Journal of Cardiac Surgery最新文献

{"title":"Mildly Elevated Pulmonary Artery Systolic Pressure is Associated with Extracorporeal Membrane Oxygenation Support after Heart Transplantation","authors":"L. Yuan, Wenrui Ma, J. Cui, Junjiang Liu, Zhao-hua Yang, Shou-guo Yang, Hongqiang Zhang, Fanshun Wang, Huan Liu, Chunsheng Wang, Xiaoning Sun","doi":"10.1155/2023/8877476","DOIUrl":"https://doi.org/10.1155/2023/8877476","url":null,"abstract":"Background. Pulmonary hypertension is a well-known risk factor for hemodynamic instability after heart transplantation. However, it remains unclear whether a mild elevation of pulmonary artery systolic pressure (PASP) is associated with higher risks of graft dysfunction and resultant extracorporeal membrane oxygenation (ECMO) support. Methods. From 2016 to 2021, 102 adult recipients undergoing orthotopic heart transplantation at our institution were investigated (mean age, 48.5 ± 13.2 years; 22.5% female). This study cohort was stratified into 3 groups based on the PASP measured by right heart catheterization before surgery: >50 mmHg, 35–50 mmHg, and <35 mmHg. The primary end point was ECMO support after procedure. Results. ECMO was implemented in 24 (23.5%) patients due to difficult weaning from cardiopulmonary bypass or cardiac low output in the intensive care unit, which was likely to be associated with higher mortality (\u0000 \u0000 P\u0000 =\u0000 0.053\u0000 \u0000 ). Age, gender, comorbidities, preoperative medications, and graft ischemia time were comparable across the 3 groups. The use of ECMO was significantly more common in patients with baseline PASP >50 mmHg (11/36, 30.6%) and 35–50 mmHg (12/38, 31.6%), while only 1 (3.6%) patient with baseline PASP <35 mmHg required ECMO support after transplant (\u0000 \u0000 P\u0000 =\u0000 0.007\u0000 \u0000 ). Multivariate logistic models demonstrated that PASP (odds ratio = 2.34; \u0000 \u0000 P\u0000 =\u0000 0.028\u0000 \u0000 ) and cardiopulmonary bypass time (odds ratio = 1.01; \u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ) were independent risk factors for postoperative ECMO. Conclusions. A mild elevation of pretransplant PASP (e.g., 35–50 mmHg) is related to low cardiac output and subsequent ECMO after heart transplantation, for which prompt administration of vasodilators before transplant may be protective.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-Printed Models for Multidisciplinary Discussion of Congenital Heart Diseases","authors":"M. Song, Sang Yoon Lee, S. Yoon, Jeong‐Wook Seo","doi":"10.1155/2023/8899573","DOIUrl":"https://doi.org/10.1155/2023/8899573","url":null,"abstract":"Background. Congenital heart defects (CHDs) are complex three-dimensional (3D) lesions with variable anatomies that present therapeutic challenges. The application of a patient-specific3D-printed model in preoperative planning and communication in medical practice can contribute to a complete understanding of the intracardiac and vascular anatomy. This study aimed to prospectively investigate the clinical value of a 3D CHD model in multidisciplinary discussions. Methods. Between August 2019 and April 2021, 19 patients with complex CHDs before surgery were prospectively enrolled in this study. Eight to 14 medical specialists participated in multidisciplinary discussions using patient-specific 3D models. A subjective satisfaction questionnaire, comprising 12 questions to be answered on a 10-point scale, was distributed. Results. Twenty 3D-printed anatomic models of 19 patients were used. The median age and weight of the enrolled patients were 0.8 years (range, 5 days to 43 years) and 9.6 kg (range, 2.8–54 kg), respectively. The most common underlying disease was a double outlet of the right ventricle. The mean scores for understanding spatial orientation, ease of communication between clinicians during discussions, prediction of surgical complications, and information additional to conventional 2D imaging were 9.4 ± 1.1, 9.4 ± 0.9, 9.0 ± 1.1, and 9.2 ± 0.4, respectively. The competency and comfort scores for each patient’s surgical plan increased significantly after using the 3D-printed model (from 6.2 ± 1.6 to 9.2 ± 0.9, \u0000 \u0000 p\u0000 \u0000  < 0.001 and from 6.3 ± 1.6 to 9.2 ± 0.8, \u0000 \u0000 p\u0000 \u0000  < 0.001, respectively). Conclusions. Patient-specific 3D models, for patients with complex CHDs, improved the understanding of the disease and facilitated multidisciplinary discussions and surgical decision-making. However, because outcomes were mainly evaluated by subjective reports, the possibility of other unknown factors affecting the outcomes should be considered. Trial Registration. This trial is registered with D-1904-031-1024.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45345058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Alternative Peripheral and Transfemoral Approaches for Transcatheter Aortic Valve Replacement: A Meta-Analysis of Propensity-Matched Studies","authors":"D. McGrath, Charley Sun, M. Kawabori, Y. Zhan","doi":"10.1155/2023/9030702","DOIUrl":"https://doi.org/10.1155/2023/9030702","url":null,"abstract":"Background. Transfemoral (TF) access is the gold standard for transcatheter aortic valve replacement (TAVR). Alternative peripheral (AP) artery access such as the carotid or axillary artery is considered when the feasibility of femoral access is in doubt. The outcomes comparison of these 2 approaches is unclear due to limited sample sizes in prior studies. Our aim is to compare the clinical outcomes of TF- and AP-TAVR by conducting a meta-analysis of propensity-matched studies. Methods. The PubMed, EMBASE, and Cochrane Library databases from inception up to and including February 2022 were searched by 3 separate researchers to identify articles reporting propensity-matched, comparative data on TF vs. AP-TAVR. Clinical outcomes were extracted from the articles and pooled for analysis. Results. Seven prior studies, including 9,004 patients, were included in our study, with 6,729 in the TF group and 2,275 in the AP group. In all studies, the baseline characteristics of the patients were highly propensity-matched with the full Newcastle-Ottawa scale. Meta-analysis revealed higher in-hospital/30-day mortality (3.3% vs. 4.4%; OR 0.69; 95% CI (0.51, 0.94); \u0000 \u0000 P\u0000 =\u0000 0.02\u0000 \u0000 ) as well as the incidence of stroke (1.9% vs. 3.5%; OR 0.60; 95% CI (0.43, 0.84); \u0000 \u0000 P\u0000 =\u0000 0.003\u0000 \u0000 ) for the AP group. There were no significant differences in the incidence of major vascular complications, pacemaker implantation, bleeding, or acute kidney injury. Conclusions. Our meta-analysis of propensity-matched studies showed AP-TAVR contains an additional 1.1% risk of early mortality and an additional 1.6% risk of stroke compared to TF-TAVR. These risks should be considered when deciding on access.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45650828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Medicare Reimbursement for Adult Cardiothoracic Surgery Procedures: 2007 to 2020","authors":"Keyana Zahiri, Aditya Khurana, L. Scrimgeour, A. Eltorai","doi":"10.1155/2023/2790790","DOIUrl":"https://doi.org/10.1155/2023/2790790","url":null,"abstract":"Background. Cardiovascular disease has been the leading cause of death in the US for decades. Over half a million cardiothoracic surgery procedures are performed per year, with an increasingly aging population and rising healthcare costs. The purpose of this study was to evaluate trends in Medicare reimbursement rates from 2007 to 2020 for various cardiothoracic surgery procedures. Methods. The Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool was queried for common procedural terminology codes for 119 common cardiothoracic surgery procedures to obtain reimbursement data by year. Procedures were organized into cardiac, CABG, and thoracic subgroups. All monetary data were adjusted for inflation to 2020 US dollars. Adjusted data were analyzed to calculate compound annual growth rates (CAGR), average annual change, and total percent change for each procedure. Results. After adjusting for inflation, the reimbursement rates for cardiothoracic surgery procedures decreased by 10.20% on average. Reimbursement rates for cardiac, CABG, and thoracic surgical procedures decreased by 8.74%, 14.46%, and 10.94%, respectively. The mean annual change overall was −$14.47, and the CAGR was 0.82%. CABG procedures had the greatest decrease in CAGR (−1.11%), annual change (−$30.30), and total percent change (−14.46%). Conclusions. Medicare reimbursements for cardiothoracic surgery procedures steadily decreased from 2007 to 2020, with CABG procedures experiencing the highest percentage of decline. Dissemination of these findings is crucial to raising awareness for healthcare administrators, surgeons, insurance companies, and policymakers to ensure the accessibility of these procedures for high-quality cardiothoracic surgery care in the United States.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41869206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Factors Influencing Thoracic Deformities after Median Sternotomy in Infants Who Underwent Congenital Cardiac Surgery","authors":"Jian-Feng Liu, Wen-Hao Lin, Yu-Kun Chen, Qin Chen, Hua Cao","doi":"10.1155/2023/8450105","DOIUrl":"https://doi.org/10.1155/2023/8450105","url":null,"abstract":"Objective. To investigate the incidence of thoracic deformities after median sternotomy in infants who underwent congenital cardiac surgery and determine its influencing factors. Methods. This was a single-center retrospective study. A total of 156 infants who underwent congenital cardiac surgery with median sternotomy in a provincial hospital in China from September 2020 to January 2022 were included. Depending on whether thoracic deformities occurred, the patients were classified into the thoracic deformity group and the no thoracic deformity group. Relevant data were retrieved through an electronic medical record system, and statistical comparisons and analyses were performed. Results. The incidence of postoperative thoracic deformities in this cohort was 10.9%. Sternal pins for auxiliary sternal fixation were used in eighty-nine infants. After analysis, it was found that age at operation (1.9 ± 0.9 vs. 3.7 ± 1.2, \u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ) and weight-for-age Z-scores (−2.0 ± 0.7 vs. −1.4 ± 0.7, \u0000 \u0000 P\u0000 =\u0000 0.001\u0000 \u0000 ) of the thoracic deformity group were significantly lower than those of the no thoracic deformity group. In addition, sternal pin use was significantly higher in the no thoracic deformity group than in the thoracic deformity group (61.9% vs. 17.6%, \u0000 \u0000 P\u0000 =\u0000 0.001\u0000 \u0000 ). Univariable analysis showed that age at operation (OR, 4.74; 95% CI, 2.38–9.46; \u0000 \u0000 P\u0000 <\u0000 0.001\u0000 \u0000 ) and weight-for-age Z-scores (OR, 4.40; 95% CI, 1.74–11.12; \u0000 \u0000 P\u0000 =\u0000 0.002\u0000 \u0000 ) were significant risk factors for postoperative thoracic deformity. Using sternal pins for auxiliary sternal fixation was an important protective factor (OR, 7.57; 95% CI, 2.08–27.59; \u0000 \u0000 P\u0000 =\u0000 0.003\u0000 \u0000 ). Conclusions. In this study, 10.9% of infants undergoing congenital cardiac surgery through a median sternotomy developed thoracic deformities after surgery. Younger age at operation and poor nutritional conditions may be risk factors for postoperative thoracic deformity. Sternal pin-assisted fixation has a positive effect on the prevention of thoracic deformities.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44589481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical Predictors of New-Onset Atrial Fibrillation after Ascending Aorta Replacement Surgery in Acute Type A Aortic Dissection Patients","authors":"Jian Shi, Yong Cheng, Xiyu Zhu, Ze-Yi Zhou, Yi Jiang, Y. Xue, H. Cao, Dong-jin Wang","doi":"10.1155/2023/2612292","DOIUrl":"https://doi.org/10.1155/2023/2612292","url":null,"abstract":"Objective. This study aimed to determine the risk factors of new-onset postoperative atrial fibrillation after ascending aortic replacement in acute type A aortic dissection patients, with emphasis on biochemical parameters. Methods. From Jan 2020 to Dec 2021, a total of 435 acute type A aortic dissection patients who underwent ascending aortic replacement and without a history of atrial fibrillation were retrospectively analyzed in this study. Perioperative data of these patients were obtained from the hospital’s database. The 30-day follow-up was via telephone interviews. The multivariate regression analysis was used to identify risk factors that may be predictive of postoperative atrial fibrillation. Results. 218 (50.1%) patients experienced postoperative atrial fibrillation after ascending aorta replacement surgery. Older age (OR = 1.081 (1.059–1.104), \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ), higher total bile acid (OR = 1.064 (1.024–1.106), \u0000 \u0000 p\u0000 \u0000  = 0.002), glucose (OR = 1.180 (1.038–1.342), \u0000 \u0000 p\u0000 \u0000  = 0.012), and serum potassium (OR = 2.313 (1.078–4.960), \u0000 \u0000 p\u0000 \u0000  = 0.031) were identified by multivariate regression analysis as risk factors of postoperative atrial fibrillation. The multivariate regression analysis prediction model incorporating these four factors had a good prediction effect (AUC = 0.769 (0.723–0.816), \u0000 \u0000 p\u0000 <\u0000 0.001\u0000 \u0000 ). Conclusions. Older age, higher total bile acid, glucose, and serum potassium were risk factors of postoperative atrial fibrillation after ascending aortic replacement surgery in acute type A aortic dissection patients.","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64792546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of direct bilateral axillary arterial cannulation in emergency surgery for acute type A aortic dissection","authors":"Ryo Suzuki MD, PhD,&nbsp;Hiroshi Kurazumi MD, PhD,&nbsp;Ryosuke Nawata MD,&nbsp;Toshiki Yokoyama MD,&nbsp;Kazumasa Matsunaga MD,&nbsp;Sarii Tsubone MD,&nbsp;Yutaro Matsuno MD,&nbsp;Kimitaka Tomisada BS,&nbsp;Bungo Shirasawa MD, PhD,&nbsp;Akihito Mikamo MD, PhD,&nbsp;Kimikazu Hamano MD, PhD","doi":"10.1111/jocs.17175","DOIUrl":"10.1111/jocs.17175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim of the Study</h3>\u0000 \u0000 <p>To assess the validity and long-term outcomes of direct bilateral axillary arterial cannulation for acute type A aortic dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2003 and 2020, 208 consecutive patients with acute type A aortic dissection underwent emergency surgical repair. Cardiopulmonary bypass was attempted to establish direct bilateral axillary arterial cannulation and bicaval drainage. Antegrade selective cerebral perfusion was established by axillary perfusion and direct cannulation of the left common carotid artery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ascending aortic, partial arch, and extended total aortic arch replacement were performed in 50 (24.0%), 7 (3.4%), and 151 (72.6%) patients, respectively. Aortic root surgery and coronary artery bypass grafting were performed concomitantly in 23 and seven patients, respectively. Cardiopulmonary bypass was attempted only through bilateral axillary cannulation in all patients but was successful in 13 (6.3%) patients without bilateral axillary cannulation. No postoperative complications occurred related to this technique. There were seven hospital deaths (early mortality rate, 3.4%). Five patients had postoperative reoperation for bleeding, and nine (4.3%) were transferred to other hospitals due to postoperative permanent cerebral infarction, particularly two with arm ischemia. The 10-year survival rate of patients who underwent emergency surgical repair with this technique was 71.4%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Direct bilateral axillary arterial cannulation followed by selective cerebral perfusion was successful in 93.7% of patients and this may be an optimal solution for providing stable outcomes after emergency surgery for acute type A aortic dissection. However, we experienced two complications of arm ischemia, attention should be paid to potential arm ischemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of midterm outcomes after Shone's complex surgery: Analysis of reoperation and mortality risk factors","authors":"Firat Husnu Altin MD,&nbsp;Oktay Korun MD,&nbsp;Okan Yurdakok MD,&nbsp;Murat Cicek MD,&nbsp;Yigit Kilic MD,&nbsp;Arif Selcuk MD,&nbsp;Orhan Bulut MD,&nbsp;Emine Hekim Yilmaz MD,&nbsp;Selma Oktay Ergin MD,&nbsp;Ahmet Sasmazel MD,&nbsp;Numan Ali Aydemir MD","doi":"10.1111/jocs.17163","DOIUrl":"10.1111/jocs.17163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The midterm results of patients who underwent biventricular repair surgery for Shone's complex were examined, and mortality and reoperation risk factors were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 34 patients with Shone's complex who underwent mitral valve (MV) surgery between 2005 and 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 19 patients (56%) had coarctation, 10 (29%) patients had subaortic stenosis, 9 (26.5%) patients had a hypoplastic aortic arch (AA), and 9 (26.5%) patients had aortic valve (AV) stenosis. Twenty-four (70.6%) patients had bileaflet AV. Associated left-sided in-flow stenotic lesions included parachute MV in 19 (56%) patients and supramitral ring in 18 (53%) patients. The estimated freedom from reoperation rate on the 6th month, 1 year and 2 years after surgery was 84.4%, 79.5%, and 71.5%, respectively. The overall mortality rate was 20.6% (seven patients) with a median follow-up of 10 months (0–41). The estimated survival rate on the 6th month, 1 year, and 3 years after surgery was 83.8%, 79.4%, and 79.4 respectively. Bicuspid aortic valve (<i>p</i> = .017) (HR (95% CI) = 0.130 (0.025–0.695) and hammock mitral valve (<i>p</i> = .038) (HR (95% CI) = 11,008 (1,146–&gt;100) were associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The presence of a bicuspid aortic valve hammock mitral valve might have an effect on negative effect on the outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information Page","authors":"","doi":"10.1111/jocs.15651","DOIUrl":"10.1111/jocs.15651","url":null,"abstract":"","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocs.15651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46134542","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":"Subannular procedures on papillary muscles for secondary mitral valve regurgitation repair","authors":"Francesco Guccione MD, PhD,&nbsp;Marco Moscarelli MD, PhD,&nbsp;Roberta Sampognaro MD,&nbsp;Massimo Salardino MD,&nbsp;Daniela Bacarella MD,&nbsp;Nogara Angela MD,&nbsp;Khalil Fattouch MD, PhD","doi":"10.1111/jocs.16968","DOIUrl":"10.1111/jocs.16968","url":null,"abstract":"Mitral valve disease is a frequent cause of heart failure and death. The mitral valve must be seen as a complex apparatus made up of valve flaps, annulus, and subannular structures such as tendon cords and papillary muscles (PPM) (dependent on left ventricular [LV] performance). Emerging evidence indicates that the mitral valve is not a passive structure, but even in adult life remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Functional mitral regurgitation is a condition characterized by mitral regurgitation secondary to an ischemic left ventricle or cardiomyopathy. Primarily, the pathology is the result of the perturbation of normal regional LV geometry combined with adverse remodeling. Although the surgical treatment of severe chronic secondary mitral regurgitation (sMR) in patients presenting for coronary artery bypass grafting (CABG) is recommended by the American College of Cardiology/American Heart Association guidelines, the surgical approach remains debated. Many investigators advocated mitral valve restrictive annuloplasty (RA), meanwhile others have suggested mitral valve replacement. Investigators supporting a conservative approach believe that conservation of the continuity between the valve and left ventricle lead to better long‐term results and a reverse in LV remodeling. 2 | EVIDENCE ON ISCHEMIC MITRAL REGURGITATION (iMR)","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10480445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}