Journal of Thoracic and Cardiovascular Surgery最新文献_第2页

Iatrogenic Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection. 医源性主动脉夹层：来自国际急性主动脉夹层登记的见解。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-23 DOI: 10.1016/j.jtcvs.2025.05.011

Kevin M Harris, Neilesh B Parikh, Christoph A Nienaber, Elise M Woznicki, Arturo Evangelista, Marc Schermerhorn, Maral Ouzounian, Joseph S Coselli, Chih-Wen Pai, Marek P Ehrlich, Clayton A Kaiser, Marco Di Eusanio, Thomas G Gleason, Ibrahim Sultan, Kim A Eagle, Himanshu J Patel

{"title":"Iatrogenic Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection.","authors":"Kevin M Harris, Neilesh B Parikh, Christoph A Nienaber, Elise M Woznicki, Arturo Evangelista, Marc Schermerhorn, Maral Ouzounian, Joseph S Coselli, Chih-Wen Pai, Marek P Ehrlich, Clayton A Kaiser, Marco Di Eusanio, Thomas G Gleason, Ibrahim Sultan, Kim A Eagle, Himanshu J Patel","doi":"10.1016/j.jtcvs.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.05.011","url":null,"abstract":"Objectives: Risk factors, presentation, treatment, and outcomes were evaluated for iatrogenic (iAD) in comparison to spontaneous aortic dissection (sAD).Methods: Patients with acute AD enrolled in IRAD from 1996-2023 were separated into two groups: (iAD) (n=333 (2.5% of total ADs); type A - 252, type B - 81) and (sAD) (n=13,122; type A - 8846, type B - 4,276).Results: The etiology of iAD was predominantly cardiac surgery (n=146; 51% type A, 32% type B) and catheter-induced (n=134; 41% type A, 47% type B). Patients with iAD were more likely to be older, with a higher preponderance of atherosclerosis, known aortic aneurysm, valve disease, and peripheral arterial disease. Type A iAD patients had smaller aortic size and less frequent aortic regurgitation, and pericardial effusion. They also had less typical symptoms of AD. Medical management of type A AD was utilized more frequently in iatrogenic compared to spontaneous cases (13% vs. 8%, p= 0.016); management was statistically similar for type B. Overall Type A iAD had a higher hospital (25.8% vs 18.4%, p=0.005) and 4-year mortality (p=0.003), though mortality was similar for type B AD (p= NS). In a multivariable model, there was no difference in Type A hospital mortality between sAD and iAD.Conclusions: IAD occurs in older patients with known atherosclerosis and frequently without typical symptoms. Medical management is utilized more frequently for type A iAD. Mortality was higher for type A iAD compared to sAD, however no differences were seen for type B or in overall mortality in a multivariable model.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Commentary: Another Day, Another Model…Where Does Red Cell Distribution Width Fit in Perioperative Risk Prediction? 评论：新的一天，新的模型……红细胞分布宽度在围手术期风险预测中的适用范围？

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-20 DOI: 10.1016/j.jtcvs.2025.05.009

Chiedozie Udeh, Asha Singh

引用次数: 0

Commentator Discussion: Incidental use of angiotensin system inhibitors during neoadjuvant therapy for esophageal adenocarcinoma: An analysis of survival. 评论员讨论：在食管癌的新辅助治疗中偶然使用血管紧张素系统抑制剂：生存分析。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-19 DOI: 10.1016/j.jtcvs.2025.04.030

引用次数: 0

Reply: presence, progress, and parity: Sustaining momentum for women in cardiothoracic surgery. 回答：存在、进步和平等：女性在心胸外科手术中的持续动力。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-19 DOI: 10.1016/j.jtcvs.2025.04.039

Christina M Stuart, Nicole M Mott, Elizabeth A David

引用次数: 0

Commentator Discussion: AQG analysis of an aortic surgeon's lifetime experience: Step into the new age. 解说员讨论：主动脉外科医生一生经验的AQG分析：步入新时代。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-16 DOI: 10.1016/j.jtcvs.2025.04.026

引用次数: 0

The Long-term Outcomes of Concomitant Cox-Maze IV Procedure in Patients with Mitral Valve Disease and Atrial Fibrillation. 二尖瓣疾病合并心房颤动患者合并Cox-Maze IV手术的长期预后

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-16 DOI: 10.1016/j.jtcvs.2025.05.005

Jack J Yi, Tari-Ann Yates, Martha McGilvray, Connor Vinyard, Nicholas Banull, Laurie Sinn, June He, Christian Zemlin, Harold G Roberts, Matthew R Schill, Ralph J Damiano

{"title":"The Long-term Outcomes of Concomitant Cox-Maze IV Procedure in Patients with Mitral Valve Disease and Atrial Fibrillation.","authors":"Jack J Yi, Tari-Ann Yates, Martha McGilvray, Connor Vinyard, Nicholas Banull, Laurie Sinn, June He, Christian Zemlin, Harold G Roberts, Matthew R Schill, Ralph J Damiano","doi":"10.1016/j.jtcvs.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.05.005","url":null,"abstract":"Background: The most common indication worldwide for surgical ablation of atrial fibrillation (AF) is patients referred for mitral valve surgery. However, few reports have described late outcomes. This study examined ten-year outcomes in AF patients undergoing mitral surgery with and without concomitant Cox-Maze IV Procedure.Methods: Since January 2002, 847 patients with AF and mitral valve disease underwent either mitral surgery with a concomitant Cox-Maze IV Procedure (CMP-IV) (N = 407) or without (N = 440). The concomitant sub-groups, paroxysmal (N = 163) and non-paroxysmal AF (N = 244), were compared for freedom from tachyarrhythmias, and recurrence-free survival. Late survival was compared after propensity score-matching analysis.Results: The concomitant procedure provided good freedom from atrial tachyarrhythmias of 80% and 65% at years 5 and 10 respectively. The freedom from symptomatic AF recurrence was 94% and 83%, respectively. Although there was no difference between atrial tachyarrhythmia recurrence free survival between subgroups in the concomitant cohort (P = .13), there was a trend toward worse rhythm outcomes (P = .053) in patients with nonparoxysmal AF. Ten-year survival in the propensity-matched concomitant CMP-IV cohort was 54% (versus 43% without ablation), which represented a significant survival benefit in patients having concomitant ablation (P = .007).Conclusions: Cox-Maze IV procedure had good long-term outcomes in treating AF in patients undergoing mitral surgery and provided a significant survival benefit in patients receiving a concomitant ablation. There is recurrence in over 40% of patients at 10 years, indicating the need for continued rhythm follow-up.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply: Maximizing survival in patients with complex congenital heart disease: A call to arms. 答复：最大限度地提高复杂先天性心脏病患者的生存率：一个号召。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-16 DOI: 10.1016/j.jtcvs.2025.04.036

David M Kalfa, Edward Buratto

引用次数: 0

Commentary: Furthering our understanding of sex-based differences in cardiac disease. 评论：进一步加深我们对心脏疾病性别差异的理解。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-15 DOI: 10.1016/j.jtcvs.2025.05.008

Vladislav Baglaev, Jay D Pal

引用次数: 0

Commentary: "Is it really that hard?" 评论：“真的有那么难吗？”

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-15 DOI: 10.1016/j.jtcvs.2025.05.007

Brendon M Stiles, Marc Vimolratana

引用次数: 0

Hemodynamic Efficacy of Annular versus Sub-annular Repair to Repair Functional Tricuspid Regurgitation. 环状与亚环状修复修复功能性三尖瓣返流的血流动力学效果。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-05-15 DOI: 10.1016/j.jtcvs.2025.05.002

Dongyang Xu, Daisuke Onohara, Kirthana Sreerangathama Suresh, Kanika Kalra, Muralidhar Padala

{"title":"Hemodynamic Efficacy of Annular versus Sub-annular Repair to Repair Functional Tricuspid Regurgitation.","authors":"Dongyang Xu, Daisuke Onohara, Kirthana Sreerangathama Suresh, Kanika Kalra, Muralidhar Padala","doi":"10.1016/j.jtcvs.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.05.002","url":null,"abstract":"Objective: Surgical repair of functional tricuspid regurgitation caused due to annular dilatation and leaflet tethering from a dilated right ventricle is increasingly performed, but the optimal approach for such a repair is unclear. In this study, using a diseased model of FTR, an annular and sub-annular repair strategy were compared in repairing FTR and restoring valve kinematics and mobility.Methods: A diseased FTR model was developed using porcine hearts placed in a pulse duplicator (n=11 hearts). The effect of annuloplasty ring (TVA) in reducing FTR was first studied, then a sub-annular repair by septal relocation of the posterior and anterior papillary muscles (TVPA) was studied, followed by a combination of the two techniques (TVA+TVPA). FTR was quantified before and after each repair, and real time ultrasound was used to quantify leaflet coaptation, tenting, and leaflet mobility.Results: At baseline, all valves were competent without FTR. In the FTR model, regurgitation fraction increased to 28±16.2%. With TVA, FTR reduced to 11.3±5.9% (30mm ring), & 4.6±3.8% (28mm ring). With TVPA alone, FTR reduced to 6.5±8.5%. When TVA+TVPA was used, FTR reduced to 2.9±4.3% (30mm TVA+TVPA), and 1.3±1.6% (28mm TVA+TVPA). Largest systolic coaptation height and restoration of leaflet mobility to physiological levels was achieved with TVA+TVPA, with physiological levels of leaflet mobility restored.Conclusion: In this diseased model, complete correction of FTR, largest systolic coaptation height and restoration of physiological leaflet mobility was achieved with the combination of annular and sub-annular repairs, compared to isolated annular or sub-annular repair.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0