial fibrosis contributes to heart failure, myocardial infarction, and myocardial hypertrophy. This emerging field also explores the role of fibroblasts in myocardial injury and investigates innovative treatments to reduce myocardial fibrosis.</p><p><strong>Conclusions: </strong>Preventing myocardial fibrosis is a crucial strategy in the fight against heart disease. This study utilises bibliometric analysis to explore the vast array of literature on the mechanism of myocardial fibrosis, mapping the research landscape and provide literature references for potential breakthroughs in heart disease prevention and treatment strategies.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"170"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742867","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":"Mediastinal A5: a novel artery variant of the pulmonary artery system: a case report.","authors":"Gang Li, Sheng Gong, Ning Wang, Yong Peng, Xiao-Jun Yao","doi":"10.1186/s13019-025-03399-6","DOIUrl":"https://doi.org/10.1186/s13019-025-03399-6","url":null,"abstract":"<p><strong>Background: </strong>Variations in the pulmonary artery require increased attention from thoracic surgeons prior to or during lobectomy to avoid severe intraoperative bleeding. Patients with pleural and/or hilar adhesions typically experience more intraoperative bleeding and need longer surgical time. Neglect of the variant pulmonary arteries in the context of strong adhesions may result a fatal bleeding, especially in patients with adhesions caused by pulmonary tuberculosis.</p><p><strong>Case presentation: </strong>A 52-year-old man who presented with tuberculoma and strong hilar adhesions of the right upper lobe underwent tri-portal video-assisted thoracoscopic(VATS) lobectomy in our department. In this case, we identified a variant pulmonary artery (mediastinal A5) through three-dimensional computed tomography bronchography and angiography(3D-CTBA). It was an artery that originated from the proximal pulmonary artery trunk, and coursed between the branches of central vein and V1 + 3. The precise identification of this mediastinal A5 artery ensured a safe surgery procedure (Right upper lobectomy) without severe intraoperative bleeding. It is the first report that illustrated a variant mediastinal A5. Misdiagnosis of this variant pulmonary artery may result in severe intraoperative bleeding. 3D-CTBA which could illustrate the variant pulmonary arteries is essential in planning the surgical procedures.</p><p><strong>Conclusion: </strong>3D-CTBA can help illustrating a variant pulmonary artery, and identification of the mediastinal A5 is essential in preforming right upper lobectomy.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"168"},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742872","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}