JTCVS Techniques最新文献_第8页

The atrial neoannulus technique for mitral valve replacement in patients with severe mitral annular calcification 心房新环技术在严重二尖瓣钙化患者中的应用

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.001

Zubair A. Hashmi MD, Rahul Rajeev MBBS, Ye In Christopher Kwon BA, Graham Gardner MD, Holly Caboti-Jones BS, Vigneshwar Kasirajan MD

{"title":"The atrial neoannulus technique for mitral valve replacement in patients with severe mitral annular calcification","authors":"Zubair A. Hashmi MD, Rahul Rajeev MBBS, Ye In Christopher Kwon BA, Graham Gardner MD, Holly Caboti-Jones BS, Vigneshwar Kasirajan MD","doi":"10.1016/j.xjtc.2025.05.001","DOIUrl":"10.1016/j.xjtc.2025.05.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Mitral valve replacement (MVR) in patients with severe mitral annular calcification (MAC) remains technically challenging because of the risk of annular disruption and associated complications. We report short-term outcomes of a novel surgical approach that creates an atrial neoannulus for prosthetic valve implantation in high-risk patients with severe mitral stenosis or mixed disease.</div></div><div><h3>Methods</h3><div>Between September 2021 and January 2025, 27 consecutive patients with severe MAC underwent MVR at a tertiary referral center. A median sternotomy and interatrial groove approach were used to access the mitral valve. The anterior leaflet was excised, whereas the posterior leaflet was left intact with minimal decalcification. Pledgetted sutures were placed anteriorly along the annulus, incorporating the anterior leaflet cuff and posteriorly through the atrial wall, away from the heavily calcified posterior annulus. This technique created a neoannulus within the atrial tissue to anchor the prosthetic valve.</div></div><div><h3>Results</h3><div>The median patient age was 64.1 years, with 74.1% of the patients being female. Chronic kidney disease stage ≥3 was present in 51.9%, and 29.6% were reoperations. Preoperative median mitral valve gradient was 13 mm Hg. The median prosthetic valve size was 29 mm. In-hospital mortality was 7.4% (2 patients), both requiring renal replacement therapy. One late noncardiac death occurred (3.7%) at a median follow-up of 5 months. One patient (3.7%) required reintervention for left ventricular perforation, and 2 (7.4%) developed minor paravalvular leaks. At last follow-up, the median mitral valve gradient was reduced to 5 mm Hg.</div></div><div><h3>Conclusions</h3><div>Atrial neoannulus construction is a feasible MVR technique in severe MAC with acceptable short-term outcomes.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"32 ","pages":"Pages 60-67"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739371","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}

引用次数: 0

Early outcomes of robotic management of aberrant subclavian artery 机器人治疗锁骨下动脉异常的早期结果

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.04.026

Bo Chang Brian Wu MD , Meng-Han Tsai MD , Nicolas Chanes MD , Drake S. Rosenberg MSE , Robert A. Meguid MD, MPH , Muhammad Aftab MD , T. Brett Reece MD, MBA , John D. Mitchell MD

{"title":"Early outcomes of robotic management of aberrant subclavian artery","authors":"Bo Chang Brian Wu MD , Meng-Han Tsai MD , Nicolas Chanes MD , Drake S. Rosenberg MSE , Robert A. Meguid MD, MPH , Muhammad Aftab MD , T. Brett Reece MD, MBA , John D. Mitchell MD","doi":"10.1016/j.xjtc.2025.04.026","DOIUrl":"10.1016/j.xjtc.2025.04.026","url":null,"abstract":"<div><h3>Background</h3><div>Aberrant subclavian artery (ASA), though rare, can cause dysphagia lusoria and significantly affect quality of life. Conventional treatment involves open ligation and division of ASA, but a robotic approach is becoming more popular. This study assessed outcomes in patients undergoing robotic ASA division.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 9 patients with dysphagia who underwent robotic division of ASA between 2021 and 2025. Our standard approach is one-stage robotic ligation and division of the ASA, followed by open subclavian-to-carotid transposition (SCT). Patients undergo continued surveillance for potential thoracic endovascular aortic repair (TEVAR) in the event that Kommerell diverticulum (KD) expands. Patient demographics, presentations, aberrant anatomy, operative details, and outcomes were reviewed.</div></div><div><h3>Results</h3><div>The study cohort had a mean age of 49 years and mean body mass index of 30.5 kg/m<sup>2</sup>. The main presenting symptoms were dysphagia and dyspnea. An aberrant left subclavian artery with right-sided arch was seen in 5 patients; an aberrant right subclavian artery, in 4. Seven patients had KD. Eight patients underwent concurrent SCT; 1 patient had prior TEVAR and carotid-subclavian bypass for large descending thoracic and Kommerell aneurysms. The mean operative time was 169 minutes, and the mean hospital stay was 2 days. There was no postoperative stroke, bleeding, pneumothorax, chyle leak, or mortality; 1 patient experienced transient Horner syndrome. Five patients reported significant improvement in dysphagia, 1 reported moderate improvement, 1 reported mild improvement, 1 reported no change, and 1 was lost to follow-up.</div></div><div><h3>Conclusions</h3><div>This one-stage hybrid approach—robotic ASA division with open SCT—is safe, with no reported postoperative stroke or mortality, and offers excellent patient satisfaction. It provides a minimally invasive alternative for treating dysphagia lusoria.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"32 ","pages":"Pages 201-208"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739396","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}

引用次数: 0

Novel use of the intra-aortic balloon occlusion device in a complex anatomy after hybrid thoracic endovascular aortic repair 主动脉内球囊闭塞装置在混合胸血管内主动脉修复后复杂解剖中的新应用

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.015

Aayush Poddar MBBS, DrNB , Allan Klompas MBBCh, BAO , Gabor Bagameri MD

引用次数: 0

A beginner's guide to implementation science 实现科学的初学者指南

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.005

Dominique de Waard MD, MSc , Ryan Gainer MSc , Meaghan Sim PhD, RD , Claudia Cote MD, MSc , Philippe Tremblay MD, MSc , Paul Bonnar MD , Gregory Hirsch MD

引用次数: 0

Venovenous extracorporeal membrane oxygenation support in left sleeve total pneumonectomy: A case report 左套筒全肺切除术中静脉-静脉体外膜氧合支持1例

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.04.022

Weisi Ding MD , Hui Zhao MD , Zhou Zhao MD , Yi Feng MD , Haiyan An MD , Ran Zhang MD

引用次数: 0

Hybrid transcatheter aortic valve replacement for mechanical valve dysfunction in a patient with Marfan syndrome and previous Bentall procedure: A novel approach 混合经导管主动脉瓣置换术治疗马凡氏综合征患者机械性瓣膜功能障碍：一种新方法

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.04.009

Ranin Hojerat BSc , Ivan D. Hanson MD , Jeffrey M. Altshuler MD , Richard J. Bloomingdale MD , Amr E. Abbas MD , John R. Young PA-C , Rakesh M. Suri MD, DPhil

引用次数: 0

Aortopulmonary homograft: Extended “commando” concept for prosthetic root endocarditis with anterior septal involvement 主动脉-肺动脉同型移植物：扩展“突击队”概念治疗前间隔累及的假根心内膜炎

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.026

Giulia Agostini MD , Marco Pocar MD, PhD , Michele William La Torre MD , Stefano Salizzoni MD, PhD , Mauro Rinaldi MD

引用次数: 0

Feasibility of intraoperative indocyanine green injection to identify lymph nodes at risk of metastatic disease for early-stage lung cancer 术中注射吲哚菁绿鉴别早期肺癌淋巴结转移风险的可行性

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.003

Desi K.M. ter Woerds MSc , Roel L.J. Verhoeven PhD , Stefan M. van der Heide MD , Erik H.J.G. Aarntzen MD, PhD , Monika G. Looijen-Salamon MD, PhD , Shoko Vos MD, PhD , Ad F.T.M. Verhagen MD, PhD , Erik H.F.M. van der Heijden MD, PhD

{"title":"Feasibility of intraoperative indocyanine green injection to identify lymph nodes at risk of metastatic disease for early-stage lung cancer","authors":"Desi K.M. ter Woerds MSc , Roel L.J. Verhoeven PhD , Stefan M. van der Heide MD , Erik H.J.G. Aarntzen MD, PhD , Monika G. Looijen-Salamon MD, PhD , Shoko Vos MD, PhD , Ad F.T.M. Verhagen MD, PhD , Erik H.F.M. van der Heijden MD, PhD","doi":"10.1016/j.xjtc.2025.05.003","DOIUrl":"10.1016/j.xjtc.2025.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite surgical resection and mediastinal lymph node dissection, 34% of patients with stage IB to IIB non–small cell lung cancer demonstrate recurrence within 3.5 years, indicating disease dissemination undetected by current staging methods. Although 23.1% of patients with clinical N0 disease are upstaged to pN1 or pN2 disease after surgery, occult disease may still be present in patients with pN0 disease. The aim of this research was to explore implementation of a sentinel lymph node (SLN) procedure to identify lymph nodes at risk and determine its effect on staging.</div></div><div><h3>Methods</h3><div>In this single-center prospective study, patients with cN0 disease with resectable non–small cell lung cancer underwent intraoperative indocyanine green injection followed by the identification of up to 3 SLNs with near-infrared imaging. All lymph nodes were analyzed by conventional hematoxylin and eosin staining and the SLNs were additionally analyzed by serial sectioning and cytokeratin staining to detect tumor cells that may be missed by conventional analysis.</div></div><div><h3>Results</h3><div>SLNs were successfully identified in all 48 patients (100%). In 3 cases, injections were incorrectly positioned, possibly leading to incorrect SLN identification. Eight patients were diagnosed with pN1 or pN2 disease postoperatively; all were detected by conventional pathological assessment. Analysis of correctly performed SLN procedures showed negative SLNs were 100% indicative of absence of metastatic spread downstream. In 2 patients, serial sectioning and cytokeratin staining of the SLN revealed isolated tumor cells in 1 N1 node.</div></div><div><h3>Conclusions</h3><div>An intraoperative SLN procedure using indocyanine green is feasible with an identification rate of 100%. A negative SLN was an indicator for absence of metastases in lymph nodes downstream.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"32 ","pages":"Pages 172-181"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739392","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}

引用次数: 0

Mapping-guided exclusion of left ventricular aneurysms for management of ventricular tachycardia 定位引导下左心室动脉瘤排除术治疗室性心动过速

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.04.011

Fatima M. Ezzeddine MD , Oisin T. Galvin MB, BCh, BAO , Juan A. Crestanello MD , Arman Arghami MD, MPH , Alan Sugrue MB, BCh, BAO , Samuel J. Asirvatham MD , Yong-Mei Cha MD , Ammar M. Killu MBBS

引用次数: 0

A novel system for intercostal nerve cryoablation during robotic hybrid ablation 机器人混合消融中肋间神经冷冻消融的新系统

IF 1.9

JTCVS Techniques Pub Date : 2025-08-01 DOI: 10.1016/j.xjtc.2025.05.008

Zain Khalpey MD, PhD , Ujjawal Kumar BA (Cantab.) MB BChir , Tyler Phillips BS , Rahul Doshi MD , Yoaav Krauthammer MD

引用次数: 0