Journal of Cardiothoracic Surgery最新文献

{"title":"Early postoperative atrial fibrillation is associated with late mortality after cardiac surgery: a systematic review and reconstructed individual patient data meta-analysis.","authors":"Michal J Kawczynski, Claudia A J van der Heijden, Jos G Maessen, Ulrich Schotten, Mariusz Kowalewski, Piotr Suwalski, Elham Bidar, Bart Maesen","doi":"10.1186/s13019-025-03504-9","DOIUrl":"10.1186/s13019-025-03504-9","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative atrial fibrillation (early-POAF) is the most common complication after cardiac surgery. Although prior studies have demonstrated an association between early-POAF and late outcomes, it is questionable whether these long-term adverse events result from early-POAF or from comorbidities that underlie the development of early-POAF. Therefore, the aim of this study was to investigate the association of early-POAF with late mortality and stroke after adjustment for age and cardiovascular comorbidities.</p><p><strong>Methods: </strong>A systematic search was conducted to identify studies reporting on late mortality after cardiac surgery in patients with and without early-POAF. Articles presenting Kaplan-Meier were included for a pooled analysis of late mortality (primary outcome) and stroke (secondary outcome). Individual time-to-event data were reconstructed from the Kaplan-Meier curves and incorporated into a multivariable mixed-effects Cox model.</p><p><strong>Results: </strong>In total, 33 studies were included in the analysis for late mortality (131 031 patients) and 10 studies in the analysis for late stroke (42 042 patients). Overall, 36 991 patients had early-POAF with a pooled incidence of 31.5% (95% CI: 27.7 to 35.6%). Unadjusted analysis showed that early-POAF was significantly associated with late mortality (Hazard Ratio [HR] = 1.62, 95%CI: 1.58-1.67, P < 0.001) and late stroke (HR = 1.72, 95%CI: 1.61-1.85, P < 0.001). Early-POAF was significantly associated with late mortality (adjusted HR = 1.19, 95% CI: 1.07-1.33, P = 0.002), but not with late stroke (adjusted HR = 1.14, 95% CI: 0.96-1.35, P = 0.122) after adjustment for age, comorbidities, surgery type, and the random effects term.</p><p><strong>Conclusion: </strong>Early-POAF after cardiac surgery is significantly associated with late mortality, but not with late stroke, after adjustments for age, sex, cardiovascular comorbidities, and type of surgery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"265"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325864","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":"CYBB identified as a key immune hub gene linking lung cancer and atrial fibrillation.","authors":"Tong Lang, Lingbing Meng","doi":"10.1186/s13019-025-03510-x","DOIUrl":"10.1186/s13019-025-03510-x","url":null,"abstract":"<p><strong>Background: </strong>The proportion of patients with lung cancer complicated by atrial fibrillation (AF) is increasing. Identifying shared molecular targets between these two conditions may provide important prognostic insights for patients with comorbidities.</p><p><strong>Methods: </strong>The GSE8569 and GSE41177 datasets were downloaded from the Gene Expression Omnibus (GEO) database. Differential expression analysis was performed using the limma package in R. Weighted gene co-expression network analysis (WGCNA) was conducted to identify significant gene modules. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses, along with gene set enrichment analysis (GSEA), were used to explore biological functions. Clinical survival data for lung cancer were obtained from The Cancer Genome Atlas (TCGA), and receiver operating characteristic (ROC) analysis was conducted using the R package ROC (version 1.17.0.1).</p><p><strong>Results: </strong>A total of 598 differentially expressed genes (DEGs) were identified. These DEGs were primarily enriched in cell proliferation, inflammatory responses, non-small cell lung cancer, the p53 signaling pathway, and the cell cycle. Three core genes (CYBB, ITGB2, FCER1G) were identified. Notably, CYBB was downregulated in lung cancer compared to normal tissue. Patients in the low-risk group had significantly better survival outcomes. Heatmap visualization showed that expression of CYBB decreased with increasing risk scores, suggesting a protective role.</p><p><strong>Conclusion: </strong>CYBB expression may influence lung cancer prognosis and contribute to the pathogenesis of AF. Further research is needed to clarify CYBB's role in patients with both conditions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"262"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325863","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":"microRNA-196b-5p expression in cancer tissues is closely associated with clinical and pathological characteristics and prognosis of patients with non-small cell lung cancer.","authors":"Wei Liu, Xiaomin Lu, Changgang Yang, Fengjun Ji, Xiaodan Wu","doi":"10.1186/s13019-025-03508-5","DOIUrl":"10.1186/s13019-025-03508-5","url":null,"abstract":"<p><strong>Objective: </strong>Non-small cell lung cancer (NSCLC) poses great mortality globally. Aberrant microRNA (miRNA/miR) expression is linked to the progression of many cancers. Herein, this study explored the association of miR-196b-5p in NSCLC tissues with the clinical features and prognosis of patients.</p><p><strong>Methods: </strong>Totally 166 NSCLC patients were retrospectively enrolled. Cancer and normal adjacent tissues (NAT) were attained for miR-196b-5p expression measurement. Clinical baseline data were attained, followed by the analysis of the relation of miR-196b-5p expression with clinical pathological features of NSCLC patients. The 3-year postoperative mortality risk was assessed in NSCLC patients with different miR-196b-5p levels, and independent risk factors (IRFs) for 3-year postoperative mortality were screened using Kaplan-Meier curves and Cox multivariate regression analysis.</p><p><strong>Results: </strong>miR-196b-5p levels were higher in cancer tissues than in NAT. Compared with stage I-II patients, miR-196b-5p in cancer tissues was upregulated in stage III patients. Patients with high/low miR-196b-5p expression showed statistically significant differences in age, capsule invasion, lymph node metastasis (LNM), maximum tumor diameter, and clinical staging. The survival and death groups were markedly different regarding age, capsule invasion, LNM, and clinical TNM staging. High miR-196b-5p expression in cancer tissues in NSCLC patients increased 3-year postoperative mortality risk. Age, clinical TNM stage, and miR-196b-5p expression in cancer tissues were IRFs for 3-year postoperative mortality in NSCLC patients.</p><p><strong>Conclusion: </strong>High miR-196b-5p expression in cancer tissues of NSCLC patients was closely linked to capsule invasion, LNM, maximum tumor diameter, and clinical TNM stage and was an IRF for 3-year postoperative mortality in NSCLC patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"264"},"PeriodicalIF":1.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325874","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":"Correlation of carotid plaque and peripheral carotid adipose tissue characteristics with coronary computed tomography angiography-based fractional flow reserve.","authors":"Yan Gu, Chongchang Miao, Ying Liu, Yonggang Zhang","doi":"10.1186/s13019-025-03482-y","DOIUrl":"10.1186/s13019-025-03482-y","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to investigate the correlation of carotid plaque and peripheral carotid adipose tissue (PCAT) characteristics with coronary computed tomography-derived fractional flow reserve (CT-FFR) values.</p><p><strong>Methods: </strong>Data of 136 patients who underwent head and neck computed tomography angiography (CTA) followed by coronary CTA were retrospectively reviewed. Based on their CT-FFR values, they were divided into CT-FFR ≤ 0.8 and CT-FFR > 0.8 groups. The patients' baseline data, carotid plaque and PCAT characteristics were collected. Univariate analysis and multivariate logistic regression were employed to identify differences between groups.</p><p><strong>Results: </strong>Univariate analysis indicated a statistical differences in carotid plaque thickness, plaque area, plaque load, the carotid plaque Crouse score, minimum plaque density, and net enhancement value of PCAT of patients (P < 0.05). Based on this, multivariate logistic regression analysis demonstrated that carotid plaque thickness (odds ratio (OR) = 0.553; 95% confidence interval (CI) = 0.360-0.847), the carotid plaque Crouse score (OR = 0.653; 95% CI = 0.514-0.830), and net enhancement value of PCAT (OR = 0.820; 95% CI = 0.730-0.919) were independent predictors of the diagnosis of CT-FFR ≤ 0.8. Furthermore, receiver operating characteristic curve analysis showed that the area under the curve of plaque thickness, the carotid plaque Crouse score, and net enhancement value of PCAT for the diagnosis of CT-FFR ≤ 0.8 were 0.816, 0.843, and 0.836, respectively.</p><p><strong>Conclusion: </strong>Carotid plaque thickness, the carotid plaque Crouse score, and net enhancement value of PCAT are independent related indicators of CT-FFR ≤ 0.8, which can be simultaneously clarified by head and neck CTA alone, as well as the severity of coronary atherosclerosis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"261"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284435","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":"Blood cardioplegia or custodiol for myocardial protection during valvular or aortic surgery: a propensity score adjusted comparison.","authors":"Manuel Carnero-Alcazar, Montero Montero-Cruces, Beltrao Beltrao-Sial, Raquel Blazquez, Nuñez Nuñez-Gil, Perez Perez-Camargo, Cobiella Cobiella-Carnicer, Juan Miguel Miranda Torron, Maria Alejandra Giraldo, Luis Maroto Castellanos","doi":"10.1186/s13019-025-03493-9","DOIUrl":"10.1186/s13019-025-03493-9","url":null,"abstract":"<p><strong>Background: </strong>There is no solid evidence on the clinical benefits of blood cardioplegia or Custodiol™ in procedures other than coronary artery bypass grafting. We aimed to compare mortality and the risk of major cardiovascular events in patients undergoing valve or aortic surgery.</p><p><strong>Methods: </strong>This retrospective single-center study included patients who underwent valve or ascending aortic surgery between 2016 and 2024. The sample was divided based on the type of cardioplegia for myocardial protection: Custodiol™ or blood cardioplegia. The comparison of outcomes between the two groups was adjusted using propensity score.</p><p><strong>Results: </strong>2909 patients were included, with 1426 (49%) receiving Custodiol™. In a propensity score-matched analysis that included 930 pairs, we observed higher perioperative mortality in the blood cardioplegia group (5.3% vs. 2.9%, p = 0.014) and worse long-term survival (p = 0.004). In an IPTW analysis, we confirmed significant differences in favor of Custodiol™ for early mortality (-2.2%, 95% CI -4; -0.4), long-term mortality (2.6 years, 95% CI 2.1; 3.2), and renal failure (-4.7%, 95% CI -7.9; -1.6), and low cardiac output syndrome requiring mechanical circulatory support (-2.2%, 95% CI -3.6;-0.9), but a higher siks of postoperative denovo atrial fibrillation (6.8%, 95% CI 2.5;11).</p><p><strong>Conclusions: </strong>In this retrospective study including patients undergoing on-pump valve and aortic surgery, Custodiol™ compared to blood cardioplegia was associated with lower short- and medium-term mortality, although no robust evidence was found for differences in other clinical events.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"259"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225538","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 bidirectional regulatory effect of TXNRD2 methylation in patients with chronic heart failure and its nonlinear dose-response relationship with key clinical parameters.","authors":"Ruonan Zhao, Lin Ma, Ruiping Wang, Rongqiang Zhang","doi":"10.1186/s13019-025-03495-7","DOIUrl":"10.1186/s13019-025-03495-7","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"260"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225561","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":"Stentless balloon angioplasty preserving growth in adolescent congenital focal abdominal aortic coarctation: a case report.","authors":"Siping Peng, Tao Hu","doi":"10.1186/s13019-025-03499-3","DOIUrl":"10.1186/s13019-025-03499-3","url":null,"abstract":"<p><strong>Background: </strong>Congenital focal abdominal aortic coarctation (CAAC) is a rare vascular malformation frequently misdiagnosed as mid-aortic syndrome (MAS). A significant challenge in managing CAAC, particularly in young individuals, is addressing the coarctation while accommodating ongoing vascular growth and development. This case highlights the value of multidisciplinary collaboration and imaging-guided stentless balloon angioplasty in preserving vascular growth potential.</p><p><strong>Case presentation: </strong>A 14-year-old male presented with a two-year history of refractory hypertension (peak:190/110mmHg) and exertional dizziness. Thoracoabdominal computed tomography angiography (CTA) revealed a focal coarctation (minimum luminal diameter: 4.2 mm, representing 70% stenosis) extending from the celiac artery origin to the superior mesenteric artery origin, without significant collateralization. Digital subtraction angiography (DSA)-guided balloon angioplasty (10 × 40 mm) resulted in a significant reduction of the transcoarctation pressure gradient from 45mmHg to 8mmHg, achieving normotension (120/80mmHg). At six-month follow-up, a 161% increase in aortic luminal diameter (to 11 mm) was observed, accompanied by complete regression of left ventricular hypertrophy (LVH), as evidenced by a decrease in interventricular septal thickness from 12 mm to 9 mm.</p><p><strong>Conclusions: </strong>Stentless balloon angioplasty is an effective strategy in treating CAAC in adolescents, achieving both immediate hemodynamic relief and facilitating growth-adaptive aortic remodeling. Comprehensive aortic imaging is crucial for the diagnosis and management of refractory hypertension in adolescents.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"258"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215939","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":"Rare case of a massive anterior mediastinal schwannoma causing cardiac compression with concurrent cervical spine lesion causing spinal cord compression.","authors":"Sajjaad H Samat, Bradley Ruehle, Emily Sheldon, Hisham Qandeel","doi":"10.1186/s13019-025-03452-4","DOIUrl":"10.1186/s13019-025-03452-4","url":null,"abstract":"<p><p>Schwannoma is the most common neurogenic tumor in the posterior mediastinum, however it is rarely found in the anterior mediastinum (Mediastinum 4, 2020; Radiat Med 13(4):175-7). We report a large anterior mediastinal schwannoma causing cardiac compression along with a concurrent cervical spine lesion causing right-sided weakness. Current literature having only a few case reports describing an anterior location for this neoplasm and even rarer to have a concurrent symptomatic cervical lesion. We present this case to highlight this rare finding and increase awareness of this potential diagnosis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"257"},"PeriodicalIF":1.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215938","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":"Kawashima procedure in single ventricle palliation: the factors affecting clinical outcomes.","authors":"Hüseyin Sicim, Arash A Sabati, Daniel A Velez, Mohamad Alaeddine","doi":"10.1186/s13019-025-03456-0","DOIUrl":"10.1186/s13019-025-03456-0","url":null,"abstract":"<p><strong>Background: </strong>The superior cavopulmonary anastomosis (SCPA) is a standard second stage procedure in single ventricle palliation. Exact timing in most single ventricle patients depends on clinical status, age, weight and in many centers a preoperative catheterization. In this study, we aimed to investigate the factors affecting the length of hospital stay after Kawashima procedure and present our center outcomes.</p><p><strong>Methods: </strong>We studied on our center's database between 2011 and 2024. Patients who underwent Kawashima procedure were analyzed for weight, height, and age as factors that may affect outcomes such as hospital stay, complications, and mortality. The effect of surgical timing on postoperative outcomes was examined. The primary outcome was length of stay.</p><p><strong>Results: </strong>We found that 15 (6.4%) of the 233 patients who underwent SCPA had interrupted inferior vena cava (IIVC) and therefore underwent the Kawashima procedure. The median age was 5.9 months (IQR, 5.2-11.2), with a 2:1 female to male distribution, and the median weight was 7.5 kg (IQR, 5.5-9.5). Of note, 4 of the patients did not have any prior surgical intervention, others were palliated with pulmonary artery (PA) band (n = 3), Blalock-Taussing (BT) shunt (n = 2), Norwood procedure (n = 3), or central shunt (n = 3). There was no mortality, and the median postoperative length of hospital stay was 9 days (IQR, 6-11). Our regression analysis showed statistically significant relationship between age and postoperative length of hospital stay (R2-adj = 0.27, p = 0.032) as well as height and postoperative length of hospital stay (R2-adj = 0.28, p = 0.03). The weight did not reach statistical significance (p = 0.13). The overall survival rate was 100% after the Kawashima procedure, and 12 patients underwent Fontan completion with hepatic vein incorporation.</p><p><strong>Conclusions: </strong>Our small study suggests that age and height may have a determining effect on the length of hospital stay and its associated conditions for this procedure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"256"},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208617","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":"Unusual onset and presentation of isolated Uni-iliac aneurysm dissection in presence of aortoiliac aneurysms.","authors":"Muhamad Zakaria Brimo Alsaman, Abdo Mohamad Zain, Rawan Al-Deeb, Mohammed Hamdan, Ghaiyath Khalil, Hussein Alkanj","doi":"10.1186/s13019-025-03474-y","DOIUrl":"10.1186/s13019-025-03474-y","url":null,"abstract":"<p><strong>Introduction: </strong>The dissection of the iliac artery aneurysm is considerably rare, with limited documentation in the existing literature. Iliac artery dissection can be attributed to several causative factors, including trauma, pregnancy, athletic activity, arterial catheterization, and connective tissue disorders.</p><p><strong>Case presentation: </strong>This case reports a 72-year-old male complaining of pain in the right iliac fossa and hypogastric region, radiating to the back. An abdominal ultrasound revealed a right dissected common iliac aneurysm, left common iliac aneurysm and an abdominal aortic aneurysm. Further investigation confirmed the same findings. Several hours later, the decision of emergency surgery was done due to signs of hemorrhagic shock caused by ruptured unilateral iliac aneurysm. The aneurysms were successfully repaired by aorto-bi-iliac dacron-graft bypass and palpable femoral pulses noted at the end of the surgery.</p><p><strong>Conclusion: </strong>Close monitoring of these patients is crucial due to the significant morbidity associated. Early intervention may be necessary, particularly before any signs of deterioration and hemorrhagic shock.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"255"},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199233","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}