JTCVS Techniques最新文献

{"title":"Tailored airway solutions: A novel approach using custom T tubes in complex tracheal stenosis","authors":"Laith A. Ayasa MD , Marta Diez-Ferrer MD , Mujtaba Mubashir MD , Catherine Fiore MD , Daniel Ospina-Delgado MD , Alma V. Burbano MD , Pavan S. Mallur MD , Mihir Parikh MD , Kai Swenson MD , Jason Beattie MD , Sidhu P. Gangadharan MD , Adnan Majid MD","doi":"10.1016/j.xjtc.2025.07.002","DOIUrl":"10.1016/j.xjtc.2025.07.002","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 264-269"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190133","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":"Proximalization of the distal anastomosis in frozen elephant trunk surgery","authors":"Philipp Pfeiffer MD,&nbsp;Karen Wittemann,&nbsp;Edoardo Zancanaro MD,&nbsp;Vanessa Buchholz,&nbsp;Leon Mattern,&nbsp;Chris Probst MD,&nbsp;Franz Masseli MD,&nbsp;Ahmed Ghazy MD,&nbsp;Hendrik Treede MD, PhD,&nbsp;Daniel-Sebastian Dohle MD, PhD","doi":"10.1016/j.xjtc.2025.06.010","DOIUrl":"10.1016/j.xjtc.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>The frozen elephant trunk (FET) technique is frequently used in aortic arch diseases. Proximalization of the distal anastomosis from zone 3 to zone 2 results in shorter distal ischemia times and improved outcomes. This study assessed the impact of performing distal anastomoses progressively more proximally.</div></div><div><h3>Methods</h3><div>A total of 243 patients treated between March 2016 and December 2023 were identified using our institutional database, and relevant data were analyzed retrospectively. The patients were stratified according to the distal anastomosis zone, and perioperative and outcome variables were compared. A subgroup analysis was performed accordingly for patients with acute aortic dissections.</div></div><div><h3>Results</h3><div>Most of the 243 included patients (66%) were treated for acute dissection, followed by chronic dissection (24%) and thoracic aortic aneurysms (10%). The patients’ mean age was 62.5 ± 10.8 years, and 175 patients (72%) were male. The distal ischemia time was significantly reduced with the more proximal anastomoses: 24.5 minutes for zone 0 (69 patients), 37.4 minutes for zone 1 (18 patients), 30.4 minutes for zone 2 (145 patients), and 38.7 minutes for zone 3 (11 patients); <em>P</em> &lt; .001. A longer cross-clamping time in zone 0 was explained by the higher number of root procedures, while other outcome parameters showed no significant differences. These same significant differences also were present in the acute dissection subgroup. In a separate analysis, a shorter duration of distal ischemia correlated with improved long-term survival (<em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>The FET technique with distal anastomosis in zone 2 is a reliable technique that produces good results. Proximalization of the distal anastomosis to zone 0 significantly reduces the ischemic burden and simplifies the procedure.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 38-50"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189892","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":"Implementation of Staphylococcus aureus decolonization in cardiac surgery","authors":"Dominique de Waard MD, MSc ,&nbsp;Ryan Gainer MSc ,&nbsp;Meaghan Sim PhD, RD ,&nbsp;Claudia Cote MD, MSc ,&nbsp;Paul Bonnar MD ,&nbsp;Gregory M. Hirsch MD","doi":"10.1016/j.xjtc.2025.06.025","DOIUrl":"10.1016/j.xjtc.2025.06.025","url":null,"abstract":"<div><h3>Objective</h3><div><em>Staphylococcus aureus</em> (SA) screening and decolonization is a guideline-recommended treatment for the prevention of surgical site infections in cardiac surgery. This study aimed to formally assess the barriers and facilitators associated with its implementation.</div></div><div><h3>Methods</h3><div>Targeted SA screening and decolonization started at our institution in November 2022. To assess barriers and facilitators to implementation, we conducted focus group interviews informed by the Consolidated Framework for Implementation Research at approximately 6 months after initiation of the intervention. We also regularly collected quantitative data on missed screening and/or decolonization to address gaps in uptake. This was reviewed at 6-month and 1-year time points. Adjustments to implementation were regularly made to address barriers.</div></div><div><h3>Results</h3><div>At 1 year, 563 nonurgent inpatients and 232 outpatients were consulted to cardiac surgery. Ninety-five percent of the inpatients and 91% of the outpatients considered for cardiac surgery were screened appropriately. Of the patients accepted for cardiac surgery, 50% of positive inpatients underwent decolonization in the first 6 months prior to focus groups compared to 67% in the subsequent 6 months. For outpatients, 77% were decolonized in the first 6 months, compared to 79% in the subsequent 6 months. Major barriers to implementation included delays in receiving screening results, difficulty meeting screening and decolonization timelines, and staffing turnover.</div></div><div><h3>Conclusions</h3><div>SA screening and decolonization was successfully implemented as a standard of care at our institution with the aid of an implementation science framework. By engaging care partners and healthcare staff throughout the implementation process and regularly addressing barriers, we developed a sustainable SA screening and decolonization program. Adjustments are ongoing to increase and sustain decolonization uptake.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 160-173"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190120","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":"Minimizing the complications of open repair of aortocaval fistula using cardiopulmonary bypass: A case report","authors":"Varun Shetty MBBS, DNB, FRCS ,&nbsp;Logeshwaran Manickam MBBS, DrNB ,&nbsp;Rohan Makwana MBBS, DNB ,&nbsp;Ragu Bheemaiah MD, PDCC, FICA, FTEE ,&nbsp;Govind Datta Chamarthi MBBS, MSCRM","doi":"10.1016/j.xjtc.2025.07.018","DOIUrl":"10.1016/j.xjtc.2025.07.018","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 58-60"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190117","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":"Sutureless total arch replacement in patients with acute type A aortic dissection","authors":"Dong-Yun Qiu MD ,&nbsp;Er-Jun Zhu MD ,&nbsp;Yong-Tao Li MD ,&nbsp;Yang-Hong Xue MD ,&nbsp;Hai-Tao Zhang MD ,&nbsp;Bo Sun MD ,&nbsp;Chao Chi MD, PhD ,&nbsp;Wei-Xin Meng MD ,&nbsp;Guo-Fu Zhang MD ,&nbsp;Lei Xu MD ,&nbsp;Hao-Dong Pan MD ,&nbsp;Hanghang Wang MD ,&nbsp;Tuo Pan MD ,&nbsp;Bao-Dong Xie MD","doi":"10.1016/j.xjtc.2025.06.018","DOIUrl":"10.1016/j.xjtc.2025.06.018","url":null,"abstract":"<div><h3>Objective</h3><div>Acute type A aortic dissection is a life-threatening condition characterized by high morbidity and mortality. Surgical intervention is the primary means of saving lives in acute type A aortic dissection cases; however, in-hospital mortality rates remain high. We implemented a novel surgical approach, the sutureless total arch replacement, aimed at reducing in-hospital mortality. This study compares the safety and efficacy of the sutureless total arch replacement with conventional total arch replacement.</div></div><div><h3>Methods</h3><div>The retrospective, single-center cohort study included 382 patients who underwent acute type A aortic dissection repair involving ascending aortic replacement, total arch replacement, and the frozen elephant trunk procedure at our institution between 2019 and 2023. Of these patients, 296 underwent conventional total arch replacement from 2019 to 2022, and 86 received sutureless total arch replacement from 2022 to 2023. Propensity score matching resulted in 77 patients each in the sutureless total arch replacement and conventional total arch replacement groups for comparison.</div></div><div><h3>Results</h3><div>The sutureless total arch replacement group had shorter total operative time, cardiopulmonary bypass time, circulatory arrest time, and reduced intraoperative bleeding (all <em>P &lt; .</em>01). The sutureless total arch replacement group had significantly lower rates of in-hospital mortality (<em>P &lt; .</em>05). There were no significant differences between the 2 groups in the incidence of postoperative complications, including the need for mechanical circulatory support, cerebrovascular events, and unplanned reoperation due to postoperative bleeding. After a minimum of 15 months of follow-up, there were no significant differences in mortality or reoperation rates among patients who survived the initial hospitalization (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Sutureless total arch replacement improves operative efficiency and bleeding control in acute type A aortic dissection repairs and is associated with lower in-hospital mortality.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189885","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":"Preoperative ultrasound evaluation of the internal thoracic artery in coronary artery bypass grafting planning","authors":"Ting Ren MD,&nbsp;Haoyi Yao MD,&nbsp;Junjie Zhang MD,&nbsp;Xiaofeng Ye MD, PhD,&nbsp;Jiapei Qiu MD,&nbsp;Qiang Zhao MD, PhD","doi":"10.1016/j.xjtc.2025.06.013","DOIUrl":"10.1016/j.xjtc.2025.06.013","url":null,"abstract":"<div><h3>Objective</h3><div>The internal thoracic artery (ITA) is the preferred conduit for coronary artery bypass grafting (CABG) due to its superior long-term patency, so preoperative meticulous evaluation of ITA quality is crucial to optimize surgical outcomes and ensure graft patency. This study employs ultrasound to assess ITA anatomical and functional characteristics, specifically investigating the relationship between ultrasound-derived ITA diameter, peak systolic velocity (PSV), and intraoperative graft flow.</div></div><div><h3>Methods</h3><div>In this prospective observational study conducted between March 2024 and March 2025, 199 patients scheduled for CABG underwent preoperative ITA ultrasound evaluation and 148 patients undergoing CABG with ITA grafting were included in the final analysis. Preoperative ultrasound measurements of ITA diameter and PSV were recorded at the third, fourth, and fifth intercostal spaces. Multivariable linear regression models were constructed to assess the associations between preoperative ITA ultrasound parameters and intraoperative graft flow, which was measured using the transit-time flow measurement method with a flowmeter.</div></div><div><h3>Results</h3><div>Examination of the ITA revealed that 98.0% showed no stenosis, whereas mild abnormalities (plaque or mild stenosis) were observed in 1.0%, and 0.8% had a tortuous course. Similarly, 96.7% of subclavian arteries exhibited no stenosis, with moderate stenosis in 2.0% and severe stenosis or occlusion in 1.3%. Among vertebral arteries, only 3.5% displayed severe stenosis or occlusion. After adjusting for various confounding factors, PSV at the fourth intercostal space was significantly associated with intraoperative ITA graft flow (β = .399, 95% CI 0.109-0.689; <em>P</em> = .007). Furthermore, after adjusting for age, PSV ≥65.0 cm/s seemed significantly predicted better ITA grafts flow (β = 10.527; <em>P</em> = .040), with a significant linear trend observed (<em>P</em> for trend = .039).</div></div><div><h3>Conclusions</h3><div>Preoperative ITA ultrasound, as a convenient, cost-effective, and noninvasive method, can be used for evaluating the ITA before surgery, thereby improving surgical outcomes in CABG.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 124-135"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190116","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":"Coronary artery bypass grafting after deep inferior epigastric perforator flap breast reconstruction: A case report","authors":"AlleaBelle Bradshaw MD ,&nbsp;Jessica B. Briscoe MD ,&nbsp;Jace C. Bradshaw MD ,&nbsp;Jennifer S. Lawton MD","doi":"10.1016/j.xjtc.2025.07.014","DOIUrl":"10.1016/j.xjtc.2025.07.014","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 146-151"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189630","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":"Tracheostomy in patients with a single ventricle during stage 1 palliation hospitalization: Prudent?","authors":"Hosam F. Ahmed MD, PhD,&nbsp;Muhammad Faateh MBBS,&nbsp;Grant Chappell BS,&nbsp;Marco Ricci MD, MBA,&nbsp;Jeffery Alten MD,&nbsp;David Lehenbauer MD,&nbsp;Awais Ashfaq MD,&nbsp;Alexis Benscoter DO,&nbsp;David L.S. Morales MD","doi":"10.1016/j.xjtc.2025.06.027","DOIUrl":"10.1016/j.xjtc.2025.06.027","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 225-229"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190326","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":"Modified intercostal artery reconstruction technique for thoracoabdominal aortic aneurysm repair","authors":"Xuliang Chen MD ,&nbsp;Nouman Ahmad PhD ,&nbsp;Yingjie Huang MS ,&nbsp;Jiawei Li MS ,&nbsp;Qian Zhang MD ,&nbsp;Haiyue Huang BS ,&nbsp;Lingjin Huang MD","doi":"10.1016/j.xjtc.2025.07.006","DOIUrl":"10.1016/j.xjtc.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>Spinal cord ischemia is a serious complication of thoracoabdominal aortic aneurysm repair. This study evaluates a modified intercostal artery reconstruction technique for preserving spinal cord perfusion, with a focus on graft patency and early outcomes.</div></div><div><h3>Methods</h3><div>Between 2023 and 2024, 24 patients (mean age, 46 ± 11 years) underwent thoracoabdominal aortic aneurysm repair (4 Crawford type I, 9 type II, 11 type III) using a modified intercostal artery reconstruction technique. Intercostal artery segments from both sides between the eighth thoracic and first lumbar vertebrae were sutured together to form an aortic roll and then anastomosed side-to-side with the Dacron vascular graft. Computed tomography angiography was performed before discharge and during follow-up to assess patency and complications.</div></div><div><h3>Results</h3><div>No cases of spinal cord ischemia, neurological deficits, or deaths occurred. Before discharge, imaging confirmed graft patency in 22 patients, 2 patients had complete aortic roll occlusion, and 1 patient showed occlusion of a single intercostal artery branch. None required further intervention or developed complications. The aortic roll diameter remained unchanged (1.18 ± 0.29 cm before discharge vs 1.18 ± 0.35 cm at follow-up, <em>P</em> = .94). The side-to-side anastomosis diameter showed no significant change over 1 year (0.62 ± 0.14 cm vs 0.67 ± 0.16 cm, <em>P</em> = .10). One-year follow-up in 6 patients revealed no new occlusions, aneurysm formation, or late complications, indicating stable reconstruction.</div></div><div><h3>Conclusions</h3><div>This technique demonstrated excellent graft patency and favorable early outcomes, offering a promising strategy to improve surgical outcomes in thoracoabdominal aortic aneurysm repair.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 13-20"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189886","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":"Successful minimally invasive valve repair for isolated severe tricuspid regurgitation due to infective endocarditis","authors":"Masahiko Fujii PhD ,&nbsp;Joji Ito PhD ,&nbsp;Kenji Mogi PhD ,&nbsp;Manabu Sakurai PhD ,&nbsp;Yoshiharu Takahara PhD","doi":"10.1016/j.xjtc.2025.06.017","DOIUrl":"10.1016/j.xjtc.2025.06.017","url":null,"abstract":"","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 90-92"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189628","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}