Journal of Cardiothoracic Surgery最新文献

{"title":"Intermittent mitral prosthetic dysfunction. what interferes the valve closure?","authors":"Pere Pericas, Ronald Morales Murillo, Marta Noris Mora, Francisco Gual-Capllonch, José Ignacio Sáez de Ibarra, Vicente Peral Disdier","doi":"10.1186/s13019-025-03521-8","DOIUrl":"10.1186/s13019-025-03521-8","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic valve dysfunction due to entrapment of the subvalvular apparatus is a rare condition, particularly when occurring as a delayed postoperative complication. Spontaneous papillary muscle rupture in the absence of an ischemic event is also uncommon. The simultaneous presence of both conditions renders this case of intermittent symptomatic mitral regurgitation exceptional.</p><p><strong>Case presentation: </strong>We present the case of a 72-year-old woman with a history of rheumatic heart disease and a mechanical mitral valve prosthesis. Although the initial postoperative course was uneventful, she developed rapidly progressive heart failure symptoms two years after surgery, secondary to newly onset severe mitral regurgitation. Transesophageal echocardiography was crucial in elucidating the underlying mechanism, revealing a ventricular mass intermittently interfering with the proper closure of the mechanical prosthesis. The main differential diagnoses regarding the origin of the mass included: remnants of the subvalvular apparatus, vegetation, thrombotic material and pannus formation. Given the clinical deterioration, surgical intervention was considered necessary despite the lack of precise knowledge regarding the nature of mass. Surgical exploration confirmed the rupture of the subvalvular apparatus involving the anterolateral papillary muscle as the underlying cause of the prosthetic dysfunction. Excision of the ruptured chordae tendineae and residual papillary muscle was performed with a favorable outcome and no complications.</p><p><strong>Conclusions: </strong>This case illustrates a rare cause of late prosthetic mitral valve dysfunction: the entrapment of the subvalvular apparatus due to spontaneous rupture of the papillary muscle. Transesophageal echocardiography proved highly valuable in understanding the mechanism of dysfunction; however, surgical exploration ultimately established the definitive diagnosis and facilitated the correction of the issue.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"283"},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564834","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":"Successful management of cardiac electrical storm after aortic valve replacement using stellate ganglion block: a case report.","authors":"Xinyi Zhang, Yi Guo, Shuo Chang","doi":"10.1186/s13019-025-03476-w","DOIUrl":"10.1186/s13019-025-03476-w","url":null,"abstract":"<p><p>Cardiac electrical storm (CES) is a life-threatening state of electrical instability characterized by 3 or more episodes of sustained ventricular arrhythmia within 24 h. The application of stellate ganglion block for the treatment of cardiac surgery has rarely been reported. Herein, we report a patient whose ventricular arrhythmia was completely relieved after receiving a stellate ganglion block. We present a case of a 35-year-old male who underwent aortic valve replacement. The patient who had aortic valve stenosis was scheduled for aortic valve replacement and simultaneous tricuspid valvuloplasty. After sedation was discontinued, malignant arrhythmias recurred. We performed stellate ganglion block for patient. As aresult, the patient achieved a complete resolution of symptoms and successfully resumed a normal productive life one year post-surgery. Stellate ganglion block is a safe and effective treatment for patients with ventricular tachycardia unresponsive to drug therapy following cardiac surgery.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"284"},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564836","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":"Study on the mechanism and clinical value of miR-210-3p and miR-582-5p in acute myocardial infarction by targeting MXD1.","authors":"Shanshan Liu, Jing Han, Shufang Gao","doi":"10.1186/s13019-025-03518-3","DOIUrl":"10.1186/s13019-025-03518-3","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) occurs rapidly and is a major cause of death in patients with coronary artery disease (CAD). To explore new biomarkers of AMI and its pathogenesis.</p><p><strong>Methods: </strong>Mining key miRNAs (miR-210-3p, miR-582-5p) and gene (MXD1) using the GEO and starbase databases. The expression of miRNAs and related genes was detected by qPCR. The clinical value of miR-210-3p/miR-582-5p was evaluated by constructing ROC curves. The targeted regulation of MXD1 by miR-210-3p and miR-582-5p was demonstrated by the dual-luciferase assay and transfection of mimics. The levels of cTnI, MDA, and Fe²⁺ were measured using kits. Overexpressing miR-210-3p, miR-582-5p, and MXD1 to explore their roles in hypoxia-induced cardiomyocyte injury.</p><p><strong>Results: </strong>MiR-210-3p and miR-582-5p were deficient in AMI patients and hypoxic cardiomyocytes, while MXD1 was high-expressed. MiR-210-3p combined with miR-582-5p could well distinguish ST elevation-AMI and non-ST elevation-AMI patients from CAD patients, with AUC of 0.865 (0.806-0.923) and 0.813 (0.744-0.881), respectively. The mimics of miR-210-3p and miR-582-5p significantly reduced luciferase activity in cells transfected with the wild-type luciferase vector of MXD1 and inhibited MXD1 expression, which was promoted by their inhibitors. Overexpression of miR-210-3p/miR-582-5p saved hypoxia-induced ferroptosis, which was reversed by co-transfection of the MXD1 plasmid.</p><p><strong>Conclusion: </strong>MiR-210-3p and miR-582-5p are good classifiers for AMI patients and CAD patients. They can negatively regulate the expression of MXD1 by directly targeting its mRNA, inhibiting ferroptosis of hypoxic cardiomyocytes, and may be effective predictors of CAD progression to AMI.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"282"},"PeriodicalIF":1.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564835","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":"Effectiveness of breathing relaxation exercises on pain due to chest tube removal: a systematic review-meta-analysis.","authors":"Ayşe Yacan Kök, Ezgi Eyiler","doi":"10.1186/s13019-025-03444-4","DOIUrl":"10.1186/s13019-025-03444-4","url":null,"abstract":"<p><strong>Background: </strong>Chest tube placement is essential for draining air or fluid from the pleural cavity, often performed after cardiothoracic surgeries to prevent complications. However, chest tube removal (CTR) can be painful and stressful for patients. Proper pain management is crucial to enhancing patient comfort.</p><p><strong>Aim: </strong>The aim of this systematic review and meta-analysis was to asssess the effectiveness of breathing and relaxation exercises for pain associated with CTR.</p><p><strong>Methods: </strong>Database searches were carried out in Pub med, Web of Science, MEDLINE, Academic Search Ultimate, CINAHL Complete, Cochrane Library, Science Direct to December 2024. The Risk of Bias 2 tool was used to assess the risk of bias. Heterogeneity and publication bias were also assessed.</p><p><strong>Findings: </strong>A total of 8 randomized controlled trials were included. Findings indicated that breathing relaxation exercises had a negative effect on chest tube removal. The mean effect size for the effect of breathing relaxation exercises on CTR was - 1.46 Three of the studies included in the meta-analysis assessed outcomes before CTR procedure. The mean effect size is 0.070 with a 95% confidence interval of -0.208 to 0.348. Also, four of the studies included in the meta-analysis assessed outcomes immediately after the procedure. The mean effect size is -1.403 with a 95% confidence interval of -2.337 to -0.469. The mean effect size in the universe of comparable studies could fall anywhere in this interval. Q-value is 30.826 with 3 degrees of freedom and p < 0.001.</p><p><strong>Conclusions: </strong>The results of this meta-analysis indicated that breathing and relaxation exercises can be effective in reducing pain associated with the CTR procedure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"281"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553677","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":"Exploring the relationship between ankle strength and endurance factors and the severity and level of ischemia in patients with peripheral arterial disease.","authors":"Mohammad Hassani, Mohammad Hassabi, Shaghayegh Khodabakhshian, Mohammad Javanbakht, Shiva Aliabbar, Alireza Movahedi, Helia Ghorbani, Mahdi Mohebbi, Hamidreza Movahedi, Mohamad Hosein Tabatabaei Nodoushan, Abolfazl Mirani","doi":"10.1186/s13019-025-03479-7","DOIUrl":"10.1186/s13019-025-03479-7","url":null,"abstract":"<p><strong>Background: </strong>Peripheral Arterial Disease (PAD) is a global health concern, particularly among aging populations. While previous studies have examined various aspects of PAD, the role of ankle muscle strength and endurance in assessing ischemia severity remains underexplored. This study investigates the relationship between ankle dorsiflexion and plantar flexion strength and ischemia severity in PAD patients.</p><p><strong>Methods: </strong>This cross-sectional observational study included 53 PAD patients with chronic limb ischemia confirmed via angiography. Mean age was 64.5 years, and the majority were male. Ankle muscle strength was measured using a custom-designed hand-held dynamometer, which underwent internal validation and reliability testing before implementation. Spearman's correlation and multiple regression models assessed the association between muscle function and ischemia severity.</p><p><strong>Results: </strong>A significant positive correlation was found between dorsiflexion/plantar flexion strength and ischemia severity one-month post-intervention (Spearman's rho = 0.35, P = 0.015; Spearman's rho = 0.40, P = 0.010). Pre-intervention assessments established a baseline correlation, allowing evaluation of ischemia progression and its impact on muscle function.</p><p><strong>Conclusion: </strong>Our data showed that ankle strength assessments may serve as predictive markers for ischemia severity in PAD patients. Implementing these measurements in clinical practice could enhance treatment optimization and patient outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"280"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528111","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":"Venous thromboembolism in patients undergoing unilateral partial pulmonary resection during hospitalization: a single-center retrospective study.","authors":"Huaimin Liang, Xiaoning Li, Zhengliang Wei","doi":"10.1186/s13019-025-03507-6","DOIUrl":"10.1186/s13019-025-03507-6","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"278"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528114","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":"Delving into immune modulation: thymectomy in myasthenia gravis.","authors":"Nanlong Lin, Zhongshan Yang, Weiqiang Yi, Yanxun Chen, Fancai Lai","doi":"10.1186/s13019-025-03480-0","DOIUrl":"10.1186/s13019-025-03480-0","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"277"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528109","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":"Infective endocarditis with perivalvular abscess following sutureless valve implantation, successfully treated with aortic root reconstruction and biological Bentall procedure.","authors":"Ryo Fujimoto, Shingo Hirao, Tatsuhiko Komiya","doi":"10.1186/s13019-025-03520-9","DOIUrl":"10.1186/s13019-025-03520-9","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve prosthetic infections can lead to the spread of infection, causing annular abscesses and annular destruction, which may require annular reconstruction and aortic root replacement. Reports on the infection and reoperation of sutureless valves are rare. Here, we present a case of infection involving a Perceval sutureless valve, which led to an annular abscess.</p><p><strong>Case presentation: </strong>We report the case of a 73-year-old woman who had previously undergone sutureless valve implantation for severe stenosis of a bicuspid aortic valve. Approximately 23 months after surgery, the patient developed recurrent Methicillin-resistant Staphylococcus aureus bacteremia and was admitted to the hospital. Following a thorough assessment, she was diagnosed with a prosthetic valve infection and an annular abscess, necessitating surgical intervention. Intraoperatively, significant annular destruction was evident after the valve was removed. The aortic root was reconstructed with a bovine patch and Bentall surgery was accomplished using a composite graft consisting of a biological valve and a Valsalva graft. The patient was discharged in good general condition with no significant post-operative complications.</p><p><strong>Conclusions: </strong>One of the issues with using a Perceval valve is that in the event of infection, it can lead to the spread of infection from the aortic root to the left ventricular outflow tract, potentially requiring extensive debridement and aortic root replacement.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"279"},"PeriodicalIF":1.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528113","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":"Effects of cilostazol for in-stent restenosis after carotid artery stenting: a meta-analysis.","authors":"Jing Sun, Duo Wang, Yue Zhao, Ying Bai, Chang Meng, Guobin Miao, Peng Liu","doi":"10.1186/s13019-025-03522-7","DOIUrl":"10.1186/s13019-025-03522-7","url":null,"abstract":"<p><strong>Objectives: </strong>There is some controversy regarding drug therapy to prevent in-stent restenosis (ISR) after carotid artery stenting. In recent years, cilostazol has received increasing research attention. We performed a meta-analysis to evaluate the effects of cilostazol on the outcome of ISR after carotid stenting.</p><p><strong>Methods: </strong>A meta-analysis was carried out to identify the clinical trials that had been published up to 22 December 2024. The databases PubMed, Embase, Cochrane Library, CNKI and Wanfang have all been queried. The study population was composed of patients with stent carotid heart disease who were receiving cilostazol. Results included in-stent-restenosis, ischemic stroke and all-cause mortality. Publications were reviewed according to the Cochrane Handbook and the guidelines set out in the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA 2020). The methodological quality of the studies was assessed using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I).</p><p><strong>Results: </strong>This study was registered with INPLASY (number INPLASY202510004). A total of 1975 patients were included in 4 randomized controlled trials (RCTs) and 5 non-RCTs. A statistically significant reduction in ISR was observed for antiplatelet regimens including cilostazol compared to the control group (OR = 0.27, 95%CI: 0.13 ~ 0.54, P<0.01, I² = 30%). Subgroup analysis revealed this finding was primarily driven by non-randomized controlled trials (non-RCTs), demonstrating a consistent effect (OR = 0.17, 95%CI: 0.08 ~ 0.39, P<0.01, I² = 0%). For other primary end events, no significant differences were noted in the incidence of ischemic stroke (OR = 0.83, 95%CI: 0.50 ~ 1.39, P = 0.49, I² = 0%) or all cause death (OR = 0.53, 95%CI: 0.26 ~ 1.05, P = 0.07, I² = 0%). The certainty of evidence for the ISR outcome was rated as low.</p><p><strong>Conclusions: </strong>Cilostazol was associated with less postoperative carotid stent restenosis, with no statistically significant difference in ischemic stroke and all-cause mortality.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"275"},"PeriodicalIF":1.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528110","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":"Expression level, correlation, and diagnostic value of serum miR-99a in pulmonary fibrosis in patients with acute respiratory distress syndrome.","authors":"Lanlan Chen, Qihong Zhuang","doi":"10.1186/s13019-025-03511-w","DOIUrl":"10.1186/s13019-025-03511-w","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is a prevalent critical condition encountered in clinical settings and is characterized by high mortality. This research investigated miR-99a in diagnosing ARDS and its role in predicting pulmonary fibrosis (PF) among ARDS patients, to identify novel and effective biomarkers for ARDS.</p><p><strong>Materials and methods: </strong>In this study, 128 patients with ARDS were selected as the experimental group, and 98 healthy people were included as the control group. ELISA measured the expression levels of IL-6, TNF-α, and IL-8, and the expression of miR-99a was measured by qRT-PCR. ROC curve evaluated the diagnostic value of miR-99a in ARDS patients and PF. Logistic regression evaluated the independent risk factors for PF in ARDS patients.</p><p><strong>Results: </strong>This research demonstrated that miR-99a and inflammatory factors (IL-6, TNF-α, and IL-8) were markedly elevated in ARDS patients. The expression levels of miR-99a exhibited a significant correlation with the Murray score, PaO2/FiO2 ratio, APACHE II score, and occurrence of PF in ARDS patients. Furthermore, miR-99a displayed a robust distinguishing capacity for ARDS patients. Notably, miR-99a was found to be highly expressed within the PF subgroup of ARDS patients. It was recognized as a critical risk factor for PF occurrence in ARDS individuals and demonstrated considerable predictive potential.</p><p><strong>Conclusion: </strong>The miR-99a could potentially be a promising biomarker for ARDS and predict the risk of PF in ARDS patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"276"},"PeriodicalIF":1.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528112","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}