Thoracic and Cardiovascular Surgeon最新文献

{"title":"The Impact of High-Fidelity Simulator System on Bronchoscopy Operation Skills of Trainees Who Receive Refresher Training: A Teaching Study.","authors":"Guoping Jin, Xiaofen Tao, Hongzhen Xu","doi":"10.1055/s-0044-1787888","DOIUrl":"10.1055/s-0044-1787888","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to explore the impact of high-fidelity simulator (HFS) training on the bronchoscopy operation skills, confidence, stress, and learning satisfaction of trainees who further their training at endoscopy center in our hospital. The study also investigated the practical application effects of HFS training and provided a reference for the development of clinical teaching and training programs in hospitals.</p><p><strong>Methods: </strong> The 18 trainees who furthered their training at the endoscopy center were evaluated for their bronchoscopy operation skills, confidence, and stress levels before and after HFS training. A survey on learning satisfaction was conducted after the completion of HFS training. The scores of all evaluations were collected for comparison of differences before and after HFS training.</p><p><strong>Results: </strong> HFS training improved the clinical operation skill levels and confidence of trainees who further their training at the endoscopy center, reduced their stress, and achieved 100% satisfaction from this training. Education level and department had no significant impact on trainees' operational skills and confidence improvement, and stress reduction (<i>p</i> > 0.05). The results of this study supported the influence of the history of endoscopy operations on the improvement of trainees' improved operational skills after HFS training, but it had no relation to the improvement of confidence and stress reduction. Trainees with a history of endoscopy operations had higher operation skill scores before and after HFS training (<i>n</i> = 5, 94.80 ± 2.95 and 97.60 ± 1.82, respectively) than those without a history of endoscopy operations (<i>n</i> = 13, 80.62 ± 2.53 and 86.38 ± 2.82, respectively), and the difference was significant (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong> HFS training is an effective clinical teaching method that can significantly improve trainees' bronchoscopy operation skills and confidence, reduce stress, and achieve high levels of satisfaction.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"568-575"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470827","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":"Total Artificial Heart Implantation as a Bridge to Transplantation in Slovakia.","authors":"Michal Hulman, Panagiotis Artemiou, Stefan Durdik, Peter Lesny, Ingrid Olejarova, Eva Goncalvesova, Ivo Gasparovic","doi":"10.1055/s-0044-1791533","DOIUrl":"https://doi.org/10.1055/s-0044-1791533","url":null,"abstract":"<p><p>Although left ventricular assist device implantation represents the majority of durable mechanical circulatory support implants for patients with advanced heart failure, as many as 20 to 30% will subsequently have right heart failure requiring extended inotropic support or short-term mechanical circulatory support, and the total artificial heart is an established tool in the bridge to transplant armamentarium. The aim of this short report is to present our center's experience with the use of SynCardia total artificial heart. Between November 2017 and April 2021, 10 SynCardia total artificial heart devices were implanted. Of the 10 patients who underwent total artificial heart implantation, 6 (60%) were successfully bridged to transplant with a median time of 6.5 (interquartile range [IQR] 6-8) months, and 4 patients died on device support during the index hospitalization. The 30-day, 1-year, and 3-year survival rates after heart transplantation were the same at 66.7% (4/6). Despite the uncertain future of total artificial hearts, it remains a viable option for patients who require biventricular bridge to transplant or for a select subset of patients with advance heart failure who may not otherwise survive.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354375","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 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":"<p><strong>Background: </strong> More effective methods are urgently needed for predicting the pathological grade and lymph node metastasis of cT1-stage lung adenocarcinoma.</p><p><strong>Methods: </strong> 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.</p><p><strong>Results: </strong> 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%.</p><p><strong>Conclusion: </strong> 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.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic Evaluation of Cardiac Remodeling after FET.","authors":"Domenic Meissl, Maximilian Kreibich, Martin Czerny, Joseph Kletzer, Matthias Eschenhagen, Stoyan Kondov, Bartosz Rylski, Roman Gottardi, Tim Berger","doi":"10.1055/s-0044-1790590","DOIUrl":"https://doi.org/10.1055/s-0044-1790590","url":null,"abstract":"<p><strong>Background: </strong> This study aimed to investigate if frozen elephant trunk (FET) implantation leads to negative cardiac remodeling in dissection and non-dissection patients and to determine whether there are differences when FET is implanted as an aortic redo procedure or initially.</p><p><strong>Methods: </strong> Between March 2013 and April 2022, 148 patients received FET without any concomitant procedures and therefore formed our cohort. One hundred and four were treated for dissecting and 44 for non-dissecting pathologies. Eighty-four received FET initially and 64 as an aortic redo procedure. Data were collected retrospectively using our center's dedicated aortic database as well as transthoracic echocardiographic reports of our cardiologists.</p><p><strong>Results: </strong> In the first weeks after FET implantation, dissection and non-dissection patients show a significant increase of mild valvular insufficiencies-a significant decrease of ejection fraction is only seen in dissection patients but these changes do not stay significant during later follow-up. Patients who receive FET as an aortic redo procedure tend to have significantly larger left ventricular (LV) end-diastolic diameters and higher LV masses, however, in longitudinal analysis, there were no long-term negative effects in patients who received FET initially or as aortic redo.</p><p><strong>Conclusion: </strong> In the first 2 years after implantation, FET has no echocardiographically measurable effect regarding negative cardiac remodeling in dissection and non-dissection patients, independent of the fact it is implanted initially or as an aortic redo procedure.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296138","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":"Staging of Early-Stage Lung Cancer without Routine PET in Candidates for Segmentectomy.","authors":"Alberto Lopez-Pastorini, Zehra Tatli, Antonia von Bargen, Dennis Faltenberg, Hendrik Beling, Aris Koryllos, Thomas Galetin, Erich Stoelben","doi":"10.1055/a-2405-2603","DOIUrl":"10.1055/a-2405-2603","url":null,"abstract":"<p><strong>Introduction: </strong> We aimed to investigate the accuracy of clinical staging without the routine use of positron emission tomography/computed tomography (PET/CT) in patients with cIA1 and cIA2 non-small-cell lung cancer (NSCLC) scheduled for segmentectomy.</p><p><strong>Methods: </strong> A total of 305 consecutive segmentectomies were retrospectively analyzed. Overall survival was calculated using the Kaplan-Meier method. Logistic regression was performed to investigate factors independently associated with pathologic upstaging.</p><p><strong>Results: </strong> The Union for International Cancer Control (UICC) upstaging was found in 86 patients (28%). Upstaged patients had longer operative times (146 ± 46 vs. 131 ± 44 minutes, <i>p</i> = 0.009), a higher number of lymph node resection (17 ± 10 vs. 13 ± 8, <i>p</i> = 0.001), and a higher rate of L1 involvement (34 vs. 16%, <i>p</i> < 0.001) than nonupstaged patients. N1 was found in 10 patients (3%) and N2 in 13 patients (4%). Nodal positive patients had longer operation times (154 ± 50 vs. 133 ± 44 minutes, <i>p</i> = 0.031) and higher rates of R1 (9 vs. 1%, <i>p</i> = 0.006) and L1 (39 vs. 20%, <i>p</i> < 0.026) than patients without nodal involvement. The 3- and 5-year overall survival rates for nonupstaged and upstaged patients were 85 and 67% and 67 and 54%, respectively (<i>p</i> = 0.040). In logistic regression, L1 involvement (odds ratio [OR]: 2.394, <i>p</i> = 0.005) and the number of dissected lymph nodes (OR: 1.037, <i>p</i> = 0.016) were independently associated with upstaging. Patients who received PET as part of clinical staging did not have a significantly lower nodal upstaging.</p><p><strong>Conclusion: </strong> Selective use of PET/CT based on the results of CT may be a viable option for patients with proven or suspected NSCLC up to 2 cm in size.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112320","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":"Gender Differences in 381 Patients Undergoing Isolated Mitral Regurgitation Repair.","authors":"Yu-Hua Cheng, Wei-Guo Ma, Jian-Wen Zeng, Yun-Fei Han, Kai Sun, Wei-Qin Huang","doi":"10.1055/a-2382-8206","DOIUrl":"10.1055/a-2382-8206","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to compare the gender differences in isolated mitral regurgitation (MR) repair.</p><p><strong>Methods: </strong> Of 381 adults aged 54.8 ± 12.3 years undergoing mitral valve repair (MVP) for isolated MR from January 2019 to December 2022, the baseline and operative data, and outcomes were compared between 161 women (42.3%) and 220 men (57.7%).</p><p><strong>Results: </strong> Women tended to be nonsmokers (98.1 vs. 45%, <i>p <</i> 0.001), and have more cerebrovascular accidents (38.5% vs. 24.1%, <i>p</i> = 0.004) and isolated annular dilatation (19.3 vs. 9.1%, <i>p</i> = 0.010), lower creatinine (70.0 ± 19.5 vs. 86.3 ± 19.9 μmol/dL, <i>p <</i> 0.001), and smaller left ventricular end-diastolic diameter (LVEDD; 54.4 ± 6.7 vs. 57.8 ± 6.6 mm, <i>p <</i> 0.001). One female died of stroke at 2 days (0.3%). Another female (0.3%) underwent mitral valve replacement for failed repair. Stroke occurred in 4 (1.0%). Two underwent reexploration for bleeding (0.5%). Women were more likely to have less 24-hour drainage (290 ± 143 vs. 385 ± 196 mL, <i>p <</i> 0.001). Over a mean follow-up of 2.1 ± 1.1 years (100% complete), 1 woman died and 1 man underwent a reoperation; 28 had moderate MR, and 9 had severe MR. Neither did early and late mortality and reoperation, nor freedom from late moderate or severe MR (71.6 vs. 71.4% at 5 years; <i>p</i> = 0.992) differ significantly between the two genders. Predictors for late moderate or severe MR were anterior leaflet prolapse (hazard ratio [HR] 4.45; 95% confidence interval [CI] 1.18-16.72; <i>p</i> = 0.027) and isolated annular dilation (HR 5.47, 95% CI 1.29-23.25; <i>p</i> = 0.021).</p><p><strong>Conclusion: </strong> In this series of patients undergoing isolated MR repair, despite significant differences in smoking, cerebrovascular accidents, creatinine, LVEDD, and isolated annular dilatation at baseline, and 24-hour drainage postoperatively, women and men did not show significant differences in early and late survival, reoperation, and freedom from late moderate or severe MR.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907773","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":"Follow-Up and Outcome after Coronary Bypass Surgery Preceded by Coronary Stent Implantation.","authors":"Marwan Hamiko, Nicole Konrad, Doreen Lagemann, Christopher Gestrich, Franz Masseli, Mehmet Oezkur, Markus Velten, Hendrik Treede, Georg Daniel Duerr","doi":"10.1055/a-2107-0481","DOIUrl":"10.1055/a-2107-0481","url":null,"abstract":"<p><strong>Background: </strong> Guidelines on myocardial revascularization define recommendations for percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery. Only little information exists on long-term follow-up and quality of life (QoL) after CABG preceded by PCI. The aim of our study was to evaluate the impact of prior PCI on outcome and QoL in patients with stable coronary artery disease who underwent CABG.</p><p><strong>Methods: </strong> In our retrospective study, CABG patients were divided in: CABG preceded by PCI: PCI-first (PCF), and CABG-only (CO) groups. The PCF group was further divided in guideline-conform (GCO) and guideline nonconform (GNC) subgroups, according to the SYNTAX score (2014 European Society of Cardiology [ESC]/European Association for Cardio-Thoracic Surgery [EACTS] guidelines). Thirty days mortality, major adverse cardiac events, and QoL using the European Quality-of-Life-5 Dimensions were evaluated.</p><p><strong>Results: </strong> A total of 997 patients were analyzed, of which 784 underwent CABG without (CO), and 213 individuals with prior PCI (PCF). The latter group consisted of 67 patients being treated in accordance (GCO), and 24 in discordance (GNC) to the 2014 ESC/EACTS guidelines. Reinfarction (PCF: 3.8% vs. CO: 1.0%; <i>p</i> = 0.024), re-angiography (PCF: 17.6% vs. CO: 9.0%; <i>p</i> = 0.004), and re-PCI (PCF: 10.4% vs. CO: 3.0%; <i>p</i> < 0.001) were observed more frequently in PCF patients. Also, patients reported better health status in the CO compared to PCF group (CO: 72.48 ± 19.31 vs. PCF: 68.20 ± 17.86; <i>p</i> = 0.01). Patients from the guideline nonconform subgroup reported poorer health status compared to the guideline-conform group (GNC: 64.23 ± 14.56 vs. GCO: 73.42 ± 17.66; <i>p</i> = 0.041) and were more likely to require re-PCI (GNC: 18.8% vs. GCO: 2.4%; <i>p</i> = 0.03). Also, GNC patients were more likely to have left main stenosis (GCO: 19.7% vs. GNC: 37.5%; <i>p</i> < 0.001) and showed higher preinterventional SYNTAX score (GCO: 18.63 ± 9.81 vs. GNC: 26.67 ± 5.07; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> PCI preceding CABG is associated with poorer outcomes such as reinfarction, re-angiography, and re-PCI, but also worse health status and higher rehospitalization. Nevertheless, results were better when PCI was guideline-conformant. This data should impact the Heart Team decision.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"423-434"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10259310","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":"Reply to Letter to the Editor.","authors":"Yoshiyuki Takami","doi":"10.1055/s-0044-1782601","DOIUrl":"10.1055/s-0044-1782601","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"457"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860479","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":"Reply by the Authors of the Original Article.","authors":"Yifei Wang","doi":"10.1055/s-0044-1779343","DOIUrl":"10.1055/s-0044-1779343","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"485"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724096","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":"Boilerplates.","authors":"Markus K Heinemann","doi":"10.1055/s-0044-1788800","DOIUrl":"10.1055/s-0044-1788800","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":"72 6","pages":"403"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146392","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}