Journal of Cardiac Surgery最新文献

{"title":"Long-Term Outcomes in Elderly Patients Undergoing Mitral Valve Surgery: A Single-Center Experience","authors":"Anupama Barua,&nbsp;Nicholas Wong,&nbsp;Ravish Jeeji,&nbsp;Prakash Nanjaiah,&nbsp;Richard Warwick,&nbsp;Lognathen Balacumaraswami","doi":"10.1155/jocs/9950497","DOIUrl":"https://doi.org/10.1155/jocs/9950497","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is an increasing trend to offer mitral valve surgery to patients ≥ 75 years of age for severe mitral regurgitation or stenosis. These patients have multiple comorbid conditions which may affect clinical outcomes. We present long-term outcomes following mitral valve surgery in patients ≥ 75 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective institutional study was performed. We analyzed data on patients ≥ 75 years who underwent mitral valve surgery from January 2013 to July 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>168 patients were included in the study with a mean age of 79 ± 1.2 years and a median EuroSCORE II of 4.7 and a median Logistic EuroSCORE of 11.02. The timing of surgery was urgent in 43.5% and elective in 56.5% of patients. There was no difference in preoperative variables between the urgent and elective groups. Infective endocarditis was present in 8% of urgent cases and 1% in elective patients. Mitral valve repair was performed in 46% of both groups, respectively, that is, urgent and elective groups. Tricuspid valve surgery was performed in 8.2% and 14.7% of patients, surgical ablation for atrial fibrillation in 4.1% and 10.5% of patients, and closure of left atrial appendage in 17.8% and 6.3% of patients, CABG in 38.4% and 32.6% of patients, and aortic valve replacement in 17.8% and 12.6% of patients. In-hospital mortality was 6.9% in the urgent group and 1.1% in the elective group. Postoperative neurological changes were seen in 4% of elective patients and 1% in the urgent group, and there was no difference in the requirement of CVVH between the two groups. One- and five-year survival rates are 92% and 84%, respectively, in the elective group and 88% and 77%, respectively, in the urgent group. Cumulative survival for both groups is 77% at 10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mitral valve surgery in association with concomitant valve or CABG operations can be safely performed in elderly patients with good early and late outcomes. Excellent 10-year survival outcomes are seen with minimal attrition in those patients who have survived to 5 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9950497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905244","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":"Surgically Treated Infective Endocarditis in Intravenous Drug Users: A Retrospective Analysis of Patient Characteristics and Survival Between 1998 and 2018","authors":"Karri Parkkila,&nbsp;Petteri Holm,&nbsp;Matti Pokela,&nbsp;Panu Taskinen,&nbsp;Tuomas Mäkelä","doi":"10.1155/jocs/9547115","DOIUrl":"https://doi.org/10.1155/jocs/9547115","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Infective endocarditis (IE) is an increasingly more common disease with poor prognosis. Recently, a few single-center studies about IE patient characteristics and surgical outcomes have been published from the capital area in Southern Finland. Our aim was to provide the first descriptive analysis of surgically treated IE patients in the northernmost university hospital in Finland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All IE patients who had their first operation due to IE between 1998 and 2018 were retrospectively collected from the hospital discharge register, and their electronic patient records were analyzed. Follow-up for survival lasted to the end of 2021. The primary endpoint in survival analyses was all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 128 novel IE cases were operated between 1998–2018. Twenty (15.6%) of the patients had a history of intravenous drug use. The median (1st–3rd quartile) follow-up after surgery was 76 (26–139) months. A total of 49 (45.5%) of the nonusers and 11 (55.0%) of the drug users died during the follow-up period. The 90-day mortality was significantly higher among nonusers compared with patients using intravenous drugs (18.5% vs. 0.0%, <i>p</i> = 0.036). <i>Staphylococcus aureus</i> was the most common underlying pathogen (42% of all cases) and posed nearly a 2-fold risk for overall mortality even after adjusting for confounding: hazard ratio: 1.781 (95% confidence interval: 1.054–3.008, <i>p</i> = 0.031).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IE is a rare disease with poor outcomes. <i>S. aureus</i> is the most common underlying pathogen and a major risk factor for mortality in patients not using intravenous drugs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9547115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145887689","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":"New Adhesive Composite Barrier in Pediatric Cardiac Surgery: A Pilot Clinical Study","authors":"Oleg A. Egunov,&nbsp;Elsa R. Mikheeva,&nbsp;Ivan V. Stepanov,&nbsp;Andrey S. Grishin,&nbsp;Alla A. Boshchenko","doi":"10.1155/jocs/5363678","DOIUrl":"https://doi.org/10.1155/jocs/5363678","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to assess the effectiveness of a new adhesive composite barrier for preventing scars between the sternum and the intracardiac structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pilot, prospective, single-center, randomized controlled study encompassing neonates with ventricular septal defect who received staged correction between January and September 2024. Patients (<i>n</i> = 20) were divided into two groups. After pulmonary artery banding, the study group (<i>n</i> = 10) had the new adhesive composite barrier implanted in the pericardium before the sternum was closed (<i>n</i> = 10). The control group (<i>n</i> = 10) had no barrier. After 3–6 months, all patients had complete correction of the ventricular septal defect, and the barrier was explanted in the study group. We recorded palliative procedure duration and continuously monitored clinical data and resternotomy duration. The histological severity of fibrosis and inflammatory reaction was assessed in the study group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No patients died during the study. The palliative procedure duration, length of stay in the ICU, and length of hospitalization did not differ between the groups. During complete correction, the severity of the adhesion process was estimated in both groups and made up 1.6 ± 0.6 points in the study group and 2.3 ± 0.6 points (<i>p</i> &lt; 0.04) in the control group. The length of hospital stay after VSD repair was the same (<i>p</i> = 0.84). The overall degree of fibrotic changes was lower in the study group: 1.9 ± 0.3 points as compared to 2.3 ± 0.4 (<i>p</i> = 0.049) in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The new adhesive composite Reperen-based barriers were easily separated from the surrounding tissues without adhering to the sternum or intracardiac structures and demonstrate high potential when used as adhesion barriers in cardiac surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5363678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891070","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":"Retrograde Type A Aortic Dissection: Surgical Challenges, Treatment Strategies, and Future Directions","authors":"Wei Wang,&nbsp;Lichi Liu,&nbsp;Gan Luo,&nbsp;Hui Zhang,&nbsp;Mingpeng Yan,&nbsp;Ruidong Wang,&nbsp;Ruize Kong,&nbsp;Minhao Chen,&nbsp;Maosheng Wang,&nbsp;Hong Ren","doi":"10.1155/jocs/3689075","DOIUrl":"https://doi.org/10.1155/jocs/3689075","url":null,"abstract":"<p>Endovascular repair of the thoracic aorta (TEVAR) has currently become a widely adopted endovascular intervention for the management of thoracic aortic pathologies in clinical practice. Retrograde type A aortic dissection (RTAD) is a rare yet life-threatening complication associated with this procedure. However, persisting controversies remain in the clinical community regarding the prophylaxis and management of this complication. This article provides a comprehensive review of the latest research advances in the risk factors and therapeutic strategies of RTAD in recent years, aiming to offer a reference for the clinical diagnosis and management of this condition.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3689075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891313","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":"Myocardial Protection During Valve Surgery: Independency of Age Depends on the Cardioplegic Solution","authors":"Lars Saemann,&nbsp;Anna Lena Baeuschlein,&nbsp;Andreas Simm,&nbsp;Gábor Szabó","doi":"10.1155/jocs/3674155","DOIUrl":"https://doi.org/10.1155/jocs/3674155","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The amount of very old patients requiring cardiac surgery increases. Commonly, most cardiac surgery procedures are performed on the cardioplegically arrested heart. However, myocardial protection in old patients currently has very limited evidence. Thus, we investigated the impact of old age on myocardial protection using the three commonly applied cardioplegic solutions Calafiore, Buckberg, and histidine–tryptophane–ketoglutarate (HTK) in valve surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In our department, we retrospectively included all adult (≥ 18 years) patients who received elective or urgent valve surgery for single or multiple heart valve disease. We compared the peak value and area under the curve (AuC) of the high-sensitive troponin t (TnT) and creatine kinase muscle brain-type (CK-MB) concentrations during the first, second, and third 24-h periods after removal of the aortic cross-clamp of patients ≥ 75 and &lt; 75 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the Calafiore population, the peak CK-MB (<i>p</i> = 0.047) release and AuC (<i>p</i> = 0.038) were significantly higher in patients ≥ 75 years. In the Buckberg population, the peak TnT (<i>p</i> &lt; 0.001) and CK-MB (<i>p</i> = 0.001) release and the TnT (<i>p</i> = 0.001) and CK-MB (<i>p</i> = 0.002) AuC were significantly higher in older patients. Neither the peak TnT (<i>p</i> = 0.929) or CK-MB (<i>p</i> = 0.279) release nor the TnT (<i>p</i> = 0.851) or CK-MB (<i>p</i> = 0.486) AuC was significantly different between patients &lt; 75 years, as compared to those ≥ 75 years of age in the HTK population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Myocardial protection is not independent of age, at least not in valve surgery. Patients ≥ 75 years develop a more pronounced myocardial injury when Calafiore or Buckberg cardioplegia is used. However, when HTK is used, myocardial protection is equally achieved in adult patients &lt; and ≥ 75 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3674155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Modification of the Senning procedure in the double-switch operation: The triangular double-door technique”","authors":"","doi":"10.1155/jocs/9803237","DOIUrl":"https://doi.org/10.1155/jocs/9803237","url":null,"abstract":"<p>S. C. Sung, H. Kim, and K. H. Choi, “Modification of the Senning procedure in the double-switch operation: The triangular double-door technique,” <i>Journal of Cardiac Surgery</i> 2020 Sep; 35(9): 2347–2349, https://doi.org/10.1111/jocs.14763.</p><p>In the article titled “Modification of the Senning procedure in the double-switch operation: The triangular double-door technique,” there was an error in the affiliation, the institutional affiliations for authors Si Chan Sung, Hyungtae Kim, and Kwang Ho Choi were incomplete.</p><p>The following affiliation should be added for Si Chan Sung, Hyungtae Kim, and Kwang Ho Choi authors:</p><p>“Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, <b>School of Medicine, Pusan National University</b>, Yangsan-si, Republic of Korea.”</p><p>We apologize for this error.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9803237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Effectiveness of posterior aortopexy for the left pulmonary vein obstruction between the left atrium and the descending aorta”","authors":"","doi":"10.1155/jocs/9802504","DOIUrl":"https://doi.org/10.1155/jocs/9802504","url":null,"abstract":"<p>K. H. Choi, H. Kim, S. C. Sung, H. D. Lee, H. Ko, and J.-H. Byun, “Effectiveness of posterior aortopexy for the left pulmonary vein obstruction between the left atrium and the descending aorta,” <i>Journal of Cardiac Surgery</i> 2021 Aug; 36(8): 2644–2650, https://doi.org/10.1111/jocs.15596.</p><p>In the article titled “Effectiveness of posterior aortopexy for the left pulmonary vein obstruction between the left atrium and the descending aorta,” there was an error in the affiliation, the institutional affiliations for authors Kwang Ho Choi, Hyungtae Kim, and Si Chan Sung were incomplete.</p><p>The following affiliation should be added for Kwang Ho Choi, Hyungtae Kim, and Si Chan Sung authors:</p><p>“Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, <b>School of Medicine, Pusan National University</b>, Yangsan-si, Republic of Korea.”</p><p>We apologize for this error.</p>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9802504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739396","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":"Retained Blood Syndrome Is Associated With High Mortality and Morbidity After Cardiac Surgery","authors":"Lean A. Al Saqer,&nbsp;Louisa Anita Fox,&nbsp;Ana Maria Soler Castells,&nbsp;Antonia Gerontati,&nbsp;Mohamad Bashir,&nbsp;Niraj S. Kumar,&nbsp;Wael I. Awad","doi":"10.1155/jocs/5567661","DOIUrl":"https://doi.org/10.1155/jocs/5567661","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bleeding into mediastinal and pleural cavities is common after cardiac surgery. Retained blood syndrome (RBS) refers to the need for further interventions to remove blood, blood clot, or bloody fluid from around the heart and lungs. The aim of this study was to ascertain the incidence of RBS following cardiac surgery at our center and evaluate ensuing outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of all patients who underwent cardiac surgery between September 2017 and February 2018, with follow-up completed in February 2022. The primary endpoint was the incidence of RBS secondary endpoints including postoperative survival at 30 days, 6 months, and 5 years, incidence of postoperative atrial fibrillation (POAF), acute kidney injury (AKI), surgical site infection (SSI), and prolonged length of stay in intensive therapy unit (ITU) (&gt; 72 h) and hospital (&gt; 10 days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1002 patients underwent surgery during the study period, of whom 12.7% (127/1002) developed RBS. Mortality was higher among RBS patients compared with non-RBS patients at 30 days, 6 months, and 5 years (11.9% vs. 2.5% (<i>p</i> &lt; 0.001), 18.1% vs. 4.2% (<i>p</i> = 0.001), and 19.0% vs, 8.9% (<i>p</i> &lt; 0.001), respectively). The incidence of all secondary endpoints was also higher among RBS patients: POAF (33.9% vs. 20.8%, <i>p</i> &lt; 0.001), AKI (38.6% vs. 17.9%, <i>p</i> &lt; 0.001), SSI (11.8% vs. 2.1%, <i>p</i> &lt; 0.001), prolonged ITU stay (61.4% vs. 31.4%, <i>p</i> &lt; 0.001), and prolonged hospital stay (51.2% vs. 19.7%, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of RBS following cardiac surgery is high and is associated with increased mortality and morbidity. Implementing interventions to minimize bleeding and reduce retained blood volume postcardiac surgery may improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5567661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739393","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":"Multiple Versus Single Arterial Grafts in Coronary Artery Bypass Grafting Among Veterans","authors":"Mohammad Arammash,&nbsp;Axel Gomez,&nbsp;William Carroway,&nbsp;Jay Patel,&nbsp;Yuvraj Mahadeshwar,&nbsp;Shiv Verma,&nbsp;Elaine E. Tseng,&nbsp;Marko T. Boskovski","doi":"10.1155/jocs/3134321","DOIUrl":"https://doi.org/10.1155/jocs/3134321","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is mounting evidence of the long-term benefits of multiple versus single arterial grafts (MAG vs. SAG) during coronary artery bypass grafting (CABG). However, the adoption of MAG has been low in nonfederal institutions as reported by the Society of Thoracic Surgeons Database, and adoption and results from lower volume federal institutions have rarely been reported. Here, we report our long-term clinical outcomes of MAG in a veteran population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected data on 521 consecutive CABG patients from 2013 to 2023. The decision for MAG was at the discretion of the operating surgeon with use of skeletonized bilateral internal mammary arteries (BIMAs) when applicable and procedures included both on-pump and off-pump CABG. The Fisher exact test was used to compare categorical variables, and the Wilcoxon rank sum test was used to compare continuous variables. A Mann–Kendall statistical test was used to test the trend of MAG use over time, and a Cox proportional hazards model was used to compare mortality between the groups after adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our patients had a mean (SD) age of 67.3 (7.2) years with 2.72 (0.68) diseased coronary vessels. Over the course of the study, 58% of the patients received MAG. There was a significant increase of MAG over time (<i>p</i> = 0.03), with 0% prior to 2013, 69.1% by 2015, and settling at 80.0% utilization in 2022. Patients who received MAG had a lower prevalence of chronic kidney disease and history of myocardial infarction. Patients who received MAG received significantly more total bypass grafts. Right internal mammary artery was utilized 69.4% and radial artery 32.9% of the time in MAG cases. There were no differences in short-term mortality or sternal wound infections between the two groups. However, there was improved long-term mortality seen as early as 5 years with MAG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a lower-volume federal center, there was a significant increase in MAG utilization over time and improved long-term survival for patients receiving MAG than SAG with no differences in short-term mortality or sternal wound infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3134321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Surgical Urgency on Outcomes and Postoperative Anemia in Jehovah’s Witnesses Undergoing Cardiovascular Surgery","authors":"Tsuyoshi Yamabe,&nbsp;Kenichiro Noguchi,&nbsp;Naomi Imai,&nbsp;Shogo Matsui,&nbsp;Chishio Arai,&nbsp;Daisuke Hama,&nbsp;Takashi Ota,&nbsp;Tohru Asai","doi":"10.1155/jocs/9190618","DOIUrl":"https://doi.org/10.1155/jocs/9190618","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to examine the outcomes of cardiovascular surgery in Jehovah’s witnesses (JWs) according to surgical urgency (elective vs. emergency), investigate the relationship between surgical urgency and postoperative anemia progression, and determine the impact of postoperative anemia on overall mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>JW patients undergoing cardiovascular surgery were categorized into elective (<i>n</i> = 35) and emergency (<i>n</i> = 7) groups. Baseline characteristics, intraoperative data, postoperative complications, and all-cause mortality were compared. Postoperative hemoglobin (Hb) trends were analyzed using linear mixed-effects models. Survival analysis, including multivariable Cox proportional hazards regression, identified independent risk factors for mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Emergent cases had lower preoperative Hb (12.2 [11.3–12.3] vs. 13.5 [12.2–14.4] g/dL, <i>p</i> = 0.024) and higher incidence of acute type A aortic dissection (85.7% vs. 2.9%) than elective cases. Perioperative Hb levels were significantly lower in emergent patients demonstrating higher rates of 30-day mortality (42.9% vs. 2.9%, <i>p</i> = 0.011). Survival analysis showed a significant difference favoring the elective group (<i>p</i> = 0.003). Cox proportional hazards analysis revealed that emergency surgery (HR, 4.01 and 95% confidence interval [CI], 1.13–14.19) and the lowest postoperative Hb level (HR, 0.66 and 95% CI, 0.45–0.98) were shown to be independent predictors of postoperative mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Emergency cardiovascular surgery in JWs is associated with significantly poorer outcomes, including higher mortality and more severe postoperative anemia, compared with elective procedures. Severe postoperative anemia is an independent predictor of postoperative mortality. These findings underscore the critical need for intensified patient blood management strategies, even in emergent settings, to mitigate risks in this vulnerable patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/9190618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695115","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}