ASIAN CARDIOVASCULAR & THORACIC ANNALS最新文献_第7页

Ross operation in current practice of aortic surgeons. 罗斯手术在主动脉外科手术中的应用。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-10-09 DOI: 10.1177/02184923251385599

Atsuo Doi

引用次数: 0

Contemporary surgical techniques and outcomes in total arch replacement: Focus on cerebral and end-organ protection. 全弓置换术的现代外科技术和结果：重点是大脑和终末器官的保护。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-10-09 DOI: 10.1177/02184923251385597

Eilon Ram, Christopher Lau, Giovanni Gagliardo, Ivancarmine Gambardella, Charles Anthony Mack, Leonard N Girardi

{"title":"Contemporary surgical techniques and outcomes in total arch replacement: Focus on cerebral and end-organ protection.","authors":"Eilon Ram, Christopher Lau, Giovanni Gagliardo, Ivancarmine Gambardella, Charles Anthony Mack, Leonard N Girardi","doi":"10.1177/02184923251385597","DOIUrl":"10.1177/02184923251385597","url":null,"abstract":"ObjectiveTo describe the clinical characteristics, operative data, and outcomes of total aortic arch replacement (TAR) performed at a high-volume aortic dedicated center, with a focus on technical aspects and neurologic protection.MethodsWe conducted a retrospective analysis of 536 consecutive patients who underwent TAR between 1997 and 2025. Data were collected from a prospectively maintained institutional database. All procedures were performed via median sternotomy with deep hypothermic circulatory arrest (DHCA) and retrograde cerebral perfusion (RCP) for neuroprotection. Arch reconstruction was performed using either island or debranching techniques, based on patient anatomy and comorbidities. Multivariable Cox regression analysis was used to identify predictors of 10-year mortality.ResultsThe mean patient age was 66.9 ± 12.9 years; 41% were female and 36.8% underwent redo operations. The mean cardiopulmonary bypass time was 158.1 ± 34.7 min, cardiac ischemic time was 102.8 ± 40.7 min, and mean circulatory arrest time was 40 ± 12.8 min. Concomitant procedures were performed in 49.6% of patients. Operative mortality was 2.1%, stroke occurred in 2.6%, and renal complications occurred in 3.2%. The 10-year survival rate was 80.7%. Multivariable analysis identified pulmonary disease, renal impairment, larger aneurysm size, and urgent/emergent presentation as independent predictors of late mortality. The use of RCP provided effective cerebral protection across a wide range of operative complexity.ConclusionTotal aortic arch replacement can be performed with low mortality and excellent long-term outcomes using DHCA with RCP. A tailored operative approach and institutional experience are key to optimizing outcomes.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"151-155"},"PeriodicalIF":0.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259533","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}

引用次数: 0

Frozen elephant trunk: Approach and innovations from the UK's leading centre. 冷冻象鼻：来自英国领先中心的方法和创新。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-12-09 DOI: 10.1177/02184923251404208

Ravi De Silva, Ujjawal Kumar, Shakil Farid

{"title":"Frozen elephant trunk: Approach and innovations from the UK's leading centre.","authors":"Ravi De Silva, Ujjawal Kumar, Shakil Farid","doi":"10.1177/02184923251404208","DOIUrl":"10.1177/02184923251404208","url":null,"abstract":"The frozen elephant trunk (FET) procedure has emerged as a transformative approach for complex aortic arch pathology, addressing limitations of conventional elephant trunk procedures, including the need for second-stage operations with interval mortality, inability to expand the true lumen in dissections and lack of distal anastomotic support.Our experience with over 200 procedures demonstrates FET technique evolution and refinement, achieving 13.8% overall mortality. Presenting pathologies were diverse, predominantly aneurysmal disease and acute or chronic dissections. Most utilised Thoraflex Hybrid, though the Jotec E-vita prosthesis has been increasingly used recently. Critical technical advancements include bilateral axillary artery cannulation, which has dramatically reduced neurological complications, including paraplegia and recurrent laryngeal nerve injury, compared to historical series. It also made the procedure technically less complex and more reproducible. In selected cases, we have also adopted a beating heart strategy to reduce the cardiac ischaemic time once the proximal aortic repair has been completed. The beating heart strategy demonstrated a tendency for reduced post-operative adrenaline requirements without compromising outcomes.Frozen elephant trunk demands advanced perfusion strategies, proactive spinal cord protection and meticulous surgical technique but reduces the need for future open repair, facilitating endovascular interventions. Our experience demonstrates that FET represents a paradigm shift toward comprehensive single-stage treatment of complex aortic arch pathology with acceptable outcomes when performed in high-volume centres by experienced multidisciplinary teams.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"177-184"},"PeriodicalIF":0.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709784","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}

引用次数: 0

Tetralogy of Fallot with pulmonary atresia - Role of patent ductus arteriosus stenting as initial palliation. 法洛四联症合并肺闭锁-动脉导管未闭支架置入术作为初始缓解的作用。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1177/02184923251410336

Muhammad Yusoff Mohd Ramdzan, Mazeni Alwi

{"title":"Tetralogy of Fallot with pulmonary atresia - Role of patent ductus arteriosus stenting as initial palliation.","authors":"Muhammad Yusoff Mohd Ramdzan, Mazeni Alwi","doi":"10.1177/02184923251410336","DOIUrl":"10.1177/02184923251410336","url":null,"abstract":"Traditionally, the modified Blalock-Taussig-Thomas shunt (mBTTS) has been the standard palliation for duct-dependent pulmonary blood flow (DDPBF) lesions, including tetralogy of Fallot with pulmonary atresia (TOF-PA). However, the risks associated with mBTTS, especially in neonates with low birth weight and small pulmonary arteries, have led to the exploration of less invasive alternatives like ductal stenting (DS). This review compares the anatomy and physiology of TOF with pulmonary stenosis and TOF-PA, noting that TOF-PA often relies on the patent ductus arteriosus (PDA) for pulmonary blood flow. It details the complexities of PDA morphology in DDPBF lesions, which can present as simple or complex structures. Historically, early experiences with DS revealed high complication rates, resulting in cautious recommendations against its use in certain anatomical contexts. However, improvements in stent technology and understanding of the complex congenital cardiac anatomy have improved the feasibility of DS as a viable option when the PDA is the sole source of pulmonary blood flow. We also explore issues like the less durable palliation compared to mBTTS, technically challenging stent placement, rapid neointimal proliferation causing in-stent stenosis and compromising pulmonary artery (PA) perfusion, and asymmetrical PA branch growth in the presence of stent jailing of a branch PA. In conclusion, this review suggests that while DS is increasingly seen as a reasonable alternative to mBTTS, it requires careful patient selection and close monitoring, alongside ongoing research to refine techniques and improve long-term outcomes for TOF-PA patients.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"207-218"},"PeriodicalIF":0.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834786","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}

引用次数: 0

Novel off-pump ventricular septal myectomy for obstructive hypertrophic cardiomyopathy: A paradigm shift in surgical management. 阻塞性肥厚性心肌病的新型非泵式室间隔肌瘤切除术：手术管理的范式转变。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2026-01-22 DOI: 10.1177/02184923261416148

Jiangtao Li, Song Wan, Xiang Wei

{"title":"Novel off-pump ventricular septal myectomy for obstructive hypertrophic cardiomyopathy: A paradigm shift in surgical management.","authors":"Jiangtao Li, Song Wan, Xiang Wei","doi":"10.1177/02184923261416148","DOIUrl":"10.1177/02184923261416148","url":null,"abstract":"Obstructive hypertrophic cardiomyopathy (oHCM) presents a significant clinical challenge, with left ventricular outflow tract obstruction being a primary driver of symptoms and adverse outcomes. Surgical septal myectomy (SM) performed under cardiopulmonary bypass and cardioplegic arrest has stood as the gold standard therapy, offering durable and complete relief of obstruction. However, its widespread adoption has been severely hampered by the limited surgical field, lack of real-time intraoperative assessment, and steep learning curve. In an effort to streamline SM, we have developed an innovative transapical beating-heart SM (TA-BSM) procedure. In this article, we outline the design of the beating-heart myectomy device that enables off-pump, real-time assessment of resection via a small left thoracotomy. We synthesize the evidence from the initial feasibility study in swine, the first-in-human trial, and large-scale clinical applications, indicating its compelling safety and efficacy profile. Furthermore, we analyze the learning curve of the TA-BSM procedure and present a structured framework for training future surgeons. Finally, we discuss the profound implications of this technique for global dissemination of oHCM care, potentially making this life-changing surgery accessible to thousands of underserved patients worldwide. In summary, TA-BSM represents not merely an incremental improvement but a true paradigm shift, moving oHCM surgery from a static, blind procedure to a dynamic, precise intervention.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"185-192"},"PeriodicalIF":0.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031129","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}

引用次数: 0

Reframing spontaneous pneumothorax: A practical guide to the PLEX variant classification. 重新定义自发性气胸：PLEX变体分类的实用指南。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1177/02184923251412929

Mohan Venkatesh Pulle, Harsh Vardhan Puri, Arvind Kumar

引用次数: 0

Decision-making to use right ventricle to pulmonary artery conduit: Advantages of the expanded polytetrafluoroethylene valved conduit. 选择右心室至肺动脉导管：膨化聚四氟乙烯带瓣导管的优势。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-12-18 DOI: 10.1177/02184923251408874

Masaaki Yamagishi, Shinichiro Oda, Hisayuki Hongu, Shuhei Fujita

{"title":"Decision-making to use right ventricle to pulmonary artery conduit: Advantages of the expanded polytetrafluoroethylene valved conduit.","authors":"Masaaki Yamagishi, Shinichiro Oda, Hisayuki Hongu, Shuhei Fujita","doi":"10.1177/02184923251408874","DOIUrl":"10.1177/02184923251408874","url":null,"abstract":"It is desirable to preserve the pulmonary valve annulus as much as possible, but the decision to preserve the annulus should be made by taking into account not only the annulus diameter but also the characteristics of the valve leaflets. Even if the valve annulus diameter is 70% or more of the normal value, in cases where the valve leaflets are poorly mobile or thickened, there is a concern that pulmonary regurgitation will worsen after pulmonary commissurotomy, so it is desirable to reconstruct the right ventricular outflow tract using a valved conduit in order to preserve right ventricular function. The choice of conduit is extremely important. The bovine jugular vein graft, which is associated with a high incidence of complications such as infection, should be avoided as much as possible. The ePTFE valved conduit is useful for preserving right ventricular function, and is recommended as a conduit for right ventricular outflow tract reconstruction. Although ePTFE valved conduits may cause relative stenosis due to weight gain, the possibility of pulmonary regurgitation is low, and the frequency of thrombosis and infection is also low. The conduit exchange free rate for large-diameter ePTFE valved conduits is high, and the need for reintervention is low.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"199-206"},"PeriodicalIF":0.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776056","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}

引用次数: 0

AAOCA: Surgical treatment options. AAOCA：手术治疗方案。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI: 10.1177/02184923251403903

Cagla Canbay Sarilar, Sertac Cicek

{"title":"AAOCA: Surgical treatment options.","authors":"Cagla Canbay Sarilar, Sertac Cicek","doi":"10.1177/02184923251403903","DOIUrl":"10.1177/02184923251403903","url":null,"abstract":"Anomalous aortic origin of a coronary artery (AAOCA) represents a rare yet clinically significant congenital anomaly associated with myocardial ischemia and sudden cardiac death, particularly in young individuals. Advances in multimodality imaging have enabled earlier detection and precise anatomical delineation, shifting the paradigm from incidental diagnosis to proactive management. This review synthesizes contemporary understanding of AAOCA pathophysiology, diagnostic strategies, and surgical management. The mechanisms of ischemia-slit-like ostium, intramural course, acute take-off angles, and interarterial compression-underscore the condition's dynamic nature. Diagnostic evaluation integrates anatomical imaging with computed tomography or cardiac magnetic resonance and functional assessment through perfusion testing to identify ischemia. Surgical intervention is indicated for high-risk anatomy or documented perfusion defects. Unroofing and coronary reimplantation remain the mainstays of therapy, while ostioplasty, pulmonary artery translocation, and coronary artery bypass grafting are reserved for anatomically or technically specific scenarios. Successful AAOCA management requires individualized surgical planning grounded in anatomical precision and physiologic understanding. Long-term surveillance with multimodality imaging and stress testing is essential, as residual or delayed complications-such as restenosis, fibrosis, or aortic insufficiency-may occur. With accurate diagnosis, meticulous surgical execution, and disciplined follow-up, most patients achieve excellent outcomes. The era of AAOCA as a mysterious postmortem diagnosis is ending; it is now a surgically correctable entity when addressed proactively and precisely.","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"167-176"},"PeriodicalIF":0.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688319","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}

引用次数: 0

Surgery for coronary anomaly: Intramural single trunk between the great arteries. 冠状动脉异常的手术：大动脉之间的壁内单干。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2025-12-23 DOI: 10.1177/02184923251410338

Takuya Kawabata, Yosuke Kuroko, Yasuhiro Kotani, Kenji Baba, Shingo Kasahara

引用次数: 0

Surgical management of purulent pericarditis with diagnostic assistance from fluorodeoxyglucose positron emission tomography/computed tomography. 化脓性心包炎的外科治疗与氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描的诊断协助。

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ASIAN CARDIOVASCULAR & THORACIC ANNALS Pub Date : 2026-02-01 Epub Date: 2026-01-28 DOI: 10.1177/02184923251415034

Hideki Isa, Kentaro Shirakura, Tomoki Nakatsu, Katsuaki Magishi, Yuichi Izumi, Fumiaki Kimura

引用次数: 0