Journal of Cardiac Surgery最新文献

{"title":"Evaluation of Saphenous Vein Graft Patency Using Wall Shear Stress and Geometry Post Coronary Artery Bypass Graft Surgery","authors":"Hashem Abdel Kader,&nbsp;Panagiotis G. Kyriazis,&nbsp;Prakash P. Punjabi","doi":"10.1155/jocs/5602643","DOIUrl":"https://doi.org/10.1155/jocs/5602643","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Saphenous vein grafts (SVGs) remain widely used in coronary artery bypass grafting (CABG). This study examines the role of wall shear stress (WSS) and graft geometry on SVG patency and evaluates the potential of computational fluid dynamics (CFD) as an assessment tool post-CABG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted in PubMed, Cochrane Library, Scopus and EMBASE using the terms ‘wall shear stress’, ‘geometry’, ‘computational fluid dynamics’ and ‘saphenous vein graft patency’. From 374 articles, 82 met the inclusion criteria, focussing on WSS and/or graft geometry in relation to SVG patency in coronary disease. Studies limited to qualitative findings or animal models were excluded, narrowing the selection to 64 eligible articles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adverse WSS conditions were linked to pronounced intimal hyperplasia, atherosclerosis and graft failure. Geometrical factors influencing SVG patency included graft diameter, target coronary diameter (&gt; 2.0 mm), graft wall thickness (&gt; 1.5 mm), curvature at the graft-host junction and anastomotic angles exceeding 15–20°. CFD-based evaluations of SVG patency aligned with existing literature findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The interplay between SVG patency, WSS and graft geometry is well documented. CFD offers a promising modality for in-depth graft analysis by gauging geometry and flow dynamics. By delivering objective information, CFD can equip surgeons with the tools to optimise strategies and thereby enhance CABG patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/5602643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145521707","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":"The Relationship Between Frailty and Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis","authors":"Tristan W. Dorey,&nbsp;Loryn J. Bohne,&nbsp;Ali Fatehi Hassanabad,&nbsp;Kaylene Duttchen,&nbsp;Stephen B. Wilton,&nbsp;Rosaleen Chun","doi":"10.1155/jocs/1336346","DOIUrl":"https://doi.org/10.1155/jocs/1336346","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postoperative atrial fibrillation (POAF) occurs in roughly one-third of patients undergoing cardiac surgery, increasing mortality, morbidity, and healthcare costs. Frailty, a syndrome of physiological decline, is associated with poor outcomes after cardiac surgery. The link between frailty and POAF has not been clearly established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed and EMBASE was conducted up to January 2025 for studies reporting preoperative frailty scores and POAF rates postcardiac surgery. Transcatheter aortic valve replacement (TAVR) studies were assessed separately. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) for frail vs. nonfrail patients were calculated using a random-effect model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies involving 9098 patients (undergoing coronary artery bypass, surgical valve replacement, or both) were included. Meta-analysis indicated that frailty was associated with a higher risk of POAF (RR 1.20; 95% CI 1.08–1.33, <i>p</i> = 0.0008). Subgroup analyses showed consistent frailty effects across different patient ages, study designs, surgery types, and sample sizes. Notably, POAF risk was higher in studies using clinical frailty scales (RR 1.33; 95% CI 1.15–1.54, <i>p</i> &lt; 0.0001) compared to those using surrogate imaging/lab-based methods (RR 1.10; 95% CI 0.92–1.33, <i>p</i> = 0.24) though comparison between subgroups did not reach statistical significance (<i>p</i> = 0.08). In 3 studies for patients undergoing TAVR, there was no association between frailty and POAF (RR 1.24; 95% CI 0.81–1.88, <i>p</i> = 0.32).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis underscores the association between frailty and increased POAF risk in cardiac surgery patients, highlighting the need for comprehensive clinical frailty assessments in preoperative evaluations to identify high-risk patients and optimize perioperative management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1336346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470178","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":"Enhanced Organ Protection During Cardiopulmonary Bypass in Cardiac Surgery: Synergistic Effects of Nitric Oxide and Hydrogen Therapy","authors":"Vladimir Pichugin,&nbsp;Alexandr Volvach,&nbsp;Anna Deryugina,&nbsp;Victor Selemir,&nbsp;Stepan Domnin,&nbsp;Sergey Fedorov,&nbsp;Darya Danilova,&nbsp;Artem Starshov,&nbsp;Roman Trofimov","doi":"10.1155/jocs/6749229","DOIUrl":"https://doi.org/10.1155/jocs/6749229","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>The present study investigates the effects of isolated administration of nitric oxide (NO) and molecular hydrogen (H₂), as well as their combined delivery into the gas supply line of the cardiopulmonary bypass (CPB) circuit. The primary objective is to evaluate their impact on antioxidant activity, biomarkers of myocardial injury, and clinical outcomes in patients undergoing cardiac surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 123 patients undergoing cardiac surgery with CPB were enrolled in the study and randomly assigned to four groups. Group 1 (<i>n</i> = 30) served as the control and received standard CPB without gas supplementation. Group 2 (<i>n</i> = 33) received isolated nitric oxide (NO) administration at a concentration of 40 ppm via the CPB circuit. Group 3 (<i>n</i> = 30) was administered molecular hydrogen (H₂) at 1.2 ppm in isolation. Group 4 (<i>n</i> = 30) received a combined supply of NO (40 ppm) and H₂ (1.2 ppm) through the CPB gas line. The following parameters were assessed: the intensity of lipid peroxidation processes (LPPs), erythrocyte aggregation, and intracellular adenosine triphosphate (ATP) concentrations. The level of cardiac troponin I (cTnI) after surgery was investigated. Clinical outcomes were registered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically significant lower levels of diene and triene conjugates, Schiff bases in Group 3 (H₂) and Group 4 (NO + H₂) during CPB were revealed. A decrease in the aggregation of the researched groups was revealed in comparison with the control group. The concentration of ATP was increased in Groups 3 and 4 relatives to the control, in which ATP was reduced. Statistically significant lower levels of cTnI after surgery in Group 2 and Group 4 were registered. No postoperative complications were noted in Groups 2 and 4. A statistically important drop in both the amount of time that ventilation was administered and the duration spent in the intensive care unit (ICU) was registered in Group 4 compared with Group 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combined administration of nitric oxide and molecular hydrogen during CPB resulted in a statistically significant reduction in lipid peroxidation activity and erythrocyte aggregation, as well as decreased postoperative levels of cTnI. These effects contributed to enhanced myocardial protection, accelerated postoperative recovery, and reduced duration of ICU stay, underscoring the clinical ef","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6749229","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407389","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":"Bicuspid Surgical Aortic Valve Replacement: Anatomical Insight, Medium Term 5 Years Outcomes, and Predictors of Mortality: An Echocardiographic Study","authors":"Roslan Aslannif,&nbsp;Si Ling Soh,&nbsp;Yee Sin Tey,&nbsp;Am Haris Norhaliza,&nbsp;Teo Jassie,&nbsp;Lynne Murray Rowina,&nbsp;Kee Soon Chong,&nbsp;Kian Boon Wong,&nbsp;Dillon Jeswant,&nbsp;Mohamed Yunus Alwi,&nbsp;Mohd Ghazi Azmee","doi":"10.1155/jocs/6619189","DOIUrl":"https://doi.org/10.1155/jocs/6619189","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Purpose</h3>\u0000 \u0000 <p>Bicuspid aortic valves (BAV) are a common cause of surgical aortic valve replacement (SAVR). This study aims to evaluate medium-term (5-year) outcomes, echocardiographic changes, and predictors of mortality in bicuspid SAVR patients, with a focus on preoperative and postoperative echocardiographic parameters, including strain measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of 448 bicuspid SAVR patients from 2015–2021 was analyzed. Preoperative echocardiograms were obtained within 1 month before surgery, with follow-up at 6 months. Parameters assessed included standard measurements (e.g., stroke volume index [SVi], ejection fraction [EF], flow rate, and pressure gradients) and advanced strain metrics (e.g., global longitudinal strain [GLS], left atrial reservoir strain [LArS], and right ventricular free wall strain [RVFWS]). Mortality data were collected via national registry, with a median follow-up of 54.2 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age was 59 years; 68.5% were male. The 30-day and 5-year mortality rates were 3.6% and 18.3%, respectively, both lower than the overall SAVR cohort. Preoperative parameters such as lower SVi (<i>p</i> = 0.027), EF (<i>p</i> = 0.045), flow rate (<i>p</i> = 0.027), and reduced strain measures (LArS, <i>p</i> &lt; 0.001; LAcS, <i>p</i> = 0.013; RVFWS, <i>p</i> = 0.005) correlated with worse outcomes. Postoperative reductions in EF and SVi were observed, but only the change in mean pressure gradient (meanPG) was associated with 5-year mortality. Higher absolute LArS independently predicted improved survival (<i>p</i> &lt; 0.001). Multivariate analysis identified hypertension, elevated urea, longer hospital stays, and higher preoperative LArS as independent predictors of mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bicuspid SAVR patients exhibit favorable medium-term survival, with 5-year mortality at 18.3%. Absolute preoperative LArS are a key independent predictor of outcomes, alongside clinical factors such as hypertension and urea levels. The reduction in meanPG postsurgery correlates with better long-term survival, emphasizing the importance of comprehensive echocardiographic assessment in risk stratification and management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/6619189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367116","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":"Machine Learning Applications in the Diagnosis and Prediction of Aortic Dissection: A Systematic Review and Meta-Analysis","authors":"Pooya Eini,&nbsp;Peyman Eini,&nbsp;Homa Serpoush,&nbsp;Mohammad Rezayee,&nbsp;Jason Tremblay","doi":"10.1155/jocs/3328006","DOIUrl":"https://doi.org/10.1155/jocs/3328006","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aortic dissection is a life-threatening condition requiring rapid and accurate diagnosis. Machine learning (ML) models have shown promise in enhancing diagnostic performance using imaging modalities, but their pooled efficacy remains unclear. This systematic review and meta-analysis evaluates the diagnostic accuracy of ML models for detecting aortic dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, we searched PubMed, Scopus, Embase, Web of Science, and ProQuest up to March 10, 2025, identifying 775 articles. After removing duplicates, 358 articles were screened, 28 underwent full-text review, and 21 studies were included, with 18 providing sufficient metrics for meta-analysis. The MIDAS module in Stata was used to pool sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) for the best-performing models, assessed via a bivariate mixed-effects model. Risk of bias was evaluated using PROBAST + AI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 21 studies included 261,477 patients (mean age 58.74 years, 66.67% male), predominantly from China (11 studies). Imaging modalities included CT angiography (10 studies) and noncontrast/contrast-enhanced CT (five studies). The best models (18 studies, 7957 positive, 41,852 negative cases) achieved a pooled sensitivity of 0.92 (95% CI: 0.87–0.96), a specificity of 0.95 (95% CI: 0.91–0.98), and an AUROC of 0.98 (95% CI: 0.96–0.99). Deep learning models (DenseNet121, Attention U-Net) predominated. Moderate to substantial heterogeneity in both pooled sensitivity (<i>I</i>² = 64.85%) and specificity (<i>I</i>² = 62.87%), likely due to diverse ML algorithms and imaging protocols, was identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ML models show strong diagnostic performance for detecting aortic dissection, highlighting their promise for clinical use. However, the standardization of methodologies is essential to reduce variability and promote broader clinical implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3328006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367164","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":"22-Year Experience With Valve-Sparing Aortic Root Replacement in a Latin American Center","authors":"Juan David Niño-Calvera,&nbsp;Julian Senociain,&nbsp;Jaime Camacho,&nbsp;Nicolas Nunez-Ordonez,&nbsp;Carlos Obando,&nbsp;Tomas Chalela,&nbsp;Carlos Villa,&nbsp;Nestor Sandoval,&nbsp;Juan P. Umaña","doi":"10.1155/jocs/3451088","DOIUrl":"https://doi.org/10.1155/jocs/3451088","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Describe the short- and long-term outcomes of valve-sparing aortic root replacement for aortic root aneurysm repair in a lower-volume center</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included patients with aortic root aneurysm who underwent the David procedure from January 2002 to June 2024 at our institution, identified by the institutional cardiac surgery database that follows the coding guidelines of the STS. We collected data from pre-, intra-, and postoperative periods. Follow-up was performed through the outpatient clinic, government databases, and telephone interviews. The main outcomes were survival, valve regurgitation recurrence, and freedom from reoperation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>150 patients were identified in 22 years. The mean age was 52 years, 81% were male, and the most frequent comorbidity was hypertension. 23 patients had Marfan syndrome and a bicuspid aortic valve. 47% of patients had severe AR, and 15% had moderate AR. 65% patients underwent elective surgery. There was concomitant aortic arch repair in 6 patients, mitral valve repair in 10 patients, and one patient required descending aorta repair. There was one perioperative death. Freedom from significant AR was 92% at 9 years, and freedom from reoperation was 90% at 8 years. There were 8 valve-related reoperations and 11 deaths in the follow-up period. Survival was 97% after 10 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Valve-sparing aortic root replacement is a safe procedure that provides outstanding short- and long-term outcomes. In the long term, AR improvement is remarkable and maintainable. In our background, the David procedure has shown favorable outcomes comparable to those reported in high-volume income centers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3451088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366454","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":"Beating Heart Versus Cardiac Arrest in Isolated Aortic Arch Reconstruction: A Comparative Study in Neonates and Infants","authors":"Mehmet Akif Önalan,&nbsp;Behzat Tüzün,&nbsp;Eymen Recep,&nbsp;Zümrüt Berra Tan Recep,&nbsp;Şerife Özalp,&nbsp;Servet Ergün,&nbsp;Serap Bas,&nbsp;Erkut Oztürk,&nbsp;Ali Can Hatemi","doi":"10.1155/jocs/3445014","DOIUrl":"https://doi.org/10.1155/jocs/3445014","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Surgical treatment of aortic arch hypoplasia includes differences in terms of perfusion strategies. We aimed to compare the early and midterm results of isolated aortic arch reconstruction in terms of operation on antegrade cerebral perfusion (ACP) with beating heart (BH) or ACP with cardiac arrest (CA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medical records of 72 patients undergoing isolated aortic arch reconstruction from October 2020 to April 2024 were retrospectively reviewed. The patients were divided into two groups: Group 1 (34 patients) underwent arch reconstruction on BH and Group 2 (38 patients) underwent arch reconstruction with CA. All arch repair procedures were performed with the patch augmentation technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age at surgery was 13 (interquartile range (IQR), 7–39.2) days and the median weight was 3.3 (IQR, 2.8–4) kg. Fifty-two patients (72.2%) were neonates and 20 (27.8%) were infants. Postoperative early mortality rate was 1.39% (1/34 vs. 0/38, <i>p</i> = 0.28). There was no statistically significant difference between two groups in terms of delayed sternal closure, intensive care unit (ICU) and hospital stays (<i>p</i> = 0.78, 0.54,  <i>a</i><i>n</i><i>d</i> 0.7). Fifteen (20.8%) of the patients were extubated on the table, and fast-track extubation rate was significantly higher in the BH group (11/34 vs. 4/38, <i>p</i> = 0.023). The median duration of follow-up was 7.2 (IQR, 1–18.2) months and there was no late death in either group. The incidence of restenosis and reintervention was not statistically significant between the two groups (1/34 vs. 1/38, <i>p</i> = 0.91).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both perfusion strategies were associated with satisfactory early and midterm results. Although the length of stay in the ICU and hospital were not significantly different for both groups, the fast-track extubation rate was significantly higher in the BH group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3445014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317309","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":"Three Decades of Coronary Artery Bypass Grafting in Octogenarians: Clinical Outcomes and Long-Term Survival","authors":"Caleb R. Weissman,&nbsp;Jessica Parker,&nbsp;Holliann Umana,&nbsp;Rima Patel,&nbsp;Taylor Zimmer,&nbsp;Justin Fanning,&nbsp;Charles Willekes,&nbsp;Stephane Leung Wai Sang,&nbsp;Tomasz Timek","doi":"10.1155/jocs/4809680","DOIUrl":"https://doi.org/10.1155/jocs/4809680","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the rapid growth of the elderly patients presenting for coronary artery bypass grafting (CABG), long-term outcomes for patients over 80 years of age are incompletely understood. We set out to investigate clinical outcomes and long-term survival for octogenarian CABG patients across 3 decades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged 80 and older who underwent isolated CABG at our center between January 1991 and June 2022 (<i>n</i> = 1268) were evaluated in this retrospective review. Patient data were collected from the Society of Thoracic Surgeons (STS) database and electronic medical records. Long-term survival was tracked via the Michigan and National Death Indices. The primary outcomes were short- and long-term mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1268 patients, 33.1% (<i>n</i> = 420) were female, with an average age of 82.5 years. Common comorbidities included hypertension (86.1%), prior myocardial infarction (45.0%), and diabetes (28.3%). In-hospital mortality was 2.9% (<i>n</i> = 36), and 30-day mortality was 3.1% (<i>n</i> = 40). Survival at 5 and 10 years was 73.3% and 33.4%, respectively. Over 3 decades, 30-day mortality rates were 3.6% (<i>n</i> = 10) in 1991–2000, 3.7% (<i>n</i> = 17) in 2001–2010%, and 2.5% (<i>n</i> = 13) in 2011–2022 (<i>p</i> = 0.49). Postoperative complications included renal failure in 6.1% (<i>n</i> = 78), atrial fibrillation in 33.7% (<i>n</i> = 427), stroke in 2.4% (<i>n</i> = 30), and reoperation for bleeding in 1.7% (<i>n</i> = 21), with no changes over time. At discharge, 61.7% (<i>n</i> = 604) of patients went home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In selected octogenarian patients, CABG can be performed with very good perioperative outcomes and home discharge for most patients. Great majority of these elderly patients were alive 5 years after surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/4809680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317310","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":"Superior Vena Cava Canulation During Minimally Invasive Cardiac Surgery: A Better Choice than Percutaneous Internal Jugular Vein for Venous Drainage","authors":"Yufei Zhan,&nbsp;Hua Lu,&nbsp;Quan Shi,&nbsp;Shengjie Liao,&nbsp;Tiange Luo,&nbsp;Yipeng Ge,&nbsp;Xiaoshen Zhang","doi":"10.1155/jocs/1277604","DOIUrl":"https://doi.org/10.1155/jocs/1277604","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Venous drainage is a critical aspect of peripheral cardiopulmonary bypass (CPB) management in minimally invasive cardiac surgery (MICS), particularly for superior vena cava (SVC) drainage. The most commonly used method for SVC drainage currently is percutaneous cannulation via the internal jugular vein. However, this method still faces challenges in drainage efficiency, cosmetic outcomes, and puncture-related complications. This study aimed to compare the safety, effectiveness, and cosmetic outcomes of direct SVC cannulation (SVCC) and percutaneous internal jugular vein (PIJV) for SVC drainage in MICS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted of patients who underwent MICS with CPB at the Cardiovascular Surgery Department of the First Affiliated Hospital of Jinan University and Guangdong General Hospital between January 2012 and August 2023. In this study, 499 patients underwent SVCC, and 572 patients received PIJV for SVC drainage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the SVCC group, one central venous catheter was mistakenly fixed with a purse-string suture (0.2%). In the PIJV group, complications included neck hematoma in 11 cases (1.9%), puncture site infection in 3 cases (0.5%), and catheter failure in 1 case (0.2%). Significant differences were noted in central venous pressure (CVP) during aortic cross-clamping (<i>p</i> &lt; 0.001), duration of mechanical ventilation (<i>p</i> = 0.049), pleural drainage volume (<i>p</i> = 0.001) and lactate levels at Intensive Care Unit (ICU) admission (<i>p</i> &lt; 0.001) between the two groups. Additionally, lactate levels were significantly different only in the subgroup of patients weighing &gt; 50 kg. Patients with a CVP ≤ 0 mmHg during aortic cross-clamping exhibited lower lactate levels on ICU admission than those with CVP &gt; 0 mmHg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SVCC in MICS provides an easy and safe method with minimal complications, improved venous drainage, and better cosmetic results than the PIJV method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/1277604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272880","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":"Establishing a Surgeon-Led Adult Cardiac Surgery Quality Improvement Program","authors":"Ahmet Can Topcu,&nbsp;Fatih Yigit,&nbsp;Emin Onur Yerlikhan,&nbsp;Mustafa Mert Ozgur,&nbsp;Melike Turkal,&nbsp;Hakan Hancer,&nbsp;Kamile Ozeren-Topcu,&nbsp;Farid Gojayev,&nbsp;Ozgul Uzunca,&nbsp;Serpil Tas,&nbsp;Kaan Kirali","doi":"10.1155/jocs/3804482","DOIUrl":"https://doi.org/10.1155/jocs/3804482","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The current article describes the methods utilized during the establishment of Kosuyolu Adult Cardiac Surgery Quality Improvement Program, shares our initial experiences, and provides insights into future directions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through inspiration from a notable example of high-performing collaborative quality initiative, we established a surgeon-led quality improvement program by voluntary participation of senior academic and early-career surgeons. Our new program aims to improve the quality of cardiac surgical care through methods of data acquisition and analysis, internal data validation, collaborative discussions on care processes and risk-adjusted outcomes, and development and implementation of quality improvement initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed significant baseline variations in outcome measures including perioperative blood utilization, postoperative mechanical ventilation duration, and postoperative length of stay between surgeon groups. During the first 2 years of the Kosuyolu Adult Cardiac Surgery Quality Improvement Program, there were significant overall improvements from baseline in multiarterial grafting rates among all-comer patients undergoing isolated coronary artery bypass surgery and in unadjusted re-exploration rates after all cardiac surgical procedures. However, no significant improvements were noted in perioperative blood utilization, postoperative mechanical ventilation duration and hospital and intensive care unit length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Surgeon-led collaborative quality improvement programs are instrumental in enhancing the quality of healthcare services provided to cardiac surgical patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15367,"journal":{"name":"Journal of Cardiac Surgery","volume":"2025 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jocs/3804482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272075","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}