Journal of Cardiothoracic Surgery最新文献

{"title":"The efficacy of the 4-hook needle localization for pulmonary ground glass nodules: a single-center retrospective analysis.","authors":"Yonghui Wu, Jiannan Xu, Kai Zhang, Yuanheng Huang, Jian Zhang, Huiguo Chen","doi":"10.1186/s13019-025-03371-4","DOIUrl":"10.1186/s13019-025-03371-4","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the efficacy of the 4-hook needle localization for pulmonary ground glass nodules (GGNs).</p><p><strong>Methods: </strong>From November 1, 2021, to May 31, 2024, 194 patients were diagnosed with one or more GGNs by computed tomography (CT) scan and underwent preoperative CT-guided 4-hook needle localization followed by video-assisted thoracoscope surgery (VATS) wedge resection, segmentectomy or lobectomy. There were 226 nodules in all patients. We analyzed the 4-hook needle localization safety, complications, safe margin and localization depth.</p><p><strong>Results: </strong>The 4-hook needle localizations success rate was 100% and didn't take place in displacement and dislodgment. The tumor margin distance is about 5-20 mm and all tumor margin was negative thorough final pathology result. 9 patients occurred small parenchymal hemorrhage, 13 patients occurred small pneumothorax and 8 patients occurred small hemoptysis, those complications needn't intervene or tackle and didn't affect surgery. Compared upper and middle lobe to lower lobe, localization time was 13.92 ± 4.6 min vs 13.66 ± 4.28 min respectively, p = 0.69, there was no significant statistical difference. Localization depth was 18.63 ± 7.8 mm vs 15.87 ± 8.52 mm respectively, p = 0.02, there were statistical differences, but the margin tumor distance was 5.16 ± 4.94 mm vs 4.93 ± 3.64 mm, p = 0.73 respectively, there was no statistical difference.</p><p><strong>Conclusions: </strong>Preoperative 4-hook needle localization is safe and feasible for GGNs. Guided by 4-hook needle localization, wedge resection can ensure enough safe margins and patient was well tolerated.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"146"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573058","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":"Abnormal arterial ligation alone for patients with anomalous systemic arterial supply to the left basal segment of the lung: three case series.","authors":"Huiming Han, Sida Cheng, Hui Zhao, Jianfeng Li, Fan Yang, Hao Li","doi":"10.1186/s13019-024-03280-y","DOIUrl":"10.1186/s13019-024-03280-y","url":null,"abstract":"<p><strong>Background: </strong>Anomalous systemic arterial supply to the left basal segment of the lung is a rare congenital pulmonary vascular malformation, historically classified as a variant of intra-lobar pulmonary sequestration. The standard surgical approach has typically involved ligation of the anomalous artery in combination with lobectomy or segmentectomy.</p><p><strong>Case description: </strong>We present three cases of anomalous systemic arterial supply to the left basal segment of the lung, all successfully treated with thoracoscopic anomalous arterial ligation alone. In one case, indocyanine green was used to assess the blood supply, enhancing procedural safety.</p><p><strong>Conclusion: </strong>Thoracoscopic ligation of the anomalous artery alone may be a safe and lung-preserving surgical option for patients with this rare anomaly. The use of indocyanine green can further improve the safety of the procedure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"147"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573055","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 role of ELISA IgG antibodies in diagnosis of cystic echinococosis of lung. A retrospective study of a single centre activity in Albania.","authors":"Fatmir Caushi, Eritjan Tashi, Arben Tanka, Arian Mezini, Valbona Gjoni, Ilir Skenduli, Silva Tafaj, Silvana Bala, Ornela Nuredini, Agron Meshi, Emira Hysa, Francesco Rulli","doi":"10.1186/s13019-024-03308-3","DOIUrl":"10.1186/s13019-024-03308-3","url":null,"abstract":"<p><strong>Background: </strong>Cystic Echinococcosis presents significant biological, medical, economic, and social challenges. The diagnosis of cystic echinococcosis relies on immunodiagnostic methods alongside radiological in combinations with clinical findings. In human Cystic Echinococcosis, false negative immunologic results can occur in 3-5% of patients and reach up to 35-40% in hyper endemic regions. This study aimed to assess the role of Elisa IgG CE serum antibody titres in diagnosing pulmonary Cystic Echinococcosis.</p><p><strong>Material and methods: </strong>A retrospective review of medical records for 362 CE patients diagnosed in a cohort of 20 years was conducted. Diagnosis was based on radiological and clinical data, personal and family history with confirmation by serodiagnosis or histology in surgery cases. Age, sex, cysts location, size, complications and treatment were reviewed. ELISA IgG CE was studied preoperatively in all cases with its specificity and sensitivity in all cases RESULTS: The cohort included 362 patients of whom 51.4% males and 48.6% females, with a mean age of 40 years (range 12-80). 42 % were from rural regions. Among the cases, 112 (31%) presented with intact cysts, while 250 (69%) were complicated. ELISA IgG CE serum antibody titre tests were conducted for all cases. 350 (96.7%) underwent surgical treatment, while the remainder received conservative care. ELISA IgG CE was positive in 181 patients (50%). The sensitivity was 70% (175 patients) for complicated cases, but only 18.8% (21 patients) for uncomplicated cases.</p><p><strong>Conclusions: </strong>ELISA IgG CE has limited value in diagnosing CE. However, it may aid in identifying complicated CE. Interpretation of ELISA IgE CE results should consider clinical imaging findings. Establishing pre and postoperative surveillance protocols involving family doctors and diagnostic imaging services can enhance patient care quality.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"145"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application feasibility of virtual models and computational fluid dynamics for the planning and evaluation of aortic repair surgery for Williams syndrome.","authors":"Jixiang Liang, Xuewei Fang, Dianyuan Li, Guangyu Pan, Gen Zhang, Bingheng Lu","doi":"10.1186/s13019-024-03286-6","DOIUrl":"10.1186/s13019-024-03286-6","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis and evaluation of Williams Syndrome (WS) are essential yet challenging for effective surgical management. This study aimed to quantify the hemodynamic changes of surgical repair for WS through virtual surgery and computational fluid dynamics (CFD) for surgical guidance and postoperative evaluation.</p><p><strong>Methods: </strong>A patient preliminarily diagnosed with WS was included in this study. 3D model alongside hemodynamic analysis was used to guide and evaluate the surgical procedure. Preoperative, predictive and postoperative models were created and analyzed using CFD. Key parameters, including blood flow velocity, pressure differences, wall shear stress, and other critical factors, were assessed to evaluate the surgery's effectiveness.</p><p><strong>Results: </strong>In the hemodynamics analysis, the CFD results of predictive model and postoperative model demonstrated a high level of consistency, and showed significant differences compared to the preoperative model. The velocity at the stenosis on the aorta decreased from 5.6 m/s before the operation to 1.6 m/s in the virtual model and 1.5 m/s in the postoperative model. Surgical repair increased the proportion of outlet flow of the descending aorta (dAo) from 28.7% to 35.5%.</p><p><strong>Conclusions: </strong>Virtual surgery and CFD can predict surgical outcomes, enabling doctors to optimize and rehearse the procedure before the actual surgery. The method of predicting surgery through virtual surgery and CFD is accurate and feasible.</p><p><strong>Trial registration: </strong>Registered by the Ethics Committee of Peking University International Hospital (No. IRB2019-062).</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"144"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556980","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":"Evaluation of hemolysis in patients supported with Impella 5.5: a single center experience.","authors":"Jessica S Clothier, Serge Kobsa, Lynette Lester, Nithya Rajeev, Markian Bojko, Jonathan Praeger, Mark Barr, Raymond Lee","doi":"10.1186/s13019-025-03352-7","DOIUrl":"10.1186/s13019-025-03352-7","url":null,"abstract":"<p><strong>Background: </strong>Hemolysis, variably defined in mechanical circulatory support (MCS), is understudied in percutaneous left ventricular assist devices. We characterize hemolytic sequelae of Impella 5.5-supported patients in the largest series to date.</p><p><strong>Methods: </strong>All Impella 5.5 patients at our center from 2020 to 2023 were identified (n = 169) and retrospectively reviewed. Patients with a plasma free hemoglobin (PfHb) recorded (and not previously elevated) were included (n = 123). The top (high hemolysis [HH], n = 26) and bottom (low hemolysis [LH], n = 25) quintiles were categorized based on PfHb levels. Analysis between groups identified factors associated with hemolysis.</p><p><strong>Results: </strong>HH patients had higher admission SCAI stages (p = 0.008), more Impella 5.5 days (23.5 v 10.0, p = 0.001), more additional MCS (16/26 [61.5%] v 6/25 [24.0%], p = 0.015), and more transfusions of packed red blood cells (12.5 v 4.0, p = 0.001), fresh frozen plasma (2.5 v 0.0, p = 0.033), and platelets (3.0 v 0.0, p = 0.002). Logistic regression identified additional MCS (OR 10.82, p = 0.004) and more Impella days (OR 1.13 p = 0.006) as hemolysis risk factors. Eleven (44%) LH and 19/26 (73%) HH patients died, with no significant differences between postoperative complications. Compared with those who died, HH survivors had fewer platelet transfusions (2.0 vs. 5.0, p = 0.01) and less PfHb elevation days (3.0 v 6.0, p = 0.007).</p><p><strong>Conclusions: </strong>Hemolysis in this high-risk cohort has a poor prognosis. HH patients spent more days on Impella 5.5, needed more MCS, and required more blood product transfusions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"143"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531495","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":"Minimally invasive surgery via bilateral thoracotomy for treating left ventricular aneurysm with concomitant ventricular septal rupture.","authors":"Qianzhen Li, Xiaodong Chen, Weiye Xu, Liangwan Chen","doi":"10.1186/s13019-025-03355-4","DOIUrl":"10.1186/s13019-025-03355-4","url":null,"abstract":"<p><strong>Background: </strong>Full median sternotomy is the traditional approach for the treatment of left ventricular aneurysms (LVA) with or without concomitant ventricular septal rupture (VSR). However, it has some disadvantages such as reduced breathing and exercise thoracic stability, which may increase the surgical risk for older or fragile patients. Herein, we report a case of successful minimally invasive bilateral thoracotomy.</p><p><strong>Patient and method: </strong>A 79-year-old male patient visited our center complaining of breathlessness and orthopnea 21 days after an acute myocardial infarction and percutaneous coronary intervention. An LVA (34.7 mm × 44.4 mm) and a VSR with a diameter of 10 mm close to the apex was detected by echocardiography. Bilateral thoracotomy was performed via two incisions: a 3 cm incision at the right 3rd intercostal space for the aortic root and left atrium vent cannula and aortic clamping; a 7 cm incision at the left 5th intercostal space to expose the apex for LVA and VSR repair. The patient was discharged 7 days postoperatively without any complications.</p><p><strong>Conclusion: </strong>LVA with or without VSR can be successfully repaired via bilateral thoracotomy with promising outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"142"},"PeriodicalIF":1.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492016","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":"Incidence of secondary pericardial effusions associated with different etiologies: a comprehensive review of literature.","authors":"Pouya Ebrahimi, Homa Taheri, Pegah Bahiraie, Florian Rader, Robert J Siegel, Mohammad Hosein Mandegar, Kaveh Hosseini, Farhan Shahid","doi":"10.1186/s13019-025-03370-5","DOIUrl":"10.1186/s13019-025-03370-5","url":null,"abstract":"<p><p>Pericardial effusion is a relatively common complication associated with inflammatory and non-inflammatory diseases. The primary etiology of this condition could be considered when choosing therapeutic options and factors such as effusion size and its hemodynamic consequence. In most cases, small to moderate pericardial effusions can be managed with observation and anti-inflammatory medications unless the effusion develops rapidly. However, in a small proportion of patients, large effusions lead to impaired cardiac filling with hemodynamic compromise and cardiovascular collapse due to cardiac tamponade. The rate at which fluid accumulates is the primary determinant of hemodynamic impact and thus guides the choice of treatment, irrespective of the effusion's size. Severe cases are typically treated with pericardiocentesis with echocardiographic guidance. More aggressive treatments may be necessary for cases due to purulent or malignant etiologies. These cases may require a pericardial window to allow for long-term drainage of the pericardial fluid. This comprehensive review focuses on the epidemiology of pericardial effusion and discusses pathophysiology, diagnostic approaches, and therapeutic options for different causes of secondary pericardial effusions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"141"},"PeriodicalIF":1.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476690","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":"Management of a malignant solitary fibrous tumor of lung by uniportal video-assisted pneumonectomy: a case report.","authors":"Ranhua Li, Yanlong Yang, Yanan Bao, Yong Zhou, Yue Cui, Guosheng Xiong, Jing Zhang, Yunping Zhao, Xiaobo Chen, Xiaochuan Yin","doi":"10.1186/s13019-025-03375-0","DOIUrl":"10.1186/s13019-025-03375-0","url":null,"abstract":"<p><strong>Background: </strong>Solitary fibrous tumor (SFT) is a rare condition first described by Klemperer and Robin in 1931. Malignant SFTs account for approximately 80% of all SFT cases, and the five-year survival for malignant SFTs is 81%. Few reports have described SFT management using uniportal video-assisted pneumonectomy.</p><p><strong>Case presentation: </strong>A 35-year-old male patient with a tumor in the left pulmonary was assessed using preoperative three-dimensional computed tomography (3D-CT) reconstruction and treated via uniportal video-assisted pneumonectomy. A pathological diagnosis of SFT was confirmed.</p><p><strong>Conclusions: </strong>The 3D-CT reconstruction may help to provide an appropriate operative strategy for surgeons. It is necessary to control the main pulmonary arterial trunk to avoid hemorrhage when preoperative evaluation does not exclude the possibility of intraoperative hemorrhage. The choice of surgery area is affected by SFT size and location.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"140"},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476055","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":"Therapeutic potential of miR-133a-transfected bone marrow mesenchymal stem cell transplantation in improving cardiac function post-myocardial infarction.","authors":"Yanglanduo Cao, Xiaohan Chen, Biao Cheng, Xuefei Tao, Wei Zhang, Yong Shi, Jie Gao, Minghuan Fu","doi":"10.1186/s13019-025-03367-0","DOIUrl":"10.1186/s13019-025-03367-0","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to examine the therapeutic efficacy of miR-133a-transfected bone marrow mesenchymal stem cells (BM-MSCs) in restoring damaged myocardium, reducing myocardial fibrosis, and improving cardiac function following myocardial infarction (MI).</p><p><strong>Methods: </strong>Bone marrow mesenchymal stem cells (BM-MSCs) were transfected with miR-133a using lentivirus vectors, and the in vitro transfection efficiency was assessed. A rat MI animal model was established to examine the survival rate of miR-133a-transfected BM-MSCs in ischemic myocardium. The effects of miR-133a transfection on rat primary cardiac fibroblasts were evaluated both in vitro and in vivo.</p><p><strong>Results: </strong>The experimental group had a significantly higher concentration of double-stranded DNA (dsDNA) compared to the control group. Fluorescent staining revealed an enhanced survival rate of MSCs in the miR-133a transfection group compared to controls. Additionally, the protein and gene expression of apoptosis-related indicators in the infarcted myocardium were lower in the experimental group compared to the control group. Following co-culture with rat primary cardiac fibroblasts, the miR-133a-transfected MSCs exhibited a significantly lower expression of myofibroblast-specific proteins and mRNA compared to controls. The levels of collagen I, connective tissue growth factor (CTGF) protein, and messenger RNA (mRNA) in the infarcted myocardium of rats transplanted with BM-MSCs transfected with miR-133a were significantly lower than those in the control group, and their left ventricular ejection fraction (LVEF) was significantly increased compared with the group that received unmodified BM-MSCs.</p><p><strong>Conclusion: </strong>Our results demonstrate that miR-133a transfection following MI improves the survival rate of transplanted MSCs in ischemia-hypoxic myocardium, inhibits the transformation of cardiac fibroblasts into myofibroblasts, reduces myocardial fibrosis, and improves cardiac function following MI. This approach holds promise as a novel therapeutic strategy for myocardial repair.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"139"},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472476","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":"Risk factors influencing the prognosis of patients with acute myocardial infarction and cardiogenic shock undergoing extracorporeal membrane oxygenation therapy.","authors":"Guoying Zheng, Zhuoqian Xu, Shuwen Yao, Xiao Liu, Shuxiang Wang, Haitian Huang, Yuanyuan Li","doi":"10.1186/s13019-025-03348-3","DOIUrl":"10.1186/s13019-025-03348-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) face high mortality rates. Extracorporeal Membrane Oxygenation (ECMO) therapy offers critical support in these cases, yet identifying factors that influence patient outcomes is crucial for improving survival rates.</p><p><strong>Methods: </strong>This retrospective study included 63 patients with AMI and CS who underwent ECMO therapy at our institution from January 2020 to December 2023. Patients were categorized into survivors (n = 33) and non-survivors (n = 30) based on 30-day outcomes. Data collected included demographics, clinical history, hemodynamic and biomarker parameters, and treatment details such as time from symptom onset to percutaneous coronary intervention (PCI) and the use of intra-aortic balloon pump (IABP). Logistic regression models and ROC curve analysis were used to evaluate the predictive value of various factors.</p><p><strong>Results: </strong>Non-survivors had significantly higher arterial blood lactate levels (8.0 [6.2, 11.0] mmol/L vs. 4.8 [3.0, 8.5] mmol/L, p = 0.015) and required more intensive vasoactive support, as indicated by higher Vasoactive-Inotropic Scores (VIS) (130 [IQR: 105, 175] vs. 100 [IQR: 60, 115], p = 0.016). They also experienced longer delays from symptom onset to PCI (15.5 [IQR: 11.0, 20.5] hours vs. 9.5 [IQR: 7.0, 12.0] hours, p = 0.001). The prevalence of left main coronary artery disease (33.3% vs. 12.1%, p = 0.013) and triple vessel disease (36.7% vs. 9.1%, p = 0.002) was higher in non-survivors. ROC analysis identified arterial blood lactate (AUC = 0.6909), time from onset to PCI (AUC = 0.7667), and VIS (AUC = 0.703) as significant predictors of prognosis. Logistic regression showed that arterial blood lactate (OR = 1.884, p = 0.039), VIS (OR = 1.122, p = 0.033), and time from onset to PCI (OR = 108.271, p = 0.039) were significantly associated with worse outcomes.</p><p><strong>Conclusions: </strong>Elevated arterial blood lactate, prolonged time to PCI, and higher VIS could be important predictors of poor outcomes in AMI-CS patients undergoing ECMO therapy. Timely intervention, including rapid revascularization and effective management of metabolic disturbances, might be key to improving survival.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"138"},"PeriodicalIF":1.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467988","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}