Thoracic and Cardiovascular Surgeon最新文献

{"title":"Applicability of Guideline-Based Aortic Intervention Thresholds in the Indian Population.","authors":"Nimrat Grewal, Mohammed Idhrees, Jedidiah Samraj, Bashi Velayudhan","doi":"10.1055/a-2921-6578","DOIUrl":"10.1055/a-2921-6578","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines for thoracic aortopathy rely on absolute diameter thresholds to guide surveillance and prophylactic intervention. These thresholds, derived largely from Western cohorts, are applied globally, including in populations with smaller baseline vascular dimensions.</p><p><strong>Methods: </strong>We performed a counterfactual, denominator-based analysis comparing the distribution of ascending aortic diameter and its body surface area (BSA)-indexed equivalent in a South Asian general population (<i>n</i> = 2,000) with diameters at presentation in a cohort of acute Stanford type A aortic dissection (ATAAD) patients (<i>n</i> = 71), with Bayesian 95% credible intervals around exposure ratios.</p><p><strong>Results: </strong>The general population showed a narrow distribution (median 30.2 mm; 95th percentile 37.6 mm; mean indexed diameter 18.5 ± 3.1 mm/m²), with under 1% reaching the 45 mm guideline threshold. Dissections occurred across a broad diameter range (median 52 mm; indexed median 28.0 mm/m², interquartile range [IQR] 22.1-34.0 mm/m²) and were disproportionately concentrated in the extreme right tail of both distributions.</p><p><strong>Conclusion: </strong>Guideline-based absolute diameter thresholds correspond to an extremely small fraction of this South Asian population, yet dissections remain concentrated in the extreme right tail, a pattern preserved and amplified after BSA indexing. These findings support population-aware interpretation of aortic size thresholds.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631569","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":"Investigating the Impact of Disease Recurrence: Comparative Analysis of Surgical Outcomes for Recurrent versus Single Episode Infective Endocarditis.","authors":"Ahmed Elderia, Ole Rasem, Patricia Soehne, Zakaria Msallati, Alina Chigri, Stephen Gerfer, Maximilian Luehr, Lenard Conradi, Carolyn Weber","doi":"10.1055/a-2903-8628","DOIUrl":"https://doi.org/10.1055/a-2903-8628","url":null,"abstract":"<p><strong>Objective: </strong>Infective endocarditis (IE) is a serious disease with a significant morbidity burden. Recurrence occurs in 8 to 10% of cases. Data on risk factors and outcomes in patients with recurrent IE are limited.</p><p><strong>Methods: </strong>This is a single-center observational analysis of consecutive patients, who underwent surgery for IE from 2009 to 2022. Patients with recurrent episodes of IE were identified and compared with patients after single episode IE regarding baseline characteristics and perioperative outcome. Risk factors for recurrence were identified by regression analysis.</p><p><strong>Results: </strong>The total cohort comprised 665 patients. Of these, 10.2% (68/665) had recurrent IE. The median time to recurrence was 1.0 (1.55-3.49) years. Patients with recurrent IE were significantly younger with 58.1 ± 15.8 versus 62.6 ± 14.6 years (<i>p</i> < 0.017), but had a similar overall risk profile with EuroSCORE II 8.8 ± 3.9% versus 8.3 ± 3.7 (<i>p</i> = 0.271) compared with counterparts in the single episode group. Prosthetic valve IE (PVE) was more frequently noticed in the recurrence group at 45.6% (31/68) versus 20.5% (122/595; <i>p</i> < 0.001). Abscess formation with fistulas was documented more frequently in the recurrence group at 5.9% versus 1.8% (<i>p</i> = 0.034). Mortality rates at 30 days was lower in the recurrence group at 2.9% versus 14.7% (<i>p</i> = 0.007), while 1-year mortality was similar at 33.3% versus 32.9% (<i>p</i> = 0.948). Kaplan-Meier (KM) estimates revealed similar long-term survival in both groups (log rank <i>p</i> = 0.726). Previous valve implantation (due to a non-infectious reason) and history of IE (previously treated conservatively or surgically) were identified as independent predictors of recurrence with odds of 1.410 (1.030-1.931; <i>p</i> = 0.023) and 1.822 (1.164-2.628; <i>p</i> < 0.001), respectively.</p><p><strong>Conclusion: </strong>Recurrence of IE is associated with previous valve implantation and paravalvular complications like fistulas. Surgical treatment of such high-risk patients is feasible with good short-term survival and similar long-term outcomes compared with single episode IE patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580223","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":"Risk Factors for Early Postoperative Cognitive Dysfunction in Aortic Arch Replacement.","authors":"Sangyu Zhou, Xuyang Chen, Bowen Zhang, Luchen Wang, Cuntao Yu, Shujuan Li, Xiaogang Sun","doi":"10.1055/a-2798-0277","DOIUrl":"https://doi.org/10.1055/a-2798-0277","url":null,"abstract":"<p><strong>Background: </strong>Postoperative cognitive dysfunction (POCD) is a common complication following aortic arch replacement. This study aimed to identify risk factors for early POCD in patients undergoing aortic arch replacement and determine the effect of POCD on long-term survival.</p><p><strong>Methods: </strong>In this prospective cohort study, 103 patients who underwent aortic arch replacement for complex aortic arch diseases were enrolled. Cognitive function was assessed preoperatively and on postoperative days 5 to 7 using the Montreal Cognitive Assessment. POCD was defined as a ≥20% decline in total score compared with baseline.</p><p><strong>Results: </strong>The incidence of POCD was 15.5%. Compared with the non-POCD group, patients with POCD were significantly older (62 ± 13 vs. 52 ± 13, <i>p</i> = 0.008), had a higher proportion of females (68.8 vs. 37.9%, <i>p</i> = 0.044), and experienced greater intraoperative blood loss (751 ± 165 vs. 667 ± 122 mL; <i>p</i> = 0.018). Postoperative adverse events were similar between the two groups. Significant declines were observed in the domains of visuospatial/executive function (<i>p</i> = 0.003), attention/concentration/working memory (<i>p</i> < 0.001), and orientation (<i>p</i> = 0.002). Multivariable logistic regression analysis identified age, female sex, and antegrade cerebral perfusion (ACP) time as independent risk factors for POCD. Midterm survival was similar between POCD and non-POCD groups (1-year survival: 100 vs. 95.2%; <i>p</i> = 0.437).</p><p><strong>Conclusion: </strong>POCD remains a common complication after aortic arch replacement. Advanced age, female sex, and prolonged ACP time are independent predictors of POCD. POCD was not associated with worse midterm survival. These findings may help preoperative risk stratification and optimization of intraoperative management.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449803","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":"Effect of Kinesio Taping on Pain at Thoracic Tube Sites After CABG: A Randomized Study.","authors":"Uzeyir Yilmaz, Güler Gülsen Ersoy, Nurcan Ayabakan Eski, Kudret Atakan Tekin, Özgür Bektas, Elif Tozlu Yılmaz","doi":"10.1055/a-2908-3226","DOIUrl":"10.1055/a-2908-3226","url":null,"abstract":"<p><strong>Background: </strong>Pain from chest tubes significantly contributes to postoperative discomfort and opioid use after coronary artery bypass grafting (CABG). Nonpharmacological interventions at drain sites may aid recovery and reduce opioid exposure.</p><p><strong>Methods: </strong>This randomized controlled study involved 100 adult patients undergoing elective CABG, randomized 1:1 to receive kinesio taping (<i>n</i> = 50) or serve as controls (<i>n</i> = 50). Kinesio tape was applied around mediastinal and thoracic drain sites before extubation, avoiding the incision. Both groups received standard analgesia with paracetamol and tramadol as rescue analgesia. Pain was measured using a visual analog scale (VAS) immediately after extubation and at 24 and 72 hours postoperatively. Opioid requirements, ICU stay, hospital stay, and complications were documented.</p><p><strong>Results: </strong>VAS scores at extubation were similar (4.00 ± 1.25 vs. 3.86 ± 0.90; <i>p</i> = 0.678). Kinesio taping patients had significantly lower VAS scores at 24 hours (3.76 ± 1.36 vs. 5.52 ± 1.20; <i>p</i> < 0.001) and 72 hours (2.60 ± 0.82 vs. 4.18 ± 0.83; <i>p</i> < 0.001). Fewer patients in the kinesio taping group required opioid rescue (24% vs. 62%; <i>p</i> < 0.001). The ICU stay was shorter with kinesio taping (2.90 ± 0.58 vs. 3.42 ± 0.86 days; <i>p</i> = 0.001), while hospital stay and infection rates were similar.</p><p><strong>Conclusion: </strong>Kinesio taping around drain sites post-CABG reduces pain, opioid needs, and ICU stay. This safe approach may enhance early postoperative pain management after cardiac surgery.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397849","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":"Pulmonary Endarterectomy in Pediatric Patients: Institutional Experience.","authors":"Çagatay Çetinkaya, Nezih Onur Ermerak, Ela Erdem Eralp, Figen Akalın, Koray Ak, Eylem Tuncer, Altug Sagir, Bedrettin Yıldızeli","doi":"10.1055/a-2875-1852","DOIUrl":"10.1055/a-2875-1852","url":null,"abstract":"<p><strong>Background: </strong>Chronic thromboembolic pulmonary hypertension (CTEPH) is rare in children, and published experience with pulmonary endarterectomy (PEA) is limited.</p><p><strong>Methods: </strong>We retrospectively reviewed six patients (<18 years) who underwent seven PEA procedures at our center between December 2011 and September 2025. Clinical characteristics, perioperative findings, hemodynamic outcomes, and follow-up data were analyzed.</p><p><strong>Results: </strong>Median age was 13 years (range, 2-17), and five patients were female. Five had a history of pulmonary embolism, while one presented with a hydatid cyst. Risk factors for CTEPH were hydrocephalus with ventriculoperitoneal shunt (<i>n</i> = 2), hydatid cyst disease (<i>n</i> = 1), infective endocarditis with left ventricular outflow tract obstruction (<i>n</i> = 1), and chronic kidney disease with prior COVID-19 infection (<i>n</i> = 1). Preoperative mean systolic pulmonary artery pressure (PAP) was 56 ± 23 mm Hg, mean pulmonary artery pressure (mPAP) was 39 ± 15 mm Hg, and mean pulmonary vascular resistance index (PVRi) was 7.51 ± 4.56 U·m². Most patients were in World Health Organization functional class III or IV. All patients underwent PEA, with concomitant procedures required in most cases. Postoperatively, mPAP decreased to 21 ± 4 mm Hg and mean PVRi to 2.36 ± 1.36 U·m². Median intensive care unit and hospital stays were 3.5 and 9 days, respectively. There was one in-hospital mortality; all other patients recovered without major complications.</p><p><strong>Conclusion: </strong>PEA is feasible and effective in carefully selected pediatric patients, including those with complex comorbidities. Significant hemodynamic and functional improvements were achieved, supporting the role of PEA as a potentially curative therapy in this rare and challenging group.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273028","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":"Long-Term Outcomes after Redo Coronary Artery Bypass Grafting: A Propensity-Matched Analysis of On-Pump and Off-Pump Techniques.","authors":"Carl Thaddäus Braun, Lena Steins, Malee Julie Scherer, Dragan Opacic, George El-Hachem, Sebastian V Rojas, Mohammad Sharaf, Jan Fritz Gummert, Darko Radakovic, Marcus-André Deutsch","doi":"10.1055/a-2900-0233","DOIUrl":"10.1055/a-2900-0233","url":null,"abstract":"<p><strong>Background: </strong>Redo coronary artery bypass grafting (redo-CABG) is technically challenging and carries a higher perioperative risk than primary CABG. Whether avoiding cardiopulmonary bypass is beneficial in this setting remains unclear. We compared perioperative and long-term outcomes of off-pump versus on-pump redo-CABG in a high-volume center.</p><p><strong>Methods: </strong>All patients undergoing redo-CABG between 2009 and 2024 were retrospectively analyzed. Perioperative, in-hospital, and long-term outcomes were evaluated. Propensity score matching was performed using preoperative covariates. Survival analyses included a subgroup of beating-heart on-pump cases. Completeness of revascularization was likewise assessed.</p><p><strong>Results: </strong>Among 370 patients (175 off-pump group; 195 on-pump group), 184 were propensity score-matched. Off-pump surgery had shorter operative time (183 vs. 208 min; <i>p</i> = 0.015) and reduced red blood cell transfusion requirements (3 vs. 5 units; <i>p</i> = 0.014). Myocardial injury biomarkers were reduced with off-pump surgery (CK-MB: 45 vs. 68 ng/mL, <i>p</i> = 0.01; high-sensitivity troponin: 3,388 vs. 7,744 ng/L, <i>p</i> = 0.001). In-hospital mortality was comparable (off-pump group 2.2 vs. 1.1% in the on-pump group; <i>p</i> = 0.621; relative risk: 1.34). Rates of stroke, myocardial infarction, cardiopulmonary resuscitation, and hemofiltration did not differ. Five-year repeat revascularization rates were similar (off-pump group: 18.5 vs. 19.6% in the on-pump group; <i>p</i> = 0.854). Long-term survival did not differ between strategies. In multivariable analysis, surgical strategy (off-pump, on-pump, beating-heart) was not an independent predictor of survival.</p><p><strong>Conclusion: </strong>Off-pump redo-CABG is safe and yields outcomes similar to on-pump surgery. Pump strategy should be individualized based on patient's anatomy and surgical expertise.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303298","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":"Comment: Topical Use of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis.","authors":"Said Umair Shah, Haris Akbar, Syed Hatim Hussain, Syed Muhammad Momin","doi":"10.1055/a-2900-0490","DOIUrl":"https://doi.org/10.1055/a-2900-0490","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Risk Calculator for Surgical Repair of Primary Mitral Regurgitation.","authors":"Serdar Akansel, Martina Dini, Simon H Sündermann, Stephan Jacobs, Volkmar Falk, Jörg Kempfert, Markus Kofler","doi":"10.1055/a-2650-6994","DOIUrl":"10.1055/a-2650-6994","url":null,"abstract":"<p><strong>Objective: </strong>Risk estimation for cardiac procedures is essential for clinical decision-making. The aim of the study is to validate the recently introduced Society of Thoracic Surgeons (STS) risk score model for mitral valve repair (MVr) in degenerative mitral regurgitation (DMR) by investigating a large cohort undergoing minimally invasive MVr (MI-MVr).</p><p><strong>Methods: </strong>A total of 1,081 consecutive patients with DMR undergoing non-emergent MI-MVr were retrospectively analyzed. The primary study endpoint was 30-day all-cause mortality (OM), while secondary endpoints were major morbidity and mortality (MM) and conversion-to-replacement (CONV). Predictive discrimination and calibration of the models were measured using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>A 30-day mortality of 0.55% was observed in the study cohort. All risk scores were significantly higher in non-survivors. Like existing risk models, the intention-to-treat-OM (ITT-OM) model was predictive for OM (OR: 2.078, 95% CI: 1.324-3.621; <i>p</i> = 0.001), but its discriminatory ability was limited based on ROC analysis. EuroSCORE II showed the best discriminatory performance for mortality among the investigated models. Furthermore, second cross-clamping and CONV were independent predictors of OM (OR: 26.2, 95% CI: 4.3-160.0; <i>p</i> < 0.001 and OR: 12.8, 95% CI: 1.8-89.2; <i>p</i> = 0.010). The ITT-MM and ITT-CONV models demonstrated an acceptable discriminatory ability for predicting operative MM and CONV.</p><p><strong>Conclusion: </strong>The ITT-based risk model was validated in our study cohort undergoing MI-MVr for DMR, showing only limited discriminatory performance for mortality, while the EuroSCORE II demonstrated better discrimination for mortality despite systematic overestimation. This is the first report validating the recently introduced model. However, further studies with larger cohorts are needed to overcome the limitations of the present study.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"324-331"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Unilateral Cerebral Perfusion Under Mild Hypothermia.","authors":"Nikolozi Vashakmadze, Otto Dapunt, Mamuka Bokuchava, Nodar Pkhakadze, Nana Ghlonti, Tengiz Purtskhvanidze, Valeri Kuzmenko","doi":"10.1055/a-2686-4606","DOIUrl":"10.1055/a-2686-4606","url":null,"abstract":"<p><strong>Background: </strong>DeBakey type I aortic dissection requires circulatory arrest during arch reconstruction, putting the brain at risk. In resource-limited centers, deep hypothermia can exacerbate coagulopathy and lead to increased bleeding. This study compares outcomes between mild and moderate hypothermia under unilateral cerebral perfusion (UCP).</p><p><strong>Methods: </strong>Retrospective analysis of 60 patients who underwent modified Bentall procedures with hemiarch replacement under UCP between 2014 and 2024. Patients were divided into two groups: mild hypothermia (mH, 32°C; <i>n</i> = 40) and moderate hypothermia (MH, 24°C; <i>n</i> = 20). Exclusion criteria included bilateral cerebral perfusion, additional procedures (e.g., total arch replacement, bypass surgery), preexisting neurological or renal conditions, and incomplete datasets. Neurological events, blood loss, transfusion requirements, acute kidney injury (AKI), and mortality were assessed.</p><p><strong>Results: </strong>Neurological outcomes (permanent neurological dysfunction and transient neurological dysfunction) were comparable in both groups (20% each). The mH group had significantly lower blood loss (787 vs. 1,183 mL), reduced red blood cell transfusion (200 vs. 828 mL), and less fresh frozen plasma use (259.5 vs. 882 mL). The mH group also had lower rates of AKI (15 vs. 30%), rethoracotomy (10 vs. 22.5%), and infections (10 vs. 20%). Mortality was 20% (mH) versus 35% (MH).</p><p><strong>Conclusion: </strong>Mild hypothermia under UCP provides cerebral protection comparable to moderate hypothermia while reducing coagulopathy, transfusion needs, and complications-particularly relevant for centers in resource-limited countries.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"305-311"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006604","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><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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":"274-282"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","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}