Journal of Cardiothoracic Surgery最新文献

{"title":"Investigation of risk factors and outcomes of aortic arch aneurysm repair in octogenarians.","authors":"Tomoki Cho, Keiji Uchida, Shota Yasuda, Yasuko Onakatomi, Kenichi Fushimi, Shotaro Kaneko, Tomoyuki Minami, Aya Saito","doi":"10.1186/s13019-025-03417-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03417-7","url":null,"abstract":"<p><strong>Objective: </strong>We reviewed the treatment outcomes for aortic arch aneurysms in elderly patients aged > 80 years, and discussed the risk factors for each technique.</p><p><strong>Methods: </strong>Octogenarians who underwent aortic arch aneurysm repair between 2007 and 2021 were included. Fifty-four patients (23 in the total arch replacement [TAR] group and 31 in the thoracic endovascular aortic repair [TEVAR] group) were included in the study. The early- and mid-term outcomes and risk factors for all-cause mortality were examined in each group. To examine timely surgical outcomes, cases of true aneurysms were included, whereas dissected aneurysms and emergency cases due to rupture or other causes were excluded.</p><p><strong>Results: </strong>No significant differences in 30-day mortality (0% in the TAR group and 5.4% in the TEVAR group) and in-hospital mortality (7.7% in the TAR group and 8.1% in the TEVAR group) were observed between the two groups. The survival rates at 5 years were 82% and 65% in the TAR and TEVAR groups, respectively, without significant difference. The aorta-related averted mortality was 91% and 81% in the TAR and TEVAR groups, respectively, without significant difference. No significant difference in the freedom from aortic events was also observed between the two groups. Previous ischemic heart disease was a significant risk factor for all-cause mortality in the TAR group. No significant risk factors were identified in this group.</p><p><strong>Conclusion: </strong>The choice of procedure was reasonable when considering frailty. Endovascular repair may be a good treatment option for patients with a history of ischemic heart disease.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"220"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023340","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":"Nomogram model for the preoperative prediction of spread through air spaces in sub-centimeter non-small cell lung cancer.","authors":"Xiao Wang, Jingwei Shi, Zhengcheng Liu","doi":"10.1186/s13019-025-03441-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03441-7","url":null,"abstract":"<p><strong>Introduction: </strong>To construct and validate a nomogram risk prediction model based on clinical characteristics and radiological features to predict spread through air spaces (STAS) of stage IA sub-centimeter non-small cell lung cancer.</p><p><strong>Methods: </strong>112 patients who underwent surgical treatment in Nanjing Drum Tower Hospital with pathologically diagnosed stage IA sub-centimeter non-small cell lung cancer were retrospectively collected. The training cohort and the validation cohort were chosen in a 7:3 ratio. Based on the presence or absence of STAS in pathology results, they were divided into STAS positive and STAS negative groups. The independent risk predictors of STAS in clinical characteristics and radiological features were selected by univariate and multivariate logistic regression analysis and then used to construct a nomogram. The sensitivity and specificity were calculated based on the Youden index, area under the curve (AUC), calibration curves and decision curve analysis (DCA) were used to evaluate the performance of the model.</p><p><strong>Results: </strong>The incidence of STAS in the training cohort was 17.9%. Univariate logistic regression analysis showed that male, anti-GAGE7 antibody positive and mean CT value were associated with the occurrence of STAS; multivariate logistic regression analysis showed that male (OR = 7.900, 95%CI: 1.502-41.545), anti-GAGE7 antibody positive (OR = 10.065, 95%CI: 1.256-80.659) and mean CT value (OR = 1.009, 95%CI: 1.004-1.014) were independent predictors for STAS. The nomogram based on the above factors achieved good predictive performance for STAS with AUC was 0.897 (sensitivity was 0.929, specificity was 0.781) in the training cohort and 0.860 in the validation cohort. The calibration curve and DCA validated the good performance of the model.</p><p><strong>Conclusion: </strong>The nomogram model established in this study had good predictive performance for STAS status of sub-centimeter lung cancer, and provide reference significance for preoperative planning of patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"218"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992790","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":"Complete obstruction of proximal left ascending artery in a very young woman with Kawasaki: a case report and literature review.","authors":"Pouya Ebrahimi, Mohammad Hossein Mandegar, Amir Nasrollahizadeh, Parnian Soltani, Hamidreza Soleimani, Pedram Ramezani, Fatemeh Naderi","doi":"10.1186/s13019-025-03454-2","DOIUrl":"https://doi.org/10.1186/s13019-025-03454-2","url":null,"abstract":"<p><strong>Introduction: </strong>Kawasaki disease is a predisposing factor for various potentially fatal anomalies that can cause coronary artery diseases in childhood, adolescence, or adulthood if they are not appropriately treated, usually done with ASA and intravenous immunoglobulin (IVIG). This study presents a case of a young woman who needed a coronary artery bypass graft (CABG) due to a history of Kawasaki and coronary artery severe stenosis.</p><p><strong>Case presentation: </strong>A 24-year-old woman presented with chest pain, exertional and at-rest dyspnea, lower limb edema, and crackle at bilateral lung bases. After stabilization, it was noted that her left anterior descending artery (LAD) had been obstructed completely. She underwent CABG successfully and recovered uneventfully. The six-month follow-up showed almost complete. His medical therapy continued with dual antiplatelet therapy, statin, diuretics, spironolactone, and some other medications to decline the process of her heart structural change (Graphical Abstract).</p><p><strong>Results: </strong>Kawasaki makes the patients prone to CAD and several other CVD diseases. Many factors determine the risk of coronary artery involvement in these cases, and the proffered treatment should be chosen based on the severity of CAD and the characteristics of the patient. These treatments include (1. Medical, 2. Interventional (PCI), 3. Surgical (CABG), 4. Combinational) along with preventive therapy, which is suggested to almost all patients. In our case, considering the complete occlusion of LAD, the patient underwent CABG.</p><p><strong>Clinical key point: </strong>Kawasaki disease is one of the most important predisposing factors for CAD in young adults, and their least significant symptoms should be taken seriously as a CVD and should be investigated. CAD in these patients might be so severe that no treatment except CABG can be responsive to problem-solving. Moreover, timely management of disease in childhood with ASA and IVIG would prevent or at least decrease the severity of symptoms can be declined significantly.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"219"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011538","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":"Single staged repair of an anastomotic tracheal fistula following Mckeown esophagectomy via cervical incision: a case report.","authors":"Haoqian Zheng, Chenyang Guo, Yadi Zhang, Hang Gu, Yinzhi Zhao, Run Xiang, Wei Dai, Xing Wei, Tianpeng Xie, Qiang Li, Xiang Wang","doi":"10.1186/s13019-025-03430-w","DOIUrl":"https://doi.org/10.1186/s13019-025-03430-w","url":null,"abstract":"<p><strong>Background: </strong>The incidence of tracheoesophageal fistula (TEF) following esophagectomy is less than 3%, but it often leads to severe complications and can even be life-threatening to patients. Surgical repair methods for TEF include muscle or omental flap support, biologic patch repair, and sleeve resection. In recent years, there has been an increasing number of case reports on primary closure via a cervical incision, with a rising success rate and a lower incidence of postoperative complications.</p><p><strong>Case presentation: </strong>A case is presented involving a 68-year-old female patient with esophageal squamous cell carcinoma who underwent thoracoscopic McKeown esophagectomy combined with gastric conduit reconstruction. On postoperative day 10, the patient presented with severe coughing. Gastroscopy and bronchoscopy confirmed a tracheoesophageal fistula at the anastomotic site. After 2 weeks of anti-infective therapy, drainage, and nutritional support, the fistula persisted. Subsequently, an exploratory surgery was performed via the original cervical incision, and the fistula was repaired with primary suture. The patient received routine dressing changes and continued anti-infective therapy postoperatively. One week later, gastroscopy and bronchoscopy revealed complete healing of the trachea, with closure of the anastomotic fistula, and no abnormalities were detected upon oral intake.</p><p><strong>Conclusion: </strong>This case demonstrates that in patients identified early, with complete drainage, adequate anti-infection measures, and improved nutritional status, primary closure of the tracheoesophageal junction through the original cervical incision can successfully treat an anastomotic trachea-fistula following esophagectomy. Our report details the process of primary repair of TEF through the cervical approach, contributing additional references to existing literature.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"217"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012641","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 planned concomitant coronary artery bypass grafting on risk of major adverse cardiovascular events in elective aortic hemiarch surgery.","authors":"Bo Chang Brian Wu, Adam M Carroll, Nicolas Chanes, Drake S Rosenberg, Michael J Kirsch, Muhammad Aftab, T Brett Reece","doi":"10.1186/s13019-025-03431-9","DOIUrl":"https://doi.org/10.1186/s13019-025-03431-9","url":null,"abstract":"<p><strong>Background: </strong>Hemiarch replacement of the ascending aorta has become routine in many aortic centers. While the addition of coronary bypass does not add a lot of time to the procedure, it carries with more significant comorbidities. We hypothesize that the addition of CABG carries a higher risk of complication than hemiarch alone.</p><p><strong>Methods: </strong>This is a single-center, retrospective cohort study of 419 patients undergoing elective hemiarch surgery between February 2010 and May 2023. Patients were categorized into concomitant CABG (n = 42) and non-CABG (n = 379) groups. Perioperative variables and outcomes were analyzed. Both univariate and multivariate logistic regressions were used to identify predictors for MACE.</p><p><strong>Results: </strong>Of 419 patients, 42 (10%) patients received adjunctive CABG. This group was older (68.1 vs. 60.4 years, p < 0.001) with more comorbidities associated with coronary artery disease (CAD), such as hypertension (92.9% vs. 59.2%, p < 0.001), type 2 diabetes (33.3% vs. 8.8%, p < 0.001), and atrial fibrillation (19% vs. 5.8%, p = 0.006). CABG patients had longer cardiopulmonary bypass (158 vs. 131 min, p < 0.001) and aortic cross-clamp (115.5 vs. 95 min, p < 0.001) times and required more intraoperative blood products, FFP (4 vs. 2 units, p = 0.010) and platelets (2 vs. 1 units, p < 0.001). Postoperative complications, including arrhythmia (40.5% vs. 21.8%, p = 0.012), mechanical circulatory support (11.9%, 1.9%, p = 0.004), acute kidney injury (16.7% vs. 0.5%, p < 0.001), infection (11.9% vs. 3.7%, p = 0.032), mortality (9.5% vs. 0.5%, p = 0.001), stroke (9.5% vs. 2.1%, p = 0.024), and the composite outcome- MACE (21.4% vs. 2.9%, p < 0.001) were higher in the CABG group. Multivariate analysis identified the number of bypassed vessels (OR: 2.23, CI 1.33-3.69, p = 0.002), age (OR: 1.07, CI: 1.02-1.13, p = 0.006), and female gender (OR: 3.53, CI: 1.31-9.64, p = 0.012) as significant risk factors for MACE.</p><p><strong>Conclusions: </strong>Concomitant CABG may increase the risk of MACE compared to other patients undergoing hemiarch. These data argue that the risk may be higher for concomitant CABG but should still undergo revascularization. Future research should focus on preoperative optimization, operative strategies, and sex-specific risk factors to improve elective hemiarch replacement outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"215"},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019763","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":"Giant cardiac tumor resection combined with left ventricular reconstruction.","authors":"Ganyi Chen, Hong Ran, Cunhua Su, Xin Chen","doi":"10.1186/s13019-025-03429-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03429-3","url":null,"abstract":"<p><p>Reports of large tumors of the left ventricle are rare. In this instance, we present a situation where a 57-year-old woman underwent surgical intervention for a sizable mass in her left ventricle. The mass was attached to the walls of the left ventricle and the apex of the left ventricle, almost filling the entire left ventricle. The individual had elective cardiac surgery. Fortunately, the patient survived, and this case may help in the treatment of cardiac sarcoma.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"216"},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972775","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":"Median arcuate ligament syndrome in an old male: a case report with occlusion of celiac artery after stenting.","authors":"Qiang Hu, Yan Zhao, Yi Yang, Gang Wang","doi":"10.1186/s13019-025-03415-9","DOIUrl":"https://doi.org/10.1186/s13019-025-03415-9","url":null,"abstract":"<p><strong>Background: </strong>Median arcuate ligament syndrome (MALS), also called celiac artery compression syndrome or Dunbar syndrome, is a rare disorder caused by the compression of the celiac trunk by the median arcuate ligament, which results in patients presenting with bloating, vomiting, nausea, weight loss, and postprandial abdominal pain.</p><p><strong>Case presentation: </strong>A 77-year-old male was admitted to our center with irregular abdominal pain over the epigastric region for the past 5 months. The pain occurred with no apparent causes, which had intensified in the last 10 days, without nausea, vomiting, and other symptoms. The physical examination, laboratory examination, abdominal ultrasound, and gastroenterological endoscope showed no obvious abnormalities. The angiography showed that the celiac artery was 90% narrowed, so revascularization was performed, leading to a resolution of the symptoms. After 6 months, the patient presented with a recurrence of abdominal pain. Computed tomography angiography showed the stent in the ostial celiac artery was compressed and deformed, which obstructed the vessel. Finally, due to the advanced age, and high surgical risk, the patient was not willing for the decompression of the celiac artery, and the post-dilation was performed, resulting in < 50% residual stenosis in the ostial celiac artery and resolution of pain.</p><p><strong>Clinical discussion: </strong>The current diagnosis of MALS is still based on postprandial abdominal pain and imaging modalities. However, due to the atypical symptoms and imaging manifestation, MALS is diagnosed precisely only after extensive evaluation and exclusion. In our case, celiac artery stenosis was initially diagnosed based on the symptoms and the results from angiography, so the revascularization of the celiac artery was conducted, leading to the deformation of the stent and a recurrence of abdominal pain 6 months later. MALS and decompression of the celiac trunk were finally considered. Although he refused to undergo celiac artery decompression because of the high surgery risk, the abdominal pain was relieved by post-dilation during the follow-up of 8 months.</p><p><strong>Conclusion: </strong>Due to the vague manifestation, MALS should be considered after excluding intestinal disorders using different imaging modalities. Once diagnosed, the goal of treatment was centered around the decompression of the celiac artery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"214"},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992788","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":"AngioVac-assisted management of histoplasma capsulatum endocarditis in a bioprosthetic aortic valve: challenges and outcomes.","authors":"Qutaiba Qafisheh, Abdalhakim Shubietah, Roaa Aljunaidi, Omar Sajdeya, Muath A Baniowda, Cole Giesige, Stephanie C El-Hajj, Robert Grande","doi":"10.1186/s13019-025-03377-y","DOIUrl":"https://doi.org/10.1186/s13019-025-03377-y","url":null,"abstract":"<p><strong>Background: </strong>Histoplasma capsulatum infective endocarditis (IE) is rare and often fatal, especially in prosthetic valve patients, due to delayed diagnosis and limited therapeutic options. This case demonstrates the utility of AngioVac for managing large fungal vegetations, underscores the importance of considering fungal IE in culture-negative cases, and highlights the role of a multidisciplinary approach in high-risk patients. We report a 76-year-old female with a bioprosthetic aortic valve who presented with persistent culture-negative fever, splenic infarcts, and large vegetations on her prosthetic valve. Extensive diagnostic workup confirmed fungal endocarditis after AngioVac-assisted debulking revealed H. capsulatum on tissue cultures. Despite prompt initiation of antifungal therapy and multidisciplinary management, her course was complicated by recurrent embolic events, septic shock, and eventual death.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering fungal IE in culture-negative cases, especially in high-risk patients such as those with prosthetic valves. It also highlights the role of advanced diagnostic techniques and minimally invasive interventions like AngioVac in managing complex cases, despite their limitations.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"213"},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010860","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":"Effect of enhanced external counterpulsation on the rehabilitation of patients with acute myocardial infarction after drug-coated balloon-based percutaneous coronary intervention.","authors":"Xiaojiao Hao, Yan Zhang, Damin Huang, Wenxi Gu, Yingmin Lu","doi":"10.1186/s13019-024-03230-8","DOIUrl":"https://doi.org/10.1186/s13019-024-03230-8","url":null,"abstract":"<p><strong>Objective: </strong>To observe, compare and explore the effect of enhanced extracorporeal counterpulsation (EECP) treatment on cardiac rehabilitation in patients with acute myocardial infarction (AMI) after undergoing percutaneous coronary intervention (PCI) using a drug-coated balloon (DCB).</p><p><strong>Methods: </strong>This study was a prospective randomised controlled trial of 60 patients with AMI after undergoing PCI using a DCB. Using a random number table method, the patients were randomly divided into control and rehabilitation groups, with 30 patients in each. The follow-up period was 6 months. Patients in the control group received conventional drug and exercise rehabilitation after undergoing DCB-based PCI; those in the rehabilitation group were also given an EECP-based rehabilitation regimen after 7 days of medication and exercise rehabilitation. The effects of EECP on the rehabilitation of patients with AMI after undergoing DCB-based PCI were evaluated by observing changes in cardiac function before and after treatment in the two groups of patients, including cardiac output (CO), stroke volume (SV), brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and 6-minute walking distance (6MWD).</p><p><strong>Results: </strong>After 6 months of treatment, the control versus the rehabilitation groups' cardiac function results were as follows: CO (5.00 ± 0.67 vs. 4.64 ± 0.58, P = 0.023), SV (70.53 ± 3.33 vs. 65.57 ± 6.10, P < 0.001), BNP (157.63 ± 15.37 vs. 219.40 ± 16.73, P < 0.001), LVEF (65.57 ± 4.33 vs. 60.10 ± 2.92, P < 0.001) and 6MWD (455.43 ± 39.75 vs. 400.73 ± 36.81, P < 0.001). The patients in the rehabilitation group showed improved cardiac function compared with the control group, with statistically significant differences. Furthermore, the improvement in the New York Heart Association cardiac function grading (P < 0.001) and Canadian Cardiovascular Association angina grading (P < 0.001) in the rehabilitation group were significantly improved compared with the gradings of the control group.</p><p><strong>Conclusion: </strong>Using EECP treatment significantly improved the cardiac function of patients with AMI after undergoing DCB-based PCI and was beneficial for their cardiac rehabilitation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"210"},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036519","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":"Beyond the vascular access: unveiling the cardiovascular impact of dialysis access flow rates.","authors":"Mohammad Moradmand, Farzad Dehghani Mahmoudabadi, Mohammad Javanbakht, Helia Ghorbani, Mahdi Mohebbi, Saeid Aghajani, Reihaneh Bayat, Mojdeh Makooie, Mohammad Mehdi Shadravan, Mohammad Mishan, Hamidreza Movahedi, Shahab Rostamkalaei, Sina Salimi, Seyed Mohamad Hossein Tabatabaei Nodoushan","doi":"10.1186/s13019-025-03424-8","DOIUrl":"https://doi.org/10.1186/s13019-025-03424-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of arteriovenous fistula (AVF) and arteriovenous graft (AVG) flow rates on cardiac function and blood pressure in hemodialysis patients, comparing changes before and after vascular access creation and assessing differences between high and non-high flow access groups.</p><p><strong>Methods: </strong>This prospective, observational study included 80 hemodialysis patients (43 males), all of Iranian ethnicity, at a university-affiliated referral hospital in Tehran, Iran. Flow rates (Qa) of vascular accesses were measured using Color Doppler ultrasonography (Acuson Sequoia system). Echocardiographic parameters, including systolic blood pressure, ejection fraction (EF), and left ventricular end-diastolic dimension (LVEDD), were assessed at baseline and six months post-intervention. Data were analyzed using paired t-tests and Pearson correlation coefficients.</p><p><strong>Results: </strong>Following vascular access creation, a significant decrease in systolic blood pressure was observed (156.48 ± 18.04 mmHg to 141.42 ± 15.82 mmHg, p < 0.001), along with a notable decline in EF (57.18% ± 6.51 to 50.31% ± 4.99, p < 0.001), and an increase in LVEDD (4.43 ± 0.27 cm to 5.51 ± 0.26 cm, p < 0.001), suggesting potential cardiovascular burden in high-flow access patients. Patients with high-flow access exhibited greater cardiovascular burden, likely due to increased cardiac output demands and risk of high-output heart failure. No significant differences in cardiac outcomes were observed between proximal and distal AVFs or upper and lower limb AVGs.</p><p><strong>Conclusions: </strong>These findings underscore the need for proactive cardiovascular monitoring, particularly in patients with high-flow vascular access, to prevent potential complications such as high-output cardiac failure. Routine Doppler ultrasonography and echocardiographic assessments should be integrated into clinical practice to identify high-risk patients and guide timely interventions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"211"},"PeriodicalIF":1.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010865","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}