Journal of Cardiac Surgery最新文献

{"title":"Cardiac Computed Tomography Assessment of the Variation of Papillary Muscle Morphology before Mitral Valve Surgery","authors":"Kenta Nishiya,&nbsp;Yosuke Takahashi,&nbsp;Keiichi Itatani,&nbsp;Akimasa Morisaki,&nbsp;Yoshito Sakon,&nbsp;Goki Inno,&nbsp;Yosuke Sumii,&nbsp;Yukihiro Nishimoto,&nbsp;Kazuki Noda,&nbsp;Masataro Doi,&nbsp;Munehide Nagao,&nbsp;Toshihiko Shibata","doi":"10.1155/2023/8872518","DOIUrl":"https://doi.org/10.1155/2023/8872518","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The morphology of the papillary muscles of the left ventricle is highly variable. Few studies have investigated papillary muscle morphology using imaging. <i>Objective</i>. This study aimed to assess papillary muscle morphology with primary mitral regurgitation (MR) using cardiac computed tomography (CT). <i>Methods</i>. We examined 116 patients who underwent robotic mitral valve repair for primary MR using preoperative cardiac CT. Papillary muscle morphology was assessed using CT images and compared with operative findings. <i>Results</i>. CT images of papillary muscles were consistent with the operative findings during robotic mitral valve repair in all cases. Both the anterolateral papillary muscle (APM) and posteromedial papillary muscle (PPM) groups were identified in all cases, and the middle papillary muscle (MPM) group was identified in 24.1% of cases. The PPM group had a higher proportion of complex morphologies with more heads and bases than the APM group (head: <i>p</i> &lt; 0.001 and base: <i>p</i> &lt; 0.001). The PPM group had smaller papillary muscle sizes than the APM group. The MPM group in most patients had one base and one head (78.6%). Papillary muscle sizes were significantly smaller in the order of the APM, PPM, and MPM groups (<i>p</i> &lt; 0.001). <i>Conclusions</i>. Cardiac CT allowed clear visualization and accurate assessment of papillary muscle morphology in the left ventricle. It may be useful to obtain the papillary muscle variations preoperatively using CT imaging in procedures involving the papillary muscles such as mitral valve repair.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8872518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253740","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":"Duration of Bridge-to-Transplant Extracorporeal Membrane Oxygenation and Heart Transplant Survival","authors":"Matthew T. McGoldrick,&nbsp;Iulia Barbur,&nbsp;Eric W. Etchill,&nbsp;Katherine Giuliano,&nbsp;Steven Hsu,&nbsp;Kavita Sharma,&nbsp;Ahmet Kilic,&nbsp;Chun Woo Choi","doi":"10.1155/2023/4339284","DOIUrl":"https://doi.org/10.1155/2023/4339284","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The 2018 Organ Procurement and Transplantation Network (OPTN) heart allocation policy change prioritizes patients bridged to transplant with mechanical circulatory support (MCS) devices, including extracorporeal membrane oxygenation (ECMO). As a result, the use of ECMO has significantly increased. <i>Methods</i>. We reviewed the OPTN database for adult patients undergoing heart transplant after bridge with ECMO between January 1^st 2000 and October 18^th 2018. We excluded patients with ≥180 days of ECMO duration, prior transplants, and those using additional MCS devices. Survival and morbidity outcomes of patients with ≥7 days of pre-transplant ECMO were compared to those of patients with &lt;7 days. <i>Results</i>. Of 362 eligible transplant recipients, 163 (45%) utilized &lt;7 days of pre-transplant ECMO and 199 (55%) utilized ≥7 days. Those with ≥7 days were younger (median age: 43 [28–54] vs. 50 [36–57] years, <i>p</i> = 0.006) and more likely to have temporary waitlist inactivity (18% vs. 7%, <i>p</i> = 0.003) with significantly longer duration of ECMO use (median: 14 [9–24] vs. 4 [2–5] days, <i>p</i>  &lt;  0.001). Patients with ≥7 days of ECMO had comparable survival to those with &lt;7 days at one year (81.1% vs. 79.4%, <i>p</i> = 0.64) and five years (61.1% vs. 49.3%, <i>p</i> = 0.27). After adjustment for clinically relevant variables, duration of ECMO ≥7 days did not increase mortality at five years (HR = 0.90, <i>p</i> = 0.59). <i>Conclusions</i>. Longer duration of ECMO (≥7 days vs. &lt;7 days) among patients successfully bridged to transplant is not associated with increased mortality or selected adverse outcome, including graft failure or rejection, at up to five years.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/4339284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143253417","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":"Changing Surgical Aortic Valve Size and Choices in the Transcatheter Aortic Valve Replacement Era","authors":"Zachary M. Gertz,&nbsp;Raymond J. Strobel,&nbsp;Alex M. Wisniewski,&nbsp;Clifford E. Fonner,&nbsp;Alan Speir,&nbsp;Nicholas R. Teman,&nbsp;Mohammed Quader","doi":"10.1155/2023/5537595","DOIUrl":"10.1155/2023/5537595","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The adoption of transcatheter aortic valve replacement (TAVR) has changed the profile of patients referred for surgical aortic valve replacement (SAVR) and drawn more attention to valve sizing and durability. We examined the influence of TAVR on SAVR practice. <i>Methods</i>. Using a statewide database, we evaluated all isolated SAVRs, categorized into three eras: pre-TAVR (2008 to 2011), early TAVR (2012 to 2015), and current-TAVR (2016 to 2022). The primary outcomes of interest were changes in prosthetic valve size and the percentage of mechanical valves used between time periods. <i>Results</i>. There were 6,445 patients included. SAVR volume declined in the current era. Valve size increased over time. In the pre-TAVR era, 41% of patients received a valve smaller than 23 mm, which declined to 33% in the early TAVR era, then to 22% in the current era (<i>p</i> &lt; 0.001 for all). The year of surgery was significantly associated with larger valve selection even after controlling for patient characteristics. Annular enlargement rose in the current-TAVR era (<i>p</i> &lt; 0.001). The use of mechanical valves rose in the current era (<i>p</i> &lt; 0.001 compared to early TAVR). Regression analysis showed that the year of surgery was not predictive of mechanical valve use, suggesting that changes in practice were driven by patient characteristics. <i>Conclusion</i>. Surgical valve choice since the adoption of TAVR has changed, with less frequent use of smaller valves. Increases in mechanical valve usage are likely a reflection of changing patient population.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5537595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949764","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":"Short-Term Outcomes of Total Arterial Revascularization Compared to Conventional Coronary Artery Bypass Graft in Patients with Multivessel Disease and Left Ventricular Dysfunction","authors":"Zhi-qin Lin,&nbsp;Zheng Xu,&nbsp;Liang-wan Chen,&nbsp;Xiao-fu Dai","doi":"10.1155/2023/5557796","DOIUrl":"10.1155/2023/5557796","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Multivessel coronary artery disease (CAD) and left ventricular dysfunction (LVD) present challenges in CABG. We aimed to compare early outcomes of total arterial revascularization (TAR) versus conventional CABG in this high-risk population. <i>Methods</i>. This was a retrospective cohort study based on a single-center registry of patients who underwent isolated CABG for multivessel CAD and LVD between January 2014 and December 2022. Primary outcome was in-hospital mortality. Secondary outcomes were early complications, graft patency rate at 3 months, readmission rate within 6 months, and freedom from angina rate within 6 months. <i>Results</i>. A total of 112 cases were included in this study; 52 patients for TAR and 60 patients for conventional CABG. Both groups had comparable baselines and operative profiles. In-hospital mortality was similar between TAR and conventional CABG (2 deaths, 3.85% vs 4 deaths, 6.67%, <i>p</i> = 0.810). TAR had shorter ICU (3.5 vs 5 days, <i>p</i> = 0.016) and hospital stay (10.5 vs 12 days, <i>p</i> = 0.007). Other postoperative complications were similar. At 3 months, TAR had superior graft patency (91.7% vs 83.7%, <i>p</i> = 0.034) and lower 6-month readmission (TAR: 2/50, 4.0% vs. CR: 10/56, 17.9%, <i>p</i> = 0.024). Freedom from angina rate within 6 months was similar between the two groups (TAR: 43/50, 86.0% vs. CR: 42/56, 75.0%, <i>p</i> = 0.240). <i>Conclusion</i>. Our findings suggest that TAR may offer benefits in terms of shorter hospital stays, higher early graft patency, and lower readmission rates for patients with multivessel CAD and LVD. However, further research, particularly large-scale, randomized trials with longer follow-up periods, are needed to fully understand the long-term clinical outcomes and confirm these promising early results.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5557796","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004024","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":"Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample","authors":"Krishna Bellam,&nbsp;Sharif A. Sabe,&nbsp;Nicholas Huang,&nbsp;Nishanth Chalasani,&nbsp;Dwight Douglas Harris,&nbsp;Noah Feldman,&nbsp;Phillip R. Schmitt,&nbsp;Anthony Harwell,&nbsp;Frank Sellke,&nbsp;Afshin Ehsan","doi":"10.1155/2023/8846398","DOIUrl":"10.1155/2023/8846398","url":null,"abstract":"<div>\u0000 <p><i>Background and Aim of the Study.</i> While several studies have suggested a relationship between adverse postoperative outcomes and systemic lupus erythematosus (SLE) in major surgical settings, no study to date has explored postoperative outcomes of SLE patients undergoing coronary artery bypass grafting (CABG). This study aimed to compare the characteristics and outcomes of SLE patients compared to non-SLE patients undergoing CABG. <i>Methods</i>. We utilized the Nationwide Inpatient Sample (NIS) data from 2008–2018 for CABG patients ≥18 years old. Patients were divided into two groups based on SLE status (confirmed SLE diagnosis or no SLE present). Primary outcomes were in-hospital mortality, favorable discharge, and length of stay (LOS). Secondary outcomes included acute kidney injury (AKI), acute liver injury (ALI), hemodialysis, acute myocardial infarction (AMI), and cardiogenic shock. Patient characteristics including age, sex, race, and preexisting comorbidities were considered. Multivariable models, adjusting for confounding variables, were utilized. <i>Results</i>. Data from a total of 352,772 patients who underwent CABG were analyzed. 980 patients had a diagnosis code for SLE. SLE and non-SLE patients had similar rates of in-hospital mortality (OR = 0.92, [0.63–1.35]), nonhome discharge (OR = 1.09, [0.95–1.24]), and LOS (OR = 1.02, [0.99–1.06]). SLE patients developed AKI at a higher rate (OR = 1.50, [1.05–1.48]) and ALI at a lower rate (OR = 0.35, [0.16–0.74]). Both groups had similar rates of hemodialysis (OR = 1.19, [0.98–1.44]), AMI (OR = 0.93, [0.81–1.06]), and cardiogenic shock (OR = 0.8, [0.61–1.05]). <i>Conclusion</i>. These findings suggest that SLE patients undergoing CABG have similar mortality, discharge disposition, and LOS compared to non-SLE patients. However, SLE patients are at increased risk of AKI and decreased risk of ALI than non-SLE patients. These associations warrant further investigation to elucidate their physiologic basis.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8846398","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586081","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":"Aortic Coarctation Associated with Distal Aortic Arch Hypoplasia in Neonates Can Be Effectively Repaired through Left Thoracotomy","authors":"Bastien Provost,&nbsp;Emmanuelle Fournier,&nbsp;Sebastien Hascoët,&nbsp;Emmanuel Le Bret,&nbsp;Régine Roussin,&nbsp;Joy Zoghbi,&nbsp;Emre Belli","doi":"10.1155/2023/5599161","DOIUrl":"10.1155/2023/5599161","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. Aortic coarctation in neonates remains a clinical challenge. Low weight, arch hypoplasia and ductal dependence have been identified as risk factors for recurrent coarctation. We hypothesized that a tailored surgical technique may prevent recurrence. <i>Methods</i>. Retrospective evaluation of neonates treated for coarctation through thoracotomy was done. No primary percutaneous procedure was performed and repairs through sternotomy were excluded. Aortic hypoplasia was defined as a ratio arch diameter (mm)/patient’s weight (kg) &lt; 1. Extended end-to-end anastomosis (EEEA), subclavian flap (Waldhausen) and Amato aortoplasty were performed. Mortality and recurrent obstruction requiring re-intervention were assessed. <i>Results</i>. Records of 340 consecutive patients (2003–2019) were analyzed. Preoperative median age and weight were, respectively, 10 days (1–30) and 3080 grams (1400–5180). Arch hypoplasia was documented in 31 patients (9.1%). Prostaglandin was infused in 220 (65.3%). Critical preoperative status was documented in 35 (10.8%). EEEA repair was performed in 273 (80.3%), Waldhausen was performed in 42 (12.4%), and Amato was performed in 25 (7.4%). The last two were more likely to be performed in the presence of arch hypoplasia (<i>p</i> &lt; 0.0001). Hospital mortality occurred in 2 patients (0.6%). Thirty-six procedures (31 percutaneous/5 surgical) were performed for recurrent arch obstruction in 33 patients. Three late deaths occurred. Low-weight, hypoplastic arch, and ductal dependency did not influence the outcome. All survivors were free from residual coarctation at a mean follow-up of 3.6 ± 3.4 years postoperatively. <i>Conclusions</i>. Surgical repair remains the procedure of choice for neonatal coarctation. A tailored approach using alternative techniques seemed to offer comparable results even in presence of associated risk factors.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5599161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590603","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":"Minimally Invasive Mitral Valve Repair with Artificial Chordae: Insights from a 6-Year Single-Center Study","authors":"Vinh Duc An Bui,&nbsp;Dang Nguyen,&nbsp;Alejandro Pizano,&nbsp;Heath Rutledge-Jukes,&nbsp;Chibuikem S. Iheagwaram,&nbsp;Simar S. Bajaj,&nbsp;Dung Hung Van,&nbsp;Nam Hoai Nguyen,&nbsp;Thomas Theologou,&nbsp;Armaan F. Akbar,&nbsp;Dominique Vervoort,&nbsp;Amer Harky,&nbsp;Dinh Hoang Nguyen","doi":"10.1155/2023/5510950","DOIUrl":"10.1155/2023/5510950","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Minimally invasive mitral valve repair (MIMVR) has been demonstrated to be safe and effective, but technical difficulty, outcome variation, and lack of standardized protocols undermine the utility of artificial chordae. This study aims to analyze the midterm outcomes of repair using artificial chordae through right minithoracotomy. <i>Methods</i>. A retrospective cohort study was conducted on consecutive patients who underwent MIMVR using artificial chordae at a single center in Vietnam between April 2016 and April 2022. Valve repairs were separated into two groups based on a previously validated complexity score: simple repair (Group 1) and intermediate-to-complex repair (Group 2). Demographic variables, comorbidities, operative characteristics, surgical outcomes, and follow-up data on survival and mitral regurgitation (MR) grade were analyzed. The learning curve was assessed by comparing the number of procedures with operation time and aorta cross-clamp time. Primary endpoints included survival and freedom from recurrent MR at four years. <i>Results</i>. Ninety patients were identified, including 41 simple and 49 intermediate-to-complex repairs. The mean age was 50.5 ± 12.9 years. Both groups had similar preoperative characteristics. The perioperative and postoperative outcomes were favorable, with no cases requiring mitral valve replacement. The median follow-up time was 30.3 months (18.2–40.4), and there were two (2.2%) cardiac deaths, with one in each group. The Kaplan–Meier survival estimates for Groups 1 and 2 at 12 and 24 months were 97% vs. 100% and 97% vs. 96%, respectively (95% CI = 0.05–12.2, <i>P</i> = 0.850), and estimates for freedom from recurrent MR were 97% vs. 92% and 97% vs. 88%, respectively (95% CI = 0.49–12.0, <i>P</i> = 0.260). There was a negative association between the volume of operations and the duration of operation and aortic cross-clamp time, leading to shorter durations. <i>Conclusion.</i> Based on our single-center experience, MIMVR using artificial chordae via right mini-thoracotomy can be safely and effectively performed in resource-limited countries for patients with MR. This approach has been shown to be applicable for a range of MR complexities, from simple to intermediate-to-complex MV repairs, and has demonstrated promising results in terms of midterm freedom from MR recurrence.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5510950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595115","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":"Thoracoscopic Surgical Biatrial Ablation vs. Catheter Ablation in Patients with Persistent Atrial Fibrillation","authors":"Chunyu Yu,&nbsp;Haojie Li,&nbsp;Shuo Yuan,&nbsp;Lihui Zheng,&nbsp;Lingmin Wu,&nbsp;Ligang Ding,&nbsp;Yan Yao,&nbsp;Zhe Zheng","doi":"10.1155/2023/9463793","DOIUrl":"10.1155/2023/9463793","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Limited randomized controlled studies showed that thoracoscopic surgical left atrial ablation was not superior to catheter ablation (CA) in patients with persistent atrial fibrillation (PerAF). Right atrium might play an important role in triggering and maintaining atrial fibrillation (AF) in patients with PerAF. This study aimed to compare the efficacy of thoracoscopic surgical biatrial ablation versus CA in patients with PerAF. <i>Methods</i>. Patients with PerAF underwent thoracoscopic surgical biatrial ablation or CA were included in this study. Propensity score matching (1 : 2) was applied to select patients in CA group and surgical ablation (SA) group. The primary endpoint was to compare the probability of freedom from atrial tachyarrhythmias between SA and CA. Atrial tachyarrhythmia recurrence was defined as any atrial tachyarrhythmias longer than 30 s documented by 24-hour Holter monitoring after the 3-month blanking period. <i>Results</i>. After propensity score matching, 51 patients in surgical biatrial ablation group and 102 patients in CA group were enrolled (mean left atrial diameter: 45.8 mm). The probability of freedom from atrial tachyarrhythmias on antiarrhythmia drugs was 62.7%, 60.6%, and 60.6% in SA group and 42.0%, 39.6%, and 36.7% in CA group at 12, 24, and 36 months, respectively (<i>p</i> = 0.011), and off antiarrhythmia drugs were 56.9%, 52.5%, and 52.5% in SA group and 36.0%, 31.4%, and 27.5% in CA group at 12, 24, and 36 months, respectively (<i>p</i> = 0.007). After adjustment of age, sex, left atrial diameter, and AF duration history, multivariable Cox regression analysis suggested that SA procedure was an independent factor to reduce the risk of atrial tachyarrhythmia recurrence (HR: 0.589, 95% CI 0.370–0.937, <i>p</i> = 0.025). <i>Conclusion</i>. Compared with CA, thoracoscopic surgical biatrial ablation might achieve superior effectiveness for patients with PerAF.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9463793","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139269276","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":"Clarifying the Pulmonary Arterial Morphology and Pulmonary Blood Supply in Patients with Tetralogy of Fallot and Pulmonary Atresia on Computed Tomography Angiography","authors":"Niraj Nirmal Pandey,&nbsp;Mumun Sinha,&nbsp;Mansi Verma,&nbsp;Sivasubramanian Ramakrishnan,&nbsp;Sanjeev Kumar,&nbsp;Priya Jagia","doi":"10.1155/2023/5511363","DOIUrl":"10.1155/2023/5511363","url":null,"abstract":"<div>\u0000 <p><i>Aim</i>. The present study sought to characterize the pulmonary arterial morphology and pulmonary blood supply in patients of tetralogy of Fallot and pulmonary atresia (TOF-PA) on CT angiography. <i>Materials and Methods</i>. We retrospectively reviewed our departmental database to identify patients with TOF-PA evaluated using CT angiography. The images were analysed to detect the presence of main and branch pulmonary arteries and pulmonary arterial confluence, presence of major aortopulmonary collateral arteries (MAPCAs), laterality and relation with pulmonary arterial morphology, and presence of patent arterial duct and associated intra- and extracardiac anomalies. <i>Results</i>. TOF-PA was identified in 177 patients (114 (64.4%) males; median age: 9 months). Pulmonary arteries were confluent in 142/177 (80.2%) patients. According to Somerville classification, type II pulmonary atresia was the most frequent pattern seen in 127/177 (71.8%). Based on McGoon’s ratio, pulmonary arteries were adequate for surgery in 123/177 (69.5%) patients. Patent arterial duct was present in 84/177 (47.5%) patients while MAPCAs were present in 124 (70.1%) patients, of which 72/124 (58.1%) patients had at least 1 essential MAPCA supplying either lung. According to Congenital Heart Surgeons’ Society classification, type B pulmonary arterial anatomy was the most prevalent, seen in 103/177 (57.6%) patients. <i>Conclusion</i>. TOF-PA is associated with marked morphologic variability in the pulmonary arterial arborization to supply the lungs. Cardiac CT angiography can accurately delineate the pulmonary arterial morphology, sources of pulmonary blood supply, and associated cardiovascular anomalies in patients with TOF-PA which aids in planning appropriate surgical management including decisions regarding the need for unifocalization of MAPCAs.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5511363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275130","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 Prediction Model for Neonatal Coarctation Repair Involving Fetal and Neonatal Echocardiographic Parameters","authors":"Qi Shi,&nbsp;Jiazhong Tang,&nbsp;Minjie Zhang,&nbsp;Sun Chen,&nbsp;Yurong Wu,&nbsp;Yanan Lu","doi":"10.1155/2023/8831107","DOIUrl":"10.1155/2023/8831107","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The aim of this study is to investigate the predictive value of fetal and neonatal echocardiographic parameters for neonatal coarctation repair in fetuses suspected of coarctation of the aorta (CoA), establish a prediction model for neonatal coarctation repair, and verify its predictive effectiveness and clinical applicability. <i>Methods.</i> From September 2017 to September 2022, fetuses suspected with CoA were enrolled. They were divided into two groups based on the need for neonatal coarctation repair. Fetal and neonatal echocardiographic parameters and clinical characteristics were collected retrospectively. Univariate and multivariate logistic regressions were applied to select significant predictors, which were further used to establish the nomogram prediction model. The area under the curve (AUC) of the receiver operating characteristic (ROC) was employed to quantify its discrimination ability. The calibration curve was drawn for internal verification, and the decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the clinical applicability of the prediction model. <i>Results</i>. This study included 50 infants suspected of CoA prenatally, of which 16 (32%) received aortic coarctation repair in the neonatal period and 34 (68%) did not. Multivariable logistic regression analysis revealed that the fetal echocardiographic parameter aortic isthmus/ductus arteriosus (AoI/DA) diameter ratio and the neonatal echocardiographic parameters such as the distance from left common carotid to left subclavian artery (LCSA) and the diameter of distal transverse aortic arch (DTAA) were independent predictors for neonatal coarctation repair. The ROC curve of the model showed excellent predictive value (AUC = 0.943). The calibration curve of the prediction model exhibited good fitness. The DCA and CIC demonstrated that the model had good clinical utility. <i>Conclusion</i>. The prediction model, which combines the fetal echocardiographic parameter AoI/DA diameter ratio and the neonatal echocardiographic parameters distance of LCSA and DTAA diameter, has an exceptional level of clinical value and prediction accuracy.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8831107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340500","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}