JTCVS Techniques最新文献

{"title":"Mitral valve repair using the free-knot technique: A simple, precise, and length-stable method for expanded polytetrafluoroethylene chordal adjustment","authors":"Yuki Wada MD,&nbsp;Takehiko Matsuo MD, PhD,&nbsp;Akira Marui MD, PhD,&nbsp;Shinichi Tsumaru MD, PhD,&nbsp;Keisuke Hakamada MD,&nbsp;Yuki Kuroda MD, PhD,&nbsp;Yuta Kitagata MD,&nbsp;Ryo Imada MD,&nbsp;Nobuhisa Ohno MD, PhD","doi":"10.1016/j.xjtc.2026.102409","DOIUrl":"10.1016/j.xjtc.2026.102409","url":null,"abstract":"<div><h3>Objectives</h3><div>Artificial chordal implantation using expanded polytetrafluoroethylene (ePTFE) is widely adopted in mitral valve repair (MVr). However, achieving precise chordal length remains challenging because durable valve competence depends on fine intraoperative adjustment. Moreover, ePTFE sutures are slippery and may change in length during knot-tying, making stable fixation difficult. The free-knot technique enables incremental intraoperative length adjustment and maintains the intended length without alteration during final knot fixation. This study aimed to describe the free-knot technique and evaluate its short-term clinical and echocardiographic outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 118 consecutive patients who underwent MVr using the free-knot technique between April 2021 and March 2025 at a single institution.</div></div><div><h3>Results</h3><div>The mean age was 59.4 ± 11.4 years, and 48% were male. Posterior, anterior, and bileaflet prolapses were present in 66.1%, 17.8%, and 16.1% of patients, respectively. All patients underwent annuloplasty, with a mean of 2.3 ± 1.1 artificial chordae implanted. None of the patients had moderate or severe residual mitral regurgitation findings at discharge. Freedom from recurrent moderate or greater mitral regurgitation was 92.9% at 1 year, 90.2% at 2 years, and 85.2% at 3 years. Freedom from severe MR and reoperation remained 100% throughout follow-up, with no significant difference in MR recurrence according to the prolapse site.</div></div><div><h3>Conclusions</h3><div>The free-knot technique is a simple, adjustable, and device-free method that ensures accurate chordal length tuning and stable fixation without length changes during knot-tying. This approach achieved excellent short-term outcomes across diverse prolapse sites, supporting its value as a versatile tool for contemporary MVr.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102409"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647332","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":"Single-stage multidisciplinary surgical repair of a secondary aortoesophageal fistula: A technical case report with 3-year uneventful follow-up","authors":"Adam Zeyara MD,&nbsp;Firas Al Saedi MD,&nbsp;Torbjörn Fransson MD, PhD,&nbsp;Shahab Nozohoor MD, PhD,&nbsp;Jonas Ahl MD, PhD,&nbsp;Per Wierup MD, PhD,&nbsp;Jan Johansson MD, PhD","doi":"10.1016/j.xjtc.2026.102417","DOIUrl":"10.1016/j.xjtc.2026.102417","url":null,"abstract":"<div><h3>Objective</h3><div>Secondary aortoesophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) is a rare but life-threatening complication. Definitive treatment guidelines are lacking, and surgical management has traditionally relied on staged procedures. Reports of successful single-stage repair with long-term follow-up remain scarce. This case report aims to describe the workup, surgical strategy, and long-term outcomes of a single-stage multidisciplinary repair of secondary AEF after TEVAR.</div></div><div><h3>Methods</h3><div>We report the case of a 75-year-old man who presented with recurrent infectious episodes 9 years after TEVAR. A secondary AEF was diagnosed in May 2022. After the failure of conservative treatment (ie, antibiotic therapy) over approximately 1 year, a multidisciplinary team recommended definitive surgery. In April 2023, a single-stage repair was performed, comprising complete resection of the infected stent graft, in situ replacement with an antibiotic-soaked prosthesis, primary esophageal repair, and interposition of a pedicled latissimus dorsi muscle flap.</div></div><div><h3>Results</h3><div>The patient was discharged on postoperative day 30. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.</div></div><div><h3>Conclusions</h3><div>In this case report, a single-stage multidisciplinary surgical repair of secondary AEF after TEVAR yielded durable infection control and favorable long-term outcomes. Careful patient selection within a multidisciplinary team, meticulous surgical planning, and close postoperative infectious disease follow-up are essential. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102417"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647343","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":"Reinforcement of skin flap tracheal reconstruction with porous titanium nickelide implants: A novel approach to persistent tracheal defect closure","authors":"Evgeny B. Topolnitskiy MD, PhD,&nbsp;Alex A. Volinsky PhD","doi":"10.1016/j.xjtc.2026.102388","DOIUrl":"10.1016/j.xjtc.2026.102388","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to evaluate the safety and efficacy of porous titanium nickelide mesh implants for reinforcing skin flap reconstruction of persistent tracheal defects after prolonged tracheostomy and laryngotracheal reconstruction.</div></div><div><h3>Methods</h3><div>This retrospective case series included 60 patients with persistent tracheal defects treated between June 2013 and December 2020. An experimental group (n = 17) received external porous titanium nickelide implant reinforcement, and a control group (n = 43) underwent conventional skin flap closure without reinforcement. The experimental group was characterized by significantly more severe tracheomalacia (<em>P</em> &lt; .001), reflecting the nonrandomized, clinician-directed selection protocol. Primary outcomes included flap stability, airway patency, and complication rates. Secondary outcomes included granulation tissue formation and need for revision surgery.</div></div><div><h3>Results</h3><div>All 17 experimental group patients achieved stable tracheal reconstruction without implant-related complications (erosion, infection, or displacement) during a median follow-up of 48 months (range, 12-120 months). Flap instability on dynamic bronchoscopy was absent in the experimental group versus 18.6% in controls (<em>P</em> = .046). Granulation tissue formation occurred more frequently in the experimental group (58.8% vs 27.9%; <em>P</em> = .047). However, all cases were limited in size, did not compromise airway patency, and were successfully managed with a single session of argon plasma coagulation. No restenosis occurred in either group.</div></div><div><h3>Conclusions</h3><div>Porous titanium nickelide reinforcement provides durable biomechanical support for skin flap tracheal reconstruction, preventing flap instability and maintaining airway patency in a higher-risk cohort selected for severe tracheomalacia. This technique is a safe and effective option when primary tracheal resection is not feasible. The selection bias inherent to this nonrandomized series should be considered when interpreting superiority claims.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102388"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647621","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":"Longitudinal computational fluid dynamics analysis of a pediatric Kommerell diverticulum: Mechanistic insight from a case report","authors":"Yongzheng Ren,&nbsp;Zheyi Chu,&nbsp;Jianyong Huang PhD,&nbsp;Yongli Cao MD,&nbsp;Chi Zhu PhD,&nbsp;Nan Ding MD","doi":"10.1016/j.xjtc.2026.102397","DOIUrl":"10.1016/j.xjtc.2026.102397","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102397"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660604","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":"Dynamic airway collapse after hybrid repair of a Kommerell diverticulum in a right-sided aortic arch: Limits of endovascular decompression","authors":"Mauin Uddin MRCSEd, MS (CTh),&nbsp;Marco Lizwan MD, MRCSI,&nbsp;Muhammad Usman Shah MRCS, FCPS, FECTS, FRCS (CTh),&nbsp;Azamal Ibrahim G. Mulla MBBS, DNB (CTh),&nbsp;Sivaraj Pillai Govindasamy MBChB (Glasgow), MRCS (Edin), FRCS CTh (Edin), FAMS","doi":"10.1016/j.xjtc.2026.102385","DOIUrl":"10.1016/j.xjtc.2026.102385","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102385"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647320","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":"Staged hybrid repair for refractory type B aortic dissection with persistent false lumen perfusion: Integration of thoracic endovascular aortic repair, frozen elephant trunk, and laser fenestration","authors":"Sivaraj Pillai Govindasamy MBChB (Glasgow), MRCS (Edin), FRCS CTh (Edin), FAMS,&nbsp;Marco Lizwan MD, MRCSI,&nbsp;Azamal Ibrahim G. Mulla MBBS, DNB (CTh),&nbsp;Deborah Harrington MD, FRCS CTh","doi":"10.1016/j.xjtc.2026.102448","DOIUrl":"10.1016/j.xjtc.2026.102448","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102448"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647344","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":"Complete resection of a giant mediastinal paraganglioma in the aortopulmonary window using aortic root transection: Report in a patient with the Carney triad","authors":"Lucas Kostic MD,&nbsp;Charbel Al Zreibi MD,&nbsp;Amedeo Iafaldano MD,&nbsp;Charles-Henri Gautier MD,&nbsp;Laure Gibault MD,&nbsp;Kim-Diep Dang-Tran MD,&nbsp;Marco Alifano MD, PhD,&nbsp;Paul Achouh MD, PhD,&nbsp;Francoise Le Pimpec-Barthes MD, PhD","doi":"10.1016/j.xjtc.2026.102398","DOIUrl":"10.1016/j.xjtc.2026.102398","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102398"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647222","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":"Aorticopulmonary paraganglioma resected via a transaortic approach: A case report","authors":"Kosuke Sugino MD,&nbsp;Shigeki Suzuki PhD,&nbsp;Takahiro Suzuki PhD,&nbsp;Yu Okubo PhD,&nbsp;Hirofumi Haida PhD,&nbsp;Kyohei Masai PhD,&nbsp;Kaoru Kaseda PhD,&nbsp;Kenichi Hashizume PhD,&nbsp;Hideyuki Shimizu PhD,&nbsp;Keisuke Asakura PhD","doi":"10.1016/j.xjtc.2026.102410","DOIUrl":"10.1016/j.xjtc.2026.102410","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102410"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647232","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":"Feasibility of tissue-engineered tracheal and bronchial reconstruction using an in vivo bioreactor technique","authors":"Ziang Wang MD,&nbsp;Yuanyuan Xu MD,&nbsp;Jiazheng Huang MD,&nbsp;Ning Wang MD,&nbsp;Feng Mao MD,&nbsp;Zhongjie Wang MD,&nbsp;Qingquan Luo MD,&nbsp;Qiang Tan MD","doi":"10.1016/j.xjtc.2026.102391","DOIUrl":"10.1016/j.xjtc.2026.102391","url":null,"abstract":"<div><h3>Objective</h3><div>Reconstruction of long-segment airway defects remains challenging because previous attempts at tissue-engineered airway (TEA) replacement have failed to provide long-term follow-up data. We report the feasibility of a novel in vivo bioreactor technique for TEA reconstruction to correct long-segment tracheal and bronchial defects.</div></div><div><h3>Methods</h3><div>The outcomes of 7 patients with end-stage tracheal lesions or proximal lung tumors requiring pneumonectomy who underwent radical lesion resection using a standard surgical technique, followed by TEA reconstruction with an in vivo bioreactor technique were retrospectively reviewed. An intramural nitinol stent was inserted between 2 layers of an acellular porcine dermal matrix, with 2 Port-a-Cath (Smiths Medical) catheters connected to a portable peristaltic pump. The TEA was continuously perfused with an antibiotic solution, and peripheral total nucleated cells were harvested and seeded into the implanted TEA substitute twice per week for 2 months.</div></div><div><h3>Results</h3><div>The 7 patients (mean age, 49 years; range, 33-67 years; 4 men) underwent either tracheal (n = 5) or bronchial (n = 2) reconstruction. Two of the 7 patients died within 1 year due to fistula formation between the trachea and brachiocephalic artery. One other major morbidity event (upper anastomosis leakage) was resolved with a longer membrane stent. Three patients died due to tumor relapse (median follow-up, 2 years), whereas 2 patients are still alive (follow-up, 6.5 years). Two patients underwent biopsy-confirmed TEA re-epithelialization.</div></div><div><h3>Conclusions</h3><div>The findings of this uncontrolled study suggest that TEA using an in vivo bioreactor technique is feasible for long-segment trachea and bronchial reconstruction. Further studies are needed to evaluate efficacy and safety.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102391"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647233","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":"Patient-specific hemodynamic assessment using experimental and computational approaches in anomalous aortic origin of the coronary artery: Case study","authors":"Thangam Natarajan PhD,&nbsp;Yasaman Farsiani PhD,&nbsp;Jayanthi Parthasarathy PhD,&nbsp;Silvana Molossi MD, PhD,&nbsp;Carlos M. Mery MD, MPH,&nbsp;Michael Jiang MD,&nbsp;Joanna Ghobrial MD,&nbsp;Athar M. Qureshi MD,&nbsp;Tara Karamlou MD, MSc,&nbsp;Lakshmiprasad Dasi PhD,&nbsp;Rajesh Krishnamurthy MD","doi":"10.1016/j.xjtc.2026.102378","DOIUrl":"10.1016/j.xjtc.2026.102378","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and demonstrate the feasibility of a patient-specific framework combining experimental and computational modeling for noninvasive hemodynamic evaluation of anomalous aortic origin of coronary artery (AAOCA) anatomy derived from coronary computed tomography angiography.</div></div><div><h3>Methods</h3><div>A patient with a left AAOCA who experienced aborted sudden cardiac death underwent an unroofing procedure and later required coronary reimplantation after recurrent aborted sudden cardiac death was studied. Patient-specific models were generated at 3 stages: preoperative, postunroofing, and postreimplantation. Experimental assessment used 3-dimensional–printed aortocoronary models integrated with a pulsatile flow loop, whereas computational simulations were performed using computational fluid dynamics. Fractional flow reserve (FFR) and flow velocities were evaluated at rest and under simulated stress and compared with clinical stress FFR obtained during cardiac catheterization.</div></div><div><h3>Results</h3><div>Clinical cardiac catheterization-derived FFR under dobutamine stress was 0.77 postunroofing and 0.99 after reimplantation. Experimental testing demonstrated similar stress FFR of 0.7 in native left AAOCA (with short intramural course), 0.8 after unroofing (compression from the intercoronary pillar), and 0.9 postreimplantation. Computational FFR agreed with both experimental and clinical measurements: lowest values were 0.74 preoperatively, 0.8 post unroofing, and 0.87 post reimplantation. Flow patterns and pressure gradients corresponded with surgical and anatomical observations, showing improved coronary perfusion after reimplantation.</div></div><div><h3>Conclusions</h3><div>This hybrid experimental-computational workflow enables patient-specific assessment of AAOCA hemodynamics across sequential surgical stages. The approach provides accurate evaluation of coronary anatomy, cross-validation of model results, and preliminary mechanistic insight into ischemia, supporting the feasibility of this hybrid approach for patient-specific hemodynamic evaluation and motivating future investigation in larger cohorts.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"38 ","pages":"Article 102378"},"PeriodicalIF":2.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647237","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}