Journal of Cardiac Surgery最新文献

{"title":"Superior Vena Cava Canulation During Minimally Invasive Cardiac Surgery: A Better Choice than Percutaneous Internal Jugular Vein for Venous Drainage","authors":"Yufei Zhan,&nbsp;Hua Lu,&nbsp;Quan Shi,&nbsp;Shengjie Liao,&nbsp;Tiange Luo,&nbsp;Yipeng Ge,&nbsp;Xiaoshen Zhang","doi":"10.1155/jocs/1277604","DOIUrl":"https://doi.org/10.1155/jocs/1277604","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Venous drainage is a critical aspect of peripheral cardiopulmonary bypass (CPB) management in minimally invasive cardiac surgery (MICS), particularly for superior vena cava (SVC) drainage. The most commonly used method for SVC drainage currently is percutaneous cannulation via the internal jugular vein. However, this method still faces challenges in drainage efficiency, cosmetic outcomes, and puncture-related complications. This study aimed to compare the safety, effectiveness, and cosmetic outcomes of direct SVC cannulation (SVCC) and percutaneous internal jugular vein (PIJV) for SVC drainage in MICS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted of patients who underwent MICS with CPB at the Cardiovascular Surgery Department of the First Affiliated Hospital of Jinan University and Guangdong General Hospital between January 2012 and August 2023. In this study, 499 patients underwent SVCC, and 572 patients received PIJV for SVC drainage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the SVCC group, one central venous catheter was mistakenly fixed with a purse-string suture (0.2%). In the PIJV group, complications included neck hematoma in 11 cases (1.9%), puncture site infection in 3 cases (0.5%), and catheter failure in 1 case (0.2%). Significant differences were noted in central venous pressure (CVP) during aortic cross-clamping (<i>p</i> &lt; 0.001), duration of mechanical ventilation (<i>p</i> = 0.049), pleural drainage volume (<i>p</i> = 0.001) and lactate levels at Intensive Care Unit (ICU) admission (<i>p</i> &lt; 0.001) between the two groups. Additionally, lactate levels were significantly different only in the subgroup of patients weighing &gt; 50 kg. Patients with a CVP ≤ 0 mmHg during aortic cross-clamping exhibited lower lactate levels on ICU admission than those with CVP &gt; 0 mmHg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SVCC in MICS provides an easy and safe method with minimal complications, improved venous drainage, and better cosmetic results than the PIJV method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1277604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272880","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":"Establishing a Surgeon-Led Adult Cardiac Surgery Quality Improvement Program","authors":"Ahmet Can Topcu,&nbsp;Fatih Yigit,&nbsp;Emin Onur Yerlikhan,&nbsp;Mustafa Mert Ozgur,&nbsp;Melike Turkal,&nbsp;Hakan Hancer,&nbsp;Kamile Ozeren-Topcu,&nbsp;Farid Gojayev,&nbsp;Ozgul Uzunca,&nbsp;Serpil Tas,&nbsp;Kaan Kirali","doi":"10.1155/jocs/3804482","DOIUrl":"https://doi.org/10.1155/jocs/3804482","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The current article describes the methods utilized during the establishment of Kosuyolu Adult Cardiac Surgery Quality Improvement Program, shares our initial experiences, and provides insights into future directions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through inspiration from a notable example of high-performing collaborative quality initiative, we established a surgeon-led quality improvement program by voluntary participation of senior academic and early-career surgeons. Our new program aims to improve the quality of cardiac surgical care through methods of data acquisition and analysis, internal data validation, collaborative discussions on care processes and risk-adjusted outcomes, and development and implementation of quality improvement initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed significant baseline variations in outcome measures including perioperative blood utilization, postoperative mechanical ventilation duration, and postoperative length of stay between surgeon groups. During the first 2 years of the Kosuyolu Adult Cardiac Surgery Quality Improvement Program, there were significant overall improvements from baseline in multiarterial grafting rates among all-comer patients undergoing isolated coronary artery bypass surgery and in unadjusted re-exploration rates after all cardiac surgical procedures. However, no significant improvements were noted in perioperative blood utilization, postoperative mechanical ventilation duration and hospital and intensive care unit length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Surgeon-led collaborative quality improvement programs are instrumental in enhancing the quality of healthcare services provided to cardiac surgical patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3804482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272075","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":"Mechanical or Biological Aortic Valve Replacement in Hemodialysis Patients: A Propensity Score Matching Analysis With Long-Term Results From the TriNetX Global Network","authors":"Benedetto Del Forno,&nbsp;Nicolò Azzola Guicciardi,&nbsp;Francesca Rusconi,&nbsp;Gema Hernandez Ibarburu,&nbsp;Guido Ascione,&nbsp;Alessandro Verzini,&nbsp;Alessandro Faggi,&nbsp;Elisabetta Lapenna,&nbsp;Michele De Bonis,&nbsp;Francesco Maisano","doi":"10.1155/jocs/9329665","DOIUrl":"https://doi.org/10.1155/jocs/9329665","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients on hemodialysis face elevated risks of cardiovascular disease, including calcified aortic valve pathology requiring replacement. The choice between biological and mechanical prostheses remains controversial, with limited evidence. This study compares early and long-term outcomes of aortic valve replacement (AVR) in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed data from the TriNetX global health research network. Hemodialysis patients undergoing isolated AVR with either biological or mechanical prostheses were included. Propensity score matching was performed to minimize baseline differences. Early outcomes (30-day mortality, stroke, and hemorrhagic events) and long-term outcomes (survival, freedom from reintervention, stroke, and hemorrhagic events) were evaluated using Kaplan–Meier estimates and Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1101 patients, 544 received biological prostheses and 557 received mechanical prostheses from 2005 to 2021. After propensity score matching, two well-balanced groups of 427 patients each were analyzed. At 30 days, no significant differences were observed in mortality (10.5% vs. 8.4%, <i>p</i> = 0.270) or stroke incidence (5.1% in both, <i>p</i> = 0.983). At 7 years, freedom from reintervention was significantly higher in the mechanical group (91.2% vs. 80%, <i>p</i> = 0.025), while survival remained poor in both groups (33.2% vs. 29.9%, <i>p</i> = 0.351). Rates of stroke and hemorrhagic events were similar between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was no significant difference in long-term survival between the two groups. Prosthesis choice should be individualized, considering life expectancy, quality of life, and transplant candidacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9329665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271861","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":"Feasibility of Transcatheter Aortic Valve Replacement After Surgical Aortic Valve Replacement With and Without Aortic Root Enlargement, Gated CT Study","authors":"Ahmad Makhdoum,&nbsp;Muhammed Suleman,&nbsp;Bhavendra Singh,&nbsp;Hatim Al-Raddadi,&nbsp;Leah Wall,&nbsp;Kandace Forsyth,&nbsp;Dominic Parry,&nbsp;Iqbal Jaffer,&nbsp;Ali Alsagheir,&nbsp;Victor Chu,&nbsp;Warkaa Shamkhani,&nbsp;Adel Dyub,&nbsp;Richard Whitlock,&nbsp;Tej Sheth","doi":"10.1155/jocs/9518444","DOIUrl":"https://doi.org/10.1155/jocs/9518444","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The feasibility of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) after surgical aortic valve replacement (SAVR) and the impact of aortic root enlargement (ARE) remain unclear. This study assesses the anatomical feasibility of Viv TAVR post-SAVR, with and without ARE through detailed pre- and postoperative gated CT scans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 62 patients undergoing SAVR (<i>n</i> = 31) or SAVR + ARE (<i>n</i> = 31) between September 2022 and May 2024. Pre- and postoperative gated CT scans were used to measure annular area, sinus of Valsalva (SOV) dimensions, coronary heights, and virtual valve-to-coronary (VTC) and valve-to-sinotubular junction (VTSTJ) distances. High-risk ViV-TAVR anatomy was defined as VTC &lt; 4 mm or VTSTJ &lt; 2 mm. Four enlargement techniques were used (Y-Incision, Manouguian, Nicks and replacement of the coronary sinus).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Female patients were more prevalent in the SAVR + ARE group (61% vs. 19.4%, <i>p</i> &lt; 0.001). Preoperatively and compared to the SAVR cohort, SAVR + ARE had a smaller annular area-derived diameter (23 ± 2 mm vs. 26.8 ± 2.2 mm, <i>p</i> &lt; 0.001) and SOV dimensions (28.8 ± 2 vs. 32.8 ± 3.6, <i>p</i> ≤ 0.001) and, both cohorts had coronary heights of ≥ 14 mm. Postoperatively, both groups had a significant reduction in coronary heights by at least 7–9 mm (<i>p</i> &lt; 0.001). On the contrary, the SOV dimension increased significantly by +3 mm in the SAVR + ARE group (&lt; 0.001), while it decreased numerically in the SAVR-only cohort (0.07). Similarly, the majority of both groups were considered low risk for future ViV TAVR (SAVR: 24/31, 74%) and (SAVR + ARE: 22/31, 71%), while 22.6% (7/31) of SAVR and 29% (9/31) of SAVR + ARE were considered anatomically high risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While most patients who had SAVR, with or without ARE, were anatomically feasible for ViV TAVR, postoperative CT scans identified high-risk anatomy in approximately 25% of cases. Pre- and post-SAVR CT imaging offers insights into surgical planning and lifetime management of aortic valve disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9518444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224024","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":"Comparative Safety and Efficacy of Rivaroxaban Versus Warfarin in Pediatric Patients Following the Fontan Procedure: A Retrospective Cohort Study","authors":"Mustafa Kemal Avşar,&nbsp;Yasin Güzel,&nbsp;İbrahim Özgür Önsel,&nbsp;Barış Kırat,&nbsp;İlker Kemal Yücel,&nbsp;Cenap Zeybek,&nbsp;Deniz Yorgancılar","doi":"10.1155/jocs/7805401","DOIUrl":"https://doi.org/10.1155/jocs/7805401","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; The extracardiac Fontan procedure, a palliative intervention for single-ventricle physiology, is associated with significant thromboembolism and bleeding risks. Warfarin has been the standard anticoagulant, but its limitations have prompted exploration of nonvitamin K oral anticoagulants, such as rivaroxaban.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To compare the safety and efficacy of rivaroxaban vs. warfarin as postoperative anticoagulation in pediatric patients following the extracardiac Fontan procedure, focusing on thromboembolic events, bleeding complications, and treatment adherence.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; This retrospective cohort study included 369 pediatric patients (aged 3–17 years) who underwent the extracardiac Fontan procedure at a single center from 2015 to 2022, selected from 412 cases reviewed, with 43 excluded due to incomplete follow-up or comorbidities. Patients received either warfarin (&lt;i&gt;n&lt;/i&gt; = 177) or rivaroxaban (&lt;i&gt;n&lt;/i&gt; = 192) for anticoagulation. Baseline characteristics, including age, sex, body weight, and pulmonary artery pressure, were comparable between groups. Anticoagulation was initiated on postoperative Day 1 per institutional protocol, excluding aspirin to standardize thromboembolism prevention due to high risk in nonanticoagulated patients. Warfarin was titrated to an international normalized ratio (INR) of 2.0–3.0, while rivaroxaban was dosed per European Medicines Agency guidelines. Outcomes included thromboembolic events (graft thrombosis, pulmonary embolism, and transient ischemic attacks [TIAs]), major and minor bleeding, mortality, and treatment discontinuation over a mean follow-up of 5 years. TIAs were defined per American Heart Association guidelines as transient neurological dysfunction lasting less than 24 h without infarction on neuroimaging. Statistical analyses used Fisher’s exact test, Kaplan–Meier survival analysis, and multivariable logistic regression, with &lt;i&gt;p&lt;/i&gt; &lt; 0.05 indicating significance; the study was designed to detect a 3% difference in major bleeding. The limited number of thromboembolic events resulted in wide confidence intervals, limiting precision in between-group comparisons.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Thromboembolic events occurred in 5.1% (&lt;i&gt;n&lt;/i&gt; = 9) of warfarin patients and 2.1% (&lt;i&gt;n&lt;/i&gt; = 4) of rivaroxaban patients (OR = 2.5, 95% CI: 0.8–8.2). Major bleeding was significantly higher with warfarin (3.4%, n = 6; 4 intracranial and 2 gastrointestinal) than rivaroxaban (0.5%, n = 1; gastrointestinal; OR = 7.0, 95% CI: 1.2–40.8). Minor bleeding rates were 9.0% (warfarin) vs. 5.7% (rivaroxaban). Two warfarin-related deaths (intracranial hemorrhage and systemic embolism post-TIA) were recorded; none occurred with rivaroxaban. Treatment discontinuation was higher with warfarin (5.1% vs. 0.5%).&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Rivaroxaban demonstrated a superior safety profile compared to warfarin, with significantly lower major bleeding rates, no associated mortality, and imp","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/7805401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224296","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":"Circ-Myh4_un770 Regulates VSMC Proliferation and Migration via miR-3593-5p in Vein Graft Stenosis: A Mechanism for Vascular Remodeling","authors":"Baiqing Huang,&nbsp;Yirou Ma,&nbsp;Haiyang Wang,&nbsp;Wenli Wang,&nbsp;Xisheng Wang","doi":"10.1155/jocs/4874721","DOIUrl":"https://doi.org/10.1155/jocs/4874721","url":null,"abstract":"<p><b>Background:</b> Coronary artery bypass grafting (CABG) is a cornerstone therapy for coronary heart disease (CHD), but vein graft failure (VGF) caused by neointimal hyperplasia remains a major clinical challenge. Vascular smooth muscle cell (VSMC) proliferation and migration are central to this pathology, yet the regulatory role of circular RNAs (circRNAs) in VGF remains unclear. This study aimed to identify circRNAs driving VSMC dysfunction and explore their mechanisms in vein graft stenosis.</p><p><b>Methods:</b> A murine jugular vein-carotid artery bypass grafting model was established. RNA sequencing identified differentially expressed circRNAs in stenotic veins versus controls. Functional validation included circRNA knockdown/overexpression in VSMCs, proliferation (CCK-8, PCNA staining), migration (Transwell), apoptosis (TUNEL, cleaved caspase-3/Bcl-2), and mechanistic studies (qPCR, FISH). Bioinformatics tools predicted circRNA-miRNA interactions. Data were analyzed using ANOVA and <i>t</i>-tests (SPSS 27.0).</p><p><b>Results:</b> Circ-Myh4_un770 was significantly upregulated in stenotic veins (log2FC &gt; 2, <i>p</i> &lt; 0.001). Knockdown of circ-Myh4_un770 suppressed VSMC proliferation (37% reduction, <i>p</i> &lt; 0.01) and migration (52% reduction, <i>p</i> &lt; 0.05), while promoting apoptosis (2.1-fold increase in cleaved caspase-3, <i>p</i> &lt; 0.01). Conversely, circ-Myh4_un770 overexpression exacerbated VSMC dysfunction. Bioinformatic prediction and expression analyses support an interaction between circ-Myh4_un770 and miR-3593-5p (65% reduction, <i>p</i> &lt; 0.01). miR-3593-5p overexpression phenocopied circ-Myh4_un770 knockdown effects, inhibiting proliferation (41% reduction, <i>p</i> &lt; 0.05) and migration (48% reduction, <i>p</i> &lt; 0.05).</p><p><b>Conclusions:</b> Our study demonstrates that circ-Myh4_un770 contributes to VSMC dysfunction in vein graft stenosis through interaction with miR-3593-5p. These findings suggest that modulating the circ-Myh4_un770/miR-3593-5p axis could represent a strategy to attenuate pathological vascular remodeling. While further validation of direct RNA interactions (e.g., luciferase assays) and human tissue studies are required, our data highlight the potential translational relevance of circ-Myh4_un770 and miR-3593-5p in VGF management.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/4874721","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146430","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":"Protecting Sight During Cardiac Surgery: Mechanisms, Risks, and Management of Perioperative Ocular Complications","authors":"Ye In Christopher Kwon,&nbsp;Yeseo Kwon,&nbsp;Michelle Burmistrova,&nbsp;David T. Zhu,&nbsp;Alan Lai,&nbsp;Andrew Min-Gi Park,&nbsp;Dean Zhang,&nbsp;David J. Ramsey,&nbsp;Michael P. Robich,&nbsp;Ahmet Kilic,&nbsp;Josue Chery,&nbsp;Vigneshwar Kasirajan,&nbsp;Zubair A. Hashmi","doi":"10.1155/jocs/5176617","DOIUrl":"https://doi.org/10.1155/jocs/5176617","url":null,"abstract":"<p>Ophthalmic complications during a major cardiac surgery are rare but may have serious consequences. Patients requiring intraoperative support from a cardiopulmonary bypass machine have an increased risk of developing ocular adverse effects because of significant hemodynamic alterations involving the systemic and ocular vasculature. Ocular conditions experienced by patients undergoing cardiac surgery range from corneal abrasions to retinal artery occlusions or ischemic optic neuropathies. Postoperative vision loss may also occur because of cerebrovascular pathologies, such as stroke, pituitary apoplexy, or even cortical blindness. Here, we review perioperative ophthalmic complications encountered in cardiac surgery patients to guide clinicians in their diagnosis and management.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5176617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145101583","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":"Hybrid Coronary Revascularization: Insights Into Long-Term Clinical Outcomes From a Single-Center Experience","authors":"Ibrahim Gadelkarim,&nbsp;Nikhil Deshmukh,&nbsp;David Holzhey,&nbsp;Wolfgang Otto,&nbsp;Philipp Kiefer,&nbsp;Suzanne de Waha,&nbsp;Steffen Desch,&nbsp;Holger Thiele,&nbsp;Piroze Davierwala,&nbsp;Michael A. Borger,&nbsp;Alexander Verevkin","doi":"10.1155/jocs/3786314","DOIUrl":"https://doi.org/10.1155/jocs/3786314","url":null,"abstract":"<p><b>Background:</b> Hybrid coronary revascularization (HCR) combines minimally invasive direct coronary artery bypass (MIDCAB) to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) for non-LAD lesions. HCR aims to balance the durability of surgical revascularization with the reduced invasiveness of PCI. This study evaluates 20 years of HCR experience at a single center, focusing on short- and long-term clinical outcomes.</p><p><b>Methods:</b> A retrospective analysis was conducted on 2969 patients who underwent MIDCAB between 1996 and 2020 at the Heart Center Leipzig. A total of 177 patients met the inclusion criteria, defined as MIDCAB followed or preceded by PCI within 100 days. Exclusion criteria included emergency procedures, planned sternotomy, and delayed HCR beyond 100 days. Propensity score matching (PSM) compared outcomes between MIDCAB-first and PCI-first strategies.</p><p><b>Results:</b> The median time interval between MIDCAB and PCI was 22 days. Early stent and graft failure rates were 2.8% and 2.2%, respectively. Kaplan–Meier estimated survival was 79.1% at 5 years, 64.2% at 10 years, 49.8% at 15 years, and 37.8% at 20 years. Freedom from repeat revascularization was 86.3% at 5 years and 73.6% at 10 years. PSM analysis showed no significant difference in 15-year survival (57.7% vs. 50.6%, <i>p</i> = 0.68) or 10-year freedom from repeat revascularization (88.9% vs. 86.1%, <i>p</i> = 0.39) between the MIDCAB-first and PCI-first groups.</p><p><b>Conclusion:</b> HCR provides durable long-term survival and revascularization outcomes, with comparable results between MIDCAB-first and PCI-first strategies. These findings support HCR as a viable alternative to conventional CABG in selected patients.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3786314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145101733","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 Aortic Valve Replacement vs. Conservative Therapy in Asymptomatic Severe Aortic Stenosis Patients: A Meta-Analysis","authors":"Mazen Alayidh,&nbsp;Ahmed A. Ibrahim,&nbsp;Najla M. Alharthi,&nbsp;Ahmed Gaber Emara,&nbsp;Jawri Abdulhadi Alamri,&nbsp;Yara Fahad Almazyad,&nbsp;Tmadher G. Alshammari,&nbsp;Asma M. Alharbi,&nbsp;Esraa H. Mustafa,&nbsp;Raghad Zaki Alzaher,&nbsp;Mustafa Turkmani,&nbsp;Esameldin Shadoul","doi":"10.1155/jocs/7981651","DOIUrl":"https://doi.org/10.1155/jocs/7981651","url":null,"abstract":"<p><b>Background:</b> Aortic stenosis (AS) is frequently seen in elderly individuals. However, the preferred strategy for asymptomatic severe AS remains unclear. We compared early aortic valve replacement (eAVR) with conservative care.</p><p><b>Methods:</b> We conducted a systematic review and meta-analysis of RCTs from major databases until December 20, 2024. Risk ratios (RRs) and mean differences (MDs) were pooled with 95% confidence intervals (CIs) using R version 4.3.</p><p><b>Results:</b> Four RCTs (1427 patients) showed no substantial difference in all-cause mortality between the early intervention and conservative care (RR: 0.69 [95% CI: 0.42–1.11]; <i>p</i> = 0.13). However, early intervention was markedly associated with a lower incidence of cardiovascular mortality (RR: 0.65 [95% CI: 0.44–0.96]; <i>p</i> = 0.03), hospitalization for heart failure (RR: 0.27 [95% CI: 0.13–0.54]; <i>p</i> &lt; 0.01), and stroke (RR: 0.62 [95% CI: 0.40–0.95]; <i>p</i> = 0.03) compared to that of conservative care. Moreover, there was no significant difference between the two groups in myocardial infarction (RR: 0.22 [95% CI: 0.04–1.24]; <i>p</i> = 0.09), repeated aortic-valve surgery (RR: 0.74 [95% CI: 0.12–4.78]; <i>p</i> = 0.75), and thromboembolic complications (RR: 0.72 [95% CI: 0.23–2.21]; <i>p</i> = 0.56).</p><p><b>Conclusion:</b> In asymptomatic severe AS, early AVR did not mitigate overall mortality but substantially lowered cardiovascular mortality, heart failure hospitalizations, and stroke risks compared to conservative management. Perioperative complications were similar in both groups.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/7981651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062772","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":"Comparative Analysis of Concurrent and Staged Surgical Treatment for Lung Cancer Complicated With Coronary Heart Disease and Its Effect on Prognosis","authors":"Yumeng Niu,&nbsp;Lei Xian,&nbsp;Yi Wang,&nbsp;Boju Zhao","doi":"10.1155/jocs/6677732","DOIUrl":"https://doi.org/10.1155/jocs/6677732","url":null,"abstract":"<p><b>Objective:</b> To investigate the effect of different surgical methods on the prognosis of 84 patients with lung cancer complicated with coronary heart disease.</p><p><b>Methods:</b> Data of patients with lung cancer complicated with coronary heart disease who received surgical treatment in our hospital from January 2018 to November 2024 were collected. The patients were divided into OPCAB¹ simultaneous operation group, PCI² postoperative operation group, and non-revascularization operation group according to the surgical method, and then, the PCI postoperative operation group was divided into two groups according to the two surgical intervals. Clinical data such as the evaluation of surgical safety and the effect of the time of operation after PCI on the prognosis of patients with lung cancer were used to guide the treatment of these patients.</p><p><b>Results:</b> The probability of coronary artery complications is higher in patients undergoing pulmonary surgery with PCI indications and no treatment for coronary artery disease. There was no significant difference in the probability of coronary artery complications in lung cancer patients who underwent surgery within 2 months after PCI versus those who underwent surgery within 2–4 months after PCI. However, the time window of surgery after PCI has an impact on the prognosis of patients with lung cancer.</p><p><b>Conclusion:</b> There was no significant difference in the duration of intraoperative bleeding, drainage tube removal, and hospital stay between patients undergoing pulmonary surgery after PCI and those without coronary revascularization. Pulmonary surgery after PCI was safe and feasible, and pulmonary surgery within 2 months after PCI was safe and feasible, and the prognosis of patients undergoing pulmonary surgery after PCI was different in different time windows. Pulmonary surgery should be performed as early as possible within the 2-month time window after PCI. Patients undergoing pulmonary surgery with PCI indications and without prior treatment of coronary artery lesions have a higher probability of postoperative coronary complications. Therefore, lung cancer surgery as soon as possible after PCI can be considered to have a good impact on the prognosis of patients.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6677732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145037943","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}