Journal of Cardiothoracic Surgery最新文献

{"title":"Evaluating the impact of 2008 NICE dental prophylaxis guidelines on surgically treated infective endocarditis: a single centre retrospective analysis.","authors":"Rickesh Bharat Karsan, Tara Chan-A-Sue, Rachel Roberts, Susan Durkan","doi":"10.1186/s13019-026-04197-4","DOIUrl":"https://doi.org/10.1186/s13019-026-04197-4","url":null,"abstract":"<p><strong>Objectives: </strong>In 2008, the National Institute for Health and Care Excellence (NICE) recommended cessation of antibiotic prophylaxis for at-risk patients undergoing dental procedures (CG64). This study aimed to evaluate the impact of these guidelines on the incidence, microbiological profile, and surgical characteristics of infective endocarditis (IE) requiring operative intervention.</p><p><strong>Methods: </strong>A retrospective analysis was performed using a prospectively maintained surgical database to identify all cases of surgically treated IE at a UK cardiothoracic centre from 2004 to 2023. Patients were stratified into pre- and post-2008 cohorts. Temporal trends in surgical IE incidence were evaluated alongside changes in microbiology, valve involvement, urgency of surgery, and proportion of dental-related organisms. Statistical comparisons included Welch's t-test, Fisher's Exact Test, chi-squared analysis, and Poisson regression.</p><p><strong>Results: </strong>A total of 313 surgical IE cases were identified (41 pre-2008, 272 post-2008). Mean annual incidence rose from 10.0 pre-2008 to 18.1 post-2008 cases per year. Poisson regression demonstrated a significantly higher incidence post-2008 (incidence rate ratio [IRR] 1.81, 95% CI 1.30-2.53, p < 0.001). The odds of dental-associated pathogens were unchanged (OR 0.65, 95% CI 0.24-1.74, p = 0.39). Staphylococcus aureus predominated in the later cohort, while the proportion of oral streptococci remained stable. Surgical characteristics, including prosthetic valve involvement (OR 1.61, 95% CI 0.78-3.29, p = 0.20) and urgency (OR 0.89, 95% CI 0.35-2.27, p = 0.81), were similar between groups.</p><p><strong>Conclusions: </strong>The 2008 NICE recommendation to discontinue dental antibiotic prophylaxis was associated with a significant rise in surgically managed IE at our centre. However, the microbiological and surgical profiles of IE remained consistent, with no increase in cases attributable to oral streptococci. These findings suggest that factors beyond dental prophylaxis may concomitantly contribute to the observed rise in surgical IE.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838439","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":"Efficacy and safety of perioperative magnesium on postoperative pain in adult patients undergoing cardiothoracic surgeries- a systematic review and meta-analysis.","authors":"R K Swetha, Balasubramaniam Gayathri, Madhumitha Haridoss, Deepakraj Kuppuraman, Sananthya Karthikeyan","doi":"10.1186/s13019-026-04252-0","DOIUrl":"https://doi.org/10.1186/s13019-026-04252-0","url":null,"abstract":"<p><strong>Background: </strong>Cardiothoracic surgeries such as CABG, valve replacement, and thoracotomy are associated with significant postoperative pain, for which opioids remain the primary treatment despite notable adverse effects and tolerance. Magnesium, an NMDA receptor antagonist with analgesic and cardioprotective properties, has been suggested as a perioperative adjuvant to improve pain control. This systematic review and meta-analysis examined the efficacy and safety of perioperative magnesium for postoperative pain relief in adult cardiothoracic surgery patients.</p><p><strong>Methods: </strong>The review followed PRISMA guidelines and was registered with PROSPERO (CRD420251049449). A search was conducted in PubMed, EMBASE, Scopus, and CENTRAL up to 14 May 2025 for randomized controlled trials comparing perioperative magnesium with placebo or other analgesics in adult patients undergoing cardiothoracic surgery. Pain scores, opioid consumption (MME), time to rescue analgesia, length of hospital stay, and adverse events were analyzed. Random-effects meta-analyses were performed using R Studio (v4.3.2) with mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Ten RCTs involving 1,140 participants were included. Magnesium significantly reduced pain intensity compared with placebo at 24 h postoperatively (MD - 0.85, 95% CI: -1.53 to - 0.16), although the effect did not reach the minimal clinically important difference. No significant differences were observed when magnesium was compared with active analgesics. For all other outcomes, including opioid consumption (MME), time to first rescue analgesia, and length of hospital stay, no significant differences were found in pooled analyses versus either placebo or other analgesics. Heterogeneity was substantial across most outcomes (I² > 75%), and no major adverse events were reported.</p><p><strong>Conclusion: </strong>Perioperative magnesium shows small and safe analgesic effects after cardiothoracic surgery, but the clinical relevance remains uncertain due to substantial heterogeneity and variable dosing. Further robust trials are needed to define its efficacy and optimal use.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838359","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":"Optical coherence tomography assessment of rapidly progressive pulmonary vein stenosis in fibrosing mediastinitis: a case report.","authors":"Haijuan Wang, Zhaofen Wang, Xiuli Li, Peng Chang","doi":"10.1186/s13019-026-04259-7","DOIUrl":"https://doi.org/10.1186/s13019-026-04259-7","url":null,"abstract":"<p><p>Fibrosing mediastinitis is a rare disease caused by benign proliferation of fibrous tissue within the mediastinum encircling the mediastinal organs, leading to compression of the surrounding bronchial and blood vessels. We report a case of fibrosing mediastinitis with rapidly progressive pulmonary vein stenosis evaluated using multimodality imaging. Computed tomographic pulmonary angiography demonstrated multiple pulmonary vein stenoses, while intravascular optical coherence tomography provided high-resolution characterization of the lesions, showing smooth vessel walls without evidence of thrombosis or significant intimal hyperplasia, suggesting an extrinsic compressive mechanism. These imaging findings complemented conventional angiography and influenced interventional strategy. This case highlights the incremental value of optical coherence tomography in assessing pulmonary vein stenosis associated with fibrosing mediastinitis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838408","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":"Evaluation of large language models in cardiovascular surgery: a comparative study of board-level clinical question answering and generation.","authors":"Mehmet Inanc Yesilkaya, Uzeyir Yilmaz","doi":"10.1186/s13019-026-04251-1","DOIUrl":"https://doi.org/10.1186/s13019-026-04251-1","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are increasingly being explored in surgical training and clinical knowledge assessment. Although these models have demonstrated promising performance in standardized examinations, their performance in highly specialized fields such as cardiovascular surgery remains insufficiently investigated. This study aimed to evaluate the performance of current large language models in answering and generating board-level cardiovascular surgery questions reflecting guideline-based clinical reasoning.</p><p><strong>Methods: </strong>In this cross-sectional evaluation study, three large language models (ChatGPT-5.1, Gemini 3, and DeepSeek v3.2) were evaluated in two stages. In the first stage, the models answered 150 multiple-choice questions developed and validated by five cardiovascular surgery specialists using a Delphi process, designed to reflect the content scope and difficulty level of the American Board of Thoracic Surgery certification examination. Accuracy rates and pairwise comparisons were analyzed using the McNemar test. In the second stage, model-generated questions were evaluated by expert cardiovascular surgeons in terms of medical accuracy, clinical relevance, exam-level appropriateness, error type, and difficulty level. Statistical analyses included Spearman correlation, Wilcoxon signed-rank test, and chi-square analysis.</p><p><strong>Results: </strong>The models demonstrated comparable accuracy rates (ChatGPT 80.7%; Gemini 78.7%; DeepSeek 82.0%), with no statistically significant differences between them. Question difficulty level was not associated with model accuracy. Error distribution differed significantly between models (χ² = 8.1; p = 0.02), with Gemini demonstrating the highest rate of valid question generation and DeepSeek showing a higher rate of major errors. A significant positive correlation was observed between model- and expert-assigned difficulty levels.</p><p><strong>Conclusions: </strong>Current large language models demonstrate strong performance in board-level cardiovascular surgery knowledge assessment. However, the presence of major errors and variability in difficulty calibration, together with known limitations in clinical reasoning, indicate that these systems should be used cautiously as supportive tools in surgical training and knowledge assessment rather than as substitutes for clinical decision-making.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838365","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":"Nationwide trends in incidence of deep sternal wound infection after cardiac surgery and its association with long-term mortality.","authors":"Luis Gisli Rabelo, Carlos Magnus Rabelo, Astridur Petursdottir, Arni Steinn Steinthorsson, Tomas Gudbjartsson","doi":"10.1186/s13019-026-04216-4","DOIUrl":"https://doi.org/10.1186/s13019-026-04216-4","url":null,"abstract":"<p><strong>Background: </strong>While early outcomes of deep sternal wound infection (DSWI) after cardiac surgery are well documented, its association with long-term mortality remains less clear. We aimed to investigate trends in DSWI incidence in a well-defined nationwide cohort and evaluate its association with long-term mortality.</p><p><strong>Materials and methods: </strong>This observational study investigated all DSWI patients after cardiac surgery via sternotomy at Landspitali University Hospital from 2001-2024, with incidence assessed across 4-year intervals. Incidence of DSWI was evaluated from 2001-2024, while survival analyses were restricted to patients operated between 2001-2017 to allow adequate long-term follow-up and ensure comparability with respect to the surgical era. Long-term survival was assessed using Kaplan-Meier graphs and a Cox regression model with time-splitting at 90 days and 5 years. Median follow-up was 9.2 [5.7-13.0] years, and survival analyses were truncated at 10 years to ensure comparable observation time between groups.</p><p><strong>Results: </strong>Out of 4596 patients who underwent cardiac surgery via median sternotomy, 53 (1.2%) developed DSWI. The incidence declined from 2.5% in 2001-2004 to 0% in 2021-2024 (p<0.001), with no DSWI cases identified after 2017. DSWI patients were older and had a higher comorbidity burden compared to the non-DSWI cohort. Patients in the DSWI group had an approximately twofold higher risk of mortality 5 to 10 years after surgery than the non-DSWI patients (aHR = 1.9, 95% CI=1.1-3.3).</p><p><strong>Conclusions: </strong>Rates of DSWI after cardiac surgery in Iceland have significantly decreased over the last 24 years, with no cases diagnosed from 2018 to 2024. This decline is important since DSWI remains associated with increased health care costs, but more importantly, higher long-term mortality after cardiac surgery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838362","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":"Myeloid sarcoma of the sternum with regional lymph node involvement in a 6-year-old child: a case report.","authors":"Zhibing Sun, Ye Lin, Xuming Mo, Yuxi Zhang, Hui Liu, Nishant Patel, Kaihong Wu","doi":"10.1186/s13019-026-04162-1","DOIUrl":"https://doi.org/10.1186/s13019-026-04162-1","url":null,"abstract":"<p><strong>Background: </strong>Myeloid sarcoma is a rare extramedullary tumor composed of myeloid progenitor cells, often associated with acute myeloid leukemia or other hematologic malignancies. Primary involvement of the sternum in children is extremely uncommon and may pose substantial diagnostic challenges.</p><p><strong>Case presentation: </strong>A 6-year-old boy presented with recurrent sternal pain lasting over four months, along with low back pain, bilateral breast pain, and fever. Imaging showed a destructive sternal lesion with an adjacent soft tissue mass, initially raising suspicion for Ewing sarcoma. Bone marrow aspiration demonstrated active hematopoiesis without increased blasts or leukemic infiltration, and leukemia immunophenotyping showed no abnormal leukemic cell population. PET-CT demonstrated a hypermetabolic destructive sternal lesion and a hypermetabolic nodular lesion adjacent to the right internal mammary vessels, without other definite malignant lesions elsewhere in the body. Because the preoperative biopsy yielded limited cellularity and remained inconclusive, surgical resection was performed for definitive diagnosis. Histopathology and immunohistochemistry confirmed myeloid sarcoma. Two resected parasternal lymph nodes also showed tumor involvement. After surgery, the patient was transferred to the hematology department and received induction chemotherapy with the VAH regimen according to the CCLG-AML-2024 protocol. According to the final hematology assessment, the patient was classified as intermediate risk. At the latest documented follow-up in January 2026, complete blood counts remained within normal limits, and chest CT showed no obvious solid mass around the sternum or enlarged mediastinal lymph nodes.</p><p><strong>Conclusions: </strong>Myeloid sarcoma should be considered in the differential diagnosis of pediatric chest masses, even in the absence of overt bone marrow involvement. Accurate diagnosis requires integration of imaging, histopathology, and immunohistochemistry. Surgery plays an important role in diagnostic confirmation and local control, whereas systemic AML-type chemotherapy remains the standard treatment strategy. Early recognition and multidisciplinary management are essential for improving outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838414","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":"What is the optimal antiplatelet therapy in patients with chronic coronary syndrome undergoing coronary artery bypass grafting?","authors":"Sleiman Sebastian Aboul-Hassan, Bartlomiej Perek, Mariusz Kowalewski, Konrad Pieszko, Slawomir Mierzwa, Tomasz Stankowski, Mario Gaudino, Sigrid Sandner, Romuald Cichon","doi":"10.1186/s13019-026-04256-w","DOIUrl":"https://doi.org/10.1186/s13019-026-04256-w","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic coronary syndrome (CCS) make up a large portion of those undergoing coronary artery bypass grafting (CABG), and there are significant gaps in the evidence regarding the optimal aspirin dosage after CABG and whether dual antiplatelet therapy (DAPT) should be initiated after CABG. Therefore, we aimed to address this issue.</p><p><strong>Methods: </strong>Between January-2010 and June-2022, 1607-patients who underwent primary isolated CABG with CCS were included in the final analysis and divided into three groups according to their discharge antiplatelet treatment: patients receiving 75 mg of aspirin (n = 526), patients receiving 300 mg of aspirin (n = 825) and patients receiving DAPT consisting of aspirin 75 mg and clopidogrel 75 mg (n = 256). Three separate propensity-matched analyses were performed: aspirin 75 mg vs aspirin 300 mg, DAPT vs aspirin 75 mg and aspirin 300 mg vs DAPT. Primary endpoint was long-term incidence major adverse cardiac and cerebral events (MACCE), defined as the composite of all-cause mortality, myocardial infarction, repeat revascularization and stroke. Furthermore, 497 angiograms were retrieved at follow-up and graft patency was evaluated.</p><p><strong>Results: </strong>In the matched cohort, aspirin 300 mg and DAPT, compared with aspirin 75 mg at discharge, were associated with reduced incidence of MACCE (HR:0.65; 95% CI [0.48-0.86]; adjusted P = 0.009) and (HR:0.62; 95% CI [0.41-0.93]; adjusted P = 0.04), respectively. However, the incidence of MACCE was comparable between aspirin 300 mg and DAPT at follow-up (HR:0.86; 95% CI [0.55-1.33]; adjusted P = 0.50). As for the retrieved angiograms at follow-up, aspirin 300 mg and DAPT were associated with a lower incidence of any graft failure (19.2% vs. 25.8%; P = 0.009) and (14.7% vs. 25.8%; P = 0.007), respectively, compared with aspirin 75 mg. On the other hand, aspirin 300 mg and DAPT had comparable incidence of any graft failure.</p><p><strong>Conclusions: </strong>In patients with CCS following CABG, discharge treatment with 300 mg aspirin or DAPT was associated with a lower incidence of MACCE and better graft patency than 75 mg aspirin; however, these findings should be interpreted cautiously given the observational design and potential for residual confounding.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838320","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":"Association of serum lactate and one-year mortality among women with coronary artery bypass grafting surgery: filling gaps in female.","authors":"Rong Zhang, Kai Zhang, Bo Li","doi":"10.1186/s13019-026-04188-5","DOIUrl":"https://doi.org/10.1186/s13019-026-04188-5","url":null,"abstract":"<p><strong>Background: </strong>An abnormal perioperative blood lactate level has been reported to be associated with poor outcomes after cardiac surgery. However, their impact on female patients remains underexplored. This large-scale retrospective study evaluated the relationship between serum lactate level and one-year mortality in critically ill female patients with coronary artery bypass grafting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort analysis using data from an American ICU registry, focusing on female patients admitted for CABG at Beth Israel Deaconess Medical Center from 2008 to 2023. The primary outcome was one-year mortality. We employed Cox regression and a restricted cubic spline to examine the association between serum lactate and outcomes.</p><p><strong>Results: </strong>A total of 1,279 female adult patients were included, with a mean age of 70.8 ± 10.0 years and a mean BMI of 30.8 ± 6.9 kg/m². After adjusting for confounders, Cox regression revealed that patients in the lowest quartile (Q1: <1.75 mmol/L) had a 0.96-fold increased risk of one-year mortality (HR 1.96; 95% CI 1.05-3.67, P = 0.036), while those in the third quartile (Q3: >2.3 mmol/L) had a 1.2-fold increased risk (HR 2.2; 95% CI 1.19-4.07, P = 0.012), compared to the second quartile (Q2: 1.75-2.3 mmol/L). Spline regression indicated a U-shaped dose-response relationship, with the lowest mortality risk observed at a serum lactate level of 140.5 mmol/L. Stratified and sensitivity analyses supported these findings.</p><p><strong>Conclusions: </strong>Our study suggests a U-shaped relationship between serum lactate levels and one-year mortality in female CABG patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838361","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":"Left ventricular assist devices and right heart dysfunction: a review of impact mechanisms, evaluation methods, and prevention and management.","authors":"Zhiwei Fan, Pengyu Zhou, Shiliang Li, Shaopeng Cheng, Yumeng Wang, Jun Pan, Kunsheng Li","doi":"10.1186/s13019-026-04003-1","DOIUrl":"https://doi.org/10.1186/s13019-026-04003-1","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular assist devices (LVADs) have become an important treatment option for patients with end-stage heart failure, significantly improving left ventricular function and patient survival rates. However, LVAD implantation has complex effects on right heart function, and right heart dysfunction is a critical factor affecting patient prognosis and quality of life.</p><p><strong>Methods: </strong>This article systematically reviews the relationship between LVADs and right heart function, focusing on the importance of right heart function in LVAD patients, evaluation methods, impact mechanisms, and prevention and management strategies. Additionally, it introduces emerging technologies and future research directions to provide references for clinical practice.</p><p><strong>Results: </strong>Studies have shown that comprehensive evaluation of right heart function is crucial for predicting the risk of postoperative right heart dysfunction. The impact mechanisms of LVAD implantation on right heart function are complex, including changes in preload and afterload and ventricular interdependence. Prevention and management of right heart dysfunction require comprehensive measures, including preoperative optimization, meticulous intraoperative procedures, close postoperative monitoring, and multidisciplinary team collaboration. Emerging technologies such as improved LVAD designs, biventricular assist devices, gene therapy, and personalized medicine offer new hope for reducing the incidence of right heart dysfunction.</p><p><strong>Conclusion: </strong>Right heart function holds undeniable importance in LVAD therapy. Through comprehensive evaluation, prevention, and management of right heart function, as well as the application of new technologies, it is expected to reduce the incidence of right heart dysfunction and improve the prognosis and quality of life of LVAD patients. More high-quality research is needed in the future to promote the clinical application of emerging technologies and provide more comprehensive treatment options for patients with end-stage heart failure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838398","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":"Evaluation of endovascular procedures for abdominal false lumen repair in patients with post-dissection aortic aneurysm.","authors":"Chen Yi Chai, Ching-Lin Ho, You-Cian Lin","doi":"10.1186/s13019-026-04196-5","DOIUrl":"https://doi.org/10.1186/s13019-026-04196-5","url":null,"abstract":"<p><strong>Background: </strong>Several endovascular strategies for post-dissection aortic aneurysm (PDAA) have been reported to show benefits and lower morbidity. This study aimed to investigate the potential benefits of the candy plug and double splint technique on abdominal false lumen repair in patients with PDAA.</p><p><strong>Methods: </strong>Patients with PDAA who received the candy plug or double splint technique for abdominal false lumen (FL) repair between November 2016 and December 2022 were retrospectively included. The mean age of patients was 49.1 ± 11.5 years (range: 27-79 years). The medical records were reviewed, and computed tomography results were utilized to evaluate the aortic remodeling after surgery.</p><p><strong>Results: </strong>Technical success was achieved in all patients without any intraoperative complications, or mortality. In patients receiving the candy plug technique, the true lumen (TL) areas at the celiac axis (p = 0.039) and superior mesenteric artery (p = 0.008) levels were significantly increased. In patients receiving the double splint technique, the TL areas at the celiac axis (p = 0.031), superior mesenteric artery (p = 0.016) and renal artery (p = 0.047) levels were significantly increased. No obvious FL expansion or operation-related complication/mortality was noted in patients receiving either procedure during the follow-up period.</p><p><strong>Conclusion: </strong>The abdominal FL expansion could be limited by both candy plug and double splint technique, which reduces the possibility of aneurysm rupture. Moreover, the aortic remodeling regarding the TL expansion was observed for both techniques. The safety of the procedures was considered acceptable. A larger sample size and longer follow-up period are needed to confirm the preliminary results.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838382","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}