European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery最新文献

{"title":"Impact of severe skeletal muscle loss during the waiting period on prognosis in lung transplantation for interstitial lung disease.","authors":"Takaki Akamine, Daisuke Nakajima, Yohei Oshima, Ichiro Sakanoue, Hidenao Kayawake, Ryota Sumitomo, Shigeto Nishikawa, Satona Tanaka, Yojiro Yutaka, Toshi Menju, Hiroshi Date","doi":"10.1093/ejcts/ezaf240","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf240","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of skeletal muscle loss during the waiting period on postoperative outcomes following lung transplantation for interstitial lung disease.</p><p><strong>Methods: </strong>This retrospective analysis included adult patients with interstitial lung disease who underwent deceased- or living-donor lung transplantation at Kyoto University Hospital between 2010 and 2022. Skeletal muscle mass and quality (mean Hounsfield units) of the erector spinae at the 12th thoracic level were quantified using computed tomography. Skeletal muscle loss was defined as a reduction in mass or density while waiting for a transplant. Overall survival and early post-transplant outcomes were compared between patients with skeletal muscle loss and those with preserved muscle.</p><p><strong>Results: </strong>Of 95 participants, 23 (24.2%) and 72 (75.8%) were classified into skeletal muscle loss and skeletal muscle-maintained groups, respectively. No significant differences were observed in age, sex, or donor types between the two groups. The skeletal muscle loss and maintained groups' median waiting times were 2.1 and 2.3 years, respectively (P = 0.838). Bilateral lung transplantation was more common in the skeletal muscle loss group. Patients with muscle loss had a significantly longer post-transplant hospital stay (77 vs 54 days; P = 0.005) and lower 5-year survival rates (59.5 vs 71.3%; log-rank P = 0.013), respectively. Multivariate Cox regression analysis indicated that skeletal muscle loss was independently associated with poor overall survival (hazard ratio, 2.8; P = 0.004).</p><p><strong>Conclusions: </strong>Maintaining skeletal muscle during the waiting period is important to improve short- and long-term outcomes after lung transplantation.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664144","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":"Role of sarcopenia in predicting one-year outcomes after mini-invasive surgical or endovascular repair of infrarenal abdominal aortic aneurysms.","authors":"Pasqualino Sirignano, David Barillà, Giulia Colonna, Chiara Pranteda, Arianna Pignataro, Carmen Emanuela Setteducati, Stefano Brizzi, Noemi Baronetto, Maurizio Taurino, Efrem Civilini","doi":"10.1093/ejcts/ezaf241","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf241","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the outcome of a frail patients electively treated for abdominal aortic aneurysm (AAA) by open surgery with enhanced repair protocol (OSER) or endovascular aneurysm repair (EVAR).</p><p><strong>Methods: </strong>A retrospective study on frail AAA patients treated by EVAR and OSER was conducted. Patients were defined as frail if presenting a normalized total psoas muscle area (nTPA) <500 mm2/m2. This study aimed to evaluate the association between sarcopenia and AAA-related as well as all-cause mortality rates. Secondary outcomes included reinterventions, operative time, blood transfusion, length of ICU and postoperative hospital stay.</p><p><strong>Results: </strong>A total of 403 patients were included in the study, of which 122 (30.3%) had a nTPA < 500mm2/m2. Among them, 272 (67.5%) patients were treated with EVAR while 131 (32.5%) with OSER. Although EVAR was more frequently performed in sarcopenic patients than OSER (p < 0.001), there were no significant differences between the two groups in terms of intraoperative and postoperative outcomes. Likewise, no statistically significant differences were found regarding mortality and reintervention rates at Kaplan-Meier analysis. However, sarcopenic patients undergoing OSER exhibited a significantly higher all-cause mortality rate at 1 month (p = 0.031) and cumulative follow-up (p = 0.004) compared to all other subgroups.</p><p><strong>Conclusions: </strong>the present experience demonstrates that less invasive approaches, but surgical or endovascular, are viable for AAA patients with no significant difference in intraoperative and immediate postoperative outcomes. Nevertheless, the potential of EVAR as a preferred strategy should be considered for frail patients based on ascertained sarcopenia.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664145","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":"Assessing the safety, feasibility, and clinical outcomes of a fast-track strategy in open cardiac surgery.","authors":"Anna Sundström, Mark Larsson, Anna Falk, Malin Stenman, Francesca Campoccia Jalde, Magnus Dalén, Magnus Fredby, Ulrik Sartipy, Per Nordberg","doi":"10.1093/ejcts/ezaf238","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf238","url":null,"abstract":"<p><strong>Objectives: </strong>To study feasibility, safety and clinical outcomes after the implementation of a fast-track concept after open cardiac surgery.</p><p><strong>Methods: </strong>A single-center observational study (2018-2023) using data from the cardiothoracic intensive care unit (ICU) registry at the Karolinska University Hospital and the SWEDEHEART registry. The fast-track intervention included immediate extubation, early and frequent mobilization, prompt oral intake and transfer to regular ward the day after surgery. Main outcomes were proportion of patients discharged to regular ward on the first postoperative day, length of hospital stay, and 30-day mortality.</p><p><strong>Results: </strong>5234 open cardiac procedures were performed of which 2801 patients (78% men, median age 63 years SD 12.3, mean EuroSCORE II 2.0 SD 2.0) were treated at the fast-track unit. The most common procedures were coronary artery bypass grafting (CABG, 42.4%) and single non-CABG procedure (37.5%). In total, 94.6% (n = 2649) of patients were discharged the day after surgery. Of those requiring ICU care (n = 152), circulatory failure (n = 57) and reoperation due to bleeding or tamponade (n = 51) were most frequent. Patients with fast-track failure had a EuroSCORE II of 2.9 vs 1.9 in discharged patients (p < 0.001). Median hospital stay was 5 days for patients discharged as planned, compared to 8.7 days for those transferred to ICU (p < 0.001). The 30-day mortality was 0.3%, with 0.2% in patients discharged as planned and 1.3% in those requiring ICU transfer (p = 0.096).</p><p><strong>Conclusions: </strong>Following the fast-track implementation after open cardiac surgery, approximately 95% of patients were discharged the day after surgery, with a 30-day mortality rate of 0.3%.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661706","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":"Histological evaluation of human pulmonary artery intimal damage caused by various clamp techniques.","authors":"Yoshiki Chiba, Masahiro Miyajima, Yuki Takahashi, Kodai Tsuruta, Ryunosuke Maki, Hirofumi Adachi, Atsushi Watanabe","doi":"10.1093/ejcts/ezaf232","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf232","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated intimal damage at the histological level resulting from various clamp techniques in human pulmonary artery specimens obtained after lobectomy.</p><p><strong>Methods: </strong>We prospectively analysed patients who underwent anatomical lung resection at two centres between April 2021 and March 2025. The double-loop technique (DLT), DeBakey vascular clamp (3rd and 4th notches), Fogarty vascular clamp (2nd notch), endovascular clips (gold and silver), and vessel loop technique (VLT) were evaluated. Pulmonary artery specimens with an external diameter ≥10 mm were included. We measured the burst pressure and evaluated the intimal damage in the human pulmonary artery by using the modified Zhang's score (MZS; 0 - 5).</p><p><strong>Results: </strong>Thirty-six patients were enrolled, and 70 pulmonary artery samples were obtained. DeBakey 3rd exerted a significantly higher burst pressure than did DLT (P = 0.022). No significant difference was found between DLT and VLT (P = 0.453). A burst pressure ≥30 mmHg was achieved in all DLT cases. None of the samples clamped with DLT and VLT exhibited MZS 3 - 5. The rate of MZS ≥2 with DeBakey 3rd, Fogarty 2nd, gold and silver clips, and VLT was statistically comparable to that for DLT, whereas DeBakey 4th resulted in significantly higher MZS values than did DLT (P = 0.029).</p><p><strong>Conclusions: </strong>The DLT is a feasible and safe for thoracoscopic clamping. Additionally, DLT, VLT, and gold clip are appropriate for clamping the peripheral pulmonary artery. For DeBakey vascular clamp, notch selection should be carefully tailored to the vessel diameter.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629228","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":"Lobectomy is the preferred choice than sublobar resection for centrally located clinical stage i non-small cell lung cancer.","authors":"Satoshi Takamori, Marina Nakatsuka, Hikaru Watanabe, Jun Suzuki, Makoto Endo, Satoshi Shiono","doi":"10.1093/ejcts/ezaf233","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf233","url":null,"abstract":"<p><strong>Objectives: </strong>Tumour location can affect clinicians' decisions regarding the surgical procedure, especially when choosing between lobectomy and segmentectomy. The biological behaviour of clinical stage I non-small-cell lung cancer may differ based on tumour location. We aimed to explore the biological behaviour of centrally located clinical stage I non-small-cell lung cancer and to identify which surgical procedure is more appropriate for such tumors.</p><p><strong>Methods: </strong>This retrospective study included 719 patients who underwent curative surgery for stage I non-small-cell lung cancer between April 2004 and December 2023. The biological behaviour of the tumors was analyzed based on tumour location. Overall and recurrence-free survivals in patients who underwent lobectomy or more extensive procedures, including hilar and mediastinal lymph node dissection, were assessed based on tumour location.</p><p><strong>Results: </strong>A total of 124 (17.2%) and 595 (82.8%) patients were included in the centrally located and peripherally located groups, respectively. The centrally located group had a significantly higher standardized uptake value maximum on positron emission tomography/computed tomography, a higher-grade adenocarcinoma subtype, and a higher frequency of lymph node metastasis than the peripherally located group. In multivariable analysis, centrally located and radiologically pure solid tumors (consolidation/tumour ratio = 1) were significant factors for occult lymph node metastasis. No significant difference was observed in survival based on tumour location.</p><p><strong>Conclusions: </strong>Centrally located clinical stage I non-small-cell lung cancers tend to be hypermetabolic and have a potential risk of lymph node metastasis. Lobectomy could be a better treatment option for centrally located clinical stage I non-small-cell lung cancer.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621737","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 European association for cardiothoracic surgery (EACTS) - Core curriculum for the cardiac/cardiovascular surgeon.","authors":"Nabil Hussein, Maroua Eid, Jules Olsthoorn, Felix Nägele, Mahmoud Loubani, Eduard Quintana, Michael Borger, Thomas van Brakel, Rafa Sadaba, Stephen Clark, Patrick Myers","doi":"10.1093/ejcts/ezaf230","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf230","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery remains a high-stakes, technically complex specialty requiring rigorous, structured training. Across Europe, significant variation exists in training pathways, assessment standards, and certification, creating disparities in preparedness among newly qualified cardiac surgeons. To address this, the European Association for Cardio-Thoracic Surgery (EACTS) developed a unified Core Curriculum for the Cardiac/Cardiovascular Surgeon.</p><p><strong>Methods: </strong>This curriculum was developed over 12 months by a taskforce comprising experienced surgeons/trainers, educational experts, and trainee surgeons. Data were gathered through two National Trainee Summits (2023 and 2024), with representation from 26 national programs. Structured feedback from these events and additional stakeholder consultations shaped the framework, which incorporates Entrustable Professional Activities (EPAs), CanMEDS competencies and European Board of Cardiothoracic Surgery (EBCTS) syllabus.</p><p><strong>Results: </strong>The curriculum defines clinical and non-clinical competencies across three training stages-introductory, intermediate, and advanced-aligned with EPA benchmarks. It outlines requirements for trainees, trainers, training institutions including operative volume, educational content, and assessment methodology. Institutions are encouraged to adopt competency-based progression, minimum case numbers, regular multi-source feedback, and final certification via standardized examinations such as the EBCTS. Emphasis is also placed on supporting struggling trainees, quality assurance mechanisms, and future workforce planning.</p><p><strong>Conclusions: </strong>The EACTS Core Curriculum offers a harmonized, flexible, and competency-based framework for cardiac surgical training. Voluntary adoption of this curriculum across Europe is expected to enhance training quality, ensure patient safety, and facilitate surgeon mobility across borders. It aims to cultivate independent, reflective, and proficient cardiac surgeons equipped for evolving clinical demands.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602785","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":"What's the optimal duration of neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer: a real-world study.","authors":"Zhoujunyi Tian, Haoshuai Yang, Jin Zhang, Derou Liu, Chaoyang Liang, Zhenrong Zhang","doi":"10.1093/ejcts/ezaf218","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf218","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal duration of neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer remains unknown. This study aimed to assess whether the number of cycles of neoadjuvant therapy affects oncologic efficacy and surgical safety in a real-world setting.</p><p><strong>Methods: </strong>Patients with resectable non-small cell lung cancer who received neoadjuvant chemoimmunotherapy and subsequent surgery were included. Patients were divided into two groups: ≤ 2 or > 2 cycles. Oncology outcomes such as pathological complete response (pCR), and surgical outcomes were compared. Binary logistic regression analyses were conducted to identify independent factors for pCR. Kaplan-Meier analysis was used to compare long-term survival between groups. Cox regression analyses were conducted to identify independent predictors for recurrence.</p><p><strong>Results: </strong>A total of 140 patients with clinical stage IB-IIIB disease were included; 68 received ≤ 2 cycles, and 72 received > 2 cycles of neoadjuvant chemoimmunotherapy. No significant difference was observed in pCR rates, surgery difficulty, and postoperative complications between groups. Multivariate binary logistic regression analysis indicated that adenocarcinoma (odds ratio [OR] 0.14, 95% confidence interval [CI] 0.04-0.50, P = 0.003) and clinical T3 stage (OR 0.18, 95% CI 0.05-0.72, P = 0.015) were unfavourable factors for pCR. Kaplan-Meier survival analysis revealed no significant difference in recurrence-free survival (RFS) or overall survival (OS) between groups. Multivariate Cox regression analysis revealed that number of neoadjuvant cycles was not a predictor of recurrence (HR 0.87, 95% CI 0.31-2.44, P = 0.8).</p><p><strong>Conclusions: </strong>Compared with 3 or more cycles, two cycles of neoadjuvant chemoimmunotherapy might achieve similar perioperative outcomes and long-term survival in selected patients. Prospective studies and extended follow-up are needed to verify the conclusions.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577575","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":"Extent of coronary artery disease and clinical outcomes with ticagrelor monotherapy versus aspirin after coronary artery bypass grafting: insights from the TiCAB trial.","authors":"Melanie Arnreiter, Moritz von Scheidt, Johannes M Albes, Tim Attmann, Andreas Boening, Yeong-Hoon Choi, Lenard Conradi, Bernhard C Danner, Andreas Fach, Ivar Friedrich, Herko Grubitzsch, Roland Heck, Alexander Joost, Christoph Knosalla, Martin Misfeld, Martin Oberhoffer, Julia Riebandt, Andreas Schaefer, Matthias Siepe, Thomas Walther, Gerhard Wimmer-Greinecker, Uwe Zeymer, Heribert Schunkert, Adnan Kastrati, Sigrid Sandner","doi":"10.1093/ejcts/ezaf175","DOIUrl":"10.1093/ejcts/ezaf175","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with extensive coronary artery disease (CAD) have a higher risk of cardiovascular events. This post hoc analysis of the Ticagrelor in CABG (TiCAB) trial examined the association of ticagrelor monotherapy versus aspirin with clinical outcomes after coronary artery bypass grafting (CABG) in relation to the extent of CAD.</p><p><strong>Methods: </strong>The TiCAB trial randomized CABG patients to ticagrelor (90 mg twice daily) or aspirin (100 mg daily) for 12 months. Patients were stratified by SYNTAX score terciles: low (≤22), intermediate (23-32) and high (≥33). The primary end-point was major adverse cardiac and cerebrovascular events (MACCE) at 12 months, including cardiovascular death, myocardial infarction, stroke or repeat revascularization. Secondary end-points included individual MACCE components and major bleeding events. Cox proportional hazards models were used to assess treatment effects.</p><p><strong>Results: </strong>Among 752 patients, 33.4% had low, 36.0% intermediate and 30.6% high SYNTAX scores (median 26.5 [20.0-33.0]). MACCE rates were similar across groups (low: 7.8%; intermediate: 9.2%; high: 8.8%; P = 0.87), though the incidence of repeat revascularization differed significantly among SYNTAX score groups (P = 0.02). Ticagrelor did not show a significant MACCE benefit over aspirin in any SYNTAX score group (low: HR 2.27, 95% CI 0.87-5.94; intermediate: HR 1.02, 95% CI 0.46-2.27; high: HR 1.76, 95% CI 0.70-4.46; Pint=0.41). Secondary outcomes, including bleeding, aligned with overall trial results.</p><p><strong>Conclusions: </strong>This analysis did not find a differential benefit of ticagrelor versus aspirin across CAD complexity levels as measured by the SYNTAX score. Further studies are warranted to refine antiplatelet strategies for patients with complex CAD undergoing CABG.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136523","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":"Valve replacement during pregnancy: literature review including new data from the Registry Of Pregnancy And Cardiac disease III.","authors":"Johanna A van der Zande, Sergii Siromakha, Puck N J Peters, Ghada Youssef, Laura Galian-Gay, Magalie Ladouceur, Gretchen Wells, Johanna J M Takkenberg, Kevin M Veen, Karishma P Ramlakhan, Roger Hall, Mark R Johnson, Jolien W Roos-Hesselink","doi":"10.1093/ejcts/ezaf180","DOIUrl":"10.1093/ejcts/ezaf180","url":null,"abstract":"<p><strong>Objectives: </strong>Heart valve replacement during pregnancy is sometimes unavoidable, and the need for anticoagulation further complicates these procedures. Our study describes cases of valve replacement in pregnancy enrolled in the Registry Of Pregnancy And Cardiac disease (ROPAC) III and gives an overview of the published literature.</p><p><strong>Methods: </strong>We performed a systematic review with new data from the ROPAC III and data available in the literature. ROPAC III is a global, prospective, observational registry that included pregnant women with 1 or more prosthetic valves between January 2018 and April 2023. Electronic databases were searched for studies enrolling pregnant women who underwent valve replacement during pregnancy with a fetus in utero. The primary outcomes were maternal and fetal death. Mixed-effect logistic regression models were used to identify predictors for maternal and fetal mortality.</p><p><strong>Results: </strong>A valve replacement was performed in 11 pregnancies. The mother and fetus died in 1 case, and in 2 cases, reversible postoperative complications occurred. We found 74 cases in the literature and calculated an overall maternal and fetal death rate of 9% and 34%, respectively. All maternal deaths occurred in women with a replacement of a prosthetic valve in mitral position. We found valve replacement in the 1st trimester (OR 10.0) and acute malfunctioning of an existing prosthetic valve (OR 19.7) as predictors for maternal mortality, and replacement of an existing prosthetic valve (OR 4.8) as predictor for fetal mortality.</p><p><strong>Conclusions: </strong>Valve replacement during pregnancy carries a high maternal and fetal death, especially in women who need a replacement of an existing prosthetic valve.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513059","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":"Outcomes of Fontan circulation in patients with cono ventricular defects - a new benchmark for future therapies.","authors":"Satoshi Miyairi, Pranava Sinha","doi":"10.1093/ejcts/ezaf168","DOIUrl":"10.1093/ejcts/ezaf168","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586172","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}