Thoracic and Cardiovascular Surgeon最新文献

Do P-Wave Indices Manifest Atrial Fibrillation after Postoperative Atrial Fibrillation? p波指标：术后房颤是否表现为房颤？

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-17 DOI: 10.1055/a-2616-3919

Christian Rau, Miriam Salzmann-Djufri, Andreas Böning, Susanne Rohrbach, Bernd Niemann

{"title":"Do P-Wave Indices Manifest Atrial Fibrillation after Postoperative Atrial Fibrillation?","authors":"Christian Rau, Miriam Salzmann-Djufri, Andreas Böning, Susanne Rohrbach, Bernd Niemann","doi":"10.1055/a-2616-3919","DOIUrl":"10.1055/a-2616-3919","url":null,"abstract":"Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. We investigated how POAF affects the manifestation of atrial fibrillation (AF) during long-term follow-up.We conducted a prospective all-comers investigation involving patients undergoing cardiac surgery. In propensity score-matched cohorts (POAF vs. sinus rhythm [SR]), ECGs were evaluated regarding P-wave duration (PWD), amplitude (PWA), morphology, variability, and their dynamics preoperatively pre-POAF and at follow-up. Predictive value of these parameters regarding the development of manifest AF after POAF was analyzed.Of 212 patients included, 50 patients (23.6%) developed POAF. Ninety patients underwent propensity score matching (PSM), 64 (71%) participated in follow-up, 21 (23%) died prior to follow-up (POAF: 13 vs. SR: 8), and 5 (6%) withdrew consent. No patient developed persistent AF. In nine patients, paroxysmal AF (pAF) events were detected (POAF: 6 vs. SR: 3). PWD, P-dispersion (PD), PWA, and interatrial block differed between POAF and SR. From pre- to postoperative ECGs, PD and P-wave peak time (PWPT) increased, and P-amplitude decreased in these. Preoperative β-blockers had only minor modulating potency. P-wave modulation was pronounced in POAF patients.Patients with POAF are prone to episodes of pAF. P-wave indices and perioperative dynamics of these indices may indicate a higher risk of manifest AF initiation among POAF patients.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111995","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}

引用次数: 0

Effectiveness of Gentamicin-Collagen Sponges in Preventing Sternal Wound Infections. 庆大霉素-胶原蛋白海绵预防胸骨伤口感染的效果。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-16 DOI: 10.1055/a-2635-3239

Roi Glam, Tom Ronai, Maged Makhoul, Tom Friedman, Mahli Raad, Zvi Adler, Oved Cohen, Benjamin Medalion, Gil Bolotin

{"title":"Effectiveness of Gentamicin-Collagen Sponges in Preventing Sternal Wound Infections.","authors":"Roi Glam, Tom Ronai, Maged Makhoul, Tom Friedman, Mahli Raad, Zvi Adler, Oved Cohen, Benjamin Medalion, Gil Bolotin","doi":"10.1055/a-2635-3239","DOIUrl":"https://doi.org/10.1055/a-2635-3239","url":null,"abstract":"Background: This study aimed to evaluate whether the combined use of gentamicin-collagen sponges and topical vancomycin reduces the incidence of sternal wound infections (SWIs) in patients at high risk for infection following cardiac surgery.Methods: A single-center, retrospective study compared two groups of high-risk cardiac surgery patients from June 2018 to September 2021. High-risk patients, identified through departmental consensus, had multiple SWI risk factors. The study group (278 patients) received gentamicin-collagen sponges plus topical vancomycin, while the control group (309 patients) received only topical vancomycin. The primary outcome was SWI incidence.Results: The incidence of SWI was significantly lower in the study group, with 2.8% (8/278) compared to 9% (28/309) in the control group (P = 0.002). After adjusting for known risk factors, the odds of infection in the control group were 4.64 times higher (95% CI: 1.63-13.21) than in the study group. The rate of deep sternal wound infections (DSWI) was 1.8% in the study group versus 4.2% in the control group (P = 0.09), with adjusted odds of DSWI being 4.1 times higher in the control group (95% CI: 0.99-16.86). Although the P-value was borderline (P = 0.05), no significant differences in mortality rates were observed between the two groups.Conclusions: The use of gentamicin-collagen sponges as part of a prophylactic regimen significantly reduces the incidence of SWI in high-risk cardiac surgery patients, suggesting its potential benefit as an adjunctive treatment in preventing post-operative infections.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310429","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}

引用次数: 0

Experimental Comparison of Esmolol- and Blood-Based Cardioplegia for Long Aortic Clamping Times. 艾司洛尔与血基心脏停搏术治疗长主动脉夹紧时间的实验比较。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-10 DOI: 10.1055/a-2618-4744

Andreas Böning, Balli Chapugi, Martina Heep, Ulrich Gärtner, Bernd Niemann, Zulfugar T Taghiyev

{"title":"Experimental Comparison of Esmolol- and Blood-Based Cardioplegia for Long Aortic Clamping Times.","authors":"Andreas Böning, Balli Chapugi, Martina Heep, Ulrich Gärtner, Bernd Niemann, Zulfugar T Taghiyev","doi":"10.1055/a-2618-4744","DOIUrl":"10.1055/a-2618-4744","url":null,"abstract":"After cardiac surgery, long aortic clamping times and extracorporeal circulation times are associated with worse outcomes. This study compares hemodynamic performance, myocardial metabolism, and ultrastructural preservation in rat hearts after applying esmolol crystalloid cardioplegia (ECCP) or Calafiore blood cardioplegia (Cala).Hearts from 18 Wistar rats were perfused in a Langendorff system. Following 120 minutes of ischemia at 36 °C, hearts received either ECCP at 32 °C for 3 minutes or Cala at 36 °C for 2 minutes every 20 minutes. During 90 minutes of reperfusion, coronary blood flow (CF), left ventricular developed pressure (LVDP), and contraction/relaxation velocities (±dp/dt) were recorded. Myocardial oxygen consumption, lactate production, and troponin I levels were measured. Electron microscopy was used for ultrastructural assessment.Baseline (BL) values of LVDP, CF, and ±dp/dt were similar between the two groups. After 90 minutes of reperfusion, CF was significantly higher in the ECCP group: 85 ± 43% of BL in the ECCP group versus 42 ± 24% of BL in the Cala group (p = 0.002). At the end of reperfusion, hearts exposed to ECCP had higher LVDP (91 ± 40%) values than Cala (43 ± 10%), indicating improved cardiac recovery with ECCP. Myocardial contraction and relaxation were notably better in the ECCP group: dLVP/dtmax was 111 ± 40% versus 59 ± 13% in the Cala group (p = 0.002), and dLVP/dtmin was 88 ± 34% versus 40 ± 7% (p = 0.001). Troponin I levels measured in Cala hearts at the end of reperfusion were higher than in ECCP hearts (Cala 1,102.6 ± 361.3 ng/mL vs. ECCP 442.3 ± 788.4 ng/mL, p = 0.036).In rat hearts, ECCP offers better hemodynamic recovery and protects the myocardium from ischemia/reperfusion-related damage, better than Cala blood cardioplegia, even with aortic clamping times of 120 minutes.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128809","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}

引用次数: 0

Impact of SGLT2 Inhibitor Therapy on Patients Undergoing Cardiac Surgery. SGLT2抑制剂治疗对心脏手术患者的影响。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-05 DOI: 10.1055/a-2616-4962

Zulfugar T Taghiyev, Lili-Marie Beier, Carina Leweling, Sophia Gunkel, Kevin Mike Sadowski, Birgit Assmus, Andreas Boening

{"title":"Impact of SGLT2 Inhibitor Therapy on Patients Undergoing Cardiac Surgery.","authors":"Zulfugar T Taghiyev, Lili-Marie Beier, Carina Leweling, Sophia Gunkel, Kevin Mike Sadowski, Birgit Assmus, Andreas Boening","doi":"10.1055/a-2616-4962","DOIUrl":"10.1055/a-2616-4962","url":null,"abstract":"Sodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) are nephroprotective in patients with recompensated acute and chronic heart failure (HF) and chronic kidney disease, but their potential influence during cardiac surgery is unclear. Currently, discontinuation of SGLT2i at least 2 days before surgery is recommended.Between March 2022 and December 2023, 53 cardiac surgical patients on SGLT2i therapy in addition to standard medical treatment for HF were compared with 447 other HF patients from the same period. After 1:1 covariate adjustment, 33 patients with SGLT2i treatment were matched with 33 controls. The primary endpoint was a change in estimated glomerular filtration rate (eGFR) 36 hours after surgery. Secondary endpoints were changes in eGFR, cumulative urine output, diuretic efficacy, and albuminuria over seven postoperative days.Mean baseline eGFR was similar between the groups (p = 0.973). Thirty-six hours postoperatively, eGFR was significantly higher in the SGLT2i group by a mean difference (MD) of 11.8 mL/min (95% CI [3.12-20.44]; p = 0.009) compared with the control group. The mean urinary albumin level was 18.1 mg/mL lower in the SGLT2i group (95% CI [-42.5-6.33]; p = 0.143). There were numerically positive changes in urine output and diuretic efficacy in the SGLT2i group without significant difference: MD 131.4 mL/24 hours (95% CI [-366.7-629.5]; p = 0.600) and MD 11.3 mL/mg (95% CI [-12.2-34.7]; p = 0.301), respectively, although the dosage of diuretics was higher in controls (30.6 ± 43.7 vs. 51.3 ± 130.1 mg/24 hours; p = 0.268, respectively).SGLT2i may have nephroprotective effects in patients undergoing heart surgery with extracorporeal circulation. More evidence is needed to determine whether SGTL2i needs to be discontinued before surgery.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111994","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}

引用次数: 0

"Vetus Sed Utilis": Open Window Thoracostomy after Lung Surgery. “Vetus Sed Utilis”：肺部手术后开窗开胸术。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-05 DOI: 10.1055/a-2616-5012

Antonio Mazzella, Claudia Bardoni, Luca Bertolaccini, Monica Casiraghi, Lara Girelli, Giorgio Lo Iacono, Lorenzo Spaggiari

{"title":"\"Vetus Sed Utilis\": Open Window Thoracostomy after Lung Surgery.","authors":"Antonio Mazzella, Claudia Bardoni, Luca Bertolaccini, Monica Casiraghi, Lara Girelli, Giorgio Lo Iacono, Lorenzo Spaggiari","doi":"10.1055/a-2616-5012","DOIUrl":"https://doi.org/10.1055/a-2616-5012","url":null,"abstract":"Open window thoracostomy (OWT) is an ancient surgical intervention, born for managing chronic thoracic infectious diseases. Our goal is to report our 25-year experience in the management of these patients, focusing on its feasibility and usefulness in our modern era.We retrospectively reviewed our database (1999-2024), reporting all clinical preoperative, intraoperative, and postoperative data of patients undergoing OWT for treating chronic empyema, linked to broncho-pleural fistula after lung resection, or not. Data were collected on the type of original surgical intervention, perioperative and postoperative management, 30- and 90-day mortality, overall survival, and following reintervention to close OWT.Sixty-six OWTs were performed to treat acute and chronic septic complications due to original lung intervention for cancer. OWT was performed for treating a late broncho-pleural fistula after pneumonectomy (56 cases; 85%) or after lobectomy (8 cases; 12%) or pleural chronic empyema (2 cases; 3%). Thirty- and 90-day mortality after OWT following pneumonectomy was 3% (2 patients) and 6% (4 patients), respectively. No 30- and 90-day death was observed in the other patients. In 15 out of 66 patients (22.7%), OWT was closed by muscle, skin, or omentum flaps. No statistical differences were observed comparing the survival of the patients undergoing or not undergoing OWT closure, after pneumonectomy (p = 0.59).OWT is a safe, feasible, and sometimes mandatory technique for the management of chronic infectious issues linked to broncho-pleural fistula (BPF) after lung surgery. It is well tolerated by guaranteeing an appropriate quality of life.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235266","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}

引用次数: 0

Totally Thoracoscopic Ablation for Atrial Fibrillation: All-Box Clamping. 全胸腔镜消融治疗心房颤动：全盒夹紧。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-03 DOI: 10.1055/a-2625-9617

Nicolas Doll, Antonia Doll, Geza Horvath, Gerold Moennig, Christian Pott, Thorsten Hanke, Taoufik Ouarrak, Jochen Senges, Mahmoud Wehbe

{"title":"Totally Thoracoscopic Ablation for Atrial Fibrillation: All-Box Clamping.","authors":"Nicolas Doll, Antonia Doll, Geza Horvath, Gerold Moennig, Christian Pott, Thorsten Hanke, Taoufik Ouarrak, Jochen Senges, Mahmoud Wehbe","doi":"10.1055/a-2625-9617","DOIUrl":"https://doi.org/10.1055/a-2625-9617","url":null,"abstract":"Background Epicardial surgical ablation is an effective strategy to treat non-paroxysmal forms of atrial fibrillation. Current thoracoscopic epicardial surgical strategies are complex, and are therefore often avoided. With slight modifications to the thoracoscopic maze procedure, totally thoracoscopic all-box-clamping may facilitate the performance of epicardial thoracoscopic ablation, while maintaining good results. Methods Between December 2023 and December 2024, 42 patients underwent thoracoscopic all-box-clamping at a single center. All-box-clamping uses commercially available bipolar radiofrequency clamps for isolation of the ipsilateral pulmonary veins and posterior left atrial wall through right and then left-sided thoracoscopic access. The left atrial appendage is occluded using a clip device, and the ligament of Marshall is transected. Assessment of a bidirectional block confirmed electrical isolation. Data from the CASE-AF registry were analyzed retrospectively. Short-term results pertaining to efficacy and safety are provided. Results All-box-clamping was successfully offered to all patients by three surgeons. The were no reported major or minor complications. The median hospital stay was 6 days (Interquartile range 5 - 6). At discharge, a sinus rhythm was observed in 92.9%, and in 76.1% of patients off any Class I/III anti-arrhythmic therapy. Conclusion Surgical ablation with a modified thoracoscopic technique is safe and feasible for the treatment of atrial fibrillation.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216945","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}

引用次数: 0

A Novel Sheath Aligning Method of Left Subclavian Artery Revascularization in TEVAR. TEVAR左锁骨下动脉血管重建术的一种新的鞘对正方法。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-03 DOI: 10.1055/a-2607-6327

Yu Zhang, Heng Wang, Jidong Liu, Song Xue

引用次数: 0

The Solid Volume Ratio is Better Than the Consolidation Tumor Ratio in Predicting the Malignant Pathological Features of cT1 Lung Adenocarcinoma. 固体体积比在预测 cT1 肺腺癌病理特征方面的作用。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-01 Epub Date: 2024-08-06 DOI: 10.1055/a-2380-6799

Yu Liu, Ning Jiang, Zhiqiang Zou, Hongxiu Liu, Chuanhang Zang, Jia Gu, Ning Xin

{"title":"The Solid Volume Ratio is Better Than the Consolidation Tumor Ratio in Predicting the Malignant Pathological Features of cT1 Lung Adenocarcinoma.","authors":"Yu Liu, Ning Jiang, Zhiqiang Zou, Hongxiu Liu, Chuanhang Zang, Jia Gu, Ning Xin","doi":"10.1055/a-2380-6799","DOIUrl":"10.1055/a-2380-6799","url":null,"abstract":"Background: More effective methods are urgently needed for predicting the pathological grade and lymph node metastasis of cT1-stage lung adenocarcinoma.Methods: We analyzed the relationships between CT quantitative parameters (including three-dimensional parameters) and pathological grade and lymph node metastasis in cT1-stage lung adenocarcinoma patients of our center between January 2015 and December 2023.Results: A total of 343 patients were included, of which there were 233 males and 110 females, aged 61.8 ± 9.4 (30-82) years. The area under the receiver operating characteristic (ROC) curve for predicting the pathological grade of lung adenocarcinoma using the consolidation-tumor ratio (CTR) and the solid volume ratio (SVR) were 0.761 and 0.777, respectively. The areas under the ROC curves (AUCs) for predicting lymph node metastasis were 0.804 and 0.873, respectively. Multivariate logistic regression analysis suggested that the SVR was an independent predictor of highly malignant lung adenocarcinoma pathology, while the SVR and pathological grade were independent predictors of lymph node metastasis. The sensitivity of predicting the pathological grading of lung adenocarcinoma based on SVR >5% was 97.2%, with a negative predictive value of 96%. The sensitivity of predicting lymph node metastasis based on SVR >47.1% was 97.3%, and the negative predictive value was 99.5%.Conclusion: The SVR has greater diagnostic value than the CTR in the preoperative prediction of pathologic grade and lymph node metastasis in stage cT1-stage lung adenocarcinoma patients, and the SVR may replace the diameter and CTR as better criteria for guiding surgical implementation.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"308-316"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898288","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}

引用次数: 0

Acquired Thrombocytopenia in Contemporary Transcatheter Aortic Valve Prosthesis. 当代经导管主动脉瓣修复术中的获得性血小板减少症。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-01 Epub Date: 2023-10-25 DOI: 10.1055/a-2198-1235

Asen Petrov, Ali Taghizadeh-Waghefi, Abdel-Hannan Diab, Linda Breuer, Sebastian Arzt, Klaus Ehrhard Matschke, Konstantin Alexiou

{"title":"Acquired Thrombocytopenia in Contemporary Transcatheter Aortic Valve Prosthesis.","authors":"Asen Petrov, Ali Taghizadeh-Waghefi, Abdel-Hannan Diab, Linda Breuer, Sebastian Arzt, Klaus Ehrhard Matschke, Konstantin Alexiou","doi":"10.1055/a-2198-1235","DOIUrl":"10.1055/a-2198-1235","url":null,"abstract":"Background: Postprocedural thrombocytopenia is a known phenomenon following transcatheter aortic valve implantation (TAVI). The aim of this study is to evaluate whether postinterventional platelet kinetics differ when comparing the current generation of balloon-expandable valve (BEV) and self-expanding valve (SEV) prostheses.Methods: We performed a retrospective analysis of patients undergoing TAVI at our facility between 2017 and 2019. Patients were stratified according to the type of prosthesis used: BEV or SEV. Hematocrit-corrected platelet counts were calculated to account for dilution. Nadir platelet counts (lowest recorded platelet count), drop platelet counts (DPC; highest relative platelet drop from baseline), and severity of thrombocytopenia during the discourse and at discharge were assessed.Results: Of the 277 included patients, 212 received SEV and 65 BEV. BEV patients were younger (81.8 ± 4.4 years vs 79.7 ± 6.8 years, p = 0.03). Further demographic characteristics were similar between groups. Implanted SEV were larger (p < 0.001) and had shorter procedural times (p < 0.01). There were no significant differences in postprocedural discourse. Postinterventional platelet drop was more pronounced in BEV patients in several evaluated metrics: mean DPC (24.3 ± 10.9% vs 18.8 ± 14.8%, p < 0.01), patients with DPC > 30% (n = 19, 29.2%, vs n = 33, 15.6%, p = 0.02), and also when comparing platelet kinetics.Conclusion: Despite improvements in outcome, the current generation of balloon-expandable TAVI prostheses carries a predisposition for postprocedural thrombocytopenia even when the effects of dilution are accounted for.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"264-271"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163025","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}

引用次数: 0

Recent Outcomes of Surgical Redo Aortic Valve Replacement in Prosthetic Valve Failure. 人工瓣膜置换术失败者重做主动脉瓣置换术的近期疗效。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-06-01 Epub Date: 2024-03-05 DOI: 10.1055/a-2281-1897

Yoonjin Kang, Nazla Amanda Soehartono, Jae Woong Choi, Kyung Hwan Kim, Ho Young Hwang, Joon Bum Kim, Hong Rae Kim, Seung Hyun Lee, Yang Hyun Cho

{"title":"Recent Outcomes of Surgical Redo Aortic Valve Replacement in Prosthetic Valve Failure.","authors":"Yoonjin Kang, Nazla Amanda Soehartono, Jae Woong Choi, Kyung Hwan Kim, Ho Young Hwang, Joon Bum Kim, Hong Rae Kim, Seung Hyun Lee, Yang Hyun Cho","doi":"10.1055/a-2281-1897","DOIUrl":"10.1055/a-2281-1897","url":null,"abstract":"Background: As redo surgical aortic valve replacement (AVR) is relatively high risk, valve-in-valve transcatheter AVR has emerged as an alternative for failed prostheses. However, the majority of studies are outdated. This study assessed the current clinical outcomes of redo AVR.Methods and results: This study enrolled 324 patients who underwent redo AVR due to prosthetic valve failure from 2010 to 2021 in four tertiary centers. The primary outcome was operative mortality. The secondary outcomes were overall survival, cardiac death, and aortic valve-related events. Logistic regression analysis, clustered Cox proportional hazards models, and competing risk analysis were used to evaluate the independent risk factors. Redo AVR was performed in 242 patients without endocarditis and 82 patients with endocarditis. Overall operative mortality was 4.6% (15 deaths). Excluding patients with endocarditis, the operative mortality of redo AVR decreased to 2.5%. Multivariate analyses demonstrated that endocarditis (hazard ratio [HR]: 3.990, p = 0.014), longer cardiopulmonary bypass time (HR: 1.006, p = 0.037), and lower left ventricular ejection fraction (LVEF) (HR: 0.956, p = 0.034) were risk factors of operative mortality. Endocarditis and lower LVEF were independent predictors of overall survival.Conclusion: The relatively high risk of redo AVR was due to reoperation for prosthetic valve endocarditis. The outcomes of redo AVR for nonendocarditis are excellent. Our findings suggest that patients without endocarditis, especially with acceptable LVEF, can be treated safely with redo AVR.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"279-287"},"PeriodicalIF":1.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040387","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}

引用次数: 0