ASIAN CARDIOVASCULAR & THORACIC ANNALS最新文献

{"title":"Valve-preserving technique for tetralogy of fallot by transannular delamination.","authors":"Yui Horikawa, Yoshinori Miyahara, Suguru Tarui, Takanari Fujii, Hideshi Tomita, Kozo Ishino","doi":"10.1177/02184923251350362","DOIUrl":"https://doi.org/10.1177/02184923251350362","url":null,"abstract":"<p><p>BackgroundValve-sparing repair for tetralogy of Fallot is challenging in patients with hypoplastic pulmonary valves. Recently, we adopted transannular incision and delamination. This study evaluates its feasibility for right ventricular outflow relief, valve function, and growth.MethodsWe retrospectively reviewed records of patients with tetralogy of Fallot or Fallot-type double-outlet right ventricle who underwent intracardiac repair from October 2013 to December 2020.ResultsTwenty-six patients were enrolled. Two patients who underwent the Rastelli procedure were excluded, leaving 24 for evaluation. Eleven underwent valve-sparing repair, eight underwent valve-preserving repair with transannular delamination, and five underwent the transannular patch procedure. The median age and weight at surgery were 11.7 months (1.9-40.2 months) and 7.6 kg (3.7-12.7 kg). No patients died or required reintervention for pulmonary valve stenosis or regurgitation during a median follow-up of 42.5 months (4.6-72.1 months). In the delamination group, the mean preoperative pulmonary valve z-score was -2.1 ± 1.0, improving significantly to 0.2 ± 0.8. Pulmonary regurgitation was mild in six of eight patients, while two with the smallest preoperative annulus developed moderate regurgitation. Despite no significant difference in the preoperative pulmonary valve annulus between the delamination and transannular patch groups, the delamination group had significantly lower postoperative pulmonary valve regurgitation, while no significant difference in stenosis.ConclusionsValve-preserving repair using the transannular delamination technique is feasible in patients with tetralogy of Fallot, reducing pulmonary regurgitation and avoiding transannular patch use. Long-term data with more patients are required to show the utility of this approach.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251350362"},"PeriodicalIF":0.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal outcomes following oral anticoagulation in non-valvular atrial fibrillation: A multicentre, propensity-matched retrospective analysis in an Asian population.","authors":"Hock Peng Koh, Jivanraj R Nagarajah, Jiaa Yinn Tang, Szu Lynn Tay, Sahimi Mohamed, Li Ling Loh, Chelfi Zhi Fei Chua, Shantini Radhakrishnan, Pradeep Kumar Nair Arumugam","doi":"10.1177/02184923251347471","DOIUrl":"https://doi.org/10.1177/02184923251347471","url":null,"abstract":"<p><p>BackgroundDirect oral anticoagulants (DOACs) have been linked to better renal outcomes than warfarin in non-valvular atrial fibrillation (NVAF). We aimed to compare the renal function outcomes in Asian NVAF patients treated with warfarin and DOAC.MethodsThis multicentre retrospective study analysed NVAF patients newly initiated on oral anticoagulant (OAC) from 2013 to 2022 across seven tertiary hospitals. Using propensity-score matching, warfarin and DOAC recipients were matched by incorporating 22 variables potentially affecting renal outcomes. Primary endpoints include clinically significant (≥30%) estimated glomerular filtration rate (eGFR) decline and worsened chronic kidney disease (CKD) stage.ResultsA total of 766 subjects (383 warfarin; 383 DOAC; mean age 70.7 ± 9.6 years) were analysed. Baseline eGFR was 75.0 (59.0-89.0) for warfarin and 76.0 (59.0-88.0) ml/min/1.73 m² for DOAC groups. Following median OAC treatment of 2.8 ± 1.6 years, 14.5% experienced clinically significant eGFR decline and 31.9% had worsened CKD stage. DOAC was associated with a lower risk of clinically significant eGFR decline (OR 0.529, 95% CI 0.343-0.817, <i>p</i> = 0.004) and worsened CKD stage (OR 0.713, 95% CI 0.521-0.975, <i>p</i> = 0.034). In subgroup analysis, rivaroxaban (OR 0.337, 95% CI 0.157-0.724, <i>p</i> = 0.005) and dabigatran (OR 0.516, 95% CI 0.285-0.934, <i>p</i> = 0.029), but not apixaban (OR 0.759, 95% CI 0.432-1.333, <i>p</i> = 0.338), were associated with a lower risk of clinically significant eGFR decline.ConclusionsSignificant renal function decline is common during follow-up of Asian NVAF patients on OAC. Among the DOACs, rivaroxaban and dabigatran, but not apixaban, were associated with a lower risk of renal function decline than warfarin. These findings warrant confirmation in prospective randomised studies.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251347471"},"PeriodicalIF":0.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascending aortic rupture by blunt abdominal trauma.","authors":"Kalogerakos Paris Dimitrios, Karagkounis Thomas, Konstantinou John, Lazopoulos Lambros, Chryssou Evangelia, Lazopoulos George","doi":"10.1177/02184923251342684","DOIUrl":"https://doi.org/10.1177/02184923251342684","url":null,"abstract":"<p><p>Traumatic ascending aortic rupture has been firmly associated with blunt thoracic trauma. Adding to the current understanding, we report a case of a patient without signs of external thoracic collision, who suffered a contained aortic rupture just distally of the sinotubular junction, due to severe blunt abdominal trauma. The increased intra-abdominal pressure ruptured the left hemidiaphragm and, presumably, led to the abrupt angulation and rupture of the proximal ascending aorta, sparing the rest of the aorta and the heart. The patient underwent an uneventful urgent aortic repair with a tubular graft, without total circulatory arrest. After a prolonged hospital stay, he was discharged.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251342684"},"PeriodicalIF":0.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-assisted thoracic surgery (VATS) in the surgical management of acquired benign broncho-esophageal fistula.","authors":"Sukhram Bishnoi, Mohan Venkatesh Pulle, Harsh Vardhan Puri, Belal Bin Asaf, Sumit Bangeria, Anmol Bhan, Anjali Singh, Arvind Kumar","doi":"10.1177/02184923251343326","DOIUrl":"https://doi.org/10.1177/02184923251343326","url":null,"abstract":"<p><p>BackgroundBenign broncho-esophageal fistula (BEF) is a rare condition that often results from infections, trauma, or prior surgical interventions. This study evaluates the outcomes of surgical management of BEF, emphasizing the role of video-assisted thoracoscopic surgery.MethodsA retrospective analysis of 19 patients who underwent surgical management for benign BEF was conducted. Patient demographics, fistula characteristics, surgical approach, perioperative outcomes, and complications were assessed.ResultsThe cohort comprised 14 males (73.7%) and 5 females (26.3%) with a median age of 34 years (range: 19-63 years). The left main bronchus was the most common fistula location (<i>n</i> = 10, 52.6%) followed by right lower lobe (<i>n</i> = 6, 31.6%), left lower lobe (<i>n</i> = 2, 10.5%), and right bronchus intermedius (<i>n</i> = 1, 5.3%). A prior history of antitubercular treatment was noted in 15 patients (79%). Video-assisted thoracic surgery was successfully performed in 17 patients (89.5%), while 2 (10.5%) required conversion to thoracotomy due to dense adhesions. During surgery, division of fistula alone was performed in 14 patients (73.7%). The distal lung destruction necessitated lobectomy in 3 patients (15.78%) and wedge resection in 2 patients (10.52%). The mean operative time was 120 min, with a median hospital stay of 5.5 days. Two patients (10.5%) experienced complications, including a minimal esophageal leak managed with a stent and a case of postoperative pneumonia which resolved with conservative measures. No recurrences were observed during a median follow-up of 48 months.ConclusionsVideo-assisted thoracic surgery is a safe and effective approach for managing benign BEF, offering excellent long-term outcomes with minimal morbidity. Conversion to thoracotomy is required in select cases with dense adhesions.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251343326"},"PeriodicalIF":0.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foot drop in the setting of VA-ECMO: A possible alternative mechanism to ischemia.","authors":"Abdulaziz M Alkhulaifi, Ahsan Ehtesham, Hafeez Lone, Yousef Alkhulaifi, Cornelia S Carr","doi":"10.1177/02184923251337649","DOIUrl":"https://doi.org/10.1177/02184923251337649","url":null,"abstract":"<p><p>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used widely as part of extracorporeal resuscitation (ECPR). Prolonged VA-ECMO may be associated with the development of foot drop, often secondary to limb ischemia. We report on three patients who developed foot drop following prolonged ECMO use, and we propose an alternative mechanism to ischemia. Three male patients, mean age 46.3 years, underwent peripheral VA-ECMO support, for an average of 22.6 days (17-25 days), two patients following ECPR and one post-cardiotomy shock. All patients underwent distal femoral artery perfusion cannula insertion within 60 min of ECMO cannulation. An intra-aortic balloon pump (IABP) was inserted on the contralateral side. During ECMO support the distal circulations in both legs were evaluated clinically, using Doppler ultrasound and measurement of blood flow in the distal cannula using a flow meter. One patient developed a foot drop on the side of the femoral cannula, one patient on the opposite side, and one patient bilaterally. Two patients needed LVAD, and one patient was successfully decannulated. All clinical parameters, Doppler flow measurements, and blood flow quantification (130-150 ml/min) were within normal limits throughout the support period. No ischemia was detected in the affected leg, nor was there evidence of compartment syndrome. Nerve conduction studies were inconclusive. We propose that the position and the immobility of the affected leg to enable groin cannula care may contribute to the development of foot drop due to compression /traction of the peroneal nerve.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251337649"},"PeriodicalIF":0.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technique for simultaneous aortic root replacement and Konno aortoventriculoplasty (Bentall-Konno).","authors":"Anton Pechenenko, Carlos A Mestres, Elena Sandoval, María Ascaso, Maksym Konodiuk, Eduard Quintana","doi":"10.1177/02184923251332978","DOIUrl":"https://doi.org/10.1177/02184923251332978","url":null,"abstract":"<p><p>Aortic valve patient-prosthesis mismatch is associated with unfavorable outcomes. There are several techniques to mitigate this. Occasionally, root replacement may be required in the context of small aortic annuli or hypoplastic left ventricular outflow tract (LVOT). For children or young adults, the Ross operation (± Konno aortoventriculoplasty) may constitute a satisfactory solution. However, most adults, particularly those older than 50 years, may not be considered candidates for the Ross operation, particularly if associated annular enlargement is needed. In clinical practice, a subgroup of patients requiring root replacement present with the need for simultaneous LVOT/annular enlargement who can benefit from an aortoventriculoplasty (Bentall-Konno). Through this modified Konno procedure, a larger prosthesis can be implanted. This option is of interest when an anterior root enlargement is prioritized, as in cases of hypoplasia of the LVOT. The technique could be especially useful in patients presenting with a normal functioning mitral prosthesis, when seeking a durable mechanical prosthetic substitute, and in patients with debilitated anterior aortic annuli (endocarditis with anterior invasion or anterior annular defects consequence of or multiple prior interventions). The use of two unified patches anchored with interrupted stitches simplifies the operation, provides a platform for root conduit anchorage, and allows appropriate right ventricular outflow tract reconstruction. We provide a detailed description of the technique, present two videos from different patients, and supplement this material with a wet lab model to facilitate safe adoption of this approach.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251332978"},"PeriodicalIF":0.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoadsorption use in adult cardiac surgery for infective endocarditis: A comprehensive meta-analysis.","authors":"Palak Dutta, Rohit Ganduboina, Cankutay Muderrisoglu, Adithya C Reddy Obulareddy, Keerthi Palagati, Vivekananda Reddy Areddy, Gaddam Ashwith Reddy, Sandeep Sainathan","doi":"10.1177/02184923251328119","DOIUrl":"https://doi.org/10.1177/02184923251328119","url":null,"abstract":"<p><p>IntroductionInfective endocarditis (IE) is a severe infection of the endocardium, primarily affecting the heart valves, exhibiting high morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary bypass (CPB) can further exacerbate the inflammatory response and cytokine production from IE. The current meta-analysis evaluates the use of CytoSorb^® hemoadsorption in IE patients undergoing cardiac surgery to determine its efficacy in reducing inflammatory mediators and improving clinical outcomes.MethodsPubMed, Cochrane, Google Scholar, Clinical Trials, and Google Scholar were searched for articles until July 2024. After performing a risk of bias and quality assessment, data on operative times, mortality, and morbidity were extracted for meta-analysis. Statistical Software R (version 4.4.0) was used to calculate odds ratio (OR) and standardized mean differences using a random-effect model with a 95% confidence interval (CI) and <i>p</i>-value less than 0.05.ResultsEight studies, encompassing 1076 patients, were included in the analysis. These comprised three randomized controlled trials and five nonrandomized studies. The majority of these studies exhibited some concerns regarding bias. Hemoadsorption group showed lower discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, <i>p</i> = 0.05) compared to controls, but no significant disparity is observed in other outcomes. In-hospital outcomes also showed higher heterogeneity, with an <i>I</i>² value greater than 50%.ConclusionCytoSorb use in patients undergoing cardiac surgery with CPB used for IE has no impact on operative mortality and morbidity but has a beneficial effect on discharge mortality.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251328119"},"PeriodicalIF":0.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milky heart: A rare case of tuberculous chylopericardium managed conservatively.","authors":"Kevin Paul DA Enriquez, John Christopher A Pilapil, Bynlee Stuart Go, Rafael Luis C Gavino, Michelle Marie Pipo, Felix Eduardo R Punzalan","doi":"10.1177/02184923251324961","DOIUrl":"https://doi.org/10.1177/02184923251324961","url":null,"abstract":"<p><p>IntroductionTuberculosis (TB) is a rare cause of chylopericardium. Optimal management remains unclear.Methods/ResultsA 30-year-old Filipino male presented with recurrent massive pericardial effusions, with pericardiostomy revealing chylopericardium. Microbiologic TB studies were negative, and other etiologies were excluded. Pericardial fluid adenosine deaminase was elevated; anti-TB regimen was initiated, leading to resolution.DiscussionThere is no consensus about the optimal management of TB chylopericardium. Adenosine deaminase represents a useful test to diagnose TB in inflammatory, lymphocyte-predominant effusions, especially when other tests are negative. Failed conservative management merits more invasive approaches.ConclusionWhile data remain lacking, this case suggests that TB chylopericardium responds to anti-TB therapy.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251324961"},"PeriodicalIF":0.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral tumoral pulmonary emboli complicating right atrial myxoma.","authors":"Albaraa Bara, Nawal Akashe, Ahmad Walid Izzat, Eyad M Chatty, Mohammad Bashar Izzat","doi":"10.1177/02184923251328067","DOIUrl":"https://doi.org/10.1177/02184923251328067","url":null,"abstract":"<p><p>A 48-year-old female underwent emergency surgery for an undetermined mass in the right atrium associated with bilateral pulmonary artery emboli. Under deep hypothermic circulatory arrest, a large gelatinous mass was excised from the right atrium, and large embolic lumps were removed from both main pulmonary arteries. Histopathological testing of excised specimens confirmed the diagnosis of a vascularized myxoma. At 6 months of follow-up, repeated transthoracic echocardiography has not shown any signs of local recurrence or elevated pulmonary artery pressure. The potential for right atrial myxoma as a source of pulmonary embolization should be borne in mind, as this potentially fatal yet curable condition demands emergency surgical intervention.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251328067"},"PeriodicalIF":0.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid support systems: A shift in managing infarct-related cardiogenic shock.","authors":"Hamrish Kumar Rajakumar","doi":"10.1177/02184923251328392","DOIUrl":"https://doi.org/10.1177/02184923251328392","url":null,"abstract":"","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251328392"},"PeriodicalIF":0.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}