Thoracic and Cardiovascular Surgeon最新文献

{"title":"Decellularized Pulmonary Xenograft Matrix PplusN versus Cryopreserved Homograft for RVOT Reconstruction during Ross Procedure in Adults.","authors":"Kiril Penov, Matz Andreas Haugen, Dejan Radakovic, Khaled Hamouda, Armin Gorski, Rainer Leyh, Constanze Bening","doi":"10.1055/s-0041-1740539","DOIUrl":"10.1055/s-0041-1740539","url":null,"abstract":"<p><strong>Background: </strong> Decellularized pulmonary homografts are being increasingly adopted for right ventricular outflow tract reconstruction in adult patients undergoing the Ross procedure. Few reports presented Matrix PplusN xenograft (Matrix) in a negative light. The objective of this study was to compare our midterm outcomes of Matrix xenograft versus standard cryopreserved pulmonary homograft (CPHG).</p><p><strong>Methods: </strong> Eighteen patients received Matrix xenograft between January 2012 and June 2016, whereas 66 patients received CPHG. Using nonparametric statistical tests and survival analysis, we compared midterm echocardiographic and clinical outcomes between the groups.</p><p><strong>Results: </strong> Except for significant age difference (the Matrix group was significantly older with 57 ± 8 years than the CPHG group, 48 ± 9 years, <i>p</i> = 0.02), the groups were similar in all other baseline characteristics. There were no significant differences in cardiopulmonary bypass times (208.3 ± 32.1 vs. 202.8 ± 34.8) or in cross-clamp times (174 ± 33.9 vs. 184.4 ± 31.1) for Matrix and CPHG, respectively. The Matrix group had significantly inferior freedom from reintervention than the CPHG group with 77.8 versus 98.5% (<i>p</i> = 0.02). Freedom from pulmonary valve regurgitation ≥ 2 was not significantly different between the groups with 82.4 versus 90.5% for Matrix versus CPHG, respectively. After median follow-up of 4.9 years, Matrix xenograft developed significantly higher peak pressure gradients compared with CPHG (20.4 ± 15.5 vs. 12.2 ± 9.0 mm Hg; <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong> After 5 years of clinical and echocardiographic follow-up, the decellularized Matrix xenograft had inferior freedom from reintervention compared with the standard CPHG. Closer follow-up is necessary to avoid progression of valve failure into right ventricular deterioration.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39776355","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":"Ten-Year Long-Term Analysis of Mechanical and Biological Aortic Valve Replacement.","authors":"Kaveh Eghbalzadeh, Elmar W Kuhn, Stephen Gerfer, Ilija Djordjevic, Parwis Rahmanian, Navid Mader, Thorsten C W Wahlers","doi":"10.1055/s-0042-1744477","DOIUrl":"10.1055/s-0042-1744477","url":null,"abstract":"<p><strong>Background: </strong> For patients undergoing aortic valve replacement (AVR), structural valve deterioration (SVD) of a bioprosthesis (BP) is substantially accelerated in younger patients and valve-in-valve implantation is not always a considerable option. The risk-benefit assessment between SVD versus the risk of bleeding and thromboembolic events in patients with a mechanical prosthesis (MP) resulted in an age limit shift irrespective of inconsistent results reported in literature.</p><p><strong>Method: </strong> This retrospective single-center study compared 10-year long-term outcomes in patients undergoing isolated AVR with MP or BP. The risk-adjusted comparison of patients undergoing isolated AVR (<i>n</i> = 121) was performed after 1:1 propensity score matching (PSM) for age, sex, endocarditis, and chronic renal impairment (caliper of 0.2) leading to 29 pairs. Short- and long-term outcomes with respect to reoperation, major bleeding, stroke, all-cause and cardiovascular mortality, and overall survival at 10 years were analyzed.</p><p><strong>Results: </strong> After PSM, groups were comparable with respect to preoperative characteristics, including patients with a mean age of 65 ± 3 years (MP) and 66 ± 4 years (BP) and an incidence rate of 6.9% for infective endocarditis in both cohorts. Short-term outcomes (transient neurologic disorder = 0.0 vs. 6.9%; stroke = 0.0%; in-hospital mortality = 3.4%) and in-hospital stays were comparable between MP and BP.</p><p><strong>Conclusion: </strong> After isolated AVR with MP and BP, 10-year long-term outcomes were comparable in the reported single-center cohort. MP can still be implanted safely without a disadvantage as regards long-term survival.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47293055","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 Incidence and Effect of Different Organ Metastasis on the Prognosis of NSCLC.","authors":"Shenhai Wei, Wenchao Wei, Bingqun Wu, Jintao Tian, Pengcheng Hu, Shouqiang Pan, Xiaoping Song","doi":"10.1055/a-2146-6879","DOIUrl":"10.1055/a-2146-6879","url":null,"abstract":"<p><strong>Objective: </strong> The aim of this study was to explore the effect of different organ metastasis on the prognosis of non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong> Patients with distant metastatic NSCLC were selected from Surveillance, Epidemiology, and End Results database during 2016 to 2019. The incidence of different organ metastasis and their association with clinicopathological factors were explored. Overall survival (OS) and lung cancer-specific survival (LCSS) for metastatic NSCLC were calculated, and multivariate Cox regression analysis was performed with a nomogram for OS being constructed based on Cox regression.</p><p><strong>Results: </strong> Total 26,210 patients with distant metastatic NSCLC were included in this study. Around 48.9% of the metastatic NSCLC were multiple-organ metastasis and bone was the most commonly involved organ (44.4%). For patients with single-organ metastasis, the prognosis for lung or distant lymph nodes (LNs) metastasis was better than others (with median OS of 15 and 16 months for lung and distant LNs metastasis, respectively), and liver metastasis resulted in the worst prognosis with median OS of 8 months. A nomogram was constructed to visualize Cox regression model, along with the receiver operating characteristic (ROC) curve demonstrated good discrimination for the predictive model with 1- and 2-year area under the curve of ROC of 0.687 and 0.702, respectively.</p><p><strong>Conclusion: </strong> The prognosis of NSCLC patients with distant metastasis was poor. Liver metastasis results in the worst prognosis among the single-organ metastasis. The nomogram developed based on the Cox regression model has provided a useful tool to estimate the probability of OS of the metastatic NSCLC.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10575677","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":"Pneumonectomy with Carinal Sleeve Resection in Patients with Non-Small-Cell Lung Cancer.","authors":"Dominik Herrmann, Urim Starova, Melanie Oggiano, Luiza Alexandra Luta, Shadi Hamouri, Santiago Ewig, Erich Hecker, Robert Scheubel","doi":"10.1055/a-2199-2164","DOIUrl":"10.1055/a-2199-2164","url":null,"abstract":"<p><strong>Background: </strong> Carinal sleeve resection with pneumonectomy is one of the rarest procedures in thoracic surgery, but for locally advanced central lung cancer with infiltration of the carina, it is an option to achieve complete resection. Additionally, it might be the method of choice for patients with stump insufficiency after pneumonectomy or in the cases with anastomosis dehiscence after sleeve lobectomy. The aim of this study was to evaluate the morbidity and long-term survival of patients with non-small-cell lung cancer (NSCLC) who underwent sleeve pneumonectomy, either for curative intent or as an option to treat postoperative complications.</p><p><strong>Methods: </strong> All consecutive patients with NSCLC who underwent carinal sleeve pneumonectomy for the aforementioned indications in our department between December 2021 and September 2003 were included in this study. An analysis of demographic characteristics, perioperative variables, and long-term survival was carried out. Data were evaluated retrospectively.</p><p><strong>Results: </strong> Fifty patients underwent pneumonectomy with carina sleeve resection. Thirty-one cases for curative treatment of NSCLC (primary sleeve pneumonectomy [pSP]) and 19 patients were treated because of postpneumonectomy bronchial stump insufficiency or bronchial anastomosis dehiscence (secondary sleeve pneumonectomy [sSP]). Complications occurred in 30 patients (60%) and the 90-day mortality was 18% (<i>n</i> = 9). Patients with pSP had an estimated overall survival of 39.6 months, compared to estimated overall survival for patients after sSP of 24.5 months (<i>p</i> = 0.01). The N status did not appear to affect outcomes.</p><p><strong>Conclusion: </strong> Carinal sleeve resection with pneumonectomy is a feasible procedure with limited morbidity and mortality. This procedure is a reasonable therapeutic option for patients with locally advanced central NSCLC after mandatory patient selection.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231056","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":"Hostile Hemodynamics in Distal Stent Graft-Induced New Entry Prior to Aortic Rupture: A Comparison of Transient versus Steady-State CFD Simulations.","authors":"Anja Osswald, Konstantinos Tsagakis, Ender Demircioglu, Alexander Weymann, Alina Zubarevich, Arjang Ruhparwar, Christof Karmonik","doi":"10.1055/s-0043-1771357","DOIUrl":"10.1055/s-0043-1771357","url":null,"abstract":"<p><strong>Background: </strong> Computational fluid dynamics (CFD) simulations model blood flow in aortic pathologies. The aim of our study was to understand the local hemodynamic environment at the site of rupture in distal stent graft-induced new entry (dSINE) after frozen elephant trunk with a clinically time efficient steady-flow simulation versus transient simulations.</p><p><strong>Methods: </strong> Steady-state simulations were performed for dSINE, prior and after its development and prior to aortic rupture. To account for potential turbulences due geometric changes at the dSINE location, Reynolds-averaged Navier-Stokes equations with the realizable <i>k</i>-ε model for turbulences were applied. Transient simulations were performed for comparison. Hemodynamic parameters were assessed at various locations of the aorta.</p><p><strong>Results: </strong> Post-dSINE, jet-like flow due to luminal narrowing was observed which increased prior to rupture and resulted in focal neighbored regions of high and low wall shear stress (WSS). Prior to rupture, aortic diameter at the rupture site increased lowering WSS at the entire aortic circumference. Concurrently, WSS and turbulence increased locally above the entry tear at the inner aortic curvature. Turbulent kinetic energy and WSS elevation in the downstream aorta demonstrated enhanced stress on the native aorta. Results of steady-state simulations were in good qualitative agreement with transient simulations.</p><p><strong>Conclusion: </strong> Steady-flow CFD simulations feasible at clinical time scales prior to aortic rupture reveal a hostile hemodynamic environment at the dSINE rupture site in agreement with lengthy transient simulations. Consequently, our developed approach may be of value in treatment planning where a fast assessment of the local hemodynamic environment is essential.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246331","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 Two-Tube Method for Treating Thoracogastric Airway Fistula.","authors":"Chenchen Zhang, Xiaobing Li, Zhanfeng He, Shuai Wang, Meipan Yin, Yaozhen Ma, Gang Wu","doi":"10.1055/a-2122-7149","DOIUrl":"10.1055/a-2122-7149","url":null,"abstract":"<p><strong>Background: </strong> Thoracogastric airway fistula (TGAF) is a fatal complication after esophagectomy. Without active treatment, patients may die of intractable pneumonia, sepsis, massive hemoptysis, or respiratory failure. We determined the clinical value of the two-tube method that involves the precise interventional placement of the nasojejunal tube (NJT) and nasogastric tube (NGT) for TGAF.</p><p><strong>Methods: </strong> Clinical data of patients with TGAF who had undergone fluoroscopic interventional placement of NJT and NGT were analyzed retrospectively. The paired <i>t</i>-test was used to compare the index values before and after treatment. Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong> In total, 212 patients (177 male and 35 female; mean age, 61.3 ± 7.9 years [47-73]) with TGAF who had undergone the two-tube method were included. Posttreatment chest spiral computed tomography and inflammatory indicators showed significantly improved pulmonary inflammation compared with that before treatment. The patients' general condition remained stable. Of 212 patients, 12 (5.7%) underwent surgical repair, 108 (50.9%) received placement of airway stents, and 92 (43.4%) cases only continued treatment with the two-tube method owing to patients' conditions. In total, 47.8% (44/92) patients died of secondary pulmonary infection, bleeding, and primary tumor progression, whereas 52.2% (48/92) patients survived with both tubes.</p><p><strong>Conclusion: </strong> The two-tube method, which involves the precise interventional placement of the NJT and NGT, is simple, safe, and effective for treating TGAF. This method is a bridge for successive treatments or a treatment itself for patients who are unsuitable for surgical repair or stent placement.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9931626","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":"Computed Tomography Scan of the Aorta to Predict Type B Aortic Dissection.","authors":"Han Lee, Qing Zhou, Haitao Zhang, Min Jin, XinLong Tang, Kai Li, Tayierjiang Tuoerxun","doi":"10.1055/s-0043-57026","DOIUrl":"10.1055/s-0043-57026","url":null,"abstract":"<p><strong>Background: </strong> The purpose of this study is to find the high-risk morphological features in type B aortic dissection (TBAD) population and to establish an early detection model.</p><p><strong>Methods: </strong> From June 2018 to February 2022, 234 patients came to our hospital because of chest pain. After examination and definite diagnosis, we excluded people with previous cardiovascular surgery history, connective tissue disease, aortic arch variation, valve malformation, and traumatic dissection. Finally, we included 49 patients in the TBAD group and 57 in the control group. The imaging data were retrospectively analyzed by Endosize (Therevna 3.1.40) software. The aortic morphological parameters mainly include diameter, length, direct distance, and tortuosity index. Multivariable logistic regression models were performed and systolic blood pressure (SBP), aortic diameter at the left common carotid artery (D3), and length of ascending aorta (L1) were chosen to build a model. The predictive capacity of the models was evaluated through the receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong> The diameters in the ascending aorta and aortic arch are larger in the TBAD group (33.9 ± 5.9 vs. 37.8 ± 4.9 mm, <i>p</i> < 0.001; 28.2 ± 3.9 vs. 31.7 ± 3.0 mm, <i>p</i> < 0.001). The ascending aorta was significantly longer in the TBAD group (80.3 ± 11.7 vs. 92.3 ± 10.6 mm, <i>p</i> < 0.001). Besides, the direct distance and tortuosity index of the ascending aorta in the TBAD group increased significantly (69.8 ± 9.0 vs. 78.7 ± 8.8 mm, <i>p</i> < 0.001; 1.15 ± 0.05 vs. 1.17 ± 0.06, <i>p</i> < 0.05). Multivariable models demonstrated that SBP, aortic diameter at the left common carotid artery (D3), and length of ascending aorta (L1) were independent predictors of TBAD occurrence. Based on the ROC analysis, area under the ROC curve of the risk prediction models was 0.831.</p><p><strong>Conclusion: </strong> Morphological characteristic including diameter of total aorta, length of ascending aorta, direct distance of ascending aorta, and tortuosity index of ascending aorta are valuable geometric risk factors. Our model shows a good performance in predicting the incidence of TBAD.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404565","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":"Design Appropriate Incision Length for Uniportal Video-Assisted Thoracoscopic Lobectomy: Take into Account Safety and Minimal Invasiveness.","authors":"Chen-Ye Shao, Can-Hui Liu, Qian-He Ren, Xiao-Long Liu, Guo-Hua Dong, Sheng Yao","doi":"10.1055/s-0042-1758825","DOIUrl":"10.1055/s-0042-1758825","url":null,"abstract":"<p><strong>Background: </strong> There is no criterion on the length of the uniportal video-assisted thoracoscopic surgery (UVATS) incision when performing lobectomy. We aimed to develop a nomogram to assist surgeons in designing incision length for different individuals.</p><p><strong>Methods: </strong> A cohort consisting of 290 patients were enrolled for nomogram development. Univariate and multivariate logistic regression analyses were performed to identify candidate variables among perioperative characteristics. <i>C</i>-index and calibration curves were utilized for evaluating the performance of the nomogram. Short-term outcomes of nomogram-predicted high-risk patients were compared between long incision group and conventional incision group.</p><p><strong>Results: </strong> Of 290 patients, 150 cases (51.7%) were performed incision extension during the surgery. Age, tumor size, and tumor location were identified as candidate variables related with intraoperative incision extension and were incorporated into the nomogram. <i>C</i>-index of the nomogram was 0.75 (95% confidence interval: 0.6961-0.8064), indicating the good predictive performance. Calibration curves presented good consistency between the nomogram prediction and actual observation. Of high-risk patients identified by the nomogram, the long incision group (<i>n</i> = 47) presented shorter duration of operation (<i>p</i> = 0.03), lower incidence of total complications (<i>p</i> = 0.01), and lower incidence of prolonged air leak (<i>p</i> = 0.03) compared with the conventional incision group (<i>n</i> = 55).</p><p><strong>Conclusion: </strong> We developed a novel nomogram for predicting the risk of intraoperative incision extension when performing uniportal video-assisted thoracoscopic lobectomy. This model has the potential to assist clinicians in designing the incision length preoperatively to ensure both safety and minimal invasiveness.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40503343","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":"Anterolateral Thoracotomy: A Novel and Simple Technique to Improve the Closure Using the Self Locking Knot.","authors":"Luis Felipe Cabrera Vargas, Mauricio Pedraza, Fabien Mantilla-Sylvain, Isabella Garavis Montagut","doi":"10.1055/a-2075-8048","DOIUrl":"10.1055/a-2075-8048","url":null,"abstract":"<p><p>Thoracotomy is defined as an incision made by the surgeon in the chest wall in order to allow visibility of the thoracic cavity content. This can be used by surgeons to treat thoracic cavity content diseases including the heart, lungs, esophagus, and other organs. Thoracic incision closure remains an item with no consensus. Therefore, we present an easy way and give a little tip for closure using the slipknot that will allow the correct approach of ribs and the successful closure of the intercostal space.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9905955","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":"Minimally Invasive versus Conventional Aortic Root Surgery: Results of an Intermediate-Volume Center.","authors":"Mahmoud Elghannam, Dritan Useini, Vadim Moustafine, Matthias Bechtel, Hamid Naraghi, Justus T Strauch, Peter Lukas Haldenwang","doi":"10.1055/a-2041-3695","DOIUrl":"10.1055/a-2041-3695","url":null,"abstract":"<p><strong>Background: </strong> We evaluate the outcome of aortic root surgery via an upper J: -shaped mini-sternotomy (MS) versus full sternotomy (FS) in an intermediate-volume center.</p><p><strong>Methods: </strong> Between November 2011 and February 2019, 94 consecutive patients underwent aortic root surgery: 62 (66%) patients were operated via a J: -shaped MS (group A) and 32 (34%) patients via FS (group B). The primary endpoints were mortality, major adverse cardiac and cerebral events (MACCE), and reoperation in a 2-year follow-up. The secondary endpoints were perioperative complications and patient's satisfaction with the procedural results.</p><p><strong>Results: </strong> Valve sparing root replacement (David procedure) was performed in 13 (21%) of the MS and 7 (22%) of the FS patients. The Bentall procedure in MS versus FS was 49 (79%) versus 25 (78%), respectively. Both groups presented similar mean operation, cardiopulmonary bypass, and cross-clamp times. Postoperative bleeding was 534 ± 300 and 755 ± 402 mL (<i>p</i> = 0.01) in MS and FS, respectively, erythrocyte concentrate substitution was 3 ± 3 and 5.3 ± 4.8 (<i>p</i> = 0.018) in MS and FS, respectively, and pneumonia rates were 0 and 9.4% (<i>p</i> = 0.03) in MS and FS, respectively. The 30-day mortality was 0% in both groups, whereas MACCE was 1.6 and 3% (<i>p</i> = 0.45) in MS and FS, respectively. After 2 years, the mortality and MACCE were 4.6 and 9.5% (<i>p</i> = 0.11) and 4.6 and 0% (<i>p</i> = 0.66) in MS and FS, respectively. The number of patients who were satisfied with the surgical cosmetic results in groups A and B was 53 (85.4%) and 26 (81%), respectively.</p><p><strong>Conclusion: </strong> Aortic root surgery via MS is a safe alternative to FS even in an intermediate-volume center. It offers a shorter recovery time and similar midterm results.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652653","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}