Journal of Cardiac Surgery最新文献

{"title":"Prediction of Postoperative Acute Kidney Injury Risk Factors for Acute Type A Aortic Dissection Patients after Modified Triple-Branched Stent Graft Implantation by a Perioperative Nomogram: A Retrospective Study","authors":"Fan Xu,&nbsp;Linfeng Xie,&nbsp;Jian He,&nbsp;Qingsong Wu,&nbsp;Xinfan Lin,&nbsp;Yunnan Hu,&nbsp;Liangwan Chen","doi":"10.1155/2023/3220929","DOIUrl":"10.1155/2023/3220929","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Predicting risk factors for acute kidney injury (AKI) after total arch replacement via modified triple-branched stent graft (MTBSG) implantation in patients with acute type A aortic dissection (AAAD) by conducting a nomogram. <i>Methods</i>. We collected the clinical data of 254 patients with AAAD who underwent MTBSG implantation surgery in our center. The independent risk factors of postoperative AKI were screened by univariate and multivariate logistic regression analysis and combined into a nomogram. We use receiver operating characteristic (ROC) curves, decision curve analysis (DCA), clinical impact curve (CIC), and calibration plots to evaluate the accuracy of the nomogram model. <i>Results</i>. Multiple logistic regression analysis showed that the risk factors of AKI after MTBSG implantation were age, malperfusion syndrome, preoperative serum creatinine, cardiopulmonary bypass time, and amount of red blood cell (RBC) transfusion. Based on these five risk factors, we established a nomogram model. The good accuracy and clinical applicability of the model were verified by drawing ROC curve (area under the curve (AUC) = 0.854), DCA curve, CIC curve, and calibration curve. <i>Conclusions</i>. Using perioperative clinical data to establish a nomogram model of AKI in patients with AAAD who received MTBSG implantation can be used as a tool to predict the occurrence of AKI after operation.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/3220929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870068","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":"Risk Factors for Acute Kidney Injury after Moderate Hypothermic Circulatory Arrest in Hemiarch Replacement","authors":"Kosaku Nishigawa,&nbsp;Takafumi Hirota,&nbsp;Hideaki Hidaka,&nbsp;Tatsuya Horibe,&nbsp;Jun Takaki,&nbsp;Takashi Yoshinaga,&nbsp;Toshihiro Fukui","doi":"10.1155/2023/6685741","DOIUrl":"10.1155/2023/6685741","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The aim of this study was to clarify the incidence and risk factors for acute kidney injury (AKI) in patients undergoing hemiarch replacement (HAR) under moderate hypothermic circulatory arrest (MHCA) with retrograde cerebral perfusion (RCP). <i>Methods</i>. We retrospectively analyzed patients who underwent HAR under MHCA with RCP at our institution between April 2015 and July 2022. Exclusion criteria were preoperative dialysis, single kidney, and lack of preoperative plasma creatinine data. The study endpoint was the incidence of postoperative AKI, defined using the Kidney Disease: Improving Global Outcomes criteria. Multivariate logistic regression analysis was performed to identify the risk factors for postoperative AKI. <i>Results</i>. One hundred and seventy-nine patients were included in this study. The most common indications for HAR were thoracic aortic aneurysm (<i>n</i> = 107) and acute aortic dissection (<i>n</i> = 57). Concomitant procedures, most frequently aortic valve surgery, were performed in 104 (60.5%) patients. Median circulatory arrest time and minimum rectal temperature were 15 minutes (interquartile range, 11 to 19) and 27.4°C (interquartile range, 25.9 to 28.1), respectively. Operative mortality was 1.1%. The incidence of postoperative AKI was 37.8%. Multivariate analysis showed that acute aortic dissection (odds ratio, 4.57; 95% confidence interval (CI), 2.13–10.14; <i>P</i> &lt; 0.001) and longer operating time (odds ratio, 1.01; 95% CI, 1.00-1.01; <i>P</i> = 0.001) were independent predictors for postoperative AKI. <i>Conclusions</i>. Acute aortic dissection and longer operating time were risk factors for postoperative AKI in patients undergoing HAR under MHCA with RCP. In contrast, neither circulatory arrest time nor minimum rectal temperature was a risk factor for AKI. This may be due to the short duration of circulatory arrest.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6685741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136317367","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":"General versus Local Anesthesia with Intravenous Sedation in Transcatheter Aortic Valve Implantation","authors":"Alexander Schutz,&nbsp;Zvonimir Krajcer,&nbsp;Qianzi Zhang,&nbsp;Scott A. LeMaire,&nbsp;Katherine G. Dougherty,&nbsp;Juan Carlos Plana,&nbsp;Stephanie A. Coulter,&nbsp;Neil E. Strickman,&nbsp;Guilherme V. Silva,&nbsp;James Anton,&nbsp;Joseph S. Coselli,&nbsp;Ourania Preventza","doi":"10.1155/2023/1379034","DOIUrl":"10.1155/2023/1379034","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Monitored anesthesia care (MAC) may offer better outcomes than general anesthesia (GA) in transcatheter aortic valve implantation (TAVI). We compared TAVI outcomes between patients who received MAC versus GA. <i>Methods</i>. We retrospectively reviewed data from all patients (<i>N</i> = 659), as well as 216 propensity-matched patients, who underwent TAVI at our institution during 2014–2019. <i>Results</i>. MAC and GA did not differ significantly in mortality (1.6% MAC vs. 4.2% GA, <i>p</i> = 0.05) or stroke (2.2% MAC vs. 2.4% GA, <i>p</i> = 0.96); however, median length of stay (LOS) was shorter in the MAC group (2 d MAC vs. 7 d GA, <i>p</i> &lt; 0.0001). In propensity-matched patients, mortality (2.8% MAC vs. 4.6% GA, <i>p</i> = 0.7) and stroke (3.7% MAC vs. 1.9% GA, <i>p</i> = 0.7) did not differ significantly between groups. LOS remained shorter in the MAC group (2 d MAC vs. 7 d GA, <i>p</i> &lt; 0.0001). <i>Conclusions</i>. In this large, single-center, retrospective study, MAC was associated with shorter hospital stay after TAVI.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1379034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136377127","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":"Triple Vessel Coronary Artery Disease Needs a Consistent Definition for Management Guidelines","authors":"Aashray K. Gupta,&nbsp;Hugh S. Paterson,&nbsp;Cheng He,&nbsp;Michael P. Vallely,&nbsp;Jayme S. Bennetts","doi":"10.1155/2023/6653354","DOIUrl":"10.1155/2023/6653354","url":null,"abstract":"<div>\u0000 <p>For over forty years, coronary artery bypass grafting (CABG) has been recommended to patients with triple vessel disease (TVD) with the aim of providing a survival benefit compared to medical therapy. Generally, the survival benefit of CABG is determined by (a) the volume of myocardium at risk of infarction according to the extent of coronary artery disease (CAD), (b) the impairment of coronary flow reserve according to severity of coronary stenoses, severity of symptoms, or objective evidence of regional ischemia, and (c) the impairment of myocardial reserve according to left ventricular function and viability. The most frequently used index of survival benefit is the extent of CAD as described by the terms of the left main coronary stenosis and TVD. However, TVD has been inconsistently defined in randomised controlled trials. Furthermore, international guidelines do not provide a specific definition of TVD. This impacts a substantially sized and high-risk population. Here, we argue that the definition of TVD should include diseases in the major artery in each of the three coronary territories in order to estimate the survival benefit provided by CABG.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/6653354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136063978","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":"Predicting Preoperative Rupture from Imaging Alone in Acute Type A Aortic Dissection","authors":"Yi Dong,&nbsp;Zai-Rong Lin,&nbsp;Liang-Wan Chen,&nbsp;Zeng-Rong Luo","doi":"10.1155/2023/1337373","DOIUrl":"10.1155/2023/1337373","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To establish risk factors for predicting preoperative ruptures in patients with acute type A aortic dissection (ATAAD) based on computed tomography angiography (CTA) imaging features alone. <i>Methods</i>. We retrospectively reviewed patients with ATAAD treated between January 2017 and December 2021 in Fujian Medical University Union Hospital, China. The primary outcome was preoperative rupture after admission. Multivariate logistic regression analysis was performed based on basic characteristics and CTA imaging variables selected by the application of the least absolute shrinkage and selection operator. <i>Results</i>. A total of 564 patients were enrolled. The rate of preoperative rupture was 14.2% (<i>n</i> = 80). Patients who experienced rupture were significantly older (<i>P</i> = 0.002) and had a higher rate of DeBakey II (<i>P</i> = 0.016), syncope (<i>P</i> = 0.003), ventilator-assisted ventilation (<i>P</i> = 0.008), preoperative shock (<i>P</i> = 0.040), hypotensive state (<i>P</i> = 0.009), hepatic insufficiency (<i>P</i> = 0.002), acute kidney injury (<i>P</i> = 0.045), and moderate or massive pericardial effusion (<i>P</i> = 0.007). Multivariate analysis identified the following independent risk factors for preoperative rupture based on CTA imaging features: DeBakey II (odds ratio (OR) = 1.988, 95% confidence interval (CI) 1.211–3.676, <i>P</i> = 0.009), ascending aorta diameter (OR = 2.077, 95% CI 1.335–4.045, <i>P</i> &lt; 0.001), ascending aorta false lumen diameter (OR = 2.988, 95% CI 2.055–4.291, <i>P</i> &lt; 0.001), ascending aorta false lumen/true lumen diameter ratio &gt;4 : 1 (OR = 3.129, 95% CI 2.031–6.225, <i>P</i> &lt; 0.001), and number of branch arteries involved in dissection &gt;6 (OR = 1.154, 95% CI 1.036–2.006, <i>P</i> = 0.036). <i>Conclusions</i>. CTA imaging features are one of the most convenient indicators for the early prediction of preoperative rupture in patients with ATAAD.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/1337373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135045095","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 versus Interventional Mitral Valve Repair: Analysis of 1,100 Propensity Score-Matched Patients","authors":"Andrea Amabile,&nbsp;Brandon Muncan,&nbsp;Arnar Geirsson,&nbsp;Andreas P. Kalogeropoulos,&nbsp;Markus Krane","doi":"10.1155/2023/8838005","DOIUrl":"10.1155/2023/8838005","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. We aimed to investigate outcomes in transcatheter versus surgical mitral valve repair in patients with secondary mitral regurgitation (MR) by leveraging a global, multi-institutional federated network database. <i>Methods</i>. Using validated ICD-10 and CPT codes, the TriNetX Analytics Research Data Network (a global federated database of electronic health records from 58 healthcare organizations) was queried to identify patients diagnosed with chronic, severe, ischemic MR and undergoing either transcatheter mitral valve repair (TMVr) or surgical mitral valve repair (SMVr) between January 1, 2015 and December 31, 2020. To adjust for baseline differences, 1 : 1 propensity score matching was performed via logistic regression using the nearest-neighbor approach and matching for 29 covariates including demographics, comorbidities, surgical history, preoperative medications, left ventricular function and heart failure status. We compared 1- and 3-year mortality rates and 1- and 3-year mitral valve reoperation rates in the matched cohorts using Kaplan-Meier estimates and adjusted Cox proportional hazards models. <i>Results</i>. A total of 2,352 patients met inclusion criteria (1,392 in the surgical mitral valve repair group and 960 in the TMVr group). After 1 : 1 propensity score matching, a total of 550 patients undergoing surgical mitral valve repair (SMVr) were compared to 550 patients undergoing TMVr. All characteristics were adequately matched between the cohorts (standardized mean difference &lt;0.1). At 1- and 3-years respectively, mortality rate was 13.4% and 20.7% for surgical patients and 19.8% and 40.3% for TMVr patients. When compared to TMVr, patients undergoing SMVr were significantly less likely to face mortality at 3 years (HR: 0.42, 95% CI: 0.31–0.56, <i>p</i>  &lt;  0.0001). At 1- and 3-years respectively, mitral valve reoperation was 2.2%, and 2.4% for surgical patients and 6.6% and 7.8% for TMVr patients. When compared to TMVr, patients undergoing SMVr were significantly less likely to undergo mitral valve reintervention at 3 years (HR: 0.29, 95% CI: 0.14–0.58, <i>p</i> = 0.0002). <i>Conclusion</i>. In a real-world, propensity score matching analysis of a large cohort of patients with chronic ischemic MR, surgical mitral valve repair had significantly better survival rates and significantly lower reintervention rates at 1- and 3-years compared to TMVr.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8838005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346113","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":"Efficiency and Safety of Temperatures Management in Aortic Arch Surgery: A System Review and Meta-Analysis","authors":"Yang Yu,&nbsp;Zheng Ding,&nbsp;Enyi Shi,&nbsp;Tianxiang Gu","doi":"10.1155/2023/8887221","DOIUrl":"10.1155/2023/8887221","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. The study evaluates the safety and efficacy of hypothermic cardiac arrest (HCA) at various temperatures in aortic arch surgeries. <i>Methods</i>. We conducted a literature search in PubMed, Google Scholar, and Embase databases. For single proportion assessments, we employed fixed-effect and random-effect models in the general linear mixture model and the inverse variance model for other computations. We analyzed factors such as age, sex, operation time, and postoperative complications, with subgroup and metaregression analyses. We used funnel plots to depict potential publication bias. <i>Results</i>. Our research incorporated 43 papers with 34,797 cases. HCA temperatures were divided into five groups (A: 30–32°C, B: 28–30°C, C: 26–28°C, D: 24–26°C, and E: &lt;24°C). There is no statistically significant difference in myocardial ischemia time (<i>P</i> = 0.90) and isolated cerebral perfusion (ICP) time (<i>P</i> = 0.95). Groups A and C have the best performance in avoiding postoperative complications including transient nerve injury (TNI), permanent nerve injury (PNI), renal failure (RF), and mortality occurrence rate. Group A has the lowest occurrence rate in PNI (3%) and mortality (3%). Group C has the lowest RF incidence (5%). <i>Conclusion</i>. Maintaining temperatures of 30–32°C in en bloc anastomosis or 26–28°C during arch replacement with separate grafts can significantly reduce complications including PNI, RF, and in-hospital mortality.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8887221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417624","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":"Does Aortic Arch Anatomy Affect Stroke Laterality in Transcatheter Aortic Valve Implantation?","authors":"Caterina Campanella,&nbsp;Keti Vitanova,&nbsp;Melchior Burri,&nbsp;Hendrik Ruge,&nbsp;Rüdiger Lange,&nbsp;Stephanie Voss","doi":"10.1155/2023/5563121","DOIUrl":"10.1155/2023/5563121","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Current data reveal a predominace of left as opposed to right-sided cerebral strokes after transcatether aortic valve replacement (TAVR). Aortic arch variations might raise the likelihood of cardioembolic particles entering predominantly the left cerebral circulation during catheter tracking and manipulation. <i>Aim</i>. We sought to analyse the impact of aortic arch anatomy on stroke laterality (right vs. left) in patients undergoing TAVR. <i>Methods</i>. All patients who developed a symptomatic, periprocedural left- or right-sided ischemic stroke after TAVR between June 2007 and August 2022 were included in this study. Multislice computed tomography (MSCT) analysis was used to assess aortic arch anatomy, arch configuration (types I–III), arch tortuosity, and the determination of the take-off angles of the supraaortic arteries. <i>Results</i>. The final study cohort comprised 77 patients. Periprocedural ischemic stroke was left-sided in 66.2% of the patients (<i>n</i> = 51) and right-sided in 33.8% (<i>n</i> = 26) (<i>p</i> = 0.006). MSCT analysis revealed a standard aortic arch branching pattern in 70.1% (<i>n</i> = 54) and a common origin of the brachiocephalic and left common arteries (bovine arch anatomy) in 29.9% (<i>n</i> = 23) of the patients. There was no association between the anatomical variations of the aortic arch and stroke laterality (<i>p</i> = 0.601). Frequency of arch configuration types was 15.6% (type I), 74.0% (type II), and 10.4% (type III). There was no correlation between the different types of configuration and the laterality of periprocedural stroke (type I: <i>p</i> = 0.526, type II: <i>p</i> = 0.585, and type III: <i>p</i> = 1.000). Aortic arch tortuosity and angulation of the supraaortic arteries did also not differ between right- and left-sided strokes. <i>Conclusion</i>. Our data add evidence that there is a significant propensity for left-hemispheric strokes in patients undergoing TAVR. However, MSCT analysis in our cohort did not reveal an association between aortic arch geometry and laterality of stroke.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/5563121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47334725","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":"Predictors of Left Ventricular Mass Index One Year after Bioprosthetic Aortic Valve Replacement for Aortic Stenosis","authors":"Sachiko Yamazaki,&nbsp;Kazunari Okawa,&nbsp;Keisuke Shunto,&nbsp;Katsuhiko Oka,&nbsp;Koki Ikemoto,&nbsp;Akiyuki Takahashi","doi":"10.1155/2023/2906311","DOIUrl":"10.1155/2023/2906311","url":null,"abstract":"<div>\u0000 <p><i>Background and Aim of Study.</i>To evaluate predictors of residual left ventricular hypertrophy (LVH) one year after surgical aortic valve replacement (SAVR) in patients with aortic stenosis and clarify the relationship between long-term outcomes and predictors. <i>Methods</i>. We retrospectively reviewed 141 patients who underwent SAVR with a bioprosthetic valve. Left ventricular dimensions and mass index were assessed using serial transthoracic echocardiography. The difference in time course and the pattern of left ventricular mass index (LVMI) regression between patients with and without residual LVH one year after surgery were evaluated. The factors associated with LVMI one year after SAVR and the prognostic impact of these predictors on long-term outcomes were analyzed. <i>Results</i>. Although LVMI one year after surgery showed a significant decrease in patients with and without LVH, greater preoperative LVMI and lesser extent of LVMI decrease resulted in high residual LVMI at one year after SAVR in patients with LVH. The preoperative left ventricular end-diastolic dimension index (<i>p</i> = 0.027) and preoperative left atrial dimension (<i>p</i> = 0.001) were significant determinants of LVMI at one year after SAVR. A cut-off value of 30 mm/m² or greater for the left ventricular end-diastolic dimension index was optimal for predicting high LVMI one year after SAVR. Overall survival was significantly lower with a left ventricular end-diastolic dimension index ≥30 mm/m² (<i>p</i> = 0.017, Log rank). <i>Conclusions</i>. High preoperative left ventricular end-diastolic dimension index and large left atrial dimension were associated with high LVMI one year after surgical aortic valve replacement. Preoperative left ventricular end-diastolic dimension index of &gt;30 mm/m² could predict adverse outcomes after surgical aortic valve replacement.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/2906311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41383443","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":"Mini-Aortic Valve Replacement versus Transcatheter Aortic Valve Implantation: A Propensity-Matched Study","authors":"María Monteagudo-Vela,&nbsp;Emilio Monguió-Santín,&nbsp;Nieves de Antonio Antón,&nbsp;Fernanda Aguirre,&nbsp;Begoña Bernal Gallego,&nbsp;Guillermo Reyes-Copa,&nbsp;Vasileios Panoulas","doi":"10.1155/2023/9501508","DOIUrl":"10.1155/2023/9501508","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Total sternotomy for aortic valve replacement has been superseded by less invasive approaches such as mini-sternotomy or transcatheter procedures. There has been an exponential uptake in transcatheter aortic valve implantation (TAVI) in younger and lower risk patients following recent randomized trials. This study aims to compare the outcomes of patients with aortic stenosis treated with minimally invasive approaches: mini-sternotomy for aortic valve replacement (mini-AVR) and TAVI implantation. <i>Methods</i>. Between January 2015 and December 2021, a total of 1437 TAVI and 176 mini-AVR patients from 2 tertiary centers fulfilled the criteria and were included in the propensity matching model. <i>Results</i>. A total of 256 TAVIs and 146 mini-AVR were included in the matched cohort. There was no significant difference in 30-day mortality in the two groups (TAVI vs. mini-AVR 2.7% vs. 2.8%, <i>p</i> = 0.935). TAVI confers slightly lower gradients in the follow-up echo when compared with mini-AVR (peak gradient 20 ± 8.7 mmHg vs. 24.5 ± 10 mmHg, <i>p</i>  &lt; 0.001; mean gradient 10.9 ± 5.6 mmHg vs. 13.2 ± 5.7 mmHg, <i>p</i> &lt; 0.001). On the other hand, mini-AVR exhibits remarkably lower rates of paravalvular leak (mild leak 8% vs. 41.5%, <i>p</i> &lt; 0.001; moderate leak 2.8% vs. 0%, <i>p</i> &lt; 0.001) and of need for permanent pacemaker implantation (2% vs. 12.2%, <i>p</i> &lt; 0.001). Unsurprisingly, TAVI has lower in-hospital stay 3 (2 to 6) days vs. 10 (8 to 13) days, <i>p</i> &lt; 0.001). <i>Conclusions</i>. For eligible aortic stenosis patients in the 7th decade of life, mini-AVR remains an excellent therapeutic option.</p>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2023 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/9501508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42512634","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}