General Thoracic and Cardiovascular Surgery Cases最新文献

{"title":"Life-threatening hemorrhagic shock due to intercostal artery perforation from a protruding staple leg after pulmonary wedge resection with a reinforced stapler: a case report.","authors":"Shin-Nosuke Watanabe, Daisuke Kimura, Takahiro Sasaki, Shuta Kimura, Chisaki Ichinohe, Tsubasa Kato, Shiori Ono, Hirose Imai, Masahito Minakawa","doi":"10.1186/s44215-026-00256-3","DOIUrl":"10.1186/s44215-026-00256-3","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary wedge resection is a lung-sparing procedure, with mechanical staplers enhancing surgical safety. Staple line reinforcement reduces air leakage; however, its effect on preventing mechanical vascular injury remains unclear. Staple-related vascular injuries rarely cause life-threatening complications. Here, we report a rare case of hemorrhagic shock caused by intercostal artery perforation from a protruding staple leg following thoracoscopic wedge resection with a reinforced stapler, which was likely triggered by lung collapse and re-expansion.</p><p><strong>Case presentation: </strong>A 76-year-old man underwent thoracoscopic wedge resection of right segment 6 for suspected metachronous lung adenocarcinoma using a reinforced stapler with a gold cartridge. The surgery was uneventful. On postoperative day (POD) 1, accidental chest drain removal caused lung collapse. After drain reinsertion and lung re-expansion on POD 2, the patient developed hemorrhagic shock on POD 3. Emergency thoracotomy revealed massive intrathoracic hemorrhage from the eighth intercostal artery due to a staple leg protruding through the reinforcement and perforating the artery during lung inflation. Hemostasis was achieved using electrocautery and artery ligation, followed by removal of the protruding staple and additional staple line reinforcement. The postoperative course was uneventful, and the patient was discharged on POD 10.</p><p><strong>Conclusions: </strong>Mechanical vascular injury due to staple protrusion can occur despite reinforced staplers. Lung collapse and re-expansion may alter the spatial relationship between the staple line and adjacent chest wall vessels, thereby increasing arterial injury risk. Careful staple line inspection, appropriate cartridge selection based on tissue thickness, and chest drain management are essential for preventing this rare complication.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"5 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207465","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":"Re-do Konno procedure and aortic root replacement for prosthetic valve endocarditis involving the aorto-ventriculoplasty patch: a case report.","authors":"Hayate Nomura, Shintaro Katahira, Kota Itagaki, Koki Ito, Goro Takahashi, Kiichiro Kumagai, Yoshikatsu Saiki","doi":"10.1186/s44215-026-00263-4","DOIUrl":"10.1186/s44215-026-00263-4","url":null,"abstract":"<p><strong>Background: </strong>The Konno procedure is an effective option for performing aortic valve replacement in pediatric patients utilizing an aortoventriculoplasty patch with a right ventricular outflow patch. However, re-do procedures are technically demanding and carry a non-negligible risk of surgical complications when the prosthetic materials are infected. We report a case of a patient who successfully underwent a re-do Konno procedure and an aortic root replacement for prosthetic valve endocarditis involving an aortoventriculoplasty patch.</p><p><strong>Case presentation: </strong>A 21-year-old male patient had undergone multiple aortic valvular surgeries since childhood. The patient's subsequent clinical course was complicated by prosthetic valve endocarditis caused by Propionibacterium acnes that occurred at the age of 19 years, which was treated with antibiotics. Due to the occurrence of a subdural hematoma associated with recurrent endocarditis and exacerbated residual paravalvular leak, the patient was referred to our hospital to receive the appropriate multidisciplinary care throughout the perioperative period. After managing the intracranial hemorrhage, aortic root replacement along with reconstruction of the Konno patch and right ventricular outflow tract was performed using a fresh autologous pericardium. Postoperative echocardiography revealed hemodynamic stability without residual paravalvular leakage. Computed tomography revealed the absence of pseudoaneurysms. The patient was discharged uneventfully after six weeks of antibiotic treatment.</p><p><strong>Conclusions: </strong>The re-do Konno procedure and aortic root replacement can be effective surgical options to resolve sustained infection with indwelling prosthetic materials.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145970","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":"Right middle and lower bilobectomy using a modified fissureless technique: a case report.","authors":"Eiji Narusawa, Toshiteru Nagashima, Yoichi Ohtaki, Natsuko Kawatani, Tomohiro Yazawa, Ryohei Yoshikawa, Masazumi Koike, Ken Shirabe, Seshiru Nakazawa","doi":"10.1186/s44215-026-00262-5","DOIUrl":"10.1186/s44215-026-00262-5","url":null,"abstract":"<p><strong>Background: </strong>Fissureless lobectomy has been shown to prevent air leaks in patients with fused or incomplete interlobar fissures or emphysema. The technique is also beneficial in advanced lung cancers involving adjacent lobes, where interlobar manipulation is technically difficult. Although this technique is widely used in standard lobectomies, reports on bilobectomy remain scarce.</p><p><strong>Case presentation: </strong>A 57-year-old woman with left-sided tongue cancer (pT2N0M0, Stage II) underwent subtotal glossectomy followed by postoperative concurrent chemoradiotherapy. Eighteen months after the surgery, imaging revealed a mass in the right lower lobe. Bronchoscopy confirmed squamous cell carcinoma, and the patient was referred to our department with suspected pulmonary metastasis. Over the 3 weeks following initial presentation, the lung tumor enlarged rapidly. The tumor was centered in the lower lobe with invasion of the middle and upper lobes, and the distal lung parenchyma was complicated by obstructive pneumonia. Although antibiotics were administered, the fever and inflammatory markers persisted; thus, we decided to proceed with surgery for infection control. Due to the presence of incomplete lung fissure and the lower lobe tumor invading the other lobes, pneumonectomy was the initial option. However, to preserve lung capacity, we decided to perform a fissure-last right middle and lower bilobectomy with division of the interlobar pulmonary artery prior to resection of the bronchus. The patient was discharged 16 days after surgery without complications.</p><p><strong>Conclusions: </strong>We report a case of bilobectomy using a modified fissureless technique and describe the technical details of how we dissect the pulmonary artery prior to resection of the bronchus. Being familiar with the fissureless bilobectomy technique is an important option for avoiding right pneumonectomy.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937148","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":"Transatrial left-ventricular cannulation for a shaggy aorta in aortic arch surgery: a case report.","authors":"Atsutaka Aratame, Masanori Sakaguchi, Ryosuke Ieguchi, Toshio Baba","doi":"10.1186/s44215-026-00260-7","DOIUrl":"10.1186/s44215-026-00260-7","url":null,"abstract":"<p><strong>Background: </strong>Ascending aortic cannulation is the standard arterial inflow strategy for cardiovascular surgery that requires cardiopulmonary bypass. However, this approach can be problematic in patients with extensive atheromatous disease of the ascending aorta, commonly referred to as shaggy aorta, because of the increased risk of thromboembolic complications. Therefore, alternative cannulation strategies are required in such high-risk settings.</p><p><strong>Case presentation: </strong>A 75-year-old woman presented with a 55-mm distal aortic arch aneurysm accompanied by an extensively shaggy aorta involving the ascending aorta. Ascending aortic arch replacement using the frozen elephant trunk technique was performed, and the transatrial left ventricular cannulation technique for arterial inflow. Cardiopulmonary bypass was established while preserving the spontaneous cardiac activity with epicardial pacing during cooling. Additional embolic prevention strategies include temporary retrograde cerebral perfusion before selective antegrade cerebral perfusion and controlled blood evacuation via the femoral artery during reperfusion. The operative, cardiopulmonary bypass, cardiac arrest, and circulatory arrest times were 326, 185, 91, and 61 min, respectively. The postoperative course was uneventful, and no thromboembolic complications, including cerebral infarction, were observed. Postoperative imaging confirmed the complete exclusion of the aneurysm without endoleaks.</p><p><strong>Conclusion: </strong>Thoracic aortic aneurysm surgery in patients with a shaggy ascending aorta carries a substantial risk of embolism. The present case demonstrates that transatrial left ventricular cannulation combined with multiple embolic prevention strategies might be a safe and effective option for aortic arch surgery in this high-risk population.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937181","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":"Early prosthetic valve endocarditis presenting as acute right coronary artery occlusion 1 month after aortic valve replacement: a case report.","authors":"Koki Yokawa, Kazunori Yoshida, Ko Ishimoto, Taku Nakagawa, Yosuke Tanaka, Tomonori Higuma, Yoshihiro Oshima, Hidefumi Obo, Hidetaka Wakiyama","doi":"10.1186/s44215-026-00257-2","DOIUrl":"10.1186/s44215-026-00257-2","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic valve endocarditis (PVE) is a life-threatening complication following valve replacement and is often challenging to diagnose in the early postoperative period. Coronary embolization is a rare manifestation of infective endocarditis, and PVE presenting as acute coronary syndrome is exceptionally uncommon.</p><p><strong>Case presentation: </strong>A 73-year-old man underwent surgical aortic valve replacement with a 21-mm bioprosthetic valve. His postoperative course was uneventful, and he was discharged without anticoagulation therapy. One month later, he developed exertional dyspnea, gastrointestinal symptoms, and intermittent chest pain, which progressed to cardiogenic shock with severe bradycardia. Emergent coronary angiography revealed acute occlusion of the right coronary artery, and percutaneous coronary intervention was performed. Intravascular ultrasound and contrast-enhanced computed tomography revealed a low-echoic, low-attenuation lesion at the right coronary ostium, initially interpreted as thrombotic material. Despite successful revascularization, profound circulatory instability persisted. Subsequent echocardiography revealed prosthetic valve dehiscence with an annular abscess, confirming early PVE. Emergent surgery included annular reconstruction with a bovine pericardial patch, aortic root replacement, removal of the coronary stent, and coronary artery bypass grafting. Intraoperative hemodynamics remained unstable, necessitating postoperative veno-arterial extracorporeal membrane oxygenation support. The patient ultimately succumbed to non-occlusive mesenteric ischemia on postoperative day 10.</p><p><strong>Conclusions: </strong>This case illustrates a rare and complex presentation of early PVE manifesting as acute right coronary artery occlusion. Coronary imaging alone may be insufficient to differentiate infected vegetation from thrombus. Early valve-focused echocardiographic evaluation is essential in patients with recent valve surgery presenting with acute coronary events.</p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848865","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":"Thoracoscopic right S1 + S3 segmentectomy for lung cancer with a displaced B2 bronchus: a case report.","authors":"Yuki Shindo, Shinjiro Nagai, Katsushi Toyohara, Kaoru Ochi, Kiyoshi Sato, Nobuharu Hanaoka, Takahiro Katsumata","doi":"10.1186/s44215-026-00261-6","DOIUrl":"10.1186/s44215-026-00261-6","url":null,"abstract":"","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794369","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":"Unusual radiological presentation of extralobar pulmonary sequestration: a preoperative diagnostic challenge.","authors":"Yuya Nobori, Takehiro Tsuchiya, Masaki Anraku","doi":"10.1186/s44215-026-00258-1","DOIUrl":"10.1186/s44215-026-00258-1","url":null,"abstract":"<p><p>BACKGROUND: Extralobar pulmonary sequestration is a rare disease and is frequently associated with congenital malformations. Herein, we report an adult case of an unusual extralobar sequestration accompanied by a bronchogenic cyst and the concurrent absence of the left pericardium. CASE PRESENTATION: A 57-year-old female patient presented with an abnormal shadow on a chest radiograph. Contrast-enhanced computed tomography revealed a partially enhanced cystic mass in the left anterior mediastinum. Another cystic lesion was detected on the left side of the trachea in the upper mediastinum. The anterior mediastinal mass was suspected to be a cystic thymoma, and thus, a left thoracoscopic surgery was performed for its resection. The mass originated from a left pulmonary hilar region and was covered by an independent visceral pleura. The feeding artery originated from the left pulmonary artery with no connection to the bronchus. Histopathological results revealed that the mass consisted of alveolar cells, bronchial epithelium, cartilage, and a cystic structure with highly viscous contents, and it was finally diagnosed as extralobar sequestration. CONCLUSIONS: Extralobar sequestration should be considered a differential diagnosis for atypical anterior mediastinal masses near the hilar region, especially in patients with other congenital malformations. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794422","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":"Potential deformation of the stented portion in partial frozen elephant trunk: a double-edged sword during retrograde flow under retrograde perfusion.","authors":"Takeshi Shimamoto, Kenji Minatoya","doi":"10.1186/s44215-026-00259-0","DOIUrl":"10.1186/s44215-026-00259-0","url":null,"abstract":"","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":"5 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731111","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":"Successful orthotopic heart transplantation following total aortic replacement in a patient with Marfan syndrome: case report.","authors":"Tatsuya Tago, Masatoshi Akiyama, Kentaro Yuda, Kota Itagaki, Katsuhiro Hosoyama, Koki Ito, Yusuke Suzuki, Shintaro Katahira, Goro Takahashi, Kiichiro Kumagai, Yoshikatsu Saiki","doi":"10.1186/s44215-026-00249-2","DOIUrl":"10.1186/s44215-026-00249-2","url":null,"abstract":"<p><p>BACKGROUND: Aortic dissection and aneurysm rupture are leading causes of death in patients with Marfan syndrome. Due to the risk of such vascular complications, the indication for heart transplantation in this population remains controversial. Previous reports, however, have demonstrated that heart transplantation in patients with Marfan syndrome can result in good long-term survival comparable to that in patients without Marfan syndrome. Here, we present a case of successful orthotopic heart transplantation after total aortic replacement in a patient with Marfan syndrome. CASE PRESENTATION: A 41-year-old man with Marfan syndrome, who had been managed conservatively for type B aortic dissection, developed acute type A dissection involving both coronary arteries at age 30, resulting in myocardial infarction. He underwent aortic root replacement with a mechanical valve. Thereafter, he was repeatedly hospitalized for heart failure due to ischemic cardiomyopathy. Three years later, at age 33, he was referred to our institution for heart transplant registration because of progressively deteriorating cardiac function and frequent episodes of intractable lethal arrhythmias. He underwent replacement of the ascending aorta and aortic arch, along with bioprosthetic aortic valve replacement. His immediate postoperative course was complicated by hemodynamic decompensation, necessitating support with an extracorporeal left ventricular assist device. One year later, he underwent a thoracoabdominal aortic replacement and bridge-to-bridge implantation of a left ventricular assist device. Three years later, at age 37, he underwent replacement of the durable device because of a pump pocket infection. After 7 years on the transplantation list, he underwent successful orthotopic heart transplantation from a suitable donor at the age of 41. CONCLUSIONS: This rare case report describes a patient with Marfan syndrome who underwent orthotopic heart transplantation after total aortic replacement, followed by multiple surgical procedures, including extracorporeal and durable left ventricular assist device implantations, over an extended period. Although total aortic replacement was challenging in the context of complex coexisting cardiovascular disease, this approach enabled subsequent heart transplantation after mitigating the potential risk of Marfan syndrome-associated cardiovascular events. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719286","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":"Resection and patch aortoplasty for right renal artery aneurysm through a midline laparotomy.","authors":"Ryo Nakanishi, Hiroaki Osada, Takehiko Matsuo, Kenji Minatoya","doi":"10.1186/s44215-026-00255-4","DOIUrl":"10.1186/s44215-026-00255-4","url":null,"abstract":"<p><p>BACKGROUND: Renal artery aneurysm (RAA) is a rare but potentially life-threatening vascular pathology. Surgical management depends on the aneurysm’s location and morphology. In cases with extensive aortic calcification or anatomical complexity, standard clamping techniques may be infeasible, requiring alternative hemostatic strategies. We present a unique case of RAA in a patient with Takayasu’s arteritis and diffuse aortic calcification, in whom intra-aortic balloon occlusion and patch aortoplasty were used as a salvage technique during surgical repair. CASE PRESENTATION: An 80-year-old woman with a history of Takayasu’s arteritis was referred for surgical treatment of an enlarging right RAA (55 × 74 mm), incidentally detected on imaging during hospitalization for pneumonia. Preoperative computed tomography (CT) demonstrated diffuse calcification of the entire aorta and an aneurysm located at the origin of the right renal artery. The distal segment of the right renal artery was occluded, and the right kidney could not be identified. Due to anticipated bleeding risk and poor clamping accessibility, cardiopulmonary bypass was established via the right femoral vessels. Multiple intra-aortic balloon occlusion catheters were inserted, though several ruptured intraoperatively. Hemostasis was ultimately achieved by inflating a balloon inserted directly through the operative field and performing a patch closure of the dilated right renal artery ostium. The patient required massive transfusion and temporary renal replacement therapy postoperatively. She was discharged to rehabilitation on postoperative day 49. Postoperative CT confirmed patch integrity, but a localized aortic dissection at the balloon site was observed. CONCLUSIONS: This case illustrated the technical challenges of surgical approaches for RAA in patients with severe aortic calcification due to Takayasu’s arteritis. Intra-aortic balloon occlusion is a useful alternative to conventional clamping but carries a risk of rupture, particularly in calcified aorta. Patch aortoplasty may be considered for elderly patients where graft replacement is not feasible. Preoperative imaging is essential to plan individualized strategies for bleeding control and vascular access in high-risk patients. </p>","PeriodicalId":520286,"journal":{"name":"General Thoracic and Cardiovascular Surgery Cases","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611661","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}