Cirugia Cardiovascular最新文献

{"title":"Valve-sparing root replacement. Toronto General Hospital experience","authors":"María Ascaso ,&nbsp;Christopher M. Feindel ,&nbsp;Maral Ouzounian ,&nbsp;Tirone E. David","doi":"10.1016/j.circv.2024.07.002","DOIUrl":"10.1016/j.circv.2024.07.002","url":null,"abstract":"<div><h3>Introduction and methods</h3><div>Aortic valve-sparing operations were developed at Toronto General Hospital in early 90's in an aim to preserve normal native aortic valve in the setting of root disease. This procedure has been mastered over the last 30 years. In this manuscript, we present our clinical and long-term outcomes using the implantation technique for both tricuspid and bicuspid valves, along with a detailed step-by-step explanation of the surgical technique, based on our experience.</div></div><div><h3>Results</h3><div>The reimplantation technique can be performed in many elective and urgent situations, but not all valves are suitable for optimal repair and an extensive valve morphology assessment using echocardiogram or intraoperative direct assessment, has been the key to achieve excellent long-term results.</div><div>Our group showed 1% postoperative death with low pacemaker implantation (1.9%) and stroke rates (0.6%). All patients left the operating room with mild or less aortic regurgitation. Excellent perioperative results are achieved with a perfect and careful surgical technique. A detailed step-by-step description of the reimplantation technique is provided in this manuscript. Important technical considerations are included. Our series showed 84% 15-year survival and less than 10% recurrence of more than mild aortic regurgitation.</div></div><div><h3>Conclusions</h3><div>The valve-sparing root replacement procedure provides excellent long-term clinical outcomes in terms of survival, freedom from reoperation and valve-related complications, along with stable aortic valve function, for both tricuspid and bicuspid aortic valve with favorable cusp morphology.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 57-61"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416227","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":"La cirugía de la aorta: historia y perspectivas de futuro","authors":"Juan José Legarra Calderón","doi":"10.1016/j.circv.2026.01.005","DOIUrl":"10.1016/j.circv.2026.01.005","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 53-54"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416226","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":"The ABC and B-C of the Penn classification in acute aortic syndromes","authors":"Selim Mosbahi ,&nbsp;Mikolaj Berezowski ,&nbsp;John J. Kelly ,&nbsp;Joseph E. Bavaria","doi":"10.1016/j.circv.2024.04.005","DOIUrl":"10.1016/j.circv.2024.04.005","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 55-56"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714488","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":"Cirugía Cardiovascular, sus orígenes y su realidad actual. El tributo: Emili Saura i Grifol (1943–2025)","authors":"Carlos A. Mestres ,&nbsp;Fernando Hornero ,&nbsp;Jacobo Silva ,&nbsp;Rafael Garcia-Fuster","doi":"10.1016/j.circv.2026.01.006","DOIUrl":"10.1016/j.circv.2026.01.006","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 96-97"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416225","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":"Reparación híbrida de arco aórtico tipo I (sin sustitución aorta ascendente) y tipo II (con sustitución aorta ascendente) como puente a TEVAR","authors":"Danela Figuereo Beltre ,&nbsp;Elisabet Berastegui Garcia ,&nbsp;Valentina Mescola ,&nbsp;Miquel Gil Olaria ,&nbsp;Pere Altes Mas ,&nbsp;Christian Muñoz Guijosa","doi":"10.1016/j.circv.2024.02.008","DOIUrl":"10.1016/j.circv.2024.02.008","url":null,"abstract":"<div><h3>Objetives</h3><div>To present the results of supra-aortic trunk bypass surgery (TSA) in patients with aortic arch pathology, as a bridge to thoracic endovascular repair (TEVAR).</div></div><div><h3>Material and methods</h3><div>A retrospective observational study of consecutive patients with aortic arch pathology who underwent supra-aortic trunk bypass was performed. Preoperative risk, conmorbidities and anatomical characteristics, surgical procedures and morbimortality.</div></div><div><h3>Results</h3><div>Twelve patients were operated on, in the period 2013-2022, performing intrathoracic bypass from the ascending aorta to the supra-aortic trunks. 91.6% were men. The mean age was 73 years, being 41.6% of the sample older than 75 years. The most frequent clinical presentation was chest pain (N<!--> <!-->=<!--> <!-->7); 4 patients presented with type B aortic dissection and 3 patients had aortic arch aneurysm. The surgical approach was through median sternotomy. Only in 4 cases the surgery was performed under extracorporeal circulation. The techniques used were: intrathoracic bypass to the brachiocephalic<!--> <!-->+<!--> <!-->left carotid trunk (N<!--> <!-->=<!--> <!-->6), bypass to the 3<!--> <!-->supra-aortic trunks (N<!--> <!-->=<!--> <!-->5) and isolated bypass to the left carotid (N<!--> <!-->=<!--> <!-->1).</div><div>Technical success was 100%. The mean time between supra-aortic trunk bypass and TEVAR was 7 days. The average hospital stay was 13 days. There were no neurological complications. The 30-day mortality was 8.3% (N<!--> <!-->=<!--> <!-->1), who died before TEVAR. 1 patient died during follow-up due to infective endocarditis.</div></div><div><h3>Conclusion</h3><div>Supraraortic trunk bypass techniques represent a valid and safe strategy in order to allow a more proximal landing zones for TEVAR, with good medium-long term results.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 81-85"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279704","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":"Aprendizajes y experiencia inicial con endoprótesis torácica ramificada Castor™ / Cratos™","authors":"Iván Martín-González ,&nbsp;Alexandra Merino-Orozco ,&nbsp;Gerardo A. Dieguez-Palacios ,&nbsp;Ana M. Bel-Mínguez ,&nbsp;Tomás Heredia-Cambra ,&nbsp;Audelio Guevara-Bonilla ,&nbsp;Carlos Domínguez-Massa ,&nbsp;José A. Rincón-Almanza ,&nbsp;Eduardo Tebar-Botí ,&nbsp;Manuel Pérez-Guillem ,&nbsp;María J. Dalmau-Sorlí ,&nbsp;Manuel I. Sánchez-Nevárez ,&nbsp;Laura Gálvez Núñez ,&nbsp;Francisco J. Valera-Martínez","doi":"10.1016/j.circv.2025.12.007","DOIUrl":"10.1016/j.circv.2025.12.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Castor™ / Cratos™ (MicroPort®) is a single-branched thoracic endograft designed for partial aortic arch sealing. Although its instructions for use focus on type B aortic dissections, contemporary clinical practice has expanded its application to other pathologies. The objective of this study was to analyze the performance of the Castor™ / Cratos™ device based on our initial experience.</div></div><div><h3>Methods</h3><div>Characteristics/implantation technique of the Castor™ / Cratos™ endograft and a single-center experience from May 2024 to October 2025 were described.</div></div><div><h3>Results</h3><div>Seven devices were implanted. The underlying pathology was type B aortic dissection in three patients (two subacute, one chronic). Two patients required urgent procedures (within 72<!--> <!-->hours), and none required emergent intervention (within 24<!--> <!-->hours). Prophylactic cerebrospinal fluid drainage was used in five patients, and evoked potential monitoring in two. The primary femoral access was percutaneous in all cases. Left upper limb access was percutaneous in four cases and radial in one. Five additional aortic extensions, one subclavian branch extension, and three concomitant planned endovascular procedures were performed. Inferior vena cava endoclamping was used in six cases, and rapid ventricular pacing in one. One type Ia endoleak was identified on immediate postoperative computarized tomograghy, which resolved during follow-up. Technical success was achieved in all patients, with no periprocedural mortality, spinal cord injury, or stroke.</div></div><div><h3>Conclusions</h3><div>In this limited initial experience, and in line with previous reports, the Castor™ / Cratos™ endograft appears to be a safe single-branched device for partial aortic arch sealing. Further studies with larger cohorts and long-term follow-up are required to confirm long-term results.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 86-95"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416224","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":"Ruptured dissecting aorta: An uncommon cause of sudden death—An autopsy study","authors":"Jayeshkumar Kanani,&nbsp;Mohammed Iliyas Sheikh","doi":"10.1016/j.circv.2024.11.009","DOIUrl":"10.1016/j.circv.2024.11.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Sudden natural deaths, particularly those resulting from cardiovascular causes such as cardiac tamponade and aortic dissection, present significant challenges in forensic medicine and public health.</div></div><div><h3>Methods</h3><div>This study prospectively analyzes six cases of sudden death due to ruptured dissecting aorta, identified through postmortem examinations conducted in 2023. Cases included all individuals who exhibited sudden collapse and death within 24<!--> <!-->h of symptom onset.</div></div><div><h3>Results</h3><div>An unusually frequent incidence of cardiac tamponade was observed during autopsies conducted in 2023, with the rupture of a dissecting aorta being the most frequent cause and found in six cases. Notably, rupture at the origin of the aorta was the most common finding, accounting for 90% of cases in our study. The affected individuals ranged in age from 35 to 55 years, and all succumbed to their symptoms within 24<!--> <!-->h of onset.</div></div><div><h3>Conclusions</h3><div>Efforts to enhance diagnostic capabilities, raise awareness among healthcare professionals, and implement preventive strategies are crucial for mitigating the burden of sudden cardiovascular deaths. Collaborative approaches involving forensic practitioners, clinicians, and researchers are essential for understanding the underlying mechanisms of sudden natural deaths and implementing evidence-based interventions to prevent future fatalities.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 69-75"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416223","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":"Root remodeling does lead to stable long-term aortic valve function","authors":"Christian Giebels,&nbsp;Karen B. Abeln,&nbsp;Tristan Ehrlich,&nbsp;Hans-Joachim Schäfers","doi":"10.1016/j.circv.2024.06.002","DOIUrl":"10.1016/j.circv.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Root remodeling is one form of valve-preserving root replacement for aortic regurgitation and root aneurysm, which we have employed consistently for more than 28 years.</div></div><div><h3>Methods</h3><div>Between 10/95 and 7/2023 root remodeling was performed in 1285 patients (76% male, mean age 53<!--> <!-->±<!--> <!-->14 years). The aortic valve morphology was unicuspid in 34 (3%), bicuspid in 525 (41%) and tricuspid in 726 (56%) patients. Fifty-four patients (4%) had Marfan's syndrome. Measurement of valve configuration (effective height) was performed in 1075 (84%), and an external suture annuloplasty was added in 705 patients (55%). Cusp repair was performed in 1143 (89%) patients, most commonly for prolapse (<em>n</em> <!-->=<!--> <!-->1000; 82%). Mean follow-up was 6.7<!--> <!-->±<!--> <!-->5.5 years (1 month to 28 years). Follow-up was 95% complete (8026 patient-years).</div></div><div><h3>Results</h3><div>Survival was 71% at 20 years, freedom from cardiac death 80%. Freedom from aortic regurgitation ≥2 was 77% at 15 years. Freedom from reoperation was 89%, higher in tricuspid (94%) compared to bicuspid (84%) and unicuspid valves (<em>p</em> <!-->&lt;<!--> <!-->0.001). With a suture annuloplasty, freedom from reoperation was 94% at 12 years. The difference with (94%) or without annuloplasty (91%) was not significant (<em>p</em> <!-->=<!--> <!-->0.949).</div></div><div><h3>Conclusion</h3><div>Root remodeling is a viable option in valve-preserving root replacement. Concomitant cusp prolapse is frequent and can be corrected reproducibly by intraoperative measurement of effective height. The long-term stability of the aortic valve depends primarily on the underlying morphology. Up to 15 years postoperatively, the addition of an annuloplasty had a limited positive effect on residual regurgitation, but (as yet) no effect on freedom from reoperation.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 62-68"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710499","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":"Aortic arch disease. Contemporary open surgical treatment strategies","authors":"María Ascaso,&nbsp;Eduard Quintana","doi":"10.1016/j.circv.2024.02.011","DOIUrl":"10.1016/j.circv.2024.02.011","url":null,"abstract":"<div><h3>Introduction and methods</h3><div>Surgery of the aortic arch is one of the most challenging procedures in cardiac surgery requiring mastery of temporary manipulation of cerebral and systemic circulation. The purpose of this article is to describe the evolution of the approach to open repair of the aortic arch and its technical peculiarities.</div></div><div><h3>Results</h3><div>Different cannulation and perfusion strategies may have a different effect on postoperative outcomes. Classically, organ protection was achieved by drastically reducing oxygen demand through hypothermia; currently, this is combined with antegrade cerebral perfusion to increase the safe time of interruption of the aortic arch without increasing neurological risk. Axillary artery cannulation in combination with other sources of cerebral perfusion is a proven and reproducible strategy.</div><div>Continuous selective cerebral perfusion throughout surgery has allowed surgery to be performed at more moderate temperatures, which has been shown to reduce surgical times, postoperative bleeding and the rate of neurological complications compared to deep hypothermia.</div><div>Despite these improvements, surgical times and systemic circulatory arrest remain the main determinants of perioperative morbi-mortality. Recently, the strategy of normothermic circulation without interruption of perfusion of the lower body – in selected cases – has been adopted for a more physiological repair of the aortic arch.</div></div><div><h3>Conclusions</h3><div>Overall, arch surgery requires extensive planning based on the aortic arch, supra-aortic vessels and cerebral anatomy. Therefore, the choice of arterial cannulation, organ perfusion strategy and the temperature at which the repair is completed should be individualized to the patient.</div></div>","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Pages 76-80"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398447","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":"Credits","authors":"","doi":"10.1016/S1134-0096(26)00014-8","DOIUrl":"10.1016/S1134-0096(26)00014-8","url":null,"abstract":"","PeriodicalId":42671,"journal":{"name":"Cirugia Cardiovascular","volume":"33 2","pages":"Page i"},"PeriodicalIF":0.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416228","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}