Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Ten years of clinical experience in the open surgical treatment of chest wall deformities.","authors":"Volkan Karaçam, Fatma Mutlu, Emrah Karcı, İlkay Kaya, Aydın Şanlı","doi":"10.4274/tjtcs.2026.2026-4-19","DOIUrl":"10.4274/tjtcs.2026.2026-4-19","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to present a 10-year single-center experience and evaluate perioperative and mid-term outcomes of open and combined surgical treatment for chest wall deformities.</p><p><strong>Methods: </strong>A total of 45 patients treated between January 2011 and December 2021 were retrospectively analyzed for age, sex, deformity type, surgical procedure, complications, hospital stay, and patient satisfaction. Statistical analyses were performed.</p><p><strong>Results: </strong>The cohort included 32 males and 13 females with a mean age of 14.14 years (median: 15, range: 12-20). Pectus carinatum was the most common deformity. Open surgery alone was performed in 31 patients (68.9%), combined with the Nuss procedure in 13 (28.9%), and with the Abramson procedure in 1 (2.2%). A significant association was found between deformity type and surgical method. The mean hospital stay was 4.22 days (median: 4, range: 2-10). Early complications occurred in 6.7% of patients, while recurrence was observed in 4.4%. Postoperative satisfaction scores were significantly higher than preoperative scores.</p><p><strong>Conclusion: </strong>Open surgery is an effective and reliable option for chest wall deformities, particularly in complex cases. Although minimally invasive techniques have advantages, surgical choice should be individualized based on patient age, deformity type, and surgical history.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"325-329"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139582","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":"Balloon-assisted detection and treatment of the origin of saccular aneurysms in ivy-like coronary arteries.","authors":"Rauf Avcı, Muhammed Rıdvan Ersoysal, Akif Durak, Göksel Çağırcı, Şakir Arslan","doi":"10.4274/tjtcs.2025.28102","DOIUrl":"10.4274/tjtcs.2025.28102","url":null,"abstract":"<p><p>Coronary artery aneurysms are increasingly identified through coronary angiography. To date, no consensus exists regarding the optimal management strategy. Treatment options include surgical intervention, stent placement, or medical therapy. We present a case demonstrating the successful use of a balloon-assisted technique to precisely locate the aneurysm origin and achieve effective exclusion with a covered stent, highlighting its potential as a novel therapeutic approach.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"263-264"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127155","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":"Perioperative ultrasonography in surgical stabilization of rib fractures: A single-center retrospective analysis of its utility in surgical planning and post-discharge follow-up.","authors":"Bayram Altuntaş","doi":"10.4274/tjtcs.2026.2026-3-14","DOIUrl":"10.4274/tjtcs.2026.2026-3-14","url":null,"abstract":"<p><strong>Background: </strong>Surgical stabilization of rib fractures (SSRF) improves outcomes in severe chest trauma. computed tomography is the gold standard for diagnosis, but real-time intraoperative localization remains a challenge. This observational study aimed to describe our single-center evaluation with perioperative ultrasonography for intraoperative localization of displaced rib fractures during SSRF.</p><p><strong>Methods: </strong>We retrospectively analyzed 16 patients with three or more displaced rib fractures who underwent SSRF between January 2020 and December 2025. All patients underwent ultrasonography in the operating room immediately prior to incision using a 4.4 MHz convex array transducer for fracture marking and incision planning. A standardized perioperative protocol was applied to all study participants to evaluate the feasibility of fracture localization. Post-discharge ultrasonography was performed as part of routine outpatient evaluation.</p><p><strong>Results: </strong>The mean postoperative hospital stay was 5.5 days. Associated thoracic injuries included pneumothorax (n=6), hemothorax (n=6), pulmonary contusion (n=2), traumatic pneumatocele (n=1) and hemopneumothorax (n=1). Perioperative ultrasonography enabled identification of displaced fracture sites and facilitated skin marking prior to incision. In all patients, cortical disruption was visualized as a step-off or discontinuity of the hyperechoic rib line using the convex probe. Postoperative complications were limited to two cases of superficial skin infection (12.5%). During follow-up, ultrasonography identified two cases (12.5%) of small, asymptomatic pleural effusions, which were subsequently confirmed by chest radiography.</p><p><strong>Conclusion: </strong>Perioperative ultrasonography appears to be a feasible adjunct for intraoperative localization of displaced rib fractures during surgical stabilization. Even with a lower-frequency convex probe, displaced fracture segments were identifiable. Larger prospective and comparative studies are required to determine its impact on operative metrics and clinical outcomes.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"319-324"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787336","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":"Left ventricular aneurysm formation as a complication of Takotsubo syndrome: Mechanistic and clinical implications.","authors":"Kenan Yalta, Muhammet Gürdoğan, Cihan Öztürk","doi":"10.4274/tjtcs.2026.2026-2-23","DOIUrl":"10.4274/tjtcs.2026.2026-2-23","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"267-268"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436850","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":"Sudden deaths due to acute aortic wall failure: A 10-year forensic autopsy series.","authors":"Caner Beşkoç, Burcu Ersoy, Yasemin Balcı","doi":"10.4274/tjtcs.2026.28721","DOIUrl":"10.4274/tjtcs.2026.28721","url":null,"abstract":"<p><strong>Background: </strong>Acute aortic wall failure (AAWF), including rupture and/or dissection phenotypes, represents a rare but often fatal acute aortic event that may develop without overt aneurysmal dilatation. The underlying pathological substrate remains incompletely characterized, although standardized histopathological criteria proposed by the Society for Cardiovascular Pathology (SCVP) have recently improved the consistency of aortic wall assessment in forensic investigations.</p><p><strong>Methods: </strong>In this retrospective autopsy-based study, 5,277 adult autopsies performed between 2013 and 2023 were reviewed. Non-traumatic fatal AAWF, confirmed by macroscopic and histopathological examination, was included. A total of 93 cases were identified, of which 78 were evaluable histologically according to the SCVP criteria. Cases were classified as rupture without dissection, dissection with rupture, and dissection without rupture. The latter was included as a comparative subgroup to contextualize medial degeneration patterns within the spectrum. Demographic characteristics, comorbidities, event location, cardiac findings, and toxicological results were recorded.</p><p><strong>Results: </strong>AAWF accounted for 6.7% of cardiovascular deaths. Median age was 58 years (interquartile range 49-67), and 68.8% were male. Eighty cases demonstrated rupture (rupture without dissection or dissection with rupture). Younger decedents (19-45 years) had lower rates of documented hypertension and atherosclerosis, while a comparable proportion met ≥3 SCVP medial degeneration criteria. The ascending aorta was most frequently involved (62.4%). Among histologically examined cases, mucoid extracellular matrix accumulation (65.4%), elastic fiber fragmentation (60.3%), and smooth muscle cell depletion (55.1%) was the most prevalent SCVP features; 43.6% met ≥3 SCVP criteria. Documented hypertension was associated with more advanced medial degeneration on univariable analysis (p=0.002) and was interpreted as pathological coexistence rather than an independent causal determinant. Increased heart weight consistent with cardiac hypertrophy was observed in 80.5% of cases.</p><p><strong>Conclusion: </strong>Fatal AAWF is characterized by structural medial degeneration identifiable using SCVP criteria and frequently coexists with hypertensive cardiac remodeling in forensic autopsy findings. Standardized SCVP-based assessment may improve diagnostic consistency in forensic practice. Molecular autopsy, particularly in younger decedents, may further clarify etiopathogenesis and support targeted evaluation.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"276-283"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379327","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":"An unexpected threat in the heart: Hydatid cyst in the interventricular septum.","authors":"Hüseyin Çetik, Mahir Kuyumcu, Muzaffer Bahçıvan","doi":"10.4274/tjtcs.2025.28110","DOIUrl":"10.4274/tjtcs.2025.28110","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"265-266"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311928","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":"Cardiac magnetic resonance imaging assessment of Del Nido versus cold blood cardioplegia in patients with low ejection fraction undergoing combined coronary artery bypass graft and mitral valve replacement: Early outcomes.","authors":"Safa Gode, Mücahit Polat, Aleyna Eroğlu Polat, Aysel Türkvatan Cansever, Mehmet Kanyılmaz, Okan Coşkun, Sarper Türker, Elif Güneysu, Soner Sanioğlu","doi":"10.4274/tjtcs.2026.2026-4-2","DOIUrl":"10.4274/tjtcs.2026.2026-4-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effects of Del Nido cardioplegia (DNC) and conventional cold blood cardioplegia (CBC) on early myocardial functional recovery, as assessed by cardiac magnetic resonance imaging, in patients with reduced ejection fraction undergoing concomitant coronary artery bypass grafting (CABG) and mitral valve replacement (MVR).</p><p><strong>Methods: </strong>This single-center prospective study was conducted between April 2024 and January 2025 and included 42 patients with a left ventricular ejection fraction (LVEF) <45% who underwent concomitant CABG and MVR. The mean age was 62.2±10.6 years, and 69.0% (n=29) of the patients were male. Patients were divided into two groups according to the myocardial protection strategy used: CBC (n=23) and DNC (n=19). Preoperative demographic, laboratory, and echocardiographic data were collected, and CMR was performed approximately 1 week before surgery to establish baseline values. Intraoperative parameters, postoperative clinical, laboratory, and echocardiographic findings as well as follow-up CMR findings obtained 1 month postoperatively were analyzed and compared between the groups.</p><p><strong>Results: </strong>The aortic cross-clamp time was significantly longer in the DNC group than in the CBC group (p=0.016), whereas the total volume of infused cardioplegia was comparable between the groups (p=0.323). Intraoperative blood transfusion requirements were significantly higher in the DNC group (p=0.013). Regarding myocardial recovery, the DNC group demonstrated superior biventricular improvement. Significant reductions in left ventricular end-diastolic volume (p<0.001) and end-systolic volume (p<0.001) indicated pronounced reverse remodeling and were accompanied by a modest increase in LVEF (p=0.046). Similarly, postoperative right ventricular (RV) function was significantly better in the DNC group (p=0.026), with a significant decrease in the RV end-systolic volume index (p=0.025), reflecting improved systolic emptying. Although in-hospital mortality was numerically higher in the DNC group (31.6% vs. 8.7%), the difference was not statistically significant (p=0.112). Importantly, all deaths were associated with refractory low cardiac output syndrome during the postoperative intensive care unit stay.</p><p><strong>Conclusion: </strong>CMR findings suggest that DNC may be a safe and effective myocardial protection strategy in patients with reduced LVEF undergoing CABG and MVR. Furthermore, DNC appeared superior to CBC in promoting early biventricular reverse remodeling in this study population. The higher mortality observed in the DNC group may be attributable to the small sample size, longer cross-clamp times, greater operative complexity, and potential selection bias.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"252-262"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363181","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":"Comparison of robot-assisted surgical and transcatheter closure of secundum atrial septal defect: A single-center retrospective study.","authors":"İsa Can, Ersin Kadiroğulları, Zinar Apaydın, Timuçin Aksu, Zihni Mert Duman, Barış Timur, Batuhan Yazıcı, Musa Kaya, Ali Rıza Demir, Taner İyigün","doi":"10.4274/tjtcs.2026.2025-12-11","DOIUrl":"10.4274/tjtcs.2026.2025-12-11","url":null,"abstract":"<p><strong>Background: </strong>Atrial septal defect (ASD) closure can be performed using either transcatheter or robot-assisted surgical approaches. This study aimed to compare the clinical outcomes, procedural characteristics, and complications associated with these two techniques in a large patient cohort.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 635 patients who underwent ASD closure via either robot-assisted surgery (Group I, n=290) or transcatheter closure (Group II, n=345). Preoperative, perioperative, and postoperative data, including procedural times, complications, and follow-up outcomes, were evaluated. In addition, patients treated after 2019 were analyzed as a subgroup and categorized as Group Is (robot-assisted surgery, n=101) and Group IIs (transcatheter closure, n=105).</p><p><strong>Results: </strong>Patients in Group I had significantly longer procedural times and hospital stays than those in Group II (p<0.001). Postoperative tricuspid regurgitation was more frequent in the transcatheter group (p=0.003). Device migration occurred in 3.2% of transcatheter cases. Overall neurological events occurred in 0.7% of Group I patients and 2.6% of Group II patients (p=0.06). No significant difference in postoperative arrhythmia rates was observed between the groups. In the subgroup analysis of patients treated after 2019, the mean hospital stay was 2.36±0.5 days in Group Is and 2.21±0.6 days in Group IIs (p=0.07). Ventilation time was 3.6±1.4 hours versus 3.1±1.9 hours (p=0.05), and intensive care unit stay was 7.8±2.9 hours versus 7.2±3.0 hours (p=0.20), respectively.</p><p><strong>Conclusion: </strong>Both transcatheter and robot-assisted surgical ASD closure are safe and effective when patients are appropriately selected. Robot-assisted surgery offers the additional advantage of concomitant tricuspid valve annuloplasty and demonstrates improved outcomes with increasing surgical experience. Larger prospective multicenter studies are needed to further validate these findings.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"34 3","pages":"246-251"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431075","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":"Erratum.","authors":"","doi":"10.4274/tjtcs.2026.e001","DOIUrl":"10.4274/tjtcs.2026.e001","url":null,"abstract":"","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":"34 3","pages":"335"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431325","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":"Effect of ultra-fast-track cardiac anesthesia on vasoactive-inotropic support after coronary artery bypass grafting.","authors":"Nezir Yılmaz, Abdurrahman Dağhan, Mehmet Ziya Ertaş, Cengiz Güven, Abuzer Deniz Sürücü","doi":"10.4274/tjtcs.2026.2026-2-38","DOIUrl":"10.4274/tjtcs.2026.2026-2-38","url":null,"abstract":"<p><strong>Background: </strong>Ultra-fast-track cardiac anesthesia (UFTCA) aims to promote rapid tracheal extubation and has increasingly been incorporated into enhanced recovery protocols after coronary artery bypass grafting (CABG). Nevertheless, its influence on early postoperative hemodynamic stability, particularly in terms of vasoactive-inotropic requirements, remains insufficiently defined.</p><p><strong>Methods: </strong>In this study with a prospective, randomized design, adult patients scheduled for elective isolated CABG were assigned in a 1:1 ratio to either immediate extubation in the operating theater (UFTCA group) or conventional extubation in the intensive care unit (ICU). All participants received standardized general anesthesia combined with ultrasound-guided thoracic paravertebral and femoral nerve blocks. The primary endpoint was the cumulative vasoactive-inotropic score (VIS) within the first 24 hours postoperatively. Secondary endpoints included ICU and hospital length of stay, time to mobilization, chest tube removal, postoperative pain, nausea and vomiting, delirium, and quality of recovery evaluated using the quality of recovery-15 (QoR-15).</p><p><strong>Results: </strong>Outcome analyses were performed on 98 randomized patients (60.2% male; mean age 63.1±8.4 years) with comparable baseline variables between groups. The UFTCA group demonstrated significantly lower 24-hour cumulative VIS values compared with the conventional extubation group (1.74±1.75 <i>vs</i>. 3.97±2.82; p<0.05). Additionally, ICU and hospital stay durations, time to mobilization, and chest tube removal occurred earlier in the UFTCA cohort. QoR-15 scores were significantly improved in the UFTCA group. Postoperative pain scores, rescue analgesic use, nausea, vomiting, and delirium rates did not differ significantly. No reintubation or respiratory complications were observed following ultra-fast-track management.</p><p><strong>Conclusion: </strong>Immediate extubation using an UFTCA strategy was associated with reduced vasoactive-inotropic support requirements and improved early recovery metrics after CABG, without compromising safety.</p>","PeriodicalId":49413,"journal":{"name":"Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"239-245"},"PeriodicalIF":0.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876363","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}