Journal of Cardiac Surgery最新文献

{"title":"Optimizing Saphenous Vein Graft Quality in CABG: Overdistension as a Central, Modifiable Target for Surgical Standardization","authors":"Clement Rajakumar,&nbsp;William Sebastian,&nbsp;Michelle Abramova,&nbsp;Samuel S. Gerlock,&nbsp;Matthew Petrides,&nbsp;Kourosh Asgarian","doi":"10.1155/jocs/2521690","DOIUrl":"https://doi.org/10.1155/jocs/2521690","url":null,"abstract":"<p>Saphenous vein graft (SVG) failure remains a major limitation of coronary artery bypass grafting (CABG), with endothelial injury serving as a critical early determinant of long-term patency. Among modifiable intraoperative factors, overdistension during graft preparation has emerged as a key mechanism driving endothelial dysfunction, thrombosis, and intimal hyperplasia. Experimental and translational data consistently demonstrate that supraphysiologic intraluminal pressures result in endothelial denudation and impaired nitric oxide bioavailability, initiating a cascade that contributes to graft failure. Despite this, intraoperative handling of SVGs remains highly variable, and pressure-controlled strategies are not universally adopted. This narrative review synthesizes current evidence on the pathophysiology of overdistension-induced injury, its impact on graft durability, and evolving strategies to mitigate damage, including pressure-controlled flushing, no-touch harvesting, external stenting, and optimized preservation techniques. We additionally address whether a definitive “safe” distension pressure can be defined and conclude that the evidence supports an operational ceiling of ≤ 140 mmHg—a validated upper limit rather than an identified injury threshold—the reliability of which depends on device-imposed pressure limitation rather than tactile estimation. We propose that standardization of SVG handling—particularly the routine use of pressure-limiting strategies—represents a practical and underutilized opportunity with the potential to improve CABG outcomes. Integration of these approaches into surgical protocols and quality metrics may enhance long-term graft patency.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/2521690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848682","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":"Correction to “Mortality and Survival after Norwood Procedure Comparison between Shunt Type in Patients with Hypoplastic Left Heart Syndrome or Its Variants: A Systematic Review and Meta-Analysis Study”","authors":"","doi":"10.1155/jocs/9898426","DOIUrl":"https://doi.org/10.1155/jocs/9898426","url":null,"abstract":"<p>A. Y. Arnaout, Y. Nerabani, A. Ali, and et al., “Mortality and Survival after Norwood Procedure Comparison between Shunt Type in Patients with Hypoplastic Left Heart Syndrome or Its Variants: A Systematic Review and Meta-Analysis Study,” <i>Journal of Cardiac Surgery</i>, 2023, 8534205, 18 pages, 2023, https://doi.org/10.1155/2023/8534205.</p><p>I want to edit the name of the author “Ahmad Sajee” to “Ahmad Sajjee”</p><p>We apologize for this error.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9898426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148848683","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":"Are Homografts Superior to Prosthetic Valves in Destructive Aortic Endocarditis? A Systematic Review and Pairwise Meta-Analysis of Early–Midterm Outcomes","authors":"W. Samir Cubas,&nbsp;Joaquín Gundelach,&nbsp;Satoshi Arimura,&nbsp;Ace Alfabeto,&nbsp;Yasuhiko Kawaguchi,&nbsp;Jonathan Hong,&nbsp;Lin-Rui Guo,&nbsp;Michael W. A. Chu","doi":"10.1155/jocs/8734329","DOIUrl":"https://doi.org/10.1155/jocs/8734329","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Destructive aortic endocarditis (DAE) requires complex surgery. Homografts are traditional gold standards, but emerging evidence questions their superiority over prosthetic valves. This systematic review and pairwise meta-analysis compare early–midterm outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of PubMed, Embase, Scopus, and Cochrane (1990–2025) identified studies comparing homografts, mechanical, and bioprosthetic valves for DAE. Outcomes included mortality, reoperation, stroke, reinfection, and midterm survival. Pairwise meta-analysis and Pearson’s correlation were applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies (9948 patients) were included (homograft <i>n</i> = 1359; mechanical <i>n</i> = 2717; biological <i>n</i> = 5872). The mean age was 53.5 years, and 74.9% were male. No significant differences were observed in 30-day mortality (homograft vs mechanical: OR 1.31, 95% CI 0.99–1.72; vs biological: OR 1.15, 95% CI 0.73–1.81), midterm survival (RR 1.00, 95% CI 0.92–1.09; RR 1.06, 95% CI 0.88–1.28), or reinfection (homograft vs mechanical: RR 0.99, 95% CI 0.82–1.19; vs biological: RR 0.77, 95% CI 0.44–1.36). Reoperation was significantly higher with homografts versus mechanical (OR 1.58, 95% CI 1.17–2.14) and biological valves (OR 1.45, 95% CI 1.22–1.72), with no heterogeneity (<i>I</i>² = 0%). Stroke risk was comparable across all comparisons, with nonsignificant numerical trends favoring homografts: homograft vs mechanical (OR 0.86, 95% CI 0.37–1.20), homograft vs biological (OR 0.65, 95% CI 0.30–1.41), and mechanical vs biological (OR 0.99, 95% CI 0.80–1.23). Unadjusted pooled proportions suggested higher early mortality with homografts (19.1%) compared to mechanical (16.8%) and biological (15.1%) valves, though these differences were not statistically significant in adjusted pairwise meta-analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Homografts do not demonstrate definitive superiority for DAE. While nonsignificant numerical trends toward lower stroke rates were observed with homografts, no statistically significant benefits were confirmed for mortality, reinfection, or midterm survival. Homografts were associated with significantly higher reoperation rates without a survival advantage. Valve selection requires patient-tailored balancing of infection control, durability, and procedural risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8734329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148785152","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 Day of the Week of CABG on Hospital Length of Stay and Readmission Rates","authors":"Yingyot Arora,&nbsp;Ashtyn P. Philipsheck,&nbsp;Yiyang Zhang,&nbsp;Kapil Kapoor,&nbsp;Kevin D. Accola,&nbsp;David G. Rabkin","doi":"10.1155/jocs/6626101","DOIUrl":"https://doi.org/10.1155/jocs/6626101","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We evaluated whether the weekday of surgery was associated with postoperative length of stay (LOS) or 30-day readmission after elective and urgent isolated coronary artery bypass grafting (CABG) and identified patient- and procedure-level predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Elective and urgent isolated CABGs performed at Loma Linda University Medical Center and AdventHealth Cardiovascular Institute from 1/1/2014 to 12/31/2024 were retrospectively reviewed. LOS was compared across weekdays using one-way ANOVA, and readmission rates were compared using Chi-square testing. Predictors of LOS were evaluated using a generalized linear model with gamma distribution and log link, with exponentiated coefficients reported as LOS ratios. Predictors of readmission were assessed using multivariable logistic regression. Covariates were selected a priori and entered simultaneously.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no difference in LOS by day among 8543 isolated CABGs (<i>p</i> = 0.241). Age increased LOS by 0.8% per year (<i>p</i> &lt; 0.001), and BMI increased LOS by 0.4% per unit (<i>p</i> = 0.001). Renal failure increased LOS by 92%, diabetes by 11%, and each additional graft by 4%; male sex decreased LOS by 8% (all <i>p</i> &lt; 0.001). Treatment at Site 2 was associated with a 44% longer LOS (<i>p</i> &lt; 0.001).For readmission, increasing age (<i>p</i> = 0.004) and diabetes (<i>p</i> &lt; 0.001) increased odds, whereas male sex was protective (<i>p</i> &lt; 0.001). Site 2 was associated with higher odds of readmission (<i>p</i> = 0.039). Although the weekday of surgery was associated with readmission in unadjusted analysis, the association was not significant after adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LOS and readmissions after CABG hinge on comorbid burden and institutional practices, not surgical timing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6626101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784251","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":"Bentall Procedure in Patients With Aortic Valve Stenosis and Root Aneurysm: A 10-Year Single-Center Experience","authors":"Veysel Kutay,&nbsp;Emine Aleyna Eroğlu Polat,&nbsp;Gökay Altaylı,&nbsp;Mehmet Okan Donbaloğlu,&nbsp;Olgar Bayserke,&nbsp;Taner İyigün","doi":"10.1155/jocs/5295223","DOIUrl":"https://doi.org/10.1155/jocs/5295223","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Aortic stenosis (AS) in patients undergoing the Bentall procedure for aortic root aneurysm is less frequent than aortic regurgitation (AR) and represents a distinct clinical entity with a higher prevalence of comorbidities, including coronary artery disease. This study examined whether the predominant aortic valve pathology influences outcomes after the Bentall procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 2015 to 2025, 442 patients who underwent elective Bentall procedures were retrospectively reviewed after predefined exclusions. Patients were stratified according to predominant aortic valve pathology into an AS group (<i>n</i> = 90) and an AR group (<i>n</i> = 352). Perioperative outcomes, early and late complications, freedom from reoperation, and long-term survival were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the AS group were older than those in the AR group and had a higher proportion of female patients, resulting in a higher EuroSCORE II, while other baseline characteristics were comparable. The incidence of major perioperative complications was comparable between groups, and overall 30-day mortality was 3%, with no significant difference between the AS and AR groups (5.4% vs. 2.5%, <i>p</i> = 0.26). During a mean follow-up of 53 months (1858 patient-years), overall survival was significantly lower in the AS group compared with the AR group (10 year survival: 76% vs. 87%, <i>p</i> &lt; 0.001). Freedom from reoperation and long-term complications, including stroke and endocarditis, were similar between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patient comorbidities, perioperative complications, and surgery-related technical factors, rather than the type of aortic valve disease, are the main determinants of outcomes after Bentall procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5295223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784254","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 Versus Later Bicavopulmonary Connection in Infants: A Systematic Review and Meta-Analysis","authors":"Abdullah Almehandi,&nbsp;Adel Altarkait,&nbsp;Yahya Ali,&nbsp;Mohammad Alhajri,&nbsp;Abdulrahman Shandala,&nbsp;Abdulrahman O. Al-Naseem,&nbsp;Hamood Al Kindi,&nbsp;Saif Awlad thani","doi":"10.1155/jocs/8599819","DOIUrl":"https://doi.org/10.1155/jocs/8599819","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The bicavopulmonary connection (BCPC) is a crucial palliation for single-ventricle physiology, improving haemodynamics by alleviating ventricular volume overload. While traditionally performed at 4–6 months, the optimal timing is debated, with a trend toward earlier intervention to reduce interstage mortality. This meta-analysis compares outcomes of early versus late BCPC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, EMBASE and Cochrane Central identified studies comparing early (&lt; 6 months) and late (≥ 6 months) stage 2 palliation. Primary outcomes were early, late and interstage mortality. Secondary outcomes included operative parameters, ICU/hospital stay, duration of mechanical ventilation, Fontan completion rates, postoperative haemodynamics and complications. Pooled risk ratios (RR), odds ratios (OR), or mean differences (MD) with 95% confidence intervals were calculated using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten studies (2220 patients: 841 early, 1379 late) were included. The incidence of early mortality was significantly greater in the early BCPC group (RR = 2.28, CI = 1.29–4.05, <i>p</i> = 0.005), though late and interstage mortality were similar. Operative parameters and haemodynamics (atrial pressure, SVC pressure, oxygen saturation) were comparable. However, the early group had significantly longer hospital stay (MD = 5.21 days, <i>p</i> = 0.02), ICU stay (MD = 2.03 days, <i>p</i> = 0.02) and duration of mechanical ventilation (MD = 36.19 h, <i>p</i> &lt; 0.0001). Time to Fontan, age at Fontan, Fontan completion rates and complications were indifferent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Early BCPC is associated with a higher risk of short-term mortality, with similar interstage and long-term survival. Postoperative recovery is prolonged with earlier intervention. Fontan completion and postoperative complications are otherwise comparable. Future randomised multicentre studies are needed to establish optimal timing for BCPC surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8599819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784319","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":"An Exploratory Machine Learning Analysis of 10-Year Mortality After Isolated CABG","authors":"Rezan Aksoy,&nbsp;Alp Önder Yener,&nbsp;Recep Çalışkan,&nbsp;Hasan Alp Boz,&nbsp;Naci Cem Aydoğdu,&nbsp;Selim Balcisoy,&nbsp;Cevdet Ugur Kocogullari","doi":"10.1155/jocs/3088313","DOIUrl":"https://doi.org/10.1155/jocs/3088313","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conventional risk scoring systems often lack optimization for long-term prognosis, necessitating the exploration of machine learning (ML) methods in predicting mortality after coronary artery bypass grafting (CABG). This study aimed to identify risk factors for long-term mortality in isolated CABG patients and compare the performance of ML models with EuroSCORE II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study analyzed the 10-year follow-up data of 350 patients who underwent isolated CABG between January 2011 and January 2012. The dataset comprised 52 variables, including clinical and procedural data. After preprocessing and SMOTE resampling, ensemble ML models were trained using Lasso-based feature selection; performance was compared with the full EuroSCORE II model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>The best-performing model utilized the top 8 features selected by Lasso regression, achieving a higher recall (0.768) and F1 score (0.462) compared to the model using the full feature set. The eight most predictive features were X-clamp time, cardiopulmonary bypass (CPB) time, first-year blood glucose levels, MACCE, elevated pulmonary artery pressure (PAH), 10th-year blood glucose levels, intervention for peripheral arterial disease (PAD), and first-year LDL levels. The ML pipeline (AUC: 0.559) achieved discrimination comparable to EuroSCORE II (AUC: 0.604) (<i>p</i> = 0.403).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ML-based analysis identified procedural duration, long-term metabolic control, and PAD-related variables as key determinants of long-term mortality after CABG. Notably, MACCE history and elevated PAH further contributed to risk stratification. ML models achieved discrimination comparable to traditional risk scores while offering improved interpretability for long-term outcomes, suggesting that integration with established clinical scoring systems may enhance patient-specific mortality prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3088313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148753598","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":"Surgical Thrombectomy and Pannus Removal in Prosthetic Heart Valve Obstruction: A Case-Series of a Single-Center Experience","authors":"Mehrzad Rahmanian,&nbsp;Arman Soltani Moghadam,&nbsp;Ali Kalhor,&nbsp;Sara Shahriyari,&nbsp;Farnoosh Larti,&nbsp;Roya Sattarzadeh Badkoubeh,&nbsp;Mehrdad Salehi","doi":"10.1155/jocs/6672344","DOIUrl":"https://doi.org/10.1155/jocs/6672344","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prosthetic heart valve obstruction (PHVO) due to thrombosis or pannus formation is a significant complication following mechanical valve replacement. Thrombectomy and pannus removal offer a surgical alternative to valve replacement for PHVO. This study aims to evaluate the clinical outcomes of patients undergoing these procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center case series study included 143 patients with a history of mechanical bileaflet prosthetic heart valve replacements who presented with PHVO and underwent surgical pannus removal or thrombectomy between 2014 and 2022. Patients with infective endocarditis or paravalvular leakage were excluded from the study. The preoperative assessment included echocardiography (transthoracic and/or transesophageal), fluoroscopy, and a laboratory workup. Outcomes, including in-hospital mortality and long-term survival, were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thrombectomy was performed in the aortic position in 43 patients (30%), mitral position in 65 (45.4%), and tricuspid position in 7 (4.8%), with 28 patients (19.5%) undergoing simultaneous cleansing of two valves. The median postoperative hospital stay was nine days, and the in-hospital mortality rate was 9.8%. After a mean follow-up of 4.3 years, a 28.7% overall mortality rate, with half of these deaths attributed to cardiovascular causes, was detected. Four patients experienced recurrent valve thrombosis, and two underwent a second valve cleansing surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Valve thrombectomy and pannus removal were associated with favorable postoperative outcomes, though in-hospital mortality remained at 9.8%. This study highlights the need for randomized clinical trials to compare surgical options and optimize treatment for PHVO.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6672344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647885","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":"Survival After CABG in Dialysis-Dependent Patients: Characterisation of Infection States and Subsequent Renal Transplantation","authors":"Tim Dong,&nbsp;Pradeep Narayan,&nbsp;Daniel P. Fudulu,&nbsp;Jeremy Chan,&nbsp;Gianni D. Angelini,&nbsp;CVD-COVID-UK/COVID-IMPACT Consortium","doi":"10.1155/jocs/7611579","DOIUrl":"https://doi.org/10.1155/jocs/7611579","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To determine the proportion of dialysis-dependent patients undergoing coronary artery bypass graft (CABG) who subsequently received a renal transplant (RT) and to compare early and mid-term outcomes with those who remained on dialysis. The levels of bacterial and viral (COVID-19) infections were also investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve datasets were accessed in NHS England’s Secure Data Environment service for England, via the BHF Data Science Centre’s CVD-COVID-UK/COVID-IMPACT consortium. A retrospective cohort study that included all adults with chronic dialysis who underwent first-time CABG in England between 1 January 2018 and 31 March 2022 was analysed. A sensitivity analysis with stratification by infection status was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 313 dialysis-dependent CABG patients, 55 (17.6%) received RT. Transplant recipients were younger (median 58 vs. 64 years, <i>p</i> &lt; 0.001), less likely to require urgent CABG (30.9% vs. 54.7%, <i>p</i> = 0.004) and more often had no prior MI (76.4% vs. 53.5%, <i>p</i> = 0.036). In-hospital mortality for the whole cohort was 9.9% (30/313) with all deaths in the group not receiving subsequent RT (12% vs. 0%, <i>p</i> &lt; 0.014). Viral infection did not significantly affect postoperative outcomes. All dialysis patients were infected with bacterial endocarditis. Kaplan–Meier analysis showed significantly better survival in RT recipients (3.64% alive at 50 months) compared with nonrecipients (0.78%) (<i>p</i> &lt; 0.001). Most patients waited for 2 years or longer before receiving RT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CABG in dialysis-dependent patients carries high mid-term mortality. Survival among those who subsequently underwent RT showed improvement but requires future substantiation through competing risk analysis (mortality vs. transplant) to prevent overestimation of the risk in the non-RT group. Further research on the effect of microbes on cardiac intervention in this context is required to identify ways to improve outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/7611579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Outcomes of Postinfarction Ventricular Septal Defects: Insights From the Texas Inpatient Discharge Database","authors":"Lee M. Fuentes,&nbsp;Madeline Petrikas,&nbsp;Alexandra MacHugh,&nbsp;Joshua C. Grimm,&nbsp;Masahiro Ono,&nbsp;William Kessler,&nbsp;Karen Kim,&nbsp;Satoshi Furukawa,&nbsp;George J. Arnaoutakis","doi":"10.1155/jocs/8352640","DOIUrl":"https://doi.org/10.1155/jocs/8352640","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Postmyocardial infarction ventricular septal defect (PMIVSD) is one of the most lethal mechanical complications of acute myocardial infarction, yet contemporary data on its regional distribution and real-world management remain limited.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We analyzed the Texas Inpatient Discharge Database (TIDD) from 2015 to 2024 to characterize the incidence, institutional distribution, resource utilization, and outcomes of PMIVSDs across Texas. Adult patients with an emergent or urgent PMIVSD admission (ICD-10 I23.2) were stratified by operative versus nonoperative management; hospitals were categorized into tertiles by PMIVSD volume. The primary outcome was in-hospital mortality.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 139 patients were identified, representing an incidence of 0.16% of all myocardial infarction admissions. Care was distributed across 60 unique hospitals, with 35 centers managing only a single admission during the study period. Mechanical circulatory support (MCS) was utilized in 58% of patients, with no significant temporal trend across the study period. Practice variation in Impella use, transcatheter VSD closure, and cardiac surgery was observed across volume tertiles. The overall in-hospital mortality was 47%. Overall in-hospital mortality differed across volume tertiles (log-rank &lt;i&gt;p&lt;/i&gt; &lt; 0.001), reflecting early divergence with the highest mortality at middle-volume centers (64%); this difference did not persist among patients surviving to a 2-week landmark (&lt;i&gt;p&lt;/i&gt; = 0.81). Operative patients at high-volume centers demonstrated significantly improved survival (&lt;i&gt;p&lt;/i&gt; = 0.0015). On conventional multivariable Cox regression, cardiac surgery was associated with decreased mortality (adjusted HR: 0.37; 95% CI: 0.19–0.69; &lt;i&gt;p&lt;/i&gt; = 0.002); however, landmark analyses accounting for immortal time bias attenuated this association to nonsignificance (HR range: 0.69–0.78; all &lt;i&gt;p&lt;/i&gt; &gt; 0.4). Hospital day 30 survival was 68.8% (95% CI: 54.9%–86.2%) for operative patients versus 35.1% (95% CI: 22.8%–51.8%) for nonoperative patients (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Management of PMIVSDs in Texas is highly fragmented, with most institutions managing fewer than two cases over the decade. High-volume centers demonstrated superior operative survival and greater procedural diversity, whereas middle-volume centers had the highest early mortality. The association between surgery and lower mortality on conventional modeling","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2026 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8352640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615513","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}