Annals of Thoracic Surgery最新文献_第2页

An Institutional Comparison of Patients Supported with Surgical versus Percutaneous Biventricular Assist Devices. 手术与经皮双心室辅助装置支持患者的制度比较。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-21 DOI: 10.1016/j.athoracsur.2025.04.038

Jessica S Clothier, Serge Kobsa, Markian Bojko, Lynette Lester, Nithya Rajeev, Jonathan Praeger, Sanjeet Patel, Anahat Dhillon, Ajay Vaidya, Aaron Wolfson, Jonathan Nattiv, Mark Barr, Amy Hackmann, Raymond Lee

{"title":"An Institutional Comparison of Patients Supported with Surgical versus Percutaneous Biventricular Assist Devices.","authors":"Jessica S Clothier, Serge Kobsa, Markian Bojko, Lynette Lester, Nithya Rajeev, Jonathan Praeger, Sanjeet Patel, Anahat Dhillon, Ajay Vaidya, Aaron Wolfson, Jonathan Nattiv, Mark Barr, Amy Hackmann, Raymond Lee","doi":"10.1016/j.athoracsur.2025.04.038","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.04.038","url":null,"abstract":"Background: Surgical Biventricular Assist Devices (sBiVADs) are well-established in end-stage heart failure, while newer and less-invasive percutaneous BiVADs (pBiVADs) are understudied. We report these two approaches in the largest pBiVAD patient series to date METHODS: All consecutive BiVAD-supported patients at our institution from 2014 to 2023 were retrospectively reviewed (n=46). sBiVAD (n=27) and pBiVAD patients (n=19) (defined as Impella 5.5 with Impella RP [n = 4] or percutaneous oxygenated-right ventricular assist device [n = 15]) were compared.Results: There were no significant differences in preoperative risk factors. pBiVAD patients required fewer intraoperative packed red blood cells (2.0 vs 6.0, p <0.001), fresh frozen plasma (0.0 vs 4.0, p=0.001), and platelet (0.0 vs 4.0, p=0.001) transfusions. pBiVADs had fewer unanticipated returns to the operating room (0.47 ± 0.70 vs 2.22 ± 1.87 per patient, p < 0.001) and fewer postoperative packed red blood cells (8.0 vs 27.0, p<0.001), fresh frozen plasma (1.0 vs 8.0, p<0.001) and platelet (0.0 vs 10.0, p<0.001) transfusions. Thirty-day survival was not significantly different between sBiVADs and pBiVADs (56.6% vs 36.8%, p = 0.341).Conclusions: We consider pBiVAD a less invasive, viable bridge to transplant, durable left ventricular assist device, or recovery.","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Supporting Professionalism: Introduction of 360 Degree Review to the Credentialing Process by the American Board of Thoracic Surgery. 支持专业：美国胸外科委员会对认证过程引入360度审查。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-21 DOI: 10.1016/j.athoracsur.2025.03.010

Thoralf M Sundt, Joseph C Cleveland, Cameron D Wright, Joseph A Dearani, Michael J Mack

引用次数: 0

A Case of Selection, Not Superiority. 这是一种选择，而不是优势。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-20 DOI: 10.1016/j.athoracsur.2025.05.005

Alexandria L Soto, Matthew G Hartwig

引用次数: 0

Nicks, Manouguian, and Y-incision Aortic Annular Enlargement: Do All Roads Lead to Rome? nick， Manouguian和y型切口主动脉环扩大：条条大路通罗马吗？

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-20 DOI: 10.1016/j.athoracsur.2025.05.006

Alexander Makkinejad, Bo Yang

引用次数: 0

Left Ventricular Outflow Tract Modification During Robotic Mitral Valve Repair. 机器人二尖瓣修复时左心室流出道的改变。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-20 DOI: 10.1016/j.athoracsur.2025.05.003

Didier F Loulmet, Ali Hage, Katherine G Phillips, Michael Dorsey, Les James, Joshua Scheinerman, Noritsugu Naito, Eugene A Grossi

{"title":"Left Ventricular Outflow Tract Modification During Robotic Mitral Valve Repair.","authors":"Didier F Loulmet, Ali Hage, Katherine G Phillips, Michael Dorsey, Les James, Joshua Scheinerman, Noritsugu Naito, Eugene A Grossi","doi":"10.1016/j.athoracsur.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.05.003","url":null,"abstract":"Background: Earlier intervention for mitral valve (MV) regurgitation leads to smaller left ventricles (LV) and potentially increases the risk of post-operative systolic anterior motion (SAM). We performed left ventricular outflow tract (LVOT) modification in patients with an increased risk of SAM.Methods: From January 2019 to May 2024, 800 consecutive totally endoscopic robotic MV repairs (TERMVR) were performed. Based on pre-bypass TEE, post-operative SAM risk was graded as low(n=610,76.2%), moderate(n=144, 18%), or high(n=46, 5.8%). Patients with moderate or high risk of SAM were categorized as \"increased risk of SAM\". To prevent post-operative SAM, LVOT modification consisted in ventricular septal bulge(VSB) myectomy and/or septal myocardial trabeculations(SMT) resection. Operative notes, echocardiograms, and STS dataset were analyzed.Results: Mean patient age was 63.8 years (range= 22-90); 45(5.6%) had prior cardiac surgery. Thirty-day mortality was 5(0.6%). A total of 190(23.8%) patients had an increased risk of SAM. LVOT modification was performed in the majority with increased risk of SAM (139/190, 73.2%) and in a minority with low risk of SAM (42/610,6.9%). In those undergoing LVOT modification(n=181), isolated VSB myectomy was performed in 140(77.3%), isolated SMT resection in 32(17.7%), and both in 9(5.0%). The anterior leaflet was never detached. One patient experienced transient SAM while on inotropes. There was no need for intraoperative MV repair revision for SAM.Conclusions: Currently, a significant proportion of MV repairs are at elevated risk of post-operative SAM. In our TERMVR experience, LVOT modification was performed with minimal morbidity and prevented any subsequent MV repair revision for SAM.","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

The burden of Patient- Prostheses- Mismatch: a problem unsolved. 患者-义肢-不匹配的负担：一个未解决的问题。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-20 DOI: 10.1016/j.athoracsur.2025.05.007

Anatol Prinzing

引用次数: 0

Society Board 社会委员会

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-19 DOI: 10.1016/S0003-4975(25)00330-3

引用次数: 0

Editor's Choice 编辑器的选择

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-19 DOI: 10.1016/S0003-4975(25)00331-5

引用次数: 0

Spinal Cord Protection for Open Descending Thoracic and Thoracoabdominal Aorta Surgery: An STS Adult Cardiac Surgery Database Analysis. 开放降胸和胸腹主动脉手术的脊髓保护：STS成人心脏手术数据库分析。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-17 DOI: 10.1016/j.athoracsur.2025.05.002

Andrea Amabile, Levi N Bonnell, Alex Del Vecchio, Ava Basciano, James Antonios, Tsuyoshi Kaneko, Robert H Habib, Gabriele Di Luozzo

{"title":"Spinal Cord Protection for Open Descending Thoracic and Thoracoabdominal Aorta Surgery: An STS Adult Cardiac Surgery Database Analysis.","authors":"Andrea Amabile, Levi N Bonnell, Alex Del Vecchio, Ava Basciano, James Antonios, Tsuyoshi Kaneko, Robert H Habib, Gabriele Di Luozzo","doi":"10.1016/j.athoracsur.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.05.002","url":null,"abstract":"Background: Spinal cord injury (SCI) is a devastating complication of open descending thoracic (DTAA) and thoracoabdominal aortic aneurysms (TAAA). We evaluated the efficacy of spinal drain placement on spinal injury in DTAA/TAAA repair.Methods: Adult patients (>18 years) undergoing open DTAA/TAAA repair without aortic root, ascending or arch involvement were identified from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2017-2023). Cases were excluded if preoperative paralysis, postoperative spinal drain placement; or if patient expired in the operating theater. Primary SCI outcomes were 1) lower extremity paralysis lasting >24 hours, and 2) a composite of paralysis and/or paresis lasting >24 hours. Multivariable logistic regression models with adjustment for patient, intraoperative, and aortic disease factors were derived to evaluate the role of spinal drain placement in DTAA and TAAA repair.Results: The study population included 2,724 patients from 224 hospitals who underwent DTAA (n=813; 61.3% spinal drain) or TAAA (n=1,911; 75.2% spinal drain) repairs. Observed rates of SCI were distinctly higher for TAAA versus DTAA repairs (paralysis: 7.3% vs. 1.9%, p<0.001; paralysis/paresis: 10.3% vs. 3.0%; p<0.001). Spinal drain was independently associated with increased paralysis (adjusted odds ratios [AOR (95% Confidence Intervals)]=3.63 [1.94-6.80], p<0.001) and paralysis/paresis (AOR=2.51 [1.58-4.00], p<0.001) in TAAA repair but not DTAA.Conclusions: An unexpected association was found between spinal drain use and increased spinal injury. We hypothesize that spinal drain use may indicate higher risk anatomy as opposed to being a causative factor of spinal cord injury.","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Exercise performance and right ventricular remodeling following the Cone repair in patients with different severity of Ebstein´s anomaly. 不同程度Ebstein异常患者椎体修复后运动表现与右室重构的关系。

IF 3.6 2区医学

Annals of Thoracic Surgery Pub Date : 2025-05-15 DOI: 10.1016/j.athoracsur.2025.04.037

Melchior Burri, Nicole Nagdyman, Lina Hock, Christian Meierhofer, Julia Hock, Julie Cleuziou, Rüdiger Lange

{"title":"Exercise performance and right ventricular remodeling following the Cone repair in patients with different severity of Ebstein´s anomaly.","authors":"Melchior Burri, Nicole Nagdyman, Lina Hock, Christian Meierhofer, Julia Hock, Julie Cleuziou, Rüdiger Lange","doi":"10.1016/j.athoracsur.2025.04.037","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.04.037","url":null,"abstract":"Background: While the Cone repair has shown good outcome regarding valve competence, its effect on exercise performance and right ventricular remodelling are unclear.Methods: Between 01/2010 and 06/2021, 60 patients underwent a Cone repair at our centre. We excluded patients with previous operation (n=6), age<5 years (n=3), in-hospital-death (n=2), replacement before discharge (n=1) and missing follow-up (n=2), resulting in a study-population of 46 patients. Median age was 27 years [range: 5.6-68.2], 28 (61%) were female. Patients were divided based on indication: (A) patients in NYHA I-II without findings of severe/progressed disease (B), patients in NYHA I-II and findings of severe/progressed disease in MRI or Spiroergometry, and (C) patients in NYHA III-IV.Results: Follow-up was 6.7±3.7years. Tricuspid regurgitation at last follow-up was none-mild in 40 patients, moderate in five, and severe in one patient, who underwent reoperation after 5.7years. NYHA class improved in 18 patients, stayed equal in 24 and worsened in four (p=0.002). CPET showed no difference between preoperative and postoperative exercise-capacity (preoperative: 72% of predicted vs. postoperative: 71%, p=1.0). Exercise-capacity improved only in group C. RV-EDVI decreased from 166ml/m2 to 114ml/m2 (p<0.001), the reduction was smaller in group A (-13%) compared to group B and C (-23% and -53%). Antegrade stroke-volume increased in every group (preoperative: 55ml, postoperative: 72ml, p=0.005).Conclusions: The Cone repair results in a substantial and sustained decrease in tricuspid valve regurgitation. While objective exercise capacity did not improve, NYHA class improvement, right ventricle size decreased and antegrade stroke volume increased.","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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