Journal of Cardiothoracic Surgery最新文献

{"title":"Paravertebral block analgesia during surgical stabilization for rib fractures patients under conscious state: a single-arm, pilot study and post-hoc analysis.","authors":"Weiming Wu, Xiaoyun Gao, Penghao Liu, Weigang Zhao, Yi Yang","doi":"10.1186/s13019-025-03397-8","DOIUrl":"10.1186/s13019-025-03397-8","url":null,"abstract":"<p><strong>Background: </strong>Paravertebral block (PVB) is commonly used for analgesia postoperatively while rarely as anesthesia during surgical stabilization for rib fractures. This study aimed to explore the feasibility and safety of PVB analgesia alone during surgical stabilization for patients with multiple rib fractures (MRF) under conscious state.</p><p><strong>Methods: </strong>This prospective single-arm pilot study was conducted in patients with MRF who schedule for surgical stabilization using PVB analgesia in Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between September 2019 and September 2020. The outcomes were the vital signs, postoperative pain and nausea and vomiting (PONV). Those who underwent general anesthesia (GA) during the same period were included for post hoc analysis.</p><p><strong>Results: </strong>Eighteen patients (aged 62 ± 10.64 years; 8 males) were enrolled. The vital signs, including SpO₂, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, of the patients at baseline, perioperative, intraoperative, and postoperative day 1 were kept normal. The postoperative numerical rating scale (NRS) pain scores at 6, 12, and 24 h were 2.67 ± 1.36, 2.44 ± 0.80, and 2.33 ± 0.86, respectively, which were improved compared with baseline (5.78 ± 1.00). No PONV, postoperative morbidity, pulmonary infections, or incision infections were observed. Additionally, post-hoc analysis for the comparison of patients who underwent GA with PVB (in the pilot study) showed a similar number of rib fracture fixation (P = 0.06) and analgesic effect (P = 0.06) after operation, while a significantly shorter total length of hospital stay (P < 0.01), postoperative hospital stay (P < 0.01), lower dose of sufentanil citrate use (P < 0.01),and total costs(P < 0.03)in patients who underwent PVB.</p><p><strong>Conclusions: </strong>PVB analgesia during surgical stabilization for MRF under a conscious state might be feasible and safe. Compared with GA, PVB analgesia might reduce the dose of narcotics, shorten the length of hospital stay, and reduce the cost of hospitalization.</p><p><strong>Clinical registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov (#NCT04536311).</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"161"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676974","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":"Quality of life and compensatory hyperhidrosis following thoracoscopic sympathectomy: a retrospective cohort study.","authors":"Jingsi Wang, Shengliang Zhao, Bo Tang, Mingzhang Xiang, Jigang Dai, Quanxing Liu","doi":"10.1186/s13019-025-03393-y","DOIUrl":"10.1186/s13019-025-03393-y","url":null,"abstract":"<p><strong>Background: </strong>Palmar hyperhidrosis (PH), characterized by excessive palm sweating, significantly impacts quality of life (QOL) in affected individuals, particularly young adults. This study aimed to evaluate the efficacy of video-assisted thoracoscopic sympathectomy (VATS) in improving symptoms and QOL among 816 patients with PH.</p><p><strong>Methods: </strong>This retrospective study included 816 patients with PH, all of whom underwent VATS under general anaesthesia. One-year follow-up via phone surveys was used to assess symptom changes and side effects. Paired t tests were used to compare pre- and postoperative QOL scores, and linear regression was used to analyse the effects of various factors on QOL changes.</p><p><strong>Results: </strong>The cohort consisted of 359 males and 457 females, with a mean age of 24.98 ± 6.47 years. All patients underwent VATS, with a 91% success rate, and the mean operative time was 53.2 ± 24.7 min. Postoperative complications included 43 cases of incision infections, 194 cases of chest pain, and 82 cases of pneumothorax; compensatory hyperhidrosis (CH) occurred in 53.80% of the T3 group and 43.74% of the T4 group after one month, with significant differences noted at the 24-month follow-up. Furthermore, the QOL scores significantly improved from 38.25 ± 3.61 preoperatively to 69.07 ± 3.48 at one year postoperatively (P < 0.05).</p><p><strong>Conclusions: </strong>VATS offers a reliable and effective treatment for severe PH, significantly enhancing patients' overall QOL. Future research should focus on long-term outcomes and the applicability of this treatment across diverse populations to further advance the clinical management of PH.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"160"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676978","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 congenital pericardial defect found during S^1 + 2 segment excision of the left upper lung by single-aperture thoracoscopy: a case report.","authors":"Xiao Wang, Jian Liu, Bichen Zhan, Mingbo Gu","doi":"10.1186/s13019-025-03390-1","DOIUrl":"10.1186/s13019-025-03390-1","url":null,"abstract":"<p><strong>Background: </strong>Congenital pericardial defect (CPD) is a rare congenital heart malformation with atypical clinical symptoms.</p><p><strong>Case presentation: </strong>The 69-year-old woman was referred because a 23-mm mixed ground glass shadow was found in the apicoposterior segment (S^1 + 2) of the left lung. The S^1 + 2 segment excision of the left upper lung was performed under uni-portal fluorescence thoracoscopy. Intraoperatively, an unintentional complete absence of the pericardium was discovered, with the phrenic nerve running behind the sternum. To reduce the intraoperative stimulation of the heart and prevent postoperative friction of the bronchial stump against the left atrial appendage, the pulmonary hilum was not separated, and the intersegmental vein (V^1 + 2b + c) was not cut off. Given the patient's lack of symptoms and the low risk of cardiac hernia, no specific pericardial surgery was performed. The patient was well at the 1-month postoperative follow-up.</p><p><strong>Conclusions: </strong>This paper reports a case of complete pericardial defect accidentally found during left upper lung S^1 + 2 segmentectomy under single-hole thoracoscopy, summarizes the main points of diagnosis and surgical precautions, and provides experience reference for similar clinical cases.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"159"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676971","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":"Transit time flow management as a management strategy in high-risk groups undergoing coronary artery bypass grafting.","authors":"John Kucera, John Duggan, Alex Peters, Gregory Trachiotis","doi":"10.1186/s13019-025-03408-8","DOIUrl":"10.1186/s13019-025-03408-8","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the surgical outcomes in three groups of individuals with diabetes mellitus (DM), end-stage renal disease (ESRD), and on (ONCAB) vs. off-pump (OPCAB) coronary artery bypass grafting (CABG). We also examined the changes in intraoperative decision-making when ultrasound and transit-time flow measurement was utilized in the operating room. This study will aim to identify the utility of HFUS and TTFM in high-risk patient categories.</p><p><strong>Methods: </strong>Data from the multicenter REQUEST (Registry for Quality assessment with ultrasound imaging and TTFM measurement in cardiac bypass surgery) had recently been compiled in three separate papers examining outcomes in patients with DM, ESRD, and on vs. off-pump bypass grafting. Data was extrapolated to determine the impact of HFUS and TTFM in patients with diabetes, ESRD, ONCAB and OPCAB. The primary outcome measured in in the REQUEST study is any change in planned surgical procedure. Secondary end points include rate of changes, coronary targets, completed grafts, and in-hospital morbidity and mortality.</p><p><strong>Results: </strong>Outcomes were predicated upon patient population surveyed. The REQUEST registry reported 1016 individuals who underwent CABG. For individuals with DM, any surgical change to the coronary target was slightly lower, measured at a change rate of 11.6% vs. 9.5% (OR 0.80, 95% CI 0.53-1.21, P = 0.288). In diabetics, the aortic component of the operation underwent a higher rate of surgical strategy change with TTFM compared to without (10.2% vs. 6.4%, OR 1.67, 95% CI 1.06-2.65; P = 0.026). In patients with ESRD, TTFM increased the rate of strategy changes compared to no TTFM (33.7% vs. 24.3%, 95% CI 1.01-2.48, P = 0.047) and number of revisions per graft (7.0% vs. 3.4%, OR 2.14, 95% CI 1.17-3.71). In the 1016 individuals who underwent CABG, 402 (39.6%) underwent OPCAB and 614 (60.4%) undergoing ONCAB. When TTFM and HFUS were utilized, OPCAB resulted in greater number of strategy changes for aortic portion of the procedure (14.7% vs. 3.4%, OR 4.03, CI 2.32-7.20) without a difference in coronary target or graft revision. In the REQUEST study, in-hospital mortality was published at 0.6%.</p><p><strong>Conclusions: </strong>TTFM use demonstrates a statistically significant impact on intra-operative decision making and operative strategy changes in patients with concomitant ESRD, DM and who are undergoing OPCAB relative to ONCAB. This difference in OPCAB vs. ONCAB may be related to higher mean graft flows in OPCAB in the setting of a standardized TTFM cutoff for determination of graft quality. This data cumulatively suggests there a role for TTFM in CABG, namely due to its positive impact on outcome and statistically significant impact on intra-operative decision making.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"158"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676981","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":"Research progress and hotspot analysis of type B aortic dissection: a bibliometric analysis from 2004 to 2023.","authors":"Zhen-Yi Zhao, Shu-Li Zhou, Yun Peng, Can Cui, Liang-Geng Gong","doi":"10.1186/s13019-025-03400-2","DOIUrl":"10.1186/s13019-025-03400-2","url":null,"abstract":"<p><p>This study aimed to analyze and visualize the research on type B aortic dissection (TBAD) over the past 20 years through bibliometric research. To reveal the development process of TBAD research and the transitions of research hotspots. Literatures was retrieved from the Web of Science Core Collection. The analysis utilized tools such as Microsoft Office Excel, VOSviewer and CiteSpace for bibliometric mapping and visualization, including assessing publication volumes and constructing collaborative networks and keyword burst graphs. A total of 1391 related articles or reviews on TBAD were included. The number of annual publications is steadily increasing. China was the top country in terms of the number of publications. University of Michigan (n = 60) was the most productive university. The Journal of Vascular Surgery (n = 183) was the most published and co-cited journal. Keywords burst analysis showed that \"guidelines\", \"spinal-cord ischemia\", \"society\", \"impact\", and \"aortic remodeling\" were the most frequently used keywords in recent years. In general, the research focus of TBAD has gradually changed from selecting the surgical method to the best clinical management and patient prognosis after thoracic endovascular aortic repair (TEVAR). Promoting positive aortic remodeling and aortic hemodynamics may be the research hotspots in the future.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"157"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670000","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":"Advancements in diagnosis and treatment of lung adenocarcinoma patients under ECMO support: a case series and comprehensive literature review.","authors":"Xinyi Luo, Jie Zhang, Jieyi Pan, Lingbo Nong, Yin Xi, Xiaowen Xie, Ya Wang, Weiqun He, Xiaobo Chen, Changhao Zhong, Haibo Zhang, Xiaoqing Liu, Chengzhi Zhou, Yonghao Xu","doi":"10.1186/s13019-025-03384-z","DOIUrl":"10.1186/s13019-025-03384-z","url":null,"abstract":"<p><p>This case series explores the use of veno-venous extracorporeal membrane oxygenation (VV ECMO) as a bridge to diagnosis and treatment in patients with suspected lung adenocarcinoma and severe respiratory failure refractory to conventional mechanical ventilation. We present three cases where ECMO support was initiated to facilitate further diagnostic evaluations, including lung biopsy and bronchoalveolar lavage fluid liquid biopsy, enabling the identification of actionable mutations and guiding targeted therapies. Two patients achieved significant clinical improvement and were successfully weaned from ECMO, while one patient experienced an unfavorable outcome due to a combination of uncontrolled tumor progression and hospital-acquired pneumonia. Our findings suggest that ECMO, traditionally considered a relative contraindication in advanced cancer, can be a valuable temporary support in carefully selected patients, allowing time for diagnosis and targeted treatment initiation. Furthermore, our experience highlights the feasibility and safety of performing lung biopsies under ECMO with appropriate anticoagulation management. This study emphasizes the importance of individualized decision-making and a multidisciplinary approach when considering ECMO for lung cancer patients, carefully weighing the risks of infection and disease progression to optimize patient outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"154"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669997","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":"Effects of different doses of ulinastatin on organ protection of deep hypothermic circulatory arrest in rats.","authors":"Yuan Teng, Jing Wang, Zhiyuan Bo, Tianlong Wang, Yuan Yuan, Guodong Gao, Bingyang Ji, Qiang Hu","doi":"10.1186/s13019-025-03379-w","DOIUrl":"10.1186/s13019-025-03379-w","url":null,"abstract":"<p><strong>Background: </strong>Deep hypothermic circulatory arrest (DHCA) can cause systemic inflammatory response (SIR) and ischemia-reperfusion (I/R) injury, potentially exacerbating organ failure. Ulinastatin (UTI) is a frequently employed anti-inflammatory medication in clinical practice, but different timing and dosage may influence its protective efficacy.</p><p><strong>Methods: </strong>24 rats were randomly divided into four groups. Three different doses of UTI (3/10/30 × 10⁴ U/kg; low/medium/high dose) were administered in the DHCA rat model, with a control group that underwent DHCA without UTI administration. Inflammatory markers and routine clinical indicators of myocardial, hepatic, and renal tissue injury were evaluated. All rats underwent the standard DHCA procedure.</p><p><strong>Results: </strong>Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and neutrophil elastase (ELA-2) levels in rats exposed to DHCA gradually increased after rewarming. Compared with the DHCA-only group, both the low dose of UTI (UTI-L) and the medium dose of UTI (UTI-M) significantly reduced IL-6 (p = 0.017, p = 0.022 ), TNF-α (p = 0.003, p < 0.001), ELA-2 levels ( p = 0.018, p = 0.001), and elevated IL-10 levels ( p < 0.001, p < 0.001) 4 h post-weaning from cardiopulmonary bypass (CPB). In addition, compared with the DHCA group, both the UTI-L and UTI-M group showed significantly lower levels of cardiac troponin I (p = 0.001, p = 0.001), creatine kinase muscle and brain isoenzyme (CK-MB) (p < 0.001, p < 0.001), creatinine (p < 0.001, p < 0.001), blood urea nitrogen (p = 0.002, p = 0.021), aspartate transaminase (p < 0.001, p < 0.001) and alanine aminotransferase (p < 0.001, p < 0.001) at the end of the experiment. The hematoxylin-eosin staining results of kidney and liver tissue damage were alleviated in the UTI-L and UTI-M groups. The high dose of UTI (UTI-H) group did not exhibit dose-dependent anti-inflammatory effects and was associated with aggravated injury to the heart, liver, and kidney.</p><p><strong>Conclusion: </strong>This study demonstrated that the administration of low to medium doses of UTI during DHCA significantly attenuated the levels of IL-6, TNF-α, and ELA-2, elevated the level of the anti-inflammatory factor IL-10, and provided protective effects on myocardial, hepatic, and renal tissues.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"156"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669998","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":"Global trends and research hotspots in acupuncture treatment for cardiovascular diseases over the past decade: a bibliometric study.","authors":"Wenhui Wang, Kewen Wang, Qianlan Zeng, Jiaojiao Zhang, Haiyan Zuo, Shuai Cui, Shengbing Wu, Meiqi Zhou","doi":"10.1186/s13019-025-03380-3","DOIUrl":"10.1186/s13019-025-03380-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to examine the status and emerging trends of acupuncture treatment for cardiovascular disease (CVD) over the past decade. By conducting a visual analysis of existing literature, it seeks to offer new insights for future research directions.</p><p><strong>Methods: </strong>From the Web of Science Core Collection database, we retrieved papers on acupuncture treatment for CVD published between January 1, 2014, and December 31, 2023. Bibliometric analyses were conducted using VOSviewer and CiteSpace software to elucidate research progress and identify key research hotspots.</p><p><strong>Results: </strong>We identified 346 publications related to acupuncture for CVD that were published between 2014 and 2023. We determined the most productive journals, countries, institutions, authors, author patterns, and main directions for future research in the field of acupuncture. China was the top publishing country with 267 publications; Beijing University of Chinese Medicine was the leading institution with 42 publications; and the journal Evidence-Based Complementary and Alternative Medicine was the most prolific, with 43 publications. High-frequency keywords included \"blood pressure,\" \"acupuncture,\" \"electroacupuncture,\" \"stimulation,\" and \"mechanism.\" The top five keywords by centrality ranking were \"electroacupuncture,\" \"myocardial ischemia,\" \"stimulation,\" \"randomized controlled trial,\" and \"acupuncture.\"</p><p><strong>Conclusion: </strong>While progress exists in bibliometric research on acupuncture treatment for CVD, more comprehensive analyses remain essential. This study provides a multidimensional overview, delineating current advancements and emerging trends, offering evidence-based insights for clinical practice and quantitative references for identifying collaborators, key institutions, and future directions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"155"},"PeriodicalIF":1.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669999","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":"Clinical management after surgical left atrial appendage exclusion.","authors":"Prashant D Bhave, Karanpreet K Dhaliwal, Sneha Chebrolu, Jonathan Brock, Matthew J Singleton, Karl M Richardson","doi":"10.1186/s13019-025-03378-x","DOIUrl":"10.1186/s13019-025-03378-x","url":null,"abstract":"<p><strong>Background: </strong>Surgical left atrial appendage (LAA) closure is an increasingly utilized approach to mitigate the risk of cardioembolic stroke in patients with atrial fibrillation (AF). Consensus is lacking regarding optimal stroke prevention management after surgical LAA management.</p><p><strong>Objective: </strong>To elucidate real world clinical management of anticoagulation in patients undergoing surgical LAA management.</p><p><strong>Methods: </strong>Over a 7-year period at a single center, 458 participants carried a diagnosis of AF and underwent surgical exclusion of their LAA during concomitant cardiac surgery. Follow-up was catalogued via retrospective chart review; median follow-up was 2 years. Successful LAA ligation was defined as maximal stump depth < 1.0 cm by transesophageal echocardiography (TEE) without distal leak.</p><p><strong>Results: </strong>Among 458 patients, 299 were discharged on OAC (142 DOAC and 157 warfarin). Of these, 31% (94/299) had a follow-up TEE. Among those without a TEE, 32% (65/205) were taken off OAC; among those who underwent TEE, 59% (55/94) were taken off OAC. Using a logistic regression model, there was no relationship between age, sex, CHA₂DS₂-VASc score, or creatinine and the probability of coming off of OAC. Among the 94 patients discharged on OAC who had a follow-up TEE:10 were unable to assess adequacy of closure, 69 were successful, and 15 showed unsuccessful closure. In the group with imaging confirmed successful exclusion of their LAA, 67% (46/69) were taken off their oral anticoagulation, with cessation occurring after the TEE in 93% (43/46) of those patients.</p><p><strong>Conclusion: </strong>Clinical management after surgical LAA management, particularly with regard to LAA imaging and OAC continuation, is highly heterogeneous.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"153"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648469","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":"The impact of thyroid function on surgical prognosis in patients undergoing cardiac and major vascular surgeries.","authors":"Qi Sun, Wei Wang, Xiaoming Mao, Hao Liu","doi":"10.1186/s13019-025-03365-2","DOIUrl":"10.1186/s13019-025-03365-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to elucidate the relationship between thyroid function and surgical prognosis in patients undergoing cardiac and major vascular surgeries.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients undergoing cardiac or major vascular surgeries. Preoperative thyroid function tests, including TSH, free T3, and free T4 levels, as well as postoperative thyroid function tests, were assessed. Key postoperative outcomes, such as total hospital stay, postoperative hospital stay, ICU stay, and duration of mechanical ventilation, were recorded and analyzed. The analytical approach included Pearson correlation, multivariable logistic regression models, and restricted cubic splines.</p><p><strong>Results: </strong>This study analyzed a cohort of 472 patients who underwent various cardiovascular surgeries, including coronary artery bypass grafting (173 patients), aortic surgery (131 patients), valve surgery (125 patients), and primary cardiac neoplasms resection (43 patients). Significant changes in thyroid hormone levels were observed preoperatively and postoperatively, with TSH, FT3, and FT4 levels showing a significant decrease from preoperative values (p < 0.001). Multivariate logistic regression analysis further revealed that ΔTSH is significantly associated with total hospital stay, postoperative hospital stay, and duration of mechanical ventilation; postoperative FT3 levels were significantly inversely related to total hospital stay, ICU stay, and ventilator requirements. Additionally, although no significant nonlinear relationships were found (all p > 0.05).</p><p><strong>Conclusions: </strong>Thyroid dysfunction may impact postoperative outcomes in cardiac and major vascular surgery patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"152"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624839","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}