Thoracic and Cardiovascular Surgeon最新文献

{"title":"Cardiac Surgery 2024 Reviewed.","authors":"Hristo Kirov, Tulio Caldonazo, Murat Mukharyamov, Sultonbek Toshmatov, Philine Fleckenstein, Timur Kyashif, Thierry Siemeni, Torsten Doenst","doi":"10.1055/a-2548-4098","DOIUrl":"https://doi.org/10.1055/a-2548-4098","url":null,"abstract":"<p><p>For the 11th consecutive time, we systematically reviewed the cardio-surgical literature for the past year (2024), using the PRISMA approach for a results-oriented summary. In 2024, the discussion on the value of randomized and registry evidence increased, triggered by consistent findings in the field of coronary artery disease (CAD) and discrepant results in structural heart disease. The literature in 2024 again confirmed the excellent long-term outcomes of CABG compared with PCI in different scenarios, generating further validation for the CABG advantage reported in randomized studies. This has been reflected in the new guidelines for chronic CAD in 2024. Two studies indicate novel perspectives for CABG, showing that cardiac shockwave therapy in CABG improves myocardial function in ischemic hearts and that CABG guided by computed tomography is safe and feasible. For aortic stenosis, an early advantage for transcatheter (TAVI) compared with surgical (SAVR) treatment has found more support; however, long-term TAVI results keep being challenged, this year by new FDA and registry data in favor of SAVR. For failed aortic valves, redo-SAVR showed superior results compared with valve-in-valve TAVI. In the mitral field, studies showed short-term noninferiority for transcatheter treatment compared with surgery for secondary mitral regurgitation (MR), and significant long-term survival benefit in registries with surgery for primary MR. Finally, surgery was associated with better survival compared with medical therapy for acute type A aortic intramural hematoma. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation but provides up-to-date information for patient-specific decision-making.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731186","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":"Metal Hypersensitivity after Nuss Procedure: What and When to do?","authors":"Serdar Evman, Mustafa Akyıl, Serkan Bayram, Volkan Baysungur","doi":"10.1055/a-2552-5825","DOIUrl":"10.1055/a-2552-5825","url":null,"abstract":"<p><p>Metal hypersensitivity after Nuss procedure is a known complication, but there is no accepted treatment guideline available. Patients undergoing Nuss procedure between 2013 and 2023 were examined retrospectively. Patients with known allergy, positive blood, and/or culture tests, and redo cases were excluded. Nine of 307 (2.9%) patients developed postoperative allergy. No significant difference was found between single or double bar patients. All were treated with medical protocol. No premature bar removal was necessitated. Medical treatment was successful in postoperative metal allergy after Nuss procedure. Ruling out other causes like surgical technical problems or infections is necessary for correct diagnosis and accurate treatment.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587098","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":"Predictors for Length of Stay after Surgical Aortic Valve Replacement.","authors":"Till Joscha Demal, Nico Arndt, Oliver D Bhadra, Sebastian Ludwig, David Grundmann, Lisa Voigtlaender-Buschmann, Lara Waldschmidt, Laura Hannen, Stefan Blankenberg, Paulus Kirchhof, Lenard Conradi, Hermann Reichenspurner, Niklas Schofer, Andreas Schaefer","doi":"10.1055/a-2466-7245","DOIUrl":"10.1055/a-2466-7245","url":null,"abstract":"<p><strong>Objectives: </strong> Aortic valve replacement improves and prolongs lives of patients with aortic valve disease, but requires significant healthcare resources, which are mainly determined by the length of associated hospital stays. Therefore, this study aims to identify risk factors for extended length of stay after surgical aortic valve replacement.</p><p><strong>Methods: </strong> Between 2018 and 2023, 458 consecutive patients underwent isolated surgical aortic valve replacement at our center and were included in our analysis. To identify independent predictors for hospital and intensive care unit stay, multivariable linear regression analysis using backward elimination process was performed.</p><p><strong>Results: </strong> Upon multivariable linear regression, endocarditis (regression coefficient [β] 2.98; 95% confidence interval [CI] 1.51, 4.45; <i>p</i> < 0.001]) and prior aortic valve surgery (β 1.72; 95% CI 0.18, 3.26; <i>p</i> = 0.029) were associated with prolonged hospital stay. Prior aortic valve surgery was associated with prolonged intensive care unit stay (β 0.99; 95% CI 0.39, 1.59; <i>p</i> = 0.001) as well as chronic obstructive pulmonary disease (COPD) (β 1.61; 95% CI 0.66, 2.55; <i>p</i> = 0.001), smaller prosthetic valve sizes (β -0.18; 95% CI -0.30, -0.06; <i>p</i> = 0.003), preoperative atrial fibrillation (β 1.06; 95% CI 0.32, 1.79; <i>p</i> = 0.005), and reduced left ventricular ejection fraction (β -0.03; 95% CI -0.05, -0.01; <i>p</i> = 0.006).</p><p><strong>Conclusion: </strong> Pending further validation, structured programs aiming to accelerate intensive care unit and hospital discharge after surgical aortic valve replacement should focus on patients with prior cardiac surgery, atrial fibrillation, and COPD. Surgeons should aim to implant large-diameter valves. Furthermore, the identified predictors should be used to discuss surgical versus transcatheter procedures in the interdisciplinary heart team.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628600","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":"Time-Varying Association of the Second Internal Thoracic Artery with Long-Term Survival after Coronary Artery Bypass Grafting.","authors":"Ibrahim Gadelkarim, Mateo Marin-Cuartas, Sergey Leontyev, Manuela De La Cuesta, Salil V Deo, Martin Misfeld, Piroze Davierwala, Michael Borger, Alexander Verevkin","doi":"10.1055/a-2524-9264","DOIUrl":"10.1055/a-2524-9264","url":null,"abstract":"<p><p>The survival advantages of bilateral internal thoracic artery (BITA) grafts in coronary artery bypass grafting (CABG) surgery remain unclear. Therefore, this study aims to systematically evaluate the time-dependent influence of BITA on long-term survival in elective CABG patients presenting with stable multivessel coronary artery disease.Data from 3,693 patients undergoing isolated CABG with single internal thoracic artery (SITA) or BITA, with or without additional vein grafts, between 2002 and 2012 were retrospectively analyzed. The entire cohort was divided into BITA and SITA groups (830 vs. 2,863 patients). A 1:3 propensity score matching was performed. Subsequent analysis of a subgroup meeting Randomized comparison of the clinical Outcome of single versus Multiple Arterial grafts (ROMA) trial criteria (<i>n</i> = 1,339) followed a 1:1 matching. Differences in restricted mean survival time (RMST) estimates were used to assess the time-varying association of BITA with long-term survival.In-hospital mortality (SITA 1.8% vs. BITA 1.1%, <i>p</i> = 0.2) and major postoperative complications were similar between the matched groups. However, long-term survival was significantly higher in BITA patients for the matched whole cohort (15-year survival: 64 vs. 51%, respectively; <i>p</i> < 0.001) and the ROMA-like population (76 vs. 60%, respectively; <i>p</i> < 0.001). RMST demonstrated an incremental survival advantage of BITA over SITA grafting over time for both the whole and ROMA-like populations (0.1, 0.5, and 1.1 years, and 0.1, 0.4, and 1.0 years at 5-, 10-, and 15-year follow-up, respectively)BITA grafting is safe and associated with superior long-term survival compared with SITA and vein grafts, with benefits extending beyond 5 years for the entire cohort and beyond 10 years for ROMA criteria patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053670","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":"Management of the Expected Difficult Airway with Planned One-Lung Ventilation: A Retrospective Analysis of 44 Cases.","authors":"Andrea Irouschek, Joachim Schmidt, Andreas Ackermann, Andreas Moritz, Denis I Trufa, Horia Sirbu, Tobias Golditz","doi":"10.1055/s-0044-1791982","DOIUrl":"10.1055/s-0044-1791982","url":null,"abstract":"<p><strong>Background: </strong> Difficult airway management is essential in anesthesia practice. Particular challenges are posed to patients who require intraoperative one-lung ventilation. Specific guidelines for these scenarios have been lacking. The recent update of German guidelines incorporates recommendations for securing the airway in anticipated difficult airway scenarios in patients requiring one-lung ventilation. However, scientific data on this specific topic is rare.</p><p><strong>Methods: </strong> A retrospective analysis was conducted on adult patients undergoing thoracic surgery with one-lung ventilation from 2016 to 2021. During these years, the standard of practice has been in line with the now published guidelines. Patients with anticipated difficult airways were identified, and airway management strategies were analyzed.</p><p><strong>Results: </strong> Among 3,197 anesthetic procedures, 44 cases involved anticipated difficult airways, primarily due to prior head and neck tumor treatment. Nasal bronchoscopic awake intubation followed by oral reintubation under videolaryngoscopic inspection and the use of bronchial blockers was the standard procedure. No severe complications were recorded, and one-lung ventilation was maintained successfully in all cases.</p><p><strong>Discussion: </strong> The study highlights the challenges of managing difficult airways during thoracic surgery. Recommendations align with recent guidelines, emphasizing the importance of tailored approaches. The use of single-lumen tubes with bronchial blockers appears favorable over double-lumen tubes, offering comparable ventilation quality with reduced risks.</p><p><strong>Conclusion: </strong> Despite limitations, the study underscores the safety and efficacy of tailored airway management strategies during one-lung ventilation in patients with anticipated difficult airways. The presented approach offers patient safety and practicability. Further multicenter studies are warranted to validate these findings and refine clinical approaches.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"156-164"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628599","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":"Reviewers for The Thoracic and Cardiovascular Surgeon.","authors":"Markus K Heinemann","doi":"10.1055/a-2536-1027","DOIUrl":"https://doi.org/10.1055/a-2536-1027","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":"73 2","pages":"92-93"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573758","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":"Results after Tricuspid Valve Surgery for Preserved and Dysfunctional Right Ventricle.","authors":"Jae Woong Choi, Ji Seong Kim, Yoonjin Kang, Suk Ho Sohn, Kyung Hwan Kim, Eun-Ah Park, Ho Young Hwang","doi":"10.1055/a-2060-5067","DOIUrl":"10.1055/a-2060-5067","url":null,"abstract":"<p><strong>Background: </strong> This study aimed to compare long-term outcomes after tricuspid valve (TV) repair (TVr) with those after TV replacement (TVR) by adjusting the right ventricular (RV) volume and function.</p><p><strong>Methods: </strong> We enrolled 147 patients who underwent TVr (<i>n</i> = 78) and TVR (<i>n</i> = 69) for grade 3 or 4 tricuspid regurgitation and had preoperative cardiac magnetic resonance data. Long-term clinical outcomes were compared between the two groups using inverse probability treatment weighting (IPTW) to adjust for differences in preoperative characteristics between the two groups. Subgroup analyses were performed in patients with preserved and dysfunctional RV (ejection fraction < 50%).</p><p><strong>Results: </strong> There were no significant differences in operative mortality or postoperative complications between the two groups before and after the IPTW adjustment. Five- and 10-year overall survival rates were 84.2 and 67.1%, respectively. Five- and 10-year cumulative incidences of TV-related events (TVREs) were 33.1 and 55.6%, respectively. There were no significant differences in overall survival and cumulative incidence of TVREs after IPTW adjustment (<i>p</i> = 0.236 and <i>p</i> = 0.989, respectively). The risk-adjusted overall survival was marginally higher in the TVr group of patients with preserved RV function (<i>p</i> = 0.054), while no such significant difference was found between the two groups of patients with dysfunctional RV (<i>p</i> = 0.513).</p><p><strong>Conclusion: </strong> Adjusted long-term clinical outcomes after TVr and TVR were comparable. TVr might be beneficial for patients with preserved RV function in terms of long-term survival; however, this benefit might disappear in patients with RV dysfunction.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"104-110"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9519764","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":"A Predictive Model Integrating AI Recognition Technology and Biomarkers for Lung Nodule Assessment.","authors":"Tao Zhou, Ping Zhu, Kaijian Xia, Benying Zhao","doi":"10.1055/a-2446-9832","DOIUrl":"10.1055/a-2446-9832","url":null,"abstract":"<p><strong>Background: </strong> Lung cancer is the most prevalent and lethal cancer globally, necessitating accurate differentiation between benign and malignant pulmonary nodules to guide treatment decisions. This study aims to develop a predictive model that integrates artificial intelligence (AI) analysis with biomarkers to enhance early detection and stratification of lung nodule malignancy.</p><p><strong>Methods: </strong> The study retrospectively analyzed the patients with pathologically confirmed pulmonary nodules. AI technology was employed to assess CT features, such as nodule size, solidity, and malignancy probability. Additionally, lung cancer blood biomarkers were measured. Statistical analysis involved univariate analysis to identify significant differences among factors, followed by multivariate logistic regression to establish independent risk factors. The model performance was validated using receiver operating characteristic curves and decision curve analysis (DCA) for internal validation. Furthermore, an external dataset comprising 51 cases of lung nodules was utilized for independent validation to assess robustness and generalizability.</p><p><strong>Results: </strong> A total of 176 patients were included, divided into benign/preinvasive (<i>n</i> = 76) and invasive cancer groups (<i>n</i> = 100). Multivariate analysis identified eight independent predictors of malignancy: lobulation sign, bronchial inflation sign, AI-predicted malignancy probability, nodule nature, diameter, solidity proportion, vascular endothelial growth factor, and lung cancer autoantibodies. The combined predictive model demonstrated high accuracy (area under the curve [AUC] = 0.946). DCA showed that the combined model significantly outperformed the traditional model, and also proved superior to models using AI-predicted malignancy probability or the seven lung cancer autoantibodies plus traditional model. External validation confirmed its robustness (AUC = 0.856), achieving a sensitivity of 0.80 and specificity of 0.86, effectively distinguishing between invasive and noninvasive nodules.</p><p><strong>Conclusion: </strong> This combined approach of AI-based CT features analysis with lung cancer biomarkers provides a more accurate and clinically useful tool for guiding treatment decisions in pulmonary nodule patients. Further studies with larger cohorts are warranted to validate these findings across diverse patient populations.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"174-181"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732705","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":"Baseline CT-Based Risk Factors for Atrioventricular Block after Surgical AVR.","authors":"Marie Claes, Francesco Pollari, Hazem Mamdooh, Theodor Fischlein","doi":"10.1055/a-2052-8848","DOIUrl":"10.1055/a-2052-8848","url":null,"abstract":"<p><strong>Background: </strong> We aimed to evaluate the impact of membranous interventricular septum (MIS) length and calcifications of the native aortic valve (AV), via preoperative multidetector computed tomography (MDCT) scan, on postoperative atrioventricular block III (AVB/AVB III) and permanent pacemaker implantation in surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong> We retrospectively analyzed preoperative contrast-enhanced MDCT scans and procedural outcomes of patients affected by AV stenosis who underwent SAVR at our center (June 2016-December 2019). The study population was divided into two groups (AVB and non-AVB), and variables were compared with a Mann-Whitney's <i>U</i>-test or chi-square test. Data were further analyzed using point biserial correlation and logistic regression.</p><p><strong>Results: </strong> A total of 155 (38% female) patients (mean age of 71.2 ± 6 years) were enrolled in our study: conventional stented bioprosthesis (<i>N</i> = 99) and sutureless prosthesis (<i>N</i> = 56) were implanted. A postoperative AVB III was observed in 11 patients (7.1%). AVB patients had significant greater calcifications in left coronary cusp (LCC) -AV (non-AVB = 181.0 mm³ [82.7-316.9] vs. AVB = 424.8 mm³ [115.9-563.2], <i>p</i> = 0.044), LCC left ventricular outflow tract (LVOT) (non-AVB = 2.1 mm³ [0-20.1] vs. AVB = 26.0 mm³ [0.1-138.0], <i>p</i> = 0.048), right coronary cusp (RCC) -LVOT (non-AVB = 0 mm³ [0-3.5] vs. AVB = 2.8 mm³ [0-29.0], <i>p</i> = 0.039), and consequently in total LVOT (non-AVB = 2.1 mm³ [0-20.1] vs. AVB = 26.0 mm³ [0.1-138.0], <i>p</i> = 0.02), while their MIS was significantly shorter than in non-AVB patients (non-AVB = 11.3 mm [9.9-13.4] vs. AVB = 9.44 mm [6.98-10.5]; <i>p</i>=0.014)). Partially, these group differences correlated positively (LCC -AV, <i>r</i> = 0.201, <i>p</i> = 0.012; RCC -LVOT, <i>r</i> = 0.283, <i>p</i> ≤ 0.001) or negatively (MIS length, <i>r</i> = -0.202, <i>p</i> = 0.008) with new-onset AVB III.</p><p><strong>Conclusion: </strong> We recommend including an MDCT in preoperative diagnostic testing for all patients undergoing surgical AVR for further risk stratification.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"117-125"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9519753","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":"A Controlled Trial Comparing One-Year Hemodynamics of Two Bovine Pericardial Valves.","authors":"Suk Ho Sohn, Yoonjin Kang, Ji Seong Kim, Jae Woong Choi, Jae Hang Lee, Jun Sung Kim, Cheong Lim, Ho Young Hwang","doi":"10.1055/a-2199-2087","DOIUrl":"10.1055/a-2199-2087","url":null,"abstract":"<p><strong>Background: </strong> This randomized controlled trial was designed to compare 1-year hemodynamic performances and clinical outcomes after aortic valve replacement (AVR) using a recently introduced (the AVALUS group) and worldwide used (the CEPME group) bovine pericardial bioprostheses.</p><p><strong>Methods: </strong> Patients were screened to enroll 70 patients in each group based on a noninferiority design. The primary endpoint of the trial was the mean pressure gradient across the aortic valve (AVMPG) at 1 year after surgery. One-year echocardiographic data were obtained from 92.1% (129 of 140 patients) of the study patients.</p><p><strong>Results: </strong> There were no differences in baseline characteristics, including sex and body surface area (1.64 ± 0.18 vs. 1.65 ± 0.15 m²) between the groups. The AVMPG on 1-year echocardiography was 14.0 ± 4.3 and 13.9 ± 5.1 mmHg in the AVALUS and CEPME groups, respectively (the <i>p-value for noninferiority</i> was 0.0004). In the subgroup analyses for the respective size of the prostheses, AVMPG of the 19-mm prostheses was significantly lower in the AVALUS group than in the CEPME group (14.0 ± 4.3 vs. 20.0 ± 4.7 mmHg, <i>p</i> = 0.012), whereas those of the other sizes were not significantly different between the two groups. There were no significant differences in the effective orifice area (1.49 ± 0.40 vs. 1.53 ± 0.38 cm², <i>p</i> = 0.500) or effective orifice area index (0.91 ± 0.22 vs 0.93 ± 0.23 cm²/m², <i>p</i> = 0.570) in all the patients, or in the subgroup analysis for the 19-mm prosthesis. There were no differences in the 1-year clinical outcomes between the two groups.</p><p><strong>Conclusion: </strong> The 1-year hemodynamic and clinical outcomes of the AVALUS group were noninferior to those of the CEPME group (NCT03796442).</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"132-140"},"PeriodicalIF":1.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231054","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}