Thoracic and Cardiovascular Surgeon最新文献

{"title":"Lung Chemoperfusion Improves Relapse-Free Survival after Metastasectomy for Colorectal Cancer.","authors":"Evgeny Levchenko, Mikhail Klochkov, Alexander Mikhnin, Nikita Levchenko, Stepan Ergnyan, Oleg Mamontov, Viktoriia Shabinskaya","doi":"10.1055/a-2652-7957","DOIUrl":"10.1055/a-2652-7957","url":null,"abstract":"<p><p>Metastasectomy is a recommended and widely used operation for pulmonary metastases from colorectal cancer (CRC). The main disadvantage of pulmonary metastasectomy is the high rate of metastasis recurrence, which occurs in almost half of patients. To suppress residual pulmonary microfoci, isolated lung chemoperfusion (ILuP) is used, but its effectiveness has not been studied.The results of pulmonary metastasectomy were studied in 160 patients. In 65 patients of the main group, open metastasectomy with isolated chemoperfusion of the lungs was performed; in 95 patients of the control group, standard open or thoracoscopic metastasectomy was performed. The study design included 1:1 pseudorandomization using the nearest neighbor method. For 17 patients who underwent standard metastasectomy and then metastasectomy with ILuP for recurrent pulmonary metastases, these patients themselves were used as the nearest neighbor. For the remaining patients, the matching pairs were selected by the Propensity Score Matching method. After balancing the sample, the main and control groups comprised 41 pairs of observations, which were subjected to further analysis with assessment of relapse-free pulmonary survival according to Kaplan-Meier. Factors influencing survival were studied in the Cox's model.The median recurrence-free survival in patients of the main group who underwent metastasectomy with ILuP was 22.3 months versus 9.1 months in the control group. One-year recurrence-free survival in the main group was 77.5 ±  6.6% versus 38.1 ± 9.1% in the control group.Isolated lung chemoperfusion increases median recurrence-free survival after pulmonary metastasectomy by more than one year for colorectal cancer.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620696","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":"Cardiopulmonary Bypass-Supported Coronary Artery Bypass Surgery: A Flexible and Effective Alternative to Off-Pump Surgery.","authors":"Hakan Guven, Demir Cetintas","doi":"10.1055/a-2650-7176","DOIUrl":"10.1055/a-2650-7176","url":null,"abstract":"<p><p>This study aimed to compare the early postoperative outcomes of cardiopulmonary bypass-supported beating-heart coronary artery bypass grafting (CPB-BH CABG) and off-pump coronary artery bypass (OPCAB) surgery.A total of 589 patients who underwent beating-heart CABG between October 2021 and January 2025 were retrospectively analyzed. Patients were categorized into two groups based on CPB usage: CPB-BH CABG (<i>n</i> = 177) and OPCAB (<i>n</i> = 412). Primary outcomes included mortality and major complications, while secondary outcomes encompassed complete revascularization rates, number of distal anastomoses, hospital stay, and transfusion requirements.No significant differences were observed between the groups regarding preoperative characteristics. The CPB-BH group had longer operative times (268.7 vs. 223.6 minutes, <i>p</i> < 0.001) and prolonged hospital stays (7 vs. 5 days, <i>p</i> < 0.001). The rates of complete revascularization and the number of bypass grafts were slightly higher in the CPB-BH group, but did not reach statistical significance. The CPB-BH group required more blood transfusions (<i>p</i> < 0.001) and had a higher incidence of new-onset atrial fibrillation (33.9% vs. 24.0%, <i>p</i> = 0.016). No significant differences were found for other major complications.CPB-BH CABG is a viable alternative to OPCAB, offering comparable revascularization outcomes while allowing the flexibility of cardiopulmonary bypass support when needed. Surgeons should not hesitate to utilize CPB when necessary to optimize surgical outcomes. Future prospective, randomized controlled trials are warranted to assess the long-term outcomes of both surgical techniques and their effectiveness in specific patient subgroups.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592434","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":"Validation of a Risk Calculator for Surgical Repair of Primary Mitral Regurgitation.","authors":"Serdar Akansel, Martina Dini, Simon H Sündermann, Stephan Jacobs, Volkmar Falk, Jörg Kempfert, Markus Kofler","doi":"10.1055/a-2650-6994","DOIUrl":"https://doi.org/10.1055/a-2650-6994","url":null,"abstract":"<p><p>Risk estimation for cardiac procedures is essential for clinical decision-making. The aim of the study is to validate the recently introduced Society of Thoracic Surgeons (STS) risk score model for mitral valve repair (MVr) in degenerative mitral regurgitation (DMR) by investigating a large cohort undergoing minimally invasive MVr (MI-MVr).A total of 1,081 consecutive patients with DMR undergoing non-emergent MI-MVr were retrospectively analyzed. The primary study endpoint was 30-day all-cause mortality (OM), while secondary endpoints were major morbidity and mortality (MM) and conversion-to-replacement (CONV). Predictive discrimination and calibration of the models were measured using receiver operating characteristic (ROC) analysis.A 30-day mortality of 0.55% was observed in the study cohort. All risk scores were significantly higher in non-survivors. Like existing risk models, the intention-to-treat-OM (ITT-OM) model was predictive for OM (OR: 2.078, 95% CI: 1.324-3.621; <i>p</i> = 0.001), but its discriminatory ability was limited based on ROC analysis. EuroSCORE II showed the best discriminatory performance for mortality among the investigated models. Furthermore, second cross-clamping and CONV were independent predictors of OM (OR: 26.2, 95% CI: 4.3-160.0; <i>p</i> < 0.001 and OR: 12.8, 95% CI: 1.8-89.2; <i>p</i> = 0.010). The ITT-MM and ITT-CONV models demonstrated an acceptable discriminatory ability for predicting operative MM and CONV.The ITT-based risk model was validated in our study cohort undergoing MI-MVr for DMR, showing only limited discriminatory performance for mortality, while the EuroSCORE II demonstrated better discrimination for mortality despite systematic overestimation. This is the first report validating the recently introduced model. However, further studies with larger cohorts are needed to overcome the limitations of the present study.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668569","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":"Transcatheter Mitral Valve Implantation Compared to Surgery: One-Year Clinical Outcome.","authors":"Hendrik Ruge, Melchior Burri, Magdalena Erlebach, Stephanie S Voss, Nazan Puluca, Caterina Campanella, Felix Wirth, Erion Xhepa, Andreas Stein, Markus Krane","doi":"10.1055/a-2650-7092","DOIUrl":"https://doi.org/10.1055/a-2650-7092","url":null,"abstract":"<p><p>Transcatheter mitral valve implantation (TMVI) is an evolving technology, expanding therapeutic options for patients at higher operative risk. Data comparing TMVI to surgical mitral valve replacement (SMVR) are lacking.Clinical outcomes after TMVI with the Tendyne mitral valve and SMVR were compared utilizing propensity score matching, including seven variables. The current study reports 1-year clinical outcomes after TMVI and 1-year mortality in both cohorts.Forty TMVI patients were compared to 80 SMVR patients. Baseline characteristics included in the matching protocol were well balanced: Age (78 years [interquartile range, IQR 75; 80] vs. 78 years [IQR 73; 80], <i>p</i> = 0.797), female sex (60% vs. 60% [<i>p</i> = 1.0]), atrial fibrillation (68% vs. 64% [<i>p</i> = 0.839]), previous coronary artery bypass grafting (CABG) or surgical aortic valve replacement (25% vs. 25% [<i>p</i> = 1.0]), body mass index (kg/m²; 26 ± 4 vs. 25 ± 4 [<i>p</i> = 0.723]), mitral valve pathology (regurgitation 70% vs. 74%, stenosis 7.5% vs. 4%, and mixed disease 22.5% vs. 23% [<i>p</i> = 0.649]), and concomitant tricuspid regurgitation (35% vs. 30% [<i>p</i> = 0.678]). Thirty-day mortality was similar in both groups (TMVI, <i>n</i> = 1, 2.5%; SMVR, <i>n</i> = 3, 3.75%, <i>p</i> = 0.47). Kaplan-Meier estimated survival at 1 year was comparable after TMVI (80 ± 6% [95% CI 69-93%]) and SMVR (86 ± 4% [95% CI 79-94%], <i>p</i> = 0.18) with seven additional deaths beyond 30 days in the TMVI group and eight in the SMVR group. In the TMVI group, two were non-cardiovascular deaths for encephalitis and sepsis after hip replacement, and five were cardiovascular deaths. In the SMVR group, one patient died due to intestinal ischemia, and in seven patients, the cause of death is unknown. At 1 year, in all TMVI patients, echocardiography showed ≤mild paravalvular regurgitation. Within 1 year after TMVI, 21 patients (52.5%) required rehospitalization for heart failure symptoms.TMVI and SMVR in a propensity score-matched cohort displaying an intermediate surgical risk resulted in similar 1-year survival. TMVI achieved a sustained MR elimination at 1 year, and 80% of patients presented in the New York Heart Association (NYHA) class I or II.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668568","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":"Midterm Outcomes of Transcatheter Closure of Anastomotic Leak after Ascending Aortic Surgery.","authors":"Cheng-Wei Yang, Wei-Guo Ma, Hao Liu, Xin Li, Ming-Liang Peng, Lian-Jun Huang, Li-Zhong Sun","doi":"10.1055/a-2641-6468","DOIUrl":"10.1055/a-2641-6468","url":null,"abstract":"<p><p>This study aimed to evaluate the safety and durability of transcatheter closure of anastomotic leak (AL) after ascending aortic (AAo) surgery.From 2016 to 2021, we performed transcatheter closure for 22 patients aged 56.9 ± 12 years (19 male, 86.4%) who sustained anastomotic leak in the ascending aorta (AAoAL) after AAo surgery. Access and device were selected according to the presence of a patent Cabrol (perigraft-to-right atrium [RA]) shunt (<i>n</i> = 16, 72.7%) and leak size.Fifteen patients had tricuspid regurgitation (TR; 68.2%), 13 were symptomatic (59.1%), and 11 were in the New York Heart Association (NYHA) functional class III/IV (50%). Mean AAoAL diameter was 3.3 ± 1.5 mm. Mean procedural time was 141 ± 53 minutes. Procedural success rate was 86.4% (19/22, 14 with Cabrol shunt). AAoAL was directly closed or coiled in 12 patients. Follow-up was complete in 100% at a mean duration of 4.9 ± 1.1 years (range 3.6-8.1). All patients were alive, and two underwent reoperation. Freedom from death and reoperation was 94.7% at 2 years and 89.5% through 8 years. AAoAL was obliterated in 11, while a trace residual shunt was seen in 8 patients. The aorta at the leak shrank significantly in all (49.1-41.4 mm, <i>p</i> = 0.010). Patients with Cabrol shunt showed a significant shrinkage of the RA (46.9 ± 8.8 mm vs. 39.1 ± 8.2 mm, <i>p</i> = 0.030) and right ventricle (41.4 ± 4.7 mm vs. 30.4 ± 6.2 mm, <i>p</i> < 0.001), along with improved heart function (NHYA class III 4/12, IV 5/12 vs. class III 4/12, IV 0/12, <i>p</i> = 0.032) and alleviation of TR (moderate 6/14, severe 3/14 vs. moderate 2/14, severe 1/14, <i>p</i> = 0.081).Transcatheter closure may be a feasible, safe, and effective approach to anastomotic leak after ascending aortic surgery in selected patients, which can achieve favorable short- to midterm outcomes.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485851","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":"Single-Incision Thoracoscopic Surgery using Spinal Needle Anchoring.","authors":"Jongbae Son, Dae Hyun Kim, Sang-Ho Cho","doi":"10.1055/a-2652-7894","DOIUrl":"https://doi.org/10.1055/a-2652-7894","url":null,"abstract":"<p><p>Single-incision thoracoscopic surgery (SITS) for primary spontaneous pneumothorax (PSP) offers advantages over multi-port VATS, but lesion retraction remains challenging. We describe a modified SITS technique using spinal needle anchoring for precise lung stabilization. A bent spinal needle inserted through an intercostal space mimics a second-port grasper, enabling multiple re-hooking maneuvers for optimal lesion alignment. This technique allows for a smaller incision, minimizes instrument crowding, and reduces postoperative pain. The needle insertion site leaves no visible scar. Additionally, it is beneficial in cases with multiple bullae or challenging lung anatomy. Spinal needle anchoring may represent a simple and effective modification of the SITS technique.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620697","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":"Surgical Repair of Pectus Arcuatum.","authors":"Tunc Lacin, Nezih Onur Ermerak, Haktan Uygar Onen, Aleyna Gultekin Aridas","doi":"10.1055/a-2642-1738","DOIUrl":"10.1055/a-2642-1738","url":null,"abstract":"<p><p>Pectus arcuatum, a very rare variant (chondromanubrial) of the carinatum chest wall deformity, occurs due to premature fusion of the sternal ossification centers causing obliteration of the manubrio-sternal joint. Typically, patients undergo surgical repair for cosmetic purposes. This study reviews the clinical experience using titanium plate systems for surgical repair of pectus arcuatum.The records of our prospective Chest Wall Deformities Clinical Database since September 2018 include 27 pectus arcuatum patients. The patients aged 17 and older were evaluated for corrective surgery (<i>n</i> = 24, 16 male, 8 female, mean age: 24.9 years). The hybrid surgical technique included wedge osteotomy of the most protruded part of the sternum, excision of the associated costochondral junctions followed by placement of two parallel titanium plates to secure the sternum, and insertion of an excavatum bar (<i>n</i> = 7) if there is a significant depression at the sternal body. Follow-up outpatient visits were every 3 to 6 months.All of the patients tolerated the surgery very well. The mean length of the surgery was 118 minutes. The mean hospital length of stay was 5.6 days. One patient experienced pericardial and right pleural effusion 2 weeks after surgery, which was resolved by anti-inflammatory treatment. The mean time to return to daily activity was 12 days. The mean follow-up was 42 months. All patients indicated the postoperative results as very good or excellent.Repair of arcuatum deformity can be performed in adults with low morbidity, short hospital stay, and satisfactory cosmetic results even in complex cases.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508389","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":"The Geometry of Survival: Left Ventricular Mass Index's Prognostic Value in Coronary Surgery.","authors":"Barış Timur, Rezan Aksoy, Zihni Mert Duman, Recep Çalışkan, Kandemir Baş, Cem Aydoğdu, Cevdet Ugur Kocogullari","doi":"10.1055/a-2637-0964","DOIUrl":"https://doi.org/10.1055/a-2637-0964","url":null,"abstract":"<p><p>This study explores the impact of left ventricular mass and geometry on the prognosis of patients undergoing coronary artery bypass grafting. Left ventricular hypertrophy is a known risk factor for cardiovascular complications, yet its role in surgical outcomes remains underexplored.A retrospective cohort of 494 elective coronary artery bypass grafting patients treated between 2013 and 2018 was analyzed. Left ventricular mass was calculated using the Devereux formula, and patients were divided into normal and increased left ventricular mass index groups. Mortality rates, postoperative complications, and echocardiographic parameters were evaluated.Patients with increased left ventricular mass exhibited significantly higher 5-year mortality rates (27.2 vs. 11.5%, <i>p</i> < 0.001), postoperative atrial fibrillation (24.8 vs. 16.0%, <i>p</i> = 0.018), and carotid stenosis (21.8 vs. 12.5%, <i>p</i> = 0.006). Elevated preoperative biomarkers, including creatinine and C-reactive protein, were observed in this group, with sustained impairment in postoperative kidney function. However, no significant differences in 30-day, 1-year, or 3-year mortality rates were detected.Left ventricular mass and geometry independently predict long-term outcomes in coronary artery bypass grafting patients. Targeted strategies to mitigate left ventricular remodeling may enhance postoperative outcomes. Future research should focus on therapeutic interventions to reverse adverse left ventricular changes and optimize patient survival and quality of life.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544973","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":"Totally Thoracoscopic Ablation for Atrial Fibrillation: All-Box Clamping.","authors":"Nicolas Doll, Antonia Doll, Geza Horvath, Gerold Mönnig, Christian Pott, Thorsten Hanke, Taoufik Ouarrak, Jochen Senges, Mahmoud Wehbe","doi":"10.1055/a-2625-9617","DOIUrl":"10.1055/a-2625-9617","url":null,"abstract":"<p><p>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.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.All-box clamping was successfully offered to all patients by three surgeons. There 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 antiarrhythmic drugs.Surgical ablation with a modified thoracoscopic technique is safe and feasible for the treatment of atrial fibrillation.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","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}

{"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":"10.1055/a-2635-3239","url":null,"abstract":"<p><p>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.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, whereas the control group (309 patients) received only topical vancomycin. The primary outcome was SWI incidence.The incidence of SWI was significantly lower in the study group, with 2.8% (8/278) compared with 9% (28/309) in the control group (<i>p</i> = 0.002). After adjusting for known risk factors, the odds of infection in the control group were 4.64 times higher (95% confidence interval [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 (<i>p</i> = 0.09), with adjusted odds of DSWI being 4.1 times higher in the control group (95% CI: 0.99-16.86). Although the <i>p</i>-value was borderline (<i>p</i> = 0.05), no significant differences in mortality rates were observed between the two groups.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 postoperative infections.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-25","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}