CJC Open最新文献

{"title":"Closing the Gaps in Heart Failure Care: A Call for a National Strategy in Canada","authors":"Stephanie Poon MD, MSc,&nbsp;Sean A. Virani MD, MSc, MPH,&nbsp;Margot K. Davis SM, MD,&nbsp;Santabhanu Chakrabarti MBBS, MD,&nbsp;Anique Ducharme MD, MSc,&nbsp;Lynette Kosar BSP, MSc (Pharm),&nbsp;Robert S. McKelvie MD, PhD,&nbsp;Nima Moghaddam MD,&nbsp;Seema Nagpal BSc Pharm, MSc, PhD,&nbsp;Lebei Pi MD,&nbsp;Rodolfo Pike RN, BN, MN, NP,&nbsp;Anne Simard MHSc,&nbsp;Harindra Wijeysundera MD, PhD","doi":"10.1016/j.cjco.2026.07.002","DOIUrl":"10.1016/j.cjco.2026.07.002","url":null,"abstract":"<div><div>Heart failure (HF) is a growing public health challenge in Canada, affecting over 787,000 individuals and contributing substantially to morbidity, mortality, and health care costs. Despite advances in therapies, HF care delivery remains fragmented, with significant variability in access to diagnostics, specialized services, and guideline-directed medical therapy (GDMT). Critically, the challenge is not a lack of evidence, but rather gaps in coordination, implementation, and accountability. Three dominant system-level issues drive poor outcomes: delayed diagnosis, vulnerability during transitions of care, and GDMT underuse. These are further compounded by geographic and sociodemographic disparities, particularly in rural, remote, and Indigenous communities, as well as the absence of standardized performance metrics and accountability frameworks. Evidence from national and international health care systems demonstrates that coordinated, data-driven approaches---incorporating standardized care pathways, performance measurement, and system-level accountability---can improve outcomes and efficiency. Early diagnosis, timely specialist follow-up, GDMT optimization, and multidisciplinary care models are associated with fewer hospitalizations, improved survival, and lower costs. Addressing these gaps will require a coordinated national strategy. Near-term priorities include establishing a national HF strategy, expanding access to diagnostic testing and improving GDMT access. Medium-term priorities include implementing standardized care pathways, strengthening care coordination, and enhancing data infrastructure to support performance measurement and quality improvement. Over the longer term, integrating HF into broader chronic disease frameworks and scaling digital solutions will be essential to ensure sustained coordination, accountability, and equitable access. Bill S-204 provides a critical opportunity to align key partners and advance a comprehensive, patient-centred, evidence-informed approach to HF care in Canada.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 10","pages":"Pages 1343-1354"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Self-Efficacy, Gender Roles, and Cultural Identity As Determinants of Vascular and Neurovascular Health in Métis People in Canada","authors":"Shara R. Johnson PhD,&nbsp;Samantha Moore BSc,&nbsp;Phil Chilibeck PhD,&nbsp;Gavin Selinger BSc,&nbsp;Adam McInnes MD,&nbsp;Heather J.A. Foulds PhD","doi":"10.1016/j.cjco.2026.05.015","DOIUrl":"10.1016/j.cjco.2026.05.015","url":null,"abstract":"<div><h3>Background</h3><div>Métis people, a distinct Indigenous group in Canada, have unique culture, identity, and experiences, although they have a shared history of colonization with other Indigenous groups. Although they are actively reclaiming and revitalizing their culture, identity, and community connections, Métis people remain disproportionally burdened by chronic illnesses, including cardiovascular diseases. This study examined relationships of psychosocial factors—self-efficacy, cultural identity affiliation, and gender role responsibilities—with established cardiovascular risk indicators in Métis people.</div></div><div><h3>Methods</h3><div>Métis adults (N = 72, 67% female, mean age = 39 ± 16 years) were invited to complete questionnaires assessing self-efficacy, cultural identity, and gender roles responsibility. Vascular and neurovascular indicators were assessed using finger photoplethysmography and infrared photoelectric sensors with a 3-lead electrocardiograph.</div></div><div><h3>Results</h3><div>Self-efficacy (β = –0.34, <em>P</em> &lt; 0.01) and Métis identity (β = 0.29, <em>P</em> = 0.01) were associated with lower-body peripheral pulse wave velocity, reflecting decreased and increased arterial stiffness, respectively. Indoor housework responsibility moderated the relationship between self-efficacy and baroceptor sensitivity (β = 0.28, <em>P</em> = 0.03). Self-efficacy moderated by outdoor housework responsibility was associated with high frequency heart rate variability, indicating higher parasympathetic activation. Specifically, Métis persons with high levels of self-efficacy and responsibility for outdoor housework had worse heart rate variability than did persons with a high level of self-efficacy and a lower level of outdoor housework responsibility.</div></div><div><h3>Conclusions</h3><div>Self-efficacy, housework roles, and cultural identity affiliation contribute significantly to some vascular and neurovascular health parameters in Métis people. There is an opportunity to enhance vascular and neurovascular health by developing community-driven strength-based approaches, grounded in Métis peoples’ resilience, self-determination, and cultural identity.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1188-1197"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Absence of the Left Atrial Appendage: A Case Report and Literature Review","authors":"Nicole Wuzynski MBBS,&nbsp;Osama Smettei MD,&nbsp;Asad Naveed MD,&nbsp;Yasser Alsaleh MD,&nbsp;Sarah Woolridge FRCPc,&nbsp;Rami M. Abazid FRCPc, MD","doi":"10.1016/j.cjco.2026.05.011","DOIUrl":"10.1016/j.cjco.2026.05.011","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1270-1273"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in Care Trajectories in Specialist Visits for Preventing Cardiovascular Events After New-Onset Diabetes: A Population-Based Cohort Study","authors":"Sarah O’Connor RD, PhD,&nbsp;Claudia Blais PhD,&nbsp;Jérémie Sylvain-Morneau MSc,&nbsp;Awa Diop PhD,&nbsp;Miceline Mésidor PhD,&nbsp;Jacinthe Leclerc PhD,&nbsp;Paul Poirier MD, PhD","doi":"10.1016/j.cjco.2026.05.006","DOIUrl":"10.1016/j.cjco.2026.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Specialist physicians may play a role in preventing major adverse cardiovascular events (MACEs; myocardial infarction/stroke/cardiovascular deaths) in patients with diabetes. Given the heterogeneity in patients and the specific needs in established atherosclerotic cardiovascular disease (ASCVD), this study sought to describe the trajectories of visits to specialists among diabetes patients with vs without ASCVD and explore their associations with MACEs.</div></div><div><h3>Methods</h3><div>Using Quebec’s administrative databases, we identified new-onset diabetes patients aged ≥ 20 years with no history of MACEs in 2013. Individual trajectories based on outpatient visits to a specialist (cardiologist, internist, or endocrinologist) were compiled for consecutive 3-month periods, up to 2 years after diagnosis, and grouped using latent class growth analysis. We assessed the risk of MACEs using weighted Cox regression models according to ASCVD status, from year 2 postdiagnosis up to December 31, 2019.</div></div><div><h3>Results</h3><div>Four trajectory groups were identified, as follows: (i) regular/frequent visits (n = 1810); (ii) early visits only (n = 1420); (iii) regular/sparse visits (n = 8670); and (iv) primary care only (n = 18,050). Patients with ASCVD consulted more specialists compared to those without ASCVD. Among patients with ASCVD (n = 4800), the early-visits-only group had a lower risk of MACEs (adjusted hazard ratio [aHR]: 0.70 [95% confidence interval {CI}:0.49-0.97]), compared with the primary-care-only group, whereas for patients without ASCVD (n = 25,150), the risk of MACEs was higher in the early-visits-only (aHR:1.76 [95% CI: 1.44-2.12]) and regular/sparse-visits groups (aHR:1.26 [95% CI: 1.13-1.41]).</div></div><div><h3>Conclusions</h3><div>This study highlights great diversity in diabetes care trajectories according to ASCVD status. We found conflicting results in the risk of MACEs; some results should be interpreted with caution.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1274-1283"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Clinical Outcomes of Subclinical Atrial Fibrillation After Heart Failure Hospitalization","authors":"Jorge A. Wong MD, MPH,&nbsp;Priya Mistry MSc,&nbsp;Ameen Patel MD,&nbsp;Umjeet Jolly MD,&nbsp;Alex Benz MD,&nbsp;Fei Yuan MMath,&nbsp;Natalia Pinilla-Echeverri MD,&nbsp;Ghaith Almidani MD,&nbsp;Nicole Latendresse BSc,&nbsp;Alex Grinvalds BSc,&nbsp;Elorm Vowotor MD,&nbsp;Jerry Chen MD,&nbsp;Alex Grindal MD,&nbsp;Sabina Rajkumar BSc,&nbsp;Ali Almhri MD,&nbsp;Shrikant Bangdiwala PhD,&nbsp;William F. McIntyre MD, PhD,&nbsp;David Conen MD MPH,&nbsp;P.J. Devereaux MD, PhD,&nbsp;Jeff S. Healey MD, MSc,&nbsp;Stuart J. Connolly MD","doi":"10.1016/j.cjco.2026.05.012","DOIUrl":"10.1016/j.cjco.2026.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Subclinical atrial fibrillation (SCAF) is common in older adults, but its clinical significance in heart failure (HF) patients remains unclear. We evaluated the prevalence of SCAF in patients hospitalized with HF without prior atrial fibrillation (AF) and examined its association with HF-related outcomes.</div></div><div><h3>Methods</h3><div>Hospitalized patients with a primary diagnosis of HF exacerbation without prior AF were prospectively recruited across 5 sites in Ontario, Canada. Participants were discharged home with 28-day continuous electrocardiogram monitoring to detect SCAF. The association between SCAF and HF readmission, cardiovascular death, and other HF-related outcomes at 1-year follow-up was determined using logistic regression models.</div></div><div><h3>Results</h3><div>Among 242 participants, the mean age was 70.9 ± 13.3 years; 51% were male; the mean body mass index was 31.6 ± 10.8 kg/m²; and the mean left ventricular ejection fraction was 42.3% ± 17.1%. SCAF was detected in 17 patients (7.1%), comprising 31 episodes with a median duration of 6.3 hours (interquartile range: 0.21-32.5). SCAF was associated with cardiovascular death (6 vs 28 events; adjusted odds ratio (aOR) 4.22 [95% confidence interval {CI}, 1.34-12.8]; <em>P</em> = 0.014) and progression to clinical AF (5 vs 14 events; aOR 8.26, [95% CI, 2.33-28.2]; <em>P</em> = 0.001), whereas a significant association was not observed with HF rehospitalization (4 vs 54 events; aOR 1.12 [95% CI, 0.32-3.31]; <em>P</em> = 0.85).</div></div><div><h3>Conclusions</h3><div>In patients hospitalized with HF and no prior AF, SCAF was detected in approximately 1 in 14 individuals early after discharge and was associated with higher cardiovascular mortality and progression to clinical AF. No association with HF rehospitalization was observed, although the study may have been underpowered for this outcome.</div></div><div><h3>Clinical Trial Registration</h3><div>NCT03541616</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1151-1157"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Echocardiographic Characteristics of Neuroendocrine Tumours and Carcinoid Heart Disease: Insights from a Contemporary Canadian Cohort","authors":"Joshua Yoon MD,&nbsp;Cynthia Yeung MD,&nbsp;Jeffrey D. Wong MD,&nbsp;Janine Mazengarb MD,&nbsp;Christina L. Luong MD, MHSc,&nbsp;Michael Y.C. Tsang MD,&nbsp;Teresa S.M. Tsang MD,&nbsp;Margot K. Davis MD, MSc,&nbsp;Kenneth Gin MD,&nbsp;John Jue MD,&nbsp;Parvathy Nair MD,&nbsp;Jonathan M. Loree MD, MS,&nbsp;Darwin F. Yeung MD, MPH","doi":"10.1016/j.cjco.2026.06.001","DOIUrl":"10.1016/j.cjco.2026.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Neuroendocrine tumours (NETs) are uncommon cancers that secrete vasoactive hormones. Around half of those with metastatic small bowel NETs develop carcinoid syndrome, and historically, up to 50% develop carcinoid heart disease (CHD). We evaluated clinical characteristics, echocardiographic features, and outcomes of patients with NETs and CHD in a contemporary cohort to identify factors associated with CHD development and mortality.</div></div><div><h3>Methods</h3><div>We identified patients with NETs who underwent an echocardiogram at a tertiary cancer centre–affiliated laboratory (2013-2023). Patients were classified based on whether they developed CHD. Clinical characteristics, echocardiographic data within 6 months of NET diagnosis, treatments, and outcomes were compared between CHD and non-CHD patients.</div></div><div><h3>Results</h3><div>Over a 10-year period, 87 patients with NETs were identified (48% female; median age, 61 years), with 18 (21%) developing CHD. Primary small bowel NETs were more common with CHD (83% vs 55%, <em>P</em> = 0.032). Patients with CHD exclusively had right-sided valve involvement: 100% tricuspid, 61% pulmonary, and 0% mitral/aortic; 17% had a patent foramen ovale. Compared to non-CHD patients, CHD patients demonstrated higher right atrial volume index and right ventricular basal diameter, with more frequent right ventricular dysfunction. Patients with CHD had a lower median survival from the time of NET diagnosis (6.6 vs 13.4 years; <em>P</em> = 0.007). Among CHD patients, primary NET resection was associated with improved survival (<em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>Within a contemporary cohort, approximately 1 in 5 patients with NETs develop CHD and exhibit only right-sided valve involvement. CHD was associated with increased mortality whereas primary NET resection was associated with improved survival.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1208-1218"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadless Pacemaker–Induced Metallic Artifact Causing Reduced Septal Uptake on Single Photon Emission Computed Tomography","authors":"Shusuke Arigami MD,&nbsp;Toru Awaya MD, PhD,&nbsp;Masako Asami MD,&nbsp;Taeko Kunimasa MD, PhD,&nbsp;Hidehiko Hara MD, PhD","doi":"10.1016/j.cjco.2026.05.013","DOIUrl":"10.1016/j.cjco.2026.05.013","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1228-1231"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decommissioning of Durable Left Ventricular Assist Devices","authors":"Ryaan EL-Andari MD,&nbsp;Holger Buchholz MD,&nbsp;Jennifer Conway MD, MSc,&nbsp;Tara Pidborochynski MSc,&nbsp;Darren H. Freed MD, PhD,&nbsp;Steven R. Meyer MD, PhD,&nbsp;Roderick G.G. MacArthur MD, MSc","doi":"10.1016/j.cjco.2026.04.017","DOIUrl":"10.1016/j.cjco.2026.04.017","url":null,"abstract":"<div><div>Cardiac recovery following durable left ventricular assist device (LVAD) implantation is the ideal outcome for heart failure patients. Traditionally, the durable LVAD has required explantation. We describe our single-centre experience with LVAD decommissioning. LVAD decommissioning involved making a sternotomy or sub-xiphoid incision, ligating the outflow graft, and removing the driveline by transecting the driveline inside and outside of the chest. Six patients underwent durable LVAD decommissioning from 2017-2024. One patient had a HeartWare (Medtronic, Galway, Ireland) device, 3 patients had a HeartMate II (Abbott, Abbott Park, IL), and 2 patients had a HeartMate 3 (Abbott). All patients were successfully decommissioned and discharged without mechanical circulatory support.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1177-1182"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact on Ice: A Case of Left Main Dissection from a Hockey Check","authors":"Ryan T. Sless MD, MSc,&nbsp;Rushil Dave BSc,&nbsp;Alan Barolet MD,&nbsp;Adriana C. Luk MD","doi":"10.1016/j.cjco.2026.05.004","DOIUrl":"10.1016/j.cjco.2026.05.004","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1245-1248"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prior Thoracic Endovascular Aortic Repair on Outcomes After Open Thoracoabdominal Aortic Replacement for Type B Aortic Dissection","authors":"Hai Yu MD,&nbsp;Bo Jia MD,&nbsp;Haoning Liu MD,&nbsp;Zhanqi Guo MD,&nbsp;Yipeng Ge MD,&nbsp;Yi Yang MD,&nbsp;Fucheng Xiao MD,&nbsp;Ruidong Qi MD,&nbsp;Chengnan Li MD,&nbsp;Junming Zhu MD","doi":"10.1016/j.cjco.2026.05.014","DOIUrl":"10.1016/j.cjco.2026.05.014","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic endovascular aortic repair (TEVAR) is a primary treatment for complicated type B aortic dissection (TBAD). However, some patients eventually require open thoracoabdominal aortic replacement (TAAR). Comparative outcomes data for TAAR with vs without prior TEVAR remain limited.</div></div><div><h3>Methods</h3><div>In this single-centre retrospective study of 198 patients undergoing TAAR for TBAD, we compared outcomes between those with (n = 60) vs without (n = 138) prior TEVAR. The primary endpoint was a composite of in-hospital death, spinal cord injury, or stroke.</div></div><div><h3>Results</h3><div>The composite endpoint was significantly higher in the prior-TEVAR group (25.0% vs 7.3%, <em>P</em> &lt; 0.001). In-hospital mortality was similar (11.7% vs 5.1%, <em>P</em> = 0.173), whereas spinal cord injury (10.0% vs 2.2%, <em>P</em> = 0.040) and cerebral hemorrhage (6.7% vs 0%, <em>P</em> = 0.012) were higher with prior TEVAR. Prior TEVAR independently predicted this composite outcome (odds ratio 3.72, <em>P</em> = 0.006). Patients with prior TEVAR had higher rates of reintubation (8.3% vs 1.5%, <em>P</em> = 0.046), and dialysis-requiring acute kidney injury also trended higher in this group (23.3% vs 12.3%, <em>P</em> = 0.050).Prior TEVAR was an independent predictor for late reintervention (hazard ratio 2.74, <em>P</em> = 0.030).</div></div><div><h3>Conclusions</h3><div>Prior TEVAR was associated with increased perioperative morbidity and late reintervention risk in patients undergoing TAAR for TBAD. This association underscores the need for enhanced perioperative management and long-term follow-up in this high-risk cohort.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 9","pages":"Pages 1259-1269"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}