Journal of Cardiothoracic Surgery最新文献

{"title":"Impact of psycho-educational interventions on patients undergoing Coronary Artery Bypass Grafting Surgery.","authors":"Shahpar Bagheri, Zahra Dadashpouromrani, Giti Setoodeh, Zahra Hadian Shirazi, Azadeh Amiri, Rozhan Ghobadimoghaddam","doi":"10.1186/s13019-025-03461-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03461-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative period of Coronary Artery Bypass Grafting can be challenging, with physical and psychological problems and symptoms. We conducted this study to explore the effect of a psycho-educational intervention on anxiety, pain and physiological parameters among Coronary Artery Bypass Grafting surgery patients.</p><p><strong>Methods: </strong>A randomized clinical trial design included one experimental and control group. Data were collected from 56 candidates for coronary artery bypass surgery (n = 28) in the intervention and (n = 28) in the usual care groups. Settings were the cardiac centers of the three teaching, specialty, and subspecialty Nemazee, Faghihi, and Al-Zahra hospitals affiliated with Shiraz University of Medical Sciences (SUMS). The data were collected using a demographic information form, the Short-Form McGill Pain Questionnaire, the Spielberger State-Trait Anxiety Inventory, and the physiological parameters form (systolic and diastolic blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation). Psycho-educational interventions were performed individually through face-to-face sessions. All tests were two-tailed, and the statistical level was considered 0.05.</p><p><strong>Results: </strong>The mean scores of state anxiety and pain decreased significantly after the intervention (p < 0.05). Also, psycho-educational interventions affected peripheral oxygen saturation percentage, and breathing rate mean scores (P < 0.05). But, they did not affect the blood pressure and pulse rate (P > 0.05). At the same time, there was no significant difference in the control group.</p><p><strong>Conclusion: </strong>This study indicated that the pre-operative psycho-educational interventions facilitated intrapersonal caring, reduce state anxiety, relieve pain and stabilize physiological parameters such as peripheral oxygen saturation percentage and breathing rate after surgery among Coronary Artery Bypass Grafting surgery patients. Hence, this intervention is recommended for developing care programs in same population.</p><p><strong>Trial registration: </strong>https://www.irct.ir/trial/55652 : IRCT20090908002432N8 (2021-09-17).</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"223"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019766","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":"Analysis of serum levels of HIF-1α and IL-6 in patients with acute stanford type a aortic dissection.","authors":"Zheyuan Wang, Junyi Wen, Shaoqin Chen, Lin Lu","doi":"10.1186/s13019-025-03459-x","DOIUrl":"https://doi.org/10.1186/s13019-025-03459-x","url":null,"abstract":"<p><strong>Background: </strong>Studies have reported that Acute Stanford type A aortic dissection (ATAAD) is associated with hypoxia and inflammation. This study aims to explore the levels of HIF-1α and IL-6 in the serum of patients with ATAAD, and to analyze the association between these two factors as well as their potential clinical significance.</p><p><strong>Methods: </strong>Serum samples were collected from 82 ATAAD patients and 19 healthy controls. Subsequently, the levels of HIF-1α and IL-6 in the serum of these samples were measured using the enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>The results showed that the serum HIF-1α level in patients with ATAAD were significantly reduced compared with the healthy control group [10.72 (7.28,14.92) vs. 19.54 ± 8.07 pg/mL, p < 0.0001], and the serum IL-6 level were significantly increased [3.12 (1.97, 9.13) vs. 1.13 (0.98, 1.42) pg/mL, p < 0.0001]. Moreover, there was no statistical difference of HIF-1α level in ATAAD patients with or without hypoxemia and IL-6. However, there was a significant positive correlation between the levels of IL-6 and the expression of HIF-1α (r = 0.5435, P < 0.0001).</p><p><strong>Conclusion: </strong>We found that levels of HIF-1α and IL-6 were abnormal in patients with ATAAD. Moreover, the HIF-1α and IL-6 level in ATAAD patients were positively correlated, suggesting that HIF-1α and IL-6 may play roles simultaneously during the development of acute aortic dissection.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"222"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992559","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":"Meta-analysis of targeted drugs for pulmonary hypertension to improve exercise tolerance and associated factors in eisenmenger syndrome.","authors":"Zhangli Yuan, Yang Wang, Jianling Wang, Yinchuan Lai, Xuechuan Dan, Juan Wang","doi":"10.1186/s13019-025-03450-6","DOIUrl":"https://doi.org/10.1186/s13019-025-03450-6","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to systematically evaluate the effect of pulmonary arterial hypertension (PAH) targeting drugs on exercise tolerance in Eisenmenger syndrome (ES) and analyze related factors.</p><p><strong>Methods: </strong>Two researchers conducted an independent search of the Chinese database and the English database, and conducted literature screening, data extraction and quality evaluation according to the inclusion and exclusion criteria respectively. According to the heterogeneity test results, the effect model was adopted for analysis by RevMan5.4 statistical software, in which the continuity data were represented by mean difference (MD) and 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 393 patients with ES were included in 13 papers, including 8 studies of endothelin receptor antagonists (ERA), 2 studies of phosphodiesterase 5 inhibitors (PDE5i) and 3 studies of prostanoids. The results of these studies showed that the targeted drugs were effective in improving exercise tolerance in ES patients. Further analyses revealed that the differences in efficacy were related to the type of targeted drug, duration of drug treatment and the presence or absence of Down syndrome (DS). 6MWD (6 min Walk Distance) and cardiac function were significantly improved in ES patients with all three classes of drugs. Prostanoids (MD = 132.35, 95% CI: 14.82-249.89, P < 0.0001, I² = 93%) improved 6MWD better than ERAs (MD = 41.60, 95% CI: 21.76-61.44, P < 0.0001, I² = 32%) and PDE5i (MD = 52.33, 95% CI: 29.16-75.50, P < 0.0001, I² = 0). Prostanoids demonstrated a more significant improvement in cardiac function compared to ERAs and PDE5i. Specifically, prostanoids [MD= -1.26, 95% CI: (-1.66, -0.86), P < 0.0001] showed a greater improvement than ERAs [MD=-0.54, 95% CI: (-0.96, -0.11), P = 0.01] and PDE5i [MD=-0.38, 95% CI: (-0.64, -0.13), P = 0.003]. Short-term pharmacological therapy (less than 12 months) significantly increased 6MWD and improved clinical cardiac function in included patients. Continued targeted drug therapy further increased the level of cardiac function (P < 0.0001). Targeted drug therapy was effective in increasing 6MWD in patients with ES combined with DS, but had no significant effect on cardiac function class. Targeted drug therapy had a favorable effect on both 6MWD and cardiac function class in non-DS patients.</p><p><strong>Conclusion: </strong>Early targeted drug therapy for ES can significantly improve the exercise tolerance of patients, and a better drug regimen and treatment time should be selected according to the clinical characteristics of patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"224"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016524","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 application of the triglyceride-glucose-body mass index (TyG-BMI) in predicting acute kidney injury in diabetic patients following coronary artery bypass grafting surgery.","authors":"Chen Li, Xiaobin Liu, Xingping Lv, Wei Zhou, Guoliang Fan, Feng Zhu","doi":"10.1186/s13019-025-03455-1","DOIUrl":"https://doi.org/10.1186/s13019-025-03455-1","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose-body mass index (TyG-BMI), a marker for insulin resistance, is recognized for its predictive role in cardiovascular and metabolic diseases, including kidney disease. we explored the TyG-BMI index's association with postoperative kidney injury in coronary artery bypass grafting (CABG) patients, who are at an elevated risk for such complications, underscoring its potential as a predictor for acute kidney injury (AKI).</p><p><strong>Methods: </strong>This single-center, retrospective study included 126 patients. Patients were divided into AKI and non-AKI groups postoperatively according to the KDIGO classification criteria. Univariate logistic regression was used to screen for variables with significant differences (P < 0.01), and multiple multivariate regression models were constructed to analyze independent risk factors in the multivariate regression model and to analyze the value of TyG-BMI in predicting AKI in diabetic patients after CABG.</p><p><strong>Results: </strong>Compared to the non-AKI group, the AKI group had statistically significant differences in preoperative fasting triglycerides, preoperative fasting glucose, preoperative and postoperative creatinine levels, ICU stay duration, and TyG-BMI levels (P < 0.05). Based on the results of univariate regression analysis, a multivariate logistic regression model A was constructed using all significant variables, and a multivariate logistic regression model 2 was constructed using significant variables other than TyG-BMI. ROC analysis showed that model 2 had better predictive performance than model 1 (AUC = 0.836 vs. 0.766). A positive correlation was observed between TyG-BMI and AKI occurrence (Spearman's correlation coefficient: R = 0.33, P = 0.00019).</p><p><strong>Conclusion: </strong>Elevated TyG-BMI levels are closely associated with AKI in diabetic patients after CABG. TyG-BMI has potentially predictive value for AKI in diabetic patients after CABG and may play a crucial role in risk stratification in clinical practice.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"221"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018853","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":"Investigation of risk factors and outcomes of aortic arch aneurysm repair in octogenarians.","authors":"Tomoki Cho, Keiji Uchida, Shota Yasuda, Yasuko Onakatomi, Kenichi Fushimi, Shotaro Kaneko, Tomoyuki Minami, Aya Saito","doi":"10.1186/s13019-025-03417-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03417-7","url":null,"abstract":"<p><strong>Objective: </strong>We reviewed the treatment outcomes for aortic arch aneurysms in elderly patients aged > 80 years, and discussed the risk factors for each technique.</p><p><strong>Methods: </strong>Octogenarians who underwent aortic arch aneurysm repair between 2007 and 2021 were included. Fifty-four patients (23 in the total arch replacement [TAR] group and 31 in the thoracic endovascular aortic repair [TEVAR] group) were included in the study. The early- and mid-term outcomes and risk factors for all-cause mortality were examined in each group. To examine timely surgical outcomes, cases of true aneurysms were included, whereas dissected aneurysms and emergency cases due to rupture or other causes were excluded.</p><p><strong>Results: </strong>No significant differences in 30-day mortality (0% in the TAR group and 5.4% in the TEVAR group) and in-hospital mortality (7.7% in the TAR group and 8.1% in the TEVAR group) were observed between the two groups. The survival rates at 5 years were 82% and 65% in the TAR and TEVAR groups, respectively, without significant difference. The aorta-related averted mortality was 91% and 81% in the TAR and TEVAR groups, respectively, without significant difference. No significant difference in the freedom from aortic events was also observed between the two groups. Previous ischemic heart disease was a significant risk factor for all-cause mortality in the TAR group. No significant risk factors were identified in this group.</p><p><strong>Conclusion: </strong>The choice of procedure was reasonable when considering frailty. Endovascular repair may be a good treatment option for patients with a history of ischemic heart disease.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"220"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023340","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":"Nomogram model for the preoperative prediction of spread through air spaces in sub-centimeter non-small cell lung cancer.","authors":"Xiao Wang, Jingwei Shi, Zhengcheng Liu","doi":"10.1186/s13019-025-03441-7","DOIUrl":"https://doi.org/10.1186/s13019-025-03441-7","url":null,"abstract":"<p><strong>Introduction: </strong>To construct and validate a nomogram risk prediction model based on clinical characteristics and radiological features to predict spread through air spaces (STAS) of stage IA sub-centimeter non-small cell lung cancer.</p><p><strong>Methods: </strong>112 patients who underwent surgical treatment in Nanjing Drum Tower Hospital with pathologically diagnosed stage IA sub-centimeter non-small cell lung cancer were retrospectively collected. The training cohort and the validation cohort were chosen in a 7:3 ratio. Based on the presence or absence of STAS in pathology results, they were divided into STAS positive and STAS negative groups. The independent risk predictors of STAS in clinical characteristics and radiological features were selected by univariate and multivariate logistic regression analysis and then used to construct a nomogram. The sensitivity and specificity were calculated based on the Youden index, area under the curve (AUC), calibration curves and decision curve analysis (DCA) were used to evaluate the performance of the model.</p><p><strong>Results: </strong>The incidence of STAS in the training cohort was 17.9%. Univariate logistic regression analysis showed that male, anti-GAGE7 antibody positive and mean CT value were associated with the occurrence of STAS; multivariate logistic regression analysis showed that male (OR = 7.900, 95%CI: 1.502-41.545), anti-GAGE7 antibody positive (OR = 10.065, 95%CI: 1.256-80.659) and mean CT value (OR = 1.009, 95%CI: 1.004-1.014) were independent predictors for STAS. The nomogram based on the above factors achieved good predictive performance for STAS with AUC was 0.897 (sensitivity was 0.929, specificity was 0.781) in the training cohort and 0.860 in the validation cohort. The calibration curve and DCA validated the good performance of the model.</p><p><strong>Conclusion: </strong>The nomogram model established in this study had good predictive performance for STAS status of sub-centimeter lung cancer, and provide reference significance for preoperative planning of patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"218"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete obstruction of proximal left ascending artery in a very young woman with Kawasaki: a case report and literature review.","authors":"Pouya Ebrahimi, Mohammad Hossein Mandegar, Amir Nasrollahizadeh, Parnian Soltani, Hamidreza Soleimani, Pedram Ramezani, Fatemeh Naderi","doi":"10.1186/s13019-025-03454-2","DOIUrl":"https://doi.org/10.1186/s13019-025-03454-2","url":null,"abstract":"<p><strong>Introduction: </strong>Kawasaki disease is a predisposing factor for various potentially fatal anomalies that can cause coronary artery diseases in childhood, adolescence, or adulthood if they are not appropriately treated, usually done with ASA and intravenous immunoglobulin (IVIG). This study presents a case of a young woman who needed a coronary artery bypass graft (CABG) due to a history of Kawasaki and coronary artery severe stenosis.</p><p><strong>Case presentation: </strong>A 24-year-old woman presented with chest pain, exertional and at-rest dyspnea, lower limb edema, and crackle at bilateral lung bases. After stabilization, it was noted that her left anterior descending artery (LAD) had been obstructed completely. She underwent CABG successfully and recovered uneventfully. The six-month follow-up showed almost complete. His medical therapy continued with dual antiplatelet therapy, statin, diuretics, spironolactone, and some other medications to decline the process of her heart structural change (Graphical Abstract).</p><p><strong>Results: </strong>Kawasaki makes the patients prone to CAD and several other CVD diseases. Many factors determine the risk of coronary artery involvement in these cases, and the proffered treatment should be chosen based on the severity of CAD and the characteristics of the patient. These treatments include (1. Medical, 2. Interventional (PCI), 3. Surgical (CABG), 4. Combinational) along with preventive therapy, which is suggested to almost all patients. In our case, considering the complete occlusion of LAD, the patient underwent CABG.</p><p><strong>Clinical key point: </strong>Kawasaki disease is one of the most important predisposing factors for CAD in young adults, and their least significant symptoms should be taken seriously as a CVD and should be investigated. CAD in these patients might be so severe that no treatment except CABG can be responsive to problem-solving. Moreover, timely management of disease in childhood with ASA and IVIG would prevent or at least decrease the severity of symptoms can be declined significantly.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"219"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011538","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":"Single staged repair of an anastomotic tracheal fistula following Mckeown esophagectomy via cervical incision: a case report.","authors":"Haoqian Zheng, Chenyang Guo, Yadi Zhang, Hang Gu, Yinzhi Zhao, Run Xiang, Wei Dai, Xing Wei, Tianpeng Xie, Qiang Li, Xiang Wang","doi":"10.1186/s13019-025-03430-w","DOIUrl":"https://doi.org/10.1186/s13019-025-03430-w","url":null,"abstract":"<p><strong>Background: </strong>The incidence of tracheoesophageal fistula (TEF) following esophagectomy is less than 3%, but it often leads to severe complications and can even be life-threatening to patients. Surgical repair methods for TEF include muscle or omental flap support, biologic patch repair, and sleeve resection. In recent years, there has been an increasing number of case reports on primary closure via a cervical incision, with a rising success rate and a lower incidence of postoperative complications.</p><p><strong>Case presentation: </strong>A case is presented involving a 68-year-old female patient with esophageal squamous cell carcinoma who underwent thoracoscopic McKeown esophagectomy combined with gastric conduit reconstruction. On postoperative day 10, the patient presented with severe coughing. Gastroscopy and bronchoscopy confirmed a tracheoesophageal fistula at the anastomotic site. After 2 weeks of anti-infective therapy, drainage, and nutritional support, the fistula persisted. Subsequently, an exploratory surgery was performed via the original cervical incision, and the fistula was repaired with primary suture. The patient received routine dressing changes and continued anti-infective therapy postoperatively. One week later, gastroscopy and bronchoscopy revealed complete healing of the trachea, with closure of the anastomotic fistula, and no abnormalities were detected upon oral intake.</p><p><strong>Conclusion: </strong>This case demonstrates that in patients identified early, with complete drainage, adequate anti-infection measures, and improved nutritional status, primary closure of the tracheoesophageal junction through the original cervical incision can successfully treat an anastomotic trachea-fistula following esophagectomy. Our report details the process of primary repair of TEF through the cervical approach, contributing additional references to existing literature.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"217"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012641","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":"Impact of planned concomitant coronary artery bypass grafting on risk of major adverse cardiovascular events in elective aortic hemiarch surgery.","authors":"Bo Chang Brian Wu, Adam M Carroll, Nicolas Chanes, Drake S Rosenberg, Michael J Kirsch, Muhammad Aftab, T Brett Reece","doi":"10.1186/s13019-025-03431-9","DOIUrl":"https://doi.org/10.1186/s13019-025-03431-9","url":null,"abstract":"<p><strong>Background: </strong>Hemiarch replacement of the ascending aorta has become routine in many aortic centers. While the addition of coronary bypass does not add a lot of time to the procedure, it carries with more significant comorbidities. We hypothesize that the addition of CABG carries a higher risk of complication than hemiarch alone.</p><p><strong>Methods: </strong>This is a single-center, retrospective cohort study of 419 patients undergoing elective hemiarch surgery between February 2010 and May 2023. Patients were categorized into concomitant CABG (n = 42) and non-CABG (n = 379) groups. Perioperative variables and outcomes were analyzed. Both univariate and multivariate logistic regressions were used to identify predictors for MACE.</p><p><strong>Results: </strong>Of 419 patients, 42 (10%) patients received adjunctive CABG. This group was older (68.1 vs. 60.4 years, p < 0.001) with more comorbidities associated with coronary artery disease (CAD), such as hypertension (92.9% vs. 59.2%, p < 0.001), type 2 diabetes (33.3% vs. 8.8%, p < 0.001), and atrial fibrillation (19% vs. 5.8%, p = 0.006). CABG patients had longer cardiopulmonary bypass (158 vs. 131 min, p < 0.001) and aortic cross-clamp (115.5 vs. 95 min, p < 0.001) times and required more intraoperative blood products, FFP (4 vs. 2 units, p = 0.010) and platelets (2 vs. 1 units, p < 0.001). Postoperative complications, including arrhythmia (40.5% vs. 21.8%, p = 0.012), mechanical circulatory support (11.9%, 1.9%, p = 0.004), acute kidney injury (16.7% vs. 0.5%, p < 0.001), infection (11.9% vs. 3.7%, p = 0.032), mortality (9.5% vs. 0.5%, p = 0.001), stroke (9.5% vs. 2.1%, p = 0.024), and the composite outcome- MACE (21.4% vs. 2.9%, p < 0.001) were higher in the CABG group. Multivariate analysis identified the number of bypassed vessels (OR: 2.23, CI 1.33-3.69, p = 0.002), age (OR: 1.07, CI: 1.02-1.13, p = 0.006), and female gender (OR: 3.53, CI: 1.31-9.64, p = 0.012) as significant risk factors for MACE.</p><p><strong>Conclusions: </strong>Concomitant CABG may increase the risk of MACE compared to other patients undergoing hemiarch. These data argue that the risk may be higher for concomitant CABG but should still undergo revascularization. Future research should focus on preoperative optimization, operative strategies, and sex-specific risk factors to improve elective hemiarch replacement outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"215"},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019763","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":"Giant cardiac tumor resection combined with left ventricular reconstruction.","authors":"Ganyi Chen, Hong Ran, Cunhua Su, Xin Chen","doi":"10.1186/s13019-025-03429-3","DOIUrl":"https://doi.org/10.1186/s13019-025-03429-3","url":null,"abstract":"<p><p>Reports of large tumors of the left ventricle are rare. In this instance, we present a situation where a 57-year-old woman underwent surgical intervention for a sizable mass in her left ventricle. The mass was attached to the walls of the left ventricle and the apex of the left ventricle, almost filling the entire left ventricle. The individual had elective cardiac surgery. Fortunately, the patient survived, and this case may help in the treatment of cardiac sarcoma.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"216"},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972775","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}