Journal of Cardiothoracic Surgery最新文献

{"title":"Surgical resection of a rare biatrial giant sarcoma: a case report.","authors":"Jingyi Wu, Yimei Lin, Juanlan Liu, Junmei Wu, Hao Zhang, Chao Liang","doi":"10.1186/s13019-025-03439-1","DOIUrl":"https://doi.org/10.1186/s13019-025-03439-1","url":null,"abstract":"<p><p>Primary cardiac undifferentiated sarcoma is an exceptionally rare entity, marked by nonspecific symptoms that considerably challenge its diagnosis and treatment. Surgical resection generally serves as the primary treatment modality. This article describes the case of a 32-year-old female patient admitted to the hospital with symptoms of abdominal distension and pain. Subsequent echocardiography revealed a cardiac tumor that occupied almost the entire left and right atria. The tumor was surgically removed in an emergency procedure, and subsequent pathological examination confirmed an undifferentiated sarcoma. The patient was successfully discharged 17 days after surgery. She then completed six cycles of chemotherapy. A six-month follow-up showed no signs of tumor recurrence or metastasis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"186"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997967","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 direct coronary artery bypass versus single internal thoracic artery grafting procedures for multivessel coronary artery disease: a single-center retrospective analysis.","authors":"Mohammad Kakoush, Amit Gordon, Ariel Farkash, Nadav Teich, Orr Sela, Dmitri Pevni, Tomer Ziv-Baran, Jonathan Kfir, Yanai Ben-Gal","doi":"10.1186/s13019-025-03410-0","DOIUrl":"https://doi.org/10.1186/s13019-025-03410-0","url":null,"abstract":"<p><strong>Objective: </strong>To compare two surgical strategies for myocardial revascularization: one by a minimally invasive direct coronary artery bypass (MIDCAB) and the other by a conventional full sternotomy coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>We reviewed the early outcomes and overall survival of all the patients treated in our center by the above strategies during 2000-2011.</p><p><strong>Results: </strong>Of 1915 patients, 1752 underwent conventional CABG utilizing a single internal thoracic artery (ITA) graft and 163 underwent a MIDCAB procedure. In the former compared to the latter, the patients were older and the median EuroSCORE was higher. The prevalences were higher of diabetes mellitus, recent myocardial infarction, emergency procedures, the.usage of an intra-aortic balloon pump, redo operations, and peripheral vascular disease; and the prevalences lower of chronic obstructive pulmonary disease and chronic renal failure. The median follow-up was 20 years. Early mortality (30 day) was greater in the conventional CABG group (3.6% vs. 0.6%, p = 0.042); and 10-, 15- and 20-year survival rates were lower: 55.1% vs. 76.7%, 37.1% vs. 63.7%, and 23.1% vs. 53.4%, respectively, p < 0.001. In an analysis that compared two matched groups of 134 patients each, early outcomes were similar, but late survival was lower following conventional CABG compared to MIDCAB after 10, 15 and 20 years: 64.7% vs. 74.6%, 44.7% vs. 64.1%, and 28.4% vs. 53.6% respectively, p = 0.004. In multivariable and univariate analysis, MIDCAB strategy compared to conventional single ITA CABG was associated with better late survival; the hazard ratio was 0.429 (95%CI 0.321-0.574, p < 0.001) for the whole cohort and 0.559 (95%CI: 0.376-0.831, p = 0.004), for the matched cohort.</p><p><strong>Conclusions: </strong>Compared to conventional CABG utilizing a single ITA, the MIDCAB procedure demonstrated early safety and long-term effectiveness for surgical myocardial revascularization of the left anterior descending artery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"188"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970458","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":"Optimizing surgical precision: a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC.","authors":"Fangfang Yang, Lei Chen, Hui Wang, Qianyun Wang, Chen Yang","doi":"10.1186/s13019-025-03436-4","DOIUrl":"https://doi.org/10.1186/s13019-025-03436-4","url":null,"abstract":"<p><strong>Background: </strong>In recent years, robot-assisted thoracoscopic surgery has seen major advances. The feasibility and safety of this new surgical procedure have been widely recognized. However, only a few studies have investigated the short-term postoperative outcomes of lobectomy in early-stage non-small cell lung cancer (NSCLC) patients using different numbers of ports in Da Vinci robot-assisted surgery. This study aimed to evaluate the clinical value of robot-assisted lobectomy by comparing the perioperative data of NSCLC patients who underwent three-port and four-port surgical methods.</p><p><strong>Methods: </strong>The data of 121 consecutive patients who were admitted to our hospital for NSCLC and underwent Da Vinci robot-assisted thoracic surgery (RATS) for radical resection from January 2020 to October 2021 were retrospectively collected and analyzed. The cases that did not meet the inclusion criteria were removed, and the patients were divided into the three-port group (76 cases) and the four-port group (45 cases). The general clinical data, perioperative data, and postoperative pain were individually compared to determine the different clinical effectiveness of the two approaches.</p><p><strong>Results: </strong>All 121 patients in the 2 groups successfully underwent lobectomy and systemic lymph node dissection. No significant difference in age, sex, tumor location, tumor size, history of chronic disease, pathological type, pathological tumor-node-metastasis (pTNM) staging, postoperative complications, and number or stations of total lymph nodes dissected was observed between the two groups (P > 0.05). The operation time [(117.32 ± 36.55) min vs. (136.83 ± 40.63) min], the console time [(90 ± 19.35) min vs. (103 ± 15.65) min], the intraoperative blood loss [(94.34 ± 32.16) mL vs. (102.73 ± 33.67) mL], the chest tube drainage time [(2.43 ± 0.65) d vs. (2.79 ± 1.42) d], and the postoperative hospitalization time [(4.55 ± 1.43) d vs. (5.14 ± 1.66) d] were lower in the three-port group compared to the four-port group but showed no statistically significant difference (P > 0.05). However, the three-port group demonstrated significantly superior visual analogue scale pain scores compared to the four-port group at 24, 48, and 72 h postoperatively (all p < 0.001).</p><p><strong>Conclusions: </strong>Compared to four-port RATS, the three-port robotic-assisted lobectomy is safe, practicable and effective. Operative incision optimization leads to less postoperative pain and appears to be more acceptable for patients with NSCLC.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"184"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020160","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":"Bronchoscopic treatment of a giant bronchopleural fistula with autologous platelet-rich plasma.","authors":"Shihu Liu, Yunpeng Xuan, Yongjie Wang, Haiyan Wang","doi":"10.1186/s13019-025-03396-9","DOIUrl":"https://doi.org/10.1186/s13019-025-03396-9","url":null,"abstract":"<p><strong>Background: </strong>Bronchopleural fistula (BPF) is a severe complication observed in patients undergoing lobectomy or pneumonectomy, often resulting in high morbidity and mortality rates.</p><p><strong>Case presentation: </strong>We present a case of successful treatment of a giant bronchopleural fistula (20 mm *10 mm). The patient underwent a thoracoscopic right lower lobectomy.The approach we used was local injection of autologous frozen platelet-rich plasma (PRP) with bronchoscopic assistance while maintaining digital chest drainage.We chose the treatment of PRP combined with digital drainage for bronchopleural fistula, not only healing of the fistula but also focusing on elimination of the residual cavity in the thoracic cavity.</p><p><strong>Conclusion: </strong>This highlights the effectiveness of this comprehensive approach in the treatment of bronchopleural fistulae and provides a promising treatment option for future treatment of similarly large bronchopleural fistulae.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"189"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992325","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":"Assessing the validity of Society of Thoracic Surgeons (STS) score in predicting stroke risk among patients undergoing cardiothoracic surgery at a tertiary hospital in Pakistan: a retrospective cohort study.","authors":"Javerya Hassan, Namra Usman, Muhammad Salman, Arshan Ali, Maryam Shaukat, Hana Khan, Ahmed Raheem, Hasanat Sharif","doi":"10.1186/s13019-025-03350-9","DOIUrl":"https://doi.org/10.1186/s13019-025-03350-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative stroke is one of the most serious consequences of cardiac surgery. Morbidity risk assessment is critical for preoperative risk assessments and resource allocation. In this article, we aim to investigate the predictive value of Society of Thoracic Surgeons (STS) score's effectiveness in stroke risk in cardiothoracic surgery patients in our population.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Aga Khan University Hospital (AKUH) using a consecutive sampling technique. The study included all eligible patients aged 18 years or older who underwent cardiac surgical procedures between January 2010 and December 2016. Of the 3,898 patients initially identified, 814 records were excluded due to incomplete data or pre-existing conditions. Statistical analyses, including chi-square tests, t-tests, and logistic regression, were performed to identify significant predictors of stroke. Prediction accuracy was assessed using a Receiver Operating Characteristic (ROC) curve, with Youden's J statistic employed to determine optimal sensitivity and specificity thresholds.</p><p><strong>Results: </strong>Out of 3,084 patients, 52 (1.7%) experienced a postoperative stroke. Stroke patients were significantly older (mean age 62.8 years vs. 57.7 years). They also had higher white blood cell count (10.7 ± 5.1 vs. 9.3 ± 3.3) and a longer history of myocardial infarction (9.2 ± 9.3 years vs. 6.9 ± 7.6 years). Cardiovascular interventions (15.4% vs. 7.7%), postoperative congestive heart failure (21.1% vs. 7.3%), and use of inotropes (5.8% vs. 1.6%) were more prevalent in stroke patients. Emergent surgical status (19.2% vs. 13.4%) and complications such as dialysis, prolonged ventilation, and intra-aortic balloon pump use were also significantly higher. The predictive model demonstrated strong accuracy in predicting postoperative stroke (AUC: 0.841, CI: 0.794-0.888). The ROC analysis for the STS stroke model showed high sensitivity (90.4%) and negative predictive value (99.7%), with moderate specificity (64.3%) and overall accuracy (64.8%), indicating excellent performance in ruling out stroke but moderate reliability in identifying positive cases.</p><p><strong>Conclusion: </strong>The STS risk score demonstrated strong predictive accuracy for postoperative stroke risk in cardiothoracic surgery patients, effectively incorporating clinical factors already accounted for in the comprehensive set of 70 variables used in its calculation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"187"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025304","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 features and prognostic nomogram development for cancer-specific death in patients with dual primary lung cancer: a population-based study from SEER database.","authors":"Tenghao Rong, Cheng Ai, Tong Yang, Qingchen Wu, Min Zhang","doi":"10.1186/s13019-025-03385-y","DOIUrl":"https://doi.org/10.1186/s13019-025-03385-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a concise and valid clinical prediction model to assess the survival prognostic risk of cancer-specific death in patients with dual primary lung cancer (DPLC).</p><p><strong>Data source: </strong>Surveillance, epidemiology, and end results (SEER) database.</p><p><strong>Design: </strong>A retrospective population-based study.</p><p><strong>Methods: </strong>Data of DPLC patients from the database from 1992 to 2020 were collected. The number of DPLC patients was determined based on the first primary LC (FPLC) and second primary LC (SPLC), and patients were randomly assigned to a training set and a testing set in a 7:3 ratio. The primary endpoint was cancer-specific survival (CSS). Kaplan-Meier survival analysis was performed to construct survival curves. Cox analysis and bilateral stepwise regression were used to analyze prognostic factors for cancer-specific death in patients and establish the nomogram. The discriminative ability of the nomogram was assayed by C-index and calibration curves, decision-making ability was assessed by decision curve analysis (DCA), and nomogram performance was measured by receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>This study included 997 DPLC patients, divided into a training set (n = 698) and a testing set (n = 299) in a 7:3 ratio. Age, gender, histological type, surgery, chemotherapy, T stage, N stage, and tumor size were identified as risk factors affecting CSS in DPLC patients (P < 0.05) and were utilized to establish a nomogram. The C-index of the nomogram in the training set was 0.671, and the AUC values of ROC curves for 1-year, 3-year, and 5-year survival rates were 0.84, 0.78, and 0.74, respectively. The C-index of the testing set was 0.644, and the AUC values were 0.72, 0.74, and 0.75, respectively. Calibration curves for both sets were close to the diagonal line, indicating good predictive ability of the nomogram. DCA curves demonstrated the good decision-making ability of the nomogram.</p><p><strong>Conclusion: </strong>This study revealed the clinical features of DPLC patients and developed an effective nomogram for predicting CSS, which can assist clinicians in making accurate and personalized clinical decisions regarding patient treatment.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"190"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965693","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":"Prognostic value of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease.","authors":"Ling-Zhi Dou, Shan-Shan Li, Sen Wang, He Jiang, Yu-Li Zheng, Meng-Meng Duan, Yi-Gang Zhang, Bing Han, Jian-Ming Li, Hong-Yun Ruan","doi":"10.1186/s13019-025-03420-y","DOIUrl":"https://doi.org/10.1186/s13019-025-03420-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the prognostic significance of non-invasive right ventricle-pulmonary artery coupling in patients with pulmonary hypertension associated with left heart disease (PH-LHD) and identify the relevant clinical factors involved.</p><p><strong>Methods: </strong>A cohort of 362 patients diagnosed with PH-LHD was included in this study. Plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured using enzyme-linked immunosorbent assay (ELISA). Echocardiography was employed to screen routine ultrasound parameters. The tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP) and S'/PASP ratios were calculated. Participants were categorized into two groups based on the TAPSE/PASP ratio: moderate-to-severe and mild uncoupling groups. Both groups underwent routine follow-up for a period of 3 to 15 months. Clinical events included all-cause mortality, heart failure rehospitalization, and stroke. Clinical events were documented, and a multivariate Cox regression model evaluated the correlation between the TAPSE/PASP ratio and prognosis. The Kaplan-Meier survival analysis was also conducted.</p><p><strong>Results: </strong>The moderate-to-severe uncoupling group exhibited significantly higher proportions of males; individuals with a history of smoking, valvular disease, diabetes mellitus, or stroke; and elevated levels of PASP, right ventricular diameter (RVD), left ventricular diameter (LVD), left ventricular end-diastolic (LVED), and lg (NT-proBNP) compared to the mild uncoupling group (P < 0.05). Conversely, parameters such as age, TAPSE, S', S' /PASP, and left ventricular ejection fraction (LVEF) were significantly lower in the moderate-to-severe uncoupling group compared to the mild uncoupling group (P < 0.05). Multivariate Cox regression analysis revealed that TAPSE/PASP (hazard ratio [HR] = 0.150, 95% confidence interval [CI] [0.023, 0.968], P = 0.046) was a protective factor for the recurrence of clinical events. In contrast, LVED (HR = 1.301, 95% CI (1.004, 1.059), P = 0.024) and lg (NT-proBNP) (HR = 1.870, 95%CI [1.304, 2.682], P = 0.001) were independent risk factors for the recurrence of clinical events. KaplanMeier survival analysis demonstrated that the mild uncoupling group exhibited a significantly higher overall survival rate compared to the moderate-to-severe uncoupling group (Log Rank P = 0.024).</p><p><strong>Conclusions: </strong>The TAPSE/PASP ratio is a predictive marker for clinical outcomes in patients with PH-LHD.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"185"},"PeriodicalIF":1.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992907","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":"Early inspiris resilia valve failure in a patient with idiopathic pulmonary valve regurgitation.","authors":"Benjamin D Seadler, Hannah K Holland, Jutta Novalija, Stefano Schena, G Hossein Almassi","doi":"10.1186/s13019-025-03398-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03398-7","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary valve failure requiring replacement (PVR) is more commonly seen in children and young adults with congenital heart disease (CHD). Adults with CHD and pulmonary regurgitation have traditionally undergone PVR with bioprosthetic valves. The inspiris resilia bovine pericardial valve is an FDA-approved bioprosthesis for the aortic position with encouraging data on 7-year outcomes. Previous reports on PVR using the Inspiris valve in young patients with CHD have demonstrated early failure of the valve. We report the early failure of this device in an elder patient with idiopathic pulmonary regurgitation.</p><p><strong>Case presentation: </strong>The patient is a 69-year-old male with preoperative evaluation demonstrating idiopathic pulmonary valve regurgitation with moderately depressed right ventricular ejection fraction. The patient declined receiving a porcine valve, and therefore underwent PVR using the inspiris resilia (IR) valve due to known encouraging results when implanted in the aortic position in elder patients. A 27 mm IR valve was utilized, and intraoperative transesophageal echocardiography showed no regurgitation at the time of surgery. Surveillance echocardiography at 17 months, however, already demonstrated moderate to severe pulmonary prosthetic valve regurgitation.</p><p><strong>Conclusions: </strong>This report highlights an early failure of the IR valve used for PVR in an elder patient with idiopathic pulmonary regurgitation. Data on the IR valve in the pulmonic position is limited to mostly small cohorts of young patients with CHD, and immediate outcomes are nearly universally satisfactory. However, recent reports in this specific population indicate early recurrence of regurgitation in the IR cohort compared to patients managed with a commercially available porcine aortic bioprosthetic valve, when used in the pulmonic position. Our reported case suggests that utilization of IR in the pulmonic position should be approached with caution in elderly patients as well.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"183"},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992784","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":"Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge-a case report.","authors":"Zheng Wang, Wenkang Zong, Shuo Liang, Fang Zhou, Xike Lu, Daqiang Sun","doi":"10.1186/s13019-024-03283-9","DOIUrl":"10.1186/s13019-024-03283-9","url":null,"abstract":"<p><strong>Background: </strong>Paragangliomas are rare neuroendocrine tumors predominantly located within the adrenal gland. Extra-adrenal paragangliomas, particularly those in the anterosuperior mediastinum, are exceedingly rare and pose significant diagnostic and therapeutic challenges due to their complex anatomical location.</p><p><strong>Case description: </strong>A 42-year-old woman was found to have an anterosuperior mediastinal mass during a routine health screening. Enhanced chest computed tomography (CT) revealed an ovoid, low-density mass intricately associated with major vascular structures including the superior vena cava, brachiocephalic trunk, left common carotid artery, aortic arch, right anonymous vein, and right subclavian artery. Despite significant intraoperative blood loss of 2000 ml, the mass was successfully excised with meticulous surgical technique and effective hemostasis. Histopathological examination showed a classic Zellballen pattern with chief cells and sustentacular cells embedded in a vascular-rich stroma. Immunohistochemistry confirmed the tumor's chromaffin nature, with chief cells testing positive for CD56, Synaptophysin, and Chromogranin A, and sustentacular cells positive for S100 protein, consistent with a diagnosis of paraganglioma. The patient's postoperative recovery was uneventful, and she was discharged one week after surgery.</p><p><strong>Conclusions: </strong>This case highlights the essential role of comprehensive preoperative imaging and the necessity for interdisciplinary surgical expertise in managing complex mediastinal paragangliomas. Advanced surgical techniques and careful intraoperative management are paramount to achieving successful outcomes. Appropriate imaging modalities and auxiliary laboratory tests are crucial for early detection of recurrences in these rare tumors.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"182"},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803358","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":"Causal relationship between mitochondrial proteins and risks of aortic aneurysms and aortic dissection: a Mendelian randomization study.","authors":"Lei Wang, Yuzuo Lin, Ziyan Lin, Qingtong Wu, Guodong Zhong, Liangwan Chen","doi":"10.1186/s13019-025-03389-8","DOIUrl":"10.1186/s13019-025-03389-8","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial dysfunction may be linked to the development of aortic aneurysm (AA) and aortic dissection (AD). This study aimed to evaluate the potential associations between proteins related to mitochondrial function and the risks of AA/AD using Mendelian randomization (MR).</p><p><strong>Methods: </strong>Large-scale publicly available genome-wide association studies (GWAS) and FinnGen summary data were utilized for MR analysis. The causal relationship between mitochondrial proteins and AA/AD was assessed using inverse-variance weighted (IVW) as the primary method. Sensitivity analyses were conducted to detect heterogeneity and pleiotropy by Cochran's Q test, MR-Egger test, MR-PRESSO global test, and \"leave-one-out\" analysis.</p><p><strong>Results: </strong>There were potential causal relationships between several mitochondrial proteins and AA/AD. Specifically, the iron-sulfur cluster assembly enzyme ISCU (OR = 1.165, 95% CI: 1.051-1.291, P = 0.004) and NFU1 iron-sulfur cluster scaffold homolog (OR = 1.184, 95% CI: 1.056-1.329, P = 0.004) were identified as potential risk factors for AA; whereas the 39 S ribosomal protein L14 (OR = 0.868, 95% CI: 0.764-0.987, P = 0.031) was found to be a protective factor for AA. Furthermore, 39 S ribosomal protein L33 (OR = 1.134, 95% CI: 1.010-1.274, P = 0.033) and cytochrome C oxidase subunit 5B (OR = 1.330, 95% CI: 1.037-1.706, P = 0.025) were associated with increased risks of AD; whereas the 39 S ribosomal protein L52 (OR = 0.736, 95% CI: 0.550-0.984, P = 0.038) and mitochondrial ubiquitin ligase activator of NFKB 1 (OR = 0.806, 95% CI: 0.656-0.989, P = 0.039) were identified as potential protective factors for AD. Sensitivity analysis confirmed the stability of the results.</p><p><strong>Conclusions: </strong>This study identified potential genetic associations between mitochondrial proteins and AA/AD. Targeting these mitochondrial proteins may help prevent the occurrence of AA/AD.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"181"},"PeriodicalIF":1.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788440","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}