Thoracic and Cardiovascular Surgeon最新文献

{"title":"Predicting the Risk of Postoperative Delirium in Patients Undergoing Lobectomy: Development and Assessment of a Novel Nomogram.","authors":"Yanan Xue, Ru Yu, Wei Wang, Lei Li, Jing Tao, Qin Zhuang, Xiaohong Li, Yang Zhang","doi":"10.1055/a-2561-8604","DOIUrl":"https://doi.org/10.1055/a-2561-8604","url":null,"abstract":"<p><p>To construct and internally validate a nomogram predicting postoperative delirium (POD) in patients with pulmonary malignancies undergoing lobectomy.Clinical electronic medical record data were retrospectively collected from 1,066 patients who underwent lobectomy, divided into a training cohort (746) and a validation cohort (320) using a 7:3 temporal split. A nomogram for POD was developed using Lasso regression and multivariable logistic regression analysis according to the TRIPOD statement. Performance was assessed through receiver operating characteristic curves (ROC) and calibration plots.POD occurred in 203 patients (19.04%). The nomogram incorporated predictors such as age, body mass index (BMI), education level, history of diabetes, history of cerebrovascular disease, surgical approach, duration of surgery, and time to recovery from anesthesia. The area under the ROC curve (AUC) was 0.871 (95% confidence interval [CI]: 0.841-0.901) for the training cohort and 0.914 (95% CI: 0.877-0.951) for the validation cohort. Calibration curves demonstrated good agreement between predicted and actual probabilities in both cohorts.This novel nomogram can help clinicians and patients' families predict the likelihood of developing delirium following lobectomy, enabling the implementation of targeted prevention strategies.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027570","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":"Do the Frequency of Aortic Dissection Surgery and 30-day Survival Depend on the Day of the Week, Climate Parameters, or Moon Phase?","authors":"Andreas Boening, Marc Brühl, Christopher Büsch, Niklas Luther, Elena Xoplaki, Rawa Arif, Thilo Noack, Jochen Pöling, Martin Czerny, Jens Brickwedel, Sven Peterss, Tomas Holubec, Philipp Jawny","doi":"10.1055/a-2547-5604","DOIUrl":"10.1055/a-2547-5604","url":null,"abstract":"<p><p>The German Registry of Aortic Dissections Type A (GERAADA) is a large European registry documenting patients with type A aortic dissection who have undergone surgical repair. This analysis investigated a potential association between the incidence of type A dissections (AADA) and lunar cycles, day of the week, or weather conditions.Data from 2,388 patients were analyzed for two endpoints: incidence of AADA surgery per day (analyzed using a Poisson regression to account for overdispersed data) and early mortality after surgery (analyzed using a logistic mixed regression to account for center heterogeneity). In both models, the influence of weather conditions (season, temperature, temperature difference, radiation, and synoptic conditions), moon phase, and weekday of operation was examined.The occurrence of AADA surgery was similar between weekdays (Monday to Friday), but less frequent on weekends. The 30-day mortality odds ratio was higher for surgeries performed on weekends than on weekdays. Operations were more frequent in winter than in other seasons. The occurrence of surgery or early mortality after surgery was not associated with synoptic weather conditions. Mean daily temperature and global radiation were not found to be different between survivors and patients with early deaths. No significant association was found between the moon phase and the occurrence or the outcome of surgery.The occurrence of AADA surgery was higher during winter, with colder mean temperatures, and lower on weekends than on weekdays. Mortality after surgery on weekends was higher than after surgery on weekdays.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531885","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":"Concomitant LAA Closure during Cardiac Surgery-Update 2025.","authors":"Sören Schenk, Simon Pecha, Nicolas Doll, Heiko Burger, Michael Knaut","doi":"10.1055/a-2561-8547","DOIUrl":"https://doi.org/10.1055/a-2561-8547","url":null,"abstract":"<p><p>Atrial fibrillation is associated with an increased risk of embolic strokes and is present in about one-fourth of all patients undergoing cardiac surgery. Closure of the left atrial appendage (LAA) can effectively reduce the risk of neurological events and is now a class IB recommendation in the most recent ESC/EACTS AF guidelines. The working group \"Heart Rhythm Disorders\" of the German Society for Thoracic and Cardiovascular Surgery (DGTHG) evaluates the current state of clinical research and recommends concomitant LAA closure in patients with preoperative atrial fibrillation as a routine part of heart surgeries.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039594","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":"Swan Song.","authors":"Markus K Heinemann","doi":"10.1055/a-2554-3049","DOIUrl":"https://doi.org/10.1055/a-2554-3049","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":"73 3","pages":"183-184"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765035","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":"Comparison of Pulmonary Outcome in Minimally Invasive (TCRAT) and Full Sternotomy CABG.","authors":"Christian Sellin, Ulrike Sand, Volodymyr Demianenko, Christoph Schmitt, Benedikt Schäfer, Robert Schier, Hilmar Doerge","doi":"10.1055/a-2378-8459","DOIUrl":"10.1055/a-2378-8459","url":null,"abstract":"<p><strong>Background: </strong> Pulmonary complications are among the main causes of increased mortality, and morbidity, as well as prolonged intensive care unit (ICU) and hospital stay after cardiac surgery. Recently, a sternum-sparing concept of minimally invasive total coronary revascularization via anterior minithoracotomy (TCRAT) was introduced. A higher risk of pulmonary injury could be anticipated due to the thoracic incision and the longer duration of surgery. Pulmonary complications in TCRAT were compared to standard coronary artery bypass grafting (CABG) via full median sternotomy (FS).</p><p><strong>Methods: </strong> Records of 151 consecutive TCRAT (from September 2021 to November 2022) and 229 consecutive FS patients (from January 2017 to December 2018) patients, who underwent elective or urgent CABG, were analyzed. Preoperative baseline characteristics (age, sex, body mass index, diabetes, hypertension, chronic obstructive pulmonary disease, smoking status, left ventricular ejection fraction, pulmonary hypertonus, and EuroScore II) were comparable between groups.</p><p><strong>Results: </strong> Differences between examined groups examined were found for the pulmonary parameters: Horowitz index 6 hours after operation (TCRAT 270 ± 72 vs. FS 293 ± 73, <i>p</i> < 0.05), pneumothorax (TCRAT 0% vs. FS 2.6%, <i>p</i> < 0.05), bronchoscopies (TCRAT 5.9% vs. FS 1.7%, <i>p</i> < 0.05), and pleural effusion (TCRAT 8.6% vs. FS 3.5%, <i>p</i> < 0.05). Moreover, there were differences between groups with regard to mean ICU stay (TCRAT 2.4 ± 3.0 days vs. FS 1.8 ± 1.8 days, <i>p</i> < 0.05), stroke (TCRAT 0% vs. FS 1.3%, <i>p</i> < 0.05), and hospital stay (TCRAT 10.9 ± 8.5 days vs. FS 13.2 ± 9.3 days, <i>p</i> < 0.05). There were no differences regarding atelectasis, reintubations, tracheostomies, ventilation time, and mortality.</p><p><strong>Conclusion: </strong> Pulmonary complications in terms of pleural effusions were more common with TCRAT, however, without substantial impact on clinical outcome.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"185-190"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879462","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":"Impella 5.5 Support for Delayed Surgical Ventricular Septal Defect Repair-A Paradigm Shift?","authors":"Kaveh Eghbalzadeh, Clara Großmann, Ihor Krasivskyi, Ilija Djordjevic, Elmar W Kuhn, Christian Origel Romero, Farhad Bakhtiary, Navid Mader, Antje Christin Deppe, Thorsten C W Wahlers","doi":"10.1055/s-0044-1788982","DOIUrl":"10.1055/s-0044-1788982","url":null,"abstract":"<p><strong>Background: </strong> Ventricular septal defects (VSDs) remain a rare but life-threatening complication of myocardial infarction. Although the incidence has decreased due to better treatment options, the mortality rate remains high. The timing of VSD repair remains critical to outcome. The use of mechanical circulatory support is rarely described in the literature, although it may help to delay repair to allow tissue stabilization. While Impella is currently considered contraindicated due to the potential worsening of the right-to-left shunt and possible systemic embolization of necrotic debris, there is no comprehensive evidence for this. Therefore, we aimed to analyze whether the use of Impella 5.5 as a first choice for patients undergoing VSD repair should be considered for discussion.</p><p><strong>Methods: </strong> This retrospective study analyses four consecutive patients who underwent delayed ventricular septal repair after prior implantation of Impella 5.5 (Abiomed Inc., Danvers, Massachusetts, United States).</p><p><strong>Results: </strong> A total of 75% of patients (<i>n</i> = 3) presented with acute right heart failure prior to implantation with a mean systolic pulmonary artery pressure of 64 ± 3.0 mmHg. Implantation was performed under local anesthesia in three cases. The mean time to surgery was 9.8 ± 3.1 days. All patients remained on the Impella 5.5 device postoperatively. Weaning from Impella 5.5 was successful in 75% (<i>n</i> = 3). The mean length of stay in the intensive care unit was 22.3 ± 7.5 days.</p><p><strong>Conclusion: </strong> Preoperative implantation of the Impella 5.5 device is a safe and feasible option for patients undergoing VSD repair. Outcomes may be improved by performing Impella implantation under local anesthesia and continuing Impella support after VSD repair. However, it is important to note that these patients represent a high-risk cohort and the mortality rate remains high.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"224-229"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971914","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":"Patient-Reported Long-Term Outcome of Balloon Pulmonary Angioplasty for Inoperable CTEPH.","authors":"Christoph B Wiedenroth, Kristin Steinhaus, Andreas Rolf, Andreas Breithecker, Miriam S D Adameit, Steffen D Kriechbaum, Moritz Haas, Fritz Roller, Christian W Hamm, H-Ardeschir Ghofrani, Eckhard Mayer, Stefan Guth, Christoph Liebetrau","doi":"10.1055/s-0043-1772770","DOIUrl":"10.1055/s-0043-1772770","url":null,"abstract":"<p><strong>Background: </strong> Balloon pulmonary angioplasty (BPA) is a promising interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Evidence in favor of BPA is growing, but long-term data remain scarce. The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is validated for the assessment of patients with pulmonary hypertension within three domains: symptoms, activity, and quality of life (QoL). The aim of the present study was to evaluate the long-term effects of BPA on these domains in patients with inoperable CTEPH.</p><p><strong>Methods: </strong> Between March 2014 and August 2019, technically inoperable patients with target lesions for BPA were included in this prospective, observational study. CAMPHOR scores were compared between baseline (before the first BPA) and 6 months after the last intervention and also for scores assessed at annual follow-ups.</p><p><strong>Results: </strong> A total of 152 patients had completed a full series of BPA interventions and a 28 (interquartile range [IQR]: 26-32) week follow-up. Further follow-up assessments including the CAMPHOR score were performed 96 (IQR: 70-117) weeks, 178 (IQR: 156-200) weeks, and 250 (IQR: 237-275) weeks after the last intervention. From baseline to the last follow-up, CAMPHOR scores for symptoms, activity, and QoL improved from 9 (IQR: 6-14) to 3 (IQR: 0-9) (<i>p</i> < 0.001), 8 (IQR: 5-12) to 4 (IQR: 2-8) (<i>p</i> < 0.001), and 5 (IQR: 2-9) to 1 (IQR: 0-5) (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> BPA leads to long-lasting, significant improvement of symptoms, physical capacity, and QoL in inoperable CTEPH patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"237-243"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10115214","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":"Female Surgeons in Cardiac Surgery: Does the Surgeon's Gender Affect the Outcome of Routine Coronary Artery Bypass Graft and Isolated Aortic Valve Surgery?","authors":"Viyan Sido, Filip Schröter, Jacqueline Rashvand, Roya Ostovar, Sofia Chopsonidou, Johannes M Albes","doi":"10.1055/s-0044-1786182","DOIUrl":"10.1055/s-0044-1786182","url":null,"abstract":"<p><strong>Background: </strong> The increasing presence of female doctors in the field of cardiac surgery has raised questions about their surgical quality compared to their male colleagues. Despite their success, female surgeons are still underrepresented in leadership positions, and biases and concerns regarding their performance persist. This study aims to examine whether female surgeons perform worse, equally well, or better than their male counterparts in commonly performed procedures that have a significant number of female patients.</p><p><strong>Method: </strong> A retrospective cohort of patients from 2011 to 2020 who underwent isolated coronary artery bypass graft (CABG) and aortic valve surgery was studied. To compare the surgical quality of men and women, a 1:1 propensity score matching (two groups of 680 patients operated by men and women, respectively, factors: age, logarithm of EuroSCORE (ES), elective, urgent or emergent surgery, isolated aortic valve, or isolated CABG) was performed. Procedure time, bypass time, x-clamp time, hospital stay, and early mortality were compared.</p><p><strong>Results: </strong> After propensity score matching between surgeons of both sexes, patients operated by males (PoM) did not differ from patients operated by females (PoF) in mean age (PoM: 66.72 ± 9.33, PoF: 67.24 ± 9.19 years, <i>p</i> = 0.346), log. ES (PoM: 5.58 ± 7.35, PoF: 5.53 ± 7.26, <i>p</i> = 0.507), or urgency of operation (PoM: 43.09% elective, 48.97% urgent, 7.94% emergency, PoF: 40.88% elective, 55.29% urgent, 3.83% emergency, <i>p</i> = 0.556). This was also the case for male and female patients separately. Female surgeons had higher procedure time (PoM: 224.35 ± 110.54 min; PoF: 265.41 ± 53.60 min), bypass time (PoM: 107.46 ± 45.09 min, PoF: 122.42 ± 36.18 min), and x-clamp time (PoM: 61.45 ± 24.77 min; PoF: 72.76 ± 24.43 min). Hospitalization time (PoM: 15.96 ± 8.12, PoF: 15.98 ± 6.91 days, <i>p</i> = 0,172) as well as early mortality (PoM: 2.21%, PoF: 3.09%, <i>p</i> = 0.328) did not differ significantly. This was also the case for male and female patients separately.</p><p><strong>Conclusion: </strong> Our study reveals that in routine heart surgery, the gender of the surgeon does not impact the success of the operation or the early outcome of patients. Despite taking more time to perform procedures, female surgeons demonstrated comparable surgical outcomes to their male counterparts. It is possible that women's inclination for thoroughness contributes to the longer duration of procedures, while male surgeons may prioritize efficiency. Nevertheless, this difference in duration did not translate into significant differences in primary outcomes following routine cardiac surgery. These findings highlight the importance of recognizing the equal competence of female surgeons and dispelling biases regarding their surgical performance.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"206-213"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903452","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":"Off-Pump Reduces Risk of Coronary Bypass Grafting in Patients with High MELD-XI Score.","authors":"Markus Richter, Alexandros Moschovas, Steffen Bargenda, Sebastian Freiburger, Murat Mukharyamov, Tulio Caldonazo, Hristo Kirov, Torsten Doenst","doi":"10.1055/s-0044-1786039","DOIUrl":"10.1055/s-0044-1786039","url":null,"abstract":"<p><strong>Background: </strong> This study aimed to assess the influence of the model of end-stage liver disease without International Normalized Ratio (INR) (MELD-XI) score on outcomes after elective coronary artery bypass surgery (CABG) without (Off-Pump) or with (On-Pump) cardiopulmonary bypass.</p><p><strong>Methods: </strong> We calculated MELD-XI (5.11 × ln serum bilirubin + 11.76 × ln serum creatinine in + 9.44) for 3,535 consecutive patients having undergone elective CABG between 2009 and 2020. A MELD-XI threshold was determined using the Youden Index based on receiver operating characteristics. Propensity score matching and logistic regression was performed to identify risk factors for inhospital mortality and Major Adverse Cardiac and Cerebrovascular Event (MACCE).</p><p><strong>Results: </strong> Patients were 68 ± 10 years old (76% male). Average MELD-XI was 10.9 ± 3.25. The MELD-XI threshold was 11. Patients below this threshold had somewhat lower EuroSCORE II than those above (3.5 ± 4 vs. 4.1 ± 4.7, <i>p</i> < 0.01), but mortality was almost four times higher above the threshold (below 1.5% vs. above 6.2%, <i>p</i> < 0.001). Two-thirds of patients received Off-Pump CABG. There was a trend towards higher risk in Off-Pump patients. Mortality was numerically but not statistically different to On-Pump below the MELD XI threshold (1.3 vs. 2.2%, <i>p</i> = 0.34) and was significantly lower above the threshold (4.9 vs. 8.9%, <i>p</i> < 0.02). Off-Pump above the threshold was also associated with less low-output syndrome and fewer strokes. Equalizing baseline differences by propensity matching verified the significant mortality difference above the threshold. Multivariable regression analysis revealed MELD-XI, On-Pump, atrial fibrillation, and the De Ritis quotient (Aspartate aminotransferase (ASAT)/Alanine Aminotransferase (ALAT)) as independent predictors of mortality.</p><p><strong>Conclusion: </strong> Elective CABG patients with elevated MELD-XI scores are at increased risk for perioperative mortality and morbidity. This risk can be significantly mitigated by performing CABG Off-Pump.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"191-198"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087795","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":"Does Timing of Coronary Artery Bypass Grafting after ST-Elevation Myocardial Infarction Impact Early- and Long-Term Outcomes?","authors":"Jagdip Kang, Mateo Marin-Cuartas, Luise Auerswald, Salil V Deo, Michael Borger, Piroze Davierwala, Alexander Verevkin","doi":"10.1055/s-0044-1787851","DOIUrl":"10.1055/s-0044-1787851","url":null,"abstract":"<p><strong>Background: </strong> The optimal timing of surgical revascularization after ST-elevation myocardial infarction (STEMI) is controversial, with some suggesting higher mortality rates in patients undergoing early surgery. The aim of the study is to determine the effect of the timing of surgical revascularization on 30-day mortality and long-term outcomes in these patients.</p><p><strong>Methods: </strong> Retrospective single-center analysis of patients with STEMI undergoing coronary artery bypass grafting (CABG) between January 2008 and December 2019 at our institution. The cohort was split into three groups based on time from symptom onset until surgical revascularization (Group 1: <12 hours, Group 2: 12-72 hours, Group 3: >72 hours). Statistical analyses were performed with and without patients in cardiogenic shock. Primary outcomes were 30-day mortality and 10-year survival.</p><p><strong>Results: </strong> During the study period, 437 consecutive patients underwent surgical revascularization in the setting of STEMI. The mean age was 67.0 years, 96 (22.0%) patients were female, and 281 (64.3%) patients underwent off-pump CABG. The overall 30-day mortality including patients with cardiogenic shock was 12.8%. The 30-day mortality was 16.1, 13.9, and 9.3% in Groups 1, 2, and 3 (<i>p</i> = 0.31), whereas 10-year survival was 48.5, 57.3, and 54.9% (log-rank: <i>p</i> = 0.40). After exclusion of patients in cardiogenic shock, there was no difference between the three groups in 30-day and 10-year mortality. Timing of surgery had no influence on early- and long-term survival.</p><p><strong>Conclusion: </strong> In patients with STEMI, early surgical revascularization achieved similar early- and long-term survival rates compared with a delayed surgical revascularization strategy. Hence, when indicated, an early CABG strategy has no disadvantages in comparison to a delayed strategy.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"214-223"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443329","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}