Journal of Cardiac Surgery最新文献

{"title":"Hypothermic Low Flow Fibrillation for Unclampable Aorta in Coronary Artery Bypass Grafting: Alternative to Off-Pump CABG","authors":"Thais Faggion Vinholo,&nbsp;Andreas Habertheuer,&nbsp;Morgan Harloff,&nbsp;Sameer A. Hirji,&nbsp;Farhang Yazdchi,&nbsp;Siobhan McGurk,&nbsp;Borami Shin,&nbsp;Prem S. Shekar,&nbsp;Tsuyoshi Kaneko,&nbsp;Sary Aranki","doi":"10.1155/jocs/1917682","DOIUrl":"https://doi.org/10.1155/jocs/1917682","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Severe calcific disease of the ascending aorta may prohibit cross-clamping during coronary artery bypass grafting (CABG) due to unacceptable morbidity and mortality associated with atheroembolic complications. Clampless hypothermic noncardioplegic low flow fibrillation (HLFF) may minimize neurologic complications while allowing for complete revascularization.</p>\u0000 <p><b>Methods:</b> From 2002 to 2019, 142 patients with unclampable aorta (UCA) underwent isolated CABG using clampless HLFF. Short-term and long-term outcomes were compared with an isolated conventional on-pump CABG cohort (<i>n</i> = 268) risk-matched (RM) for type of CABG, STS score, age, and sex.</p>\u0000 <p><b>Results:</b> UCA and RM cohort patients were comparable in terms of age (73.7 ± 7.8 vs. 72.7 ± 8.7, <i>p</i> = 0.281), sex (34.4% vs. 32.5% female, <i>p</i> = 1.000), STS score (4.01 ± 3.43 vs. 3.80 ± 3.33, <i>p</i> = 0.539), and number of diseased vessels (<i>p</i> = 0.323). 90% of patients underwent central cannulation; UCA group patients received a comparable number of arterial (<i>p</i> = 0.432) or venous grafts (<i>p</i> = 0.493). Incidence of stroke was 6.3% in the UCA cohort and 2.6% in the RM cohort (<i>p</i> = 0.059). Need for reoperation, postoperative transfusions, incidence of atrial fibrillation, and renal impairment was similar (all <i>p</i> &gt; 0.050). UCA patients spent a longer time on the ventilator, in the ICU, and in the hospital (all <i>p</i> = 0.001). Operative mortality was not different between UCA and RM groups (3.5% vs. 4.5%, <i>p</i> = 0.797) as was all-cause mortality over long-term follow-up (<i>p</i> = 0.093).</p>\u0000 <p><b>Conclusions:</b> While a higher incidence of stroke was observed, without reaching statistical significance, hypothermic fibrillatory arrest remains a valuable and safe tool for coronary revascularization in UCA patients, offering comparable short-term and long-term survival outcomes allowing for complete revascularization.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1917682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681041","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":"A Cost–Benefit Analysis of Minimally Invasive Versus Open Vein Harvesting in Cardiac Surgery Based on the German DRG System","authors":"Zulfugar T. Taghiyev,&nbsp;Justus T. Strauch,&nbsp;Yeong-Hoon Choi","doi":"10.1155/jocs/8825822","DOIUrl":"https://doi.org/10.1155/jocs/8825822","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> A cost–benefit analysis of open vein harvesting (OVH) versus endoscopic vein harvesting (EVH) for leg wound complications in intermediate- and high-risk cardiac surgical patients was performed based on the German Diagnosis-Related Groups (G-DRG) in a retrospective cohort.</p>\u0000 <p><b>Methods:</b> The highest Fowler score and EuroSCORE II were utilized as risk variables for leg wound infection. Risk adjustment (1:1) was performed to compare two groups of patients undergoing surgery with OVH or EVH techniques. Total costs, including costs of facilities, additional hospital stays, and personnel expenses based on Institute for the Hospital Remuneration System calculations, were compared with G-DRG reimbursements.</p>\u0000 <p><b>Results:</b> The baseline characteristics of the two groups did not differ significantly. Thirty-four (41.8%) patients developed a wound healing disorder, 28 in the OVH group and 6 in the EVH group (<i>p</i> = 0.037). During the hospital stay, five (7.4%) patients in the OVH group had major leg wound healing disorders. Patients in the OVH group had a marginally longer hospital stay, though without statistical significance (14.3 vs. 11.7 days; <i>p</i> = 0.424). The total cost was 23,223€ for the OVH group compared with 18,627€ for the EVH group (<i>p</i> &lt; 0.001); thus, the cost of the OVH group exceeded that of the EVH group by 4596€ based on G-DRG calculations.</p>\u0000 <p><b>Conclusion:</b> EVH was associated with significant cost savings and fewer leg wound complications in intermediate- or high-risk patients. The G-DRG reimbursement system ended with the statement that case-based flat rates are not viable for hospitals treating vulnerable groups of patients.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8825822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666601","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":"Modified Left Atrial Closure Technique Using Barbed Sutures in Robotic Cardiac Surgery: A Single-Center Retrospective Cohort Study","authors":"Tomonari Uemura,&nbsp;Yasunari Hayashi,&nbsp;Toshikuni Yamamoto,&nbsp;Masato Mutsuga","doi":"10.1155/jocs/6477970","DOIUrl":"https://doi.org/10.1155/jocs/6477970","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Reducing operative times and standardizing surgical techniques are important in robot-assisted cardiac surgery. We have implemented V-Loc barbed sutures as a technical refinement to left atrial closure and report our outcomes.</p>\u0000 <p><b>Methods:</b> We retrospectively analyzed 45 consecutive patients who underwent robot-assisted mitral valve repair between January 2023 and September 2024 at Nagoya University Hospital. Patients were divided into two groups: a V-Loc group (<i>n</i> = 29) and a conventional suture group (<i>n</i> = 16). The primary endpoint was left atrial closure time. Secondary endpoints included perioperative complication and reoperation rates.</p>\u0000 <p><b>Results:</b> The V-Loc group demonstrated a shorter left atrial closure time (11 [7.8–13] minutes vs. 16 [14.5–19] minutes in the conventional group, <i>p</i> &lt; 0.01), representing a 31.3% reduction. One patient in the V-Loc group required reoperation due to intercostal vessel bleeding, unrelated to the closure technique. No operative mortality or major complications were encountered in either group. During a median follow-up period of 16 months (up to 27 months), no complications associated with the atrial closure technique were observed.</p>\u0000 <p><b>Conclusions:</b> The use of V-Loc barbed sutures for left atrial closure in robot-assisted mitral valve surgery significantly reduced operative times while maintaining procedural safety. This technique represents a promising approach for standardizing and streamlining robotic cardiac procedures.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6477970","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657671","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":"Intraoperative Ultrasound-Based Assessment of Coagulation in Cardiac Surgery Patients: A Single-Center Experience","authors":"Curtis A. Anderson,&nbsp;Clifton Reade,&nbsp;Lance Landvater,&nbsp;Panagiotis Tasoudis,&nbsp;Melissa Alberts,&nbsp;Jamie Burns,&nbsp;Alan P. Kypson","doi":"10.1155/jocs/3615306","DOIUrl":"https://doi.org/10.1155/jocs/3615306","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Bleeding after cardiac surgery is common. Intraoperative assessment of whole blood coagulation may allow early targeted treatment of coagulopathy associated with cardiopulmonary bypass. The performance of an ultrasound-mediated method of whole blood coagulation testing is assessed and compared with guidance by routine laboratory testing.</p>\u0000 <p><b>Methods:</b> A retrospective single-center experience of 1077 patients is reported comparing transfusion practices with and without viscoelastic testing in two consecutive years with no other changes in clinical practice. The primary end point was the incidence and volume of transfusion of packed red cells, platelets, fresh frozen plasma (FFP), and cryoprecipitate. Secondary endpoints included hospital mortality, re-exploration for bleeding, stroke, new onset renal failure, and prolonged ventilation.</p>\u0000 <p><b>Results:</b> There was no difference in the incidence of patients needing transfusion, but there was a significant drop in the volume of products given with the adoption of whole-blood testing. The decline in FFP and cryoprecipitate reached statistical significance. Although there was not a statistically significant decline in red cell administration, patients tolerated targeted nonred cell administration with less postoperative anemia. There were no other changes in clinical outcomes.</p>\u0000 <p><b>Conclusion:</b> Intraoperative ultrasound-mediated whole blood coagulation testing resulted in a substantial decline in nonred cell blood product administration in cardiac surgery patients.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3615306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647591","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":"Effect of Modified Remote Ischemic Preconditioning on Perioperative Outcomes of CABG Patients With CPB","authors":"Qi Sun,&nbsp;Xiaotong Wang,&nbsp;Guodong Wang,&nbsp;Chunyan Huan,&nbsp;Minjia Guo,&nbsp;Jie Liu,&nbsp;Wanling Wu,&nbsp;Yuanyuan Luo,&nbsp;Hong Zhu,&nbsp;Yongbo Hou,&nbsp;Guoxiang Wang,&nbsp;Defeng Pan","doi":"10.1155/jocs/8854092","DOIUrl":"https://doi.org/10.1155/jocs/8854092","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> To investigate the effect of modified remote ischemic preconditioning (MRIC) on perioperative outcomes in patients undergoing coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CPB).</p>\u0000 <p><b>Methods:</b> This study included 118 patients who planned to undergo CABG surgery at the Affiliated Hospital of Xuzhou Medical University. These patients were randomly divided into the MRIC group (<i>n</i> = 40), remote ischemic preconditioning (RIPC) group (<i>n</i> = 39), or control group (<i>n</i> = 39). The MRIC group received 3 cycles of 5 min ischemia/5 min reperfusion on the left upper limb at 2 days, 1 day, and 2 h preoperatively. The RIPC group received RIPC 2 h preoperatively, while the control group did not receive ischemic preconditioning. The STS score of patients was calculated according to the coronary angiography results and clinical data for risk stratification. The serum concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase MB (CK-MB), high-sensitivity cardiac troponin-T (hs-cTnT), and creatinine (Cr) of patients were recorded at postoperative 0, 12th, 24th, 48th, 72th h , and seventh days for each patient. Major adverse cardiac events (MACEs) in the hospital were recorded.</p>\u0000 <p><b>Results:</b> A total of 118 participants were included. The overall MACE incidence was 83.4%. A total of 36 MACE cases (92.3%) occurred in the control group, 28 cases (70.0%) in the MRIC group (RR: 0.75; 95% CI: 0.61–0.95), and 35 cases (89.7%) in the RIPC group (RR: 0.97; 95% CI: 0.84–1.12). Compared to the control group, MRIC and RIPC groups had lower concentrations of CK-MB at postoperative 0 and 12th h (<i>p</i> &lt; 0.05); MRIC group had lower concentrations of hs-cTnT at postoperative 12th h (<i>p</i> &lt; 0.05). The MRIC group had a higher concentration of NT-proBNP at postoperative 24th, 48th, and 72th h (<i>p</i> &lt; 0.05). The differences in the concentration of Cr among the three groups were not statistically significant (<i>p</i> &gt; 0.05); There was no statistically significant difference in the effects of MRIC on the indexes of the low-risk patients and the medium-high-risk patients (<i>p</i> &gt; 0.05).</p>\u0000 <p><b>Conclusion:</b> (1) MRIC has cardioprotective effects and reduces the occurrence of postoperative MACE. (2) MRIC could not reduce the concentrations of NT-proBNP and Cr postoperatively. (3) MRIC showed no significant difference in myocardial protection in patients with different STS score risk stratifications.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8854092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292742","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":"Angiotensin II Use in Postcardiac Surgery Vasoplegic Syndrome Patients: A Single-Center Descriptive Experience","authors":"Jonathan S. Auerbach,&nbsp;Hayley B. Gershengorn,&nbsp;Jorge L. Cabrera,&nbsp;Joseph Lamelas,&nbsp;Samira S. Patel,&nbsp;Tanira D. Ferreira,&nbsp;Daitiara Perez,&nbsp;Pankaj Jain","doi":"10.1155/jocs/8801912","DOIUrl":"https://doi.org/10.1155/jocs/8801912","url":null,"abstract":"<div>\u0000 <p><b>Objectives:</b> We evaluated real world use of angiotensin II (AT II) in patients with vasoplegic syndrome (VS) following cardiac surgery.</p>\u0000 <p><b>Design:</b> A retrospective chart review was performed to describe and evaluate VS following cardiac surgery under cardiopulmonary bypass (CPB) for AT II use and associated outcomes. Among these outcomes examined were death, stroke, myocardial infarction, acute kidney injury (AKI), tracheostomy need, ventilator hours, and hospital and cardiovascular intensive care unit (CVICU) lengths of stay (LOS). These outcomes were compared across patients with VS who received AT II vs. patients who did not receive AT II using Wilcoxon rank sum and Chi-square testing, as appropriate.</p>\u0000 <p><b>Setting:</b> Academic medical center.</p>\u0000 <p><b>Participants:</b> Adult postcardiac surgery VS patients.</p>\u0000 <p><b>Interventions:</b> AT II vs. non-AT II receiving VS patients.</p>\u0000 <p><b>Measurements and Main Results:</b> Of 2013 included patients undergoing cardiac surgery under CPB during the study period, 52 met criteria for VS, 11 (21.2%) received AT II, and 41 (71.8%) did not. The incidence of AKI, tracheostomy, CVICU LOS, and hospital LOS was higher in the AT II group (Tables 1 and 2). The median maximum postoperative NEE dose within 24 h following surgery was higher in the AT II group: 0.44 mcg/kg/min (IQR 0.39, 0.57) versus 0.23 mcg/kg/min (IQR 0.21, 0.26, <i>p</i> &lt; 0.001).</p>\u0000 <p><b>Conclusions:</b> AT II use was rare among cardiac surgical patients. AT II use was associated with increased resource use. AT II patients were on higher pressure dosing and may have had worse outcomes without AT II. Larger, prospective studies are needed to understand the impact of AT II on outcomes in this population.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/8801912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256211","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":"Prevalence and Predictors of Venous Thromboembolism Following Coronary Bypass Surgery","authors":"Alex M. Wisniewski,&nbsp;Raymond J. Strobel,&nbsp;Andrew Young,&nbsp;Anthony V. Norman,&nbsp;Evan P. Rotar,&nbsp;Bakhtiar Chaudry,&nbsp;Mira Sridharan,&nbsp;Aditya Sharma,&nbsp;J. Hunter Mehaffey,&nbsp;Vinay Badhwar,&nbsp;Gorav Ailawadi,&nbsp;Irving L. Kron,&nbsp;Mohammed Quader,&nbsp;Nicholas R. Teman","doi":"10.1155/jocs/2717349","DOIUrl":"https://doi.org/10.1155/jocs/2717349","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Venous thromboembolism (VTE) is a rare complication after coronary artery bypass surgery (CABG), leading to increased morbidity and mortality. There are no current societal guidelines directing prophylaxis. Utilizing a regional database, we sought to determine the prevalence of VTE and characterize regional center practices.</p>\u0000 <p><b>Methods:</b> We identified all patients undergoing on-pump, isolated CABG (2010–2020). Patients on oral therapeutic anticoagulation or requiring mechanical circulatory support were excluded. Participating centers were surveyed to determine center level practices. Multivariable regression and hierarchical logistic regression were utilized for risk-adjusted outcomes and influence of center practices on VTE rates, respectively.</p>\u0000 <p><b>Results:</b> Of 20,719 CABG patients, the overall prevalence of postoperative VTE was 1.3% (266/20,719). Patients developing VTE were more often female (30.1% vs. 23.4%, <i>p</i> = 0.01), had higher STS predicted risk of mortality (1.2% [0.7%, 2.2%] vs. 0.9% [0.5%, 1.7%], <i>p</i> &lt; 0.001) and higher unadjusted operative mortality (4.1% vs. 1.0%, <i>p</i> &lt; 0.001). Risk-adjusted analysis demonstrated pulmonary embolism as an independent predictor of mortality (OR = 3.4 [1.06, 11.0], <i>p</i> = 0.04). Increasing time from admission to surgery (OR = 1.05 [1.01, 1.09], <i>p</i> = 0.001), preoperative heparin use (OR = 1.47 [1.13, 1.90], <i>p</i> = 0.004), and intraoperative prothrombin complex concentrate (PCC) (OR = 4.85 [1.47, 15.96], <i>p</i> = 0.009) were predictors of VTE. Regional practices were mainly homogenous with no specific center-level protocol associated with decreases in VTE.</p>\u0000 <p><b>Conclusion:</b> VTE following CABG is an infrequent postoperative complication with pulmonary embolism as an independent predictor of mortality. Increasing time from admission to surgery and intraoperative PCC may increase the risk of VTE.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/2717349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214175","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":"Enhancing Diagnostic and Postoperative Outcome Predictions Through Machine Learning: A Focused Analysis on Noncardiac and Cardiac Surgeries","authors":"Alexander Lombardo,&nbsp;Christopher Hannemann,&nbsp;Syme Aftab,&nbsp;Yashika Paul,&nbsp;Brandon Stretton,&nbsp;Ammar Zaka,&nbsp;Joshua Kovoor,&nbsp;Aashray Gupta,&nbsp;Stephen Bacchi","doi":"10.1155/jocs/5521566","DOIUrl":"https://doi.org/10.1155/jocs/5521566","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Traditional risk scoring tools have assisted to guide surgical practice for decades. Machine learning algorithms build upon this concept to allow dynamic and tailored patient information. These algorithms have been employed across most surgical specialties with multiple aims, including cost of care assessment, risk stratification, and prediction of procedural survival.</p>\u0000 <p><b>Methods:</b> Paper selection was based on three main criteria: relevance, recency, and novelty. Relevant studies were identified through a comprehensive search of major databases, including PubMed and Scopus.</p>\u0000 <p><b>Results:</b> Machine learning algorithms pose significant advantages compared to traditional risk scoring tools. Across cardiac and noncardiac specialties, multiple studies have identified machine learning algorithms as superior to control or traditional scoring tools at diagnosis.</p>\u0000 <p><b>Conclusion:</b> In this focused analysis, we have identified the potential of machine learning to aid in diagnosis, management, and prediction of postoperative outcomes. Surgeons must continue to integrate machine learning into their practice with the aim of improving both patient and surgeon-based outcomes.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5521566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100926","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":"No-Touch Harvesting Technique of the Great Saphenous Vein Graft Affects Graft Flow Velocity During Coronary Artery Bypass Grafting","authors":"Hiroshi Kurazumi,&nbsp;Ryo Suzuki,&nbsp;Ryosuke Nawata,&nbsp;Toshiki Yokoyama,&nbsp;Kazumasa Matsunaga,&nbsp;Sarii Tsubone,&nbsp;Yutaro Matsuno,&nbsp;Bungo Shirasawa,&nbsp;Akihito Mikamo,&nbsp;Kimikazu Hamano","doi":"10.1155/jocs/9517612","DOIUrl":"https://doi.org/10.1155/jocs/9517612","url":null,"abstract":"<div>\u0000 <p><b>Objectives:</b> We aimed to investigate whether the no-touch (NT) harvesting technique for the great saphenous vein graft (SVG) affects graft flow velocity during coronary artery bypass grafting.</p>\u0000 <p><b>Methods:</b> The study included 132 and 138 conduits that underwent NT and conventional (CV) harvesting techniques, respectively (NT and CV groups, respectively). Transit-time flow measurements and contrast-enhanced computed tomography (CT) were performed to assess graft flow velocity and patency.</p>\u0000 <p><b>Results:</b> Intraoperative graft flows, assessed using a transit-time flowmeter, were 40 ± 19 and 48 ± 27 mL/min/anastomosis in the NT and CV groups, respectively. Preoperative SVG diameters, assessed via vascular ultrasound, were 2.8 ± 0.7 and 2.8 ± 0.8 mm in the NT and CV groups, respectively. However, postoperative SVG diameters, measured using contrast-enhanced CT, were 2.7 ± 0.5 and 3.5 ± 0.6 mm in the NT and CV groups, respectively, indicating a significant reduction in the NT group (<i>p</i> &lt; 0.01). Graft flow velocities, calculated from graft flow and vascular diameter, were 7.3 ± 4.2 and 5.4 ± 3.2 cm/s/anastomosis in the NT and CV groups, respectively, being significantly higher in the NT group (<i>p</i> &lt; 0.01). The incidence of postoperative occlusion was significantly lower in the NT group (two conduits, 1.5%) than in the CV group (10 conduits, 7.3%) (<i>p</i> = 0.02). Significant differences were found in the 5-year patency rates between the two groups (NT group, 98.4%; CV group, 92.9%; <i>p</i> = 0.04).</p>\u0000 <p><b>Conclusions:</b> The NT SVG harvesting technique prevents postoperative graft diameter expansion and significantly increases graft flow velocity and patency. Further randomized studies are needed to determine whether differences in blood flow velocity are essential for graft patency over an extended observation period.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9517612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108940","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":"Usefulness of Isosurface Geometric Measurement on Volume-Rendered Images for Quantitative Measurements of Complex Cardiac Anatomical Features","authors":"Kenichi Kamiya,&nbsp;Yukihiro Nagatani,&nbsp;Jun Matsubayashi,&nbsp;Ryo Uemura,&nbsp;Tatsuya Oki,&nbsp;Yuji Matsubayashi,&nbsp;Shinya Terada,&nbsp;Piers Vigers,&nbsp;Susumu Nakata,&nbsp;Yoshiyuki Watanabe,&nbsp;Tomoaki Suzuki","doi":"10.1155/jocs/5193639","DOIUrl":"https://doi.org/10.1155/jocs/5193639","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Measuring living heart anatomy using three-dimensional (3D) images remains challenging. To address this, a method called isosurface measurement on volume-rendered images (IMVR) has been developed. This study aims to validate IMVR in quantitative measurement by comparing it with curved planar reformation (CPR).</p>\u0000 <p><b>Methods:</b> Five 3D-printed human cardiac models created from computed tomography (CT) images were optically scanned, and selected features were measured for reference. The models were CT-scanned, and the datasets were processed for IMVR and CPR measurements. Overall, 157 anatomical features (105 in the aortic root, 52 in the coronary artery) were measured three times by two observers for each method, and the agreement with the reference values was assessed using the Bland–Altman analysis.</p>\u0000 <p><b>Results:</b> In the aortic root measurement, the lower and upper 95% limits of agreement (LOAs, mm) for IMVR were (−3.1, 2.4) and (−1.3, 0.9), whereas those for CPR were (−5.9, 5.2) and (−5.9, 6.3). In the coronary artery measurement, the LOAs for IMVR were (−2.6, 2.2) and (−1.2, 0.8), while those for CPR were (−9.2, 8.6) and (−9.5, 8.5). For both methods, the intraclass coefficient indicated high intra- and interobserver reliability.</p>\u0000 <p><b>Conclusion:</b> IMVR demonstrated greater precision than CPR and facilitated 3D measurements of complex cardiovascular features.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5193639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939209","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}