Annals of thoracic surgery short reports最新文献

{"title":"\"Tricuspid valved patch\" repair with a polytetrafluoroethylene valved conduit for right ventricular outflow reconstruction","authors":"Yusuke Yamamoto MD, PhD ,&nbsp;Hajime Sakurai MD, PhD ,&nbsp;Takafumi Terada MD ,&nbsp;Masato Mutsuga MD, PhD","doi":"10.1016/j.atssr.2025.03.010","DOIUrl":"10.1016/j.atssr.2025.03.010","url":null,"abstract":"<div><div>As an alternative to bioprosthetic pulmonary valve replacement for patients with late pulmonary insufficiency of repaired tetralogy of Fallot, we developed a novel technique using a handmade polytetrafluoroethylene tricuspid valved conduit, wherein the 2 posterior sinuses of the valve were resected and interdigitated with the native tissue of the pulmonary sinuses, followed by augmentation of the pulmonary trunk with the anterior wall of the conduit. Reliable valvular function of the tricuspid valve and the favorable biocompatibility of polytetrafluoroethylene material along with the growth potential of the repaired right ventricular outflow tract suggest that it may be an optimal alternative especially for young patients.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 679-682"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934194","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":"Synchronous Minimally Invasive Resection of Carcinomas of Lung and Esophagus After Downstaging by Palliative Immunotherapy","authors":"Robbe Van Dyck MD ,&nbsp;Bob Edon MD ,&nbsp;Thierry Wagner MD ,&nbsp;Sven Philippi MD ,&nbsp;Flaviu Crisan MD ,&nbsp;Georges Decker MD","doi":"10.1016/j.atssr.2025.01.024","DOIUrl":"10.1016/j.atssr.2025.01.024","url":null,"abstract":"<div><div>We report a case of an elderly patient with synchronous locally advanced bilateral lung and esophageal adenocarcinomas downstaged by atypical multimodality induction therapy. A short course of palliative immunotherapy (stopped for complications after 2 cycles), followed by stereotactic lung irradiation and later neoadjuvant fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy, allowed subsequent synchronous minimally invasive combined esophagectomy and anatomical lung resection with excellent outcome. This report further illustrates the technical feasibility of minimally invasive synchronous anatomical lung and esophagus resection after multimodal therapy, including immunotherapy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 749-753"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934199","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":"Preserving Pathways: Strategies for Left Superior Vena Cava Management in Pediatric Cardiac Surgery","authors":"Chen Chia Wang BSc ,&nbsp;Harrison S. Stuart BA ,&nbsp;David P. Bichell MD ,&nbsp;Karla Christian MD","doi":"10.1016/j.atssr.2025.03.004","DOIUrl":"10.1016/j.atssr.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Persistent left superior vena cava (LSVC) is a common congenital anomaly requiring operative management when it causes significant right-to-left shunting or during heart transplantation. Comparative patency of various LSVC repatriation methods to the right side of the heart has not been systematically studied.</div></div><div><h3>Methods</h3><div>This is a single-institution, retrospective review of patients undergoing surgical management of LSVC from 2013 to 2023. Patients were grouped on the basis of the LSVC to right atrium path: coronary sinus (CS) group with LSVC-CS anastomosis; systemic vein (SV) group with LSVC drainage through donor superior vena cava, right atrial appendage, or innominate vein; or atrial baffle (AB) group. Our primary objective is LSVC patency rate in each group.</div></div><div><h3>Results</h3><div>Twenty-two patients with a median age of 27 months met inclusion criteria; 4 patients were in the CS group, 9 in the SV group, and 9 in the AB group. At the time of collection, 3 (75%) patients in the CS group, 3 (33%) in the SV group, and 9 (100%) in the AB group showed LSVC patency. All patients demonstrating patency in CS and SV groups were older than 2 years, whereas all patients with occlusion (except for a 35-year-old patient) were younger than 2 years.</div></div><div><h3>Conclusions</h3><div>Of the methods redirecting LSVC to the right atrium, patency may be best preserved with an undistorted LSVC reunited with a retained CS or redirected by an intracardiac baffle compared with methods that displace the LSVC. Older patients with higher weight may have better patency rates with LSVC reconstruction.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 651-656"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934210","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":"Impact of Collateral Vessels on Fontan Circulation: 0- to 1-Dimensional Fontan Circulation Model and Concept of Oxygen Supply and Consumption","authors":"Koichi Sughimoto MD, PhD ,&nbsp;Toru Miki BSc ,&nbsp;Ruichen Li PhD ,&nbsp;Kenshu Maeda BSc ,&nbsp;Daiki Koda BSc ,&nbsp;Takashi Fujiwara PhD ,&nbsp;Hao Liu PhD","doi":"10.1016/j.atssr.2025.01.003","DOIUrl":"10.1016/j.atssr.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Patients with single ventricle often undergo the Fontan operation to alleviate cyanosis and reduce ventricle volume load. However, long-term outcomes are limited by complications and hemodynamic issues, including collateral vessels, leading to cyanosis and heart failure. Studies have demonstrated considerable blood flow through these collateral vessels; however, their hemodynamic impact on Fontan circulation remains inadequately explained from a theoretical perspective. This study aims to clarify the effects of dobutamine and vasodilators on Fontan circulation in the presence of aortopulmonary collaterals (APCs) and venovenous collaterals (VVCs).</div></div><div><h3>Methods</h3><div>A Fontan hemodynamic model incorporating VVC and APC was created. Scenarios were simulated by adjusting dobutamine dosage and oxygen delivery/consumption, predicting arterial and central venous oxygen saturations. Cardiac function was evaluated based on cardiac output, arterial elastance, ejection fraction, and stroke work to pressure-volume ratio.</div></div><div><h3>Results</h3><div>Fontan circulations with VVC and APC had lower arterial and venous oxygen saturations (92% and 54%, respectively) compared with those without collaterals (96% and 62%, respectively). Decreased arterial elastance and increased stroke work to pressure-volume ratio indicated poor tissue perfusion. High pulmonary resistance decreased oxygen saturations and systemic blood flow, regardless of collaterals. Dobutamine (10 μg/kg/min) raised venous oxygen from 53% to 58%, respectively, in the presence of VVC and APC, but decreased arterial oxygen from 92% to 88%, respectively.</div></div><div><h3>Conclusions</h3><div>The results align with clinical findings, suggesting pulmonary vasodilators may improve oxygenation and perfusion in Fontan patients with collaterals. However, dobutamine effects are limited. Validation with actual patient data is needed to enhance model accuracy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 657-662"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934211","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":"Atrial Esophageal Fistulas: A Case Series Demonstrating Three Distinct Operative Approaches with Favorable Outcomes","authors":"Eric Klipsch MD ,&nbsp;Maxwell F. Kilcoyne DO ,&nbsp;Gwyneth Bradley BS ,&nbsp;Lucas Witer MD ,&nbsp;Ian C. Bostock MD, MS ,&nbsp;Barry C. Gibney DO ,&nbsp;Kathryn E. Engelhardt MD, MS","doi":"10.1016/j.atssr.2025.03.017","DOIUrl":"10.1016/j.atssr.2025.03.017","url":null,"abstract":"<div><h3>Background</h3><div>Atrial esophageal fistula (AEF) is a rare complication of atrial ablation procedures. Because of the low incidence and associated morbidity and mortality, there is no consensus on optimal treatment. We present our experience with 4 patients, each with a different management strategy.</div></div><div><h3>Methods</h3><div>Retrospective chart review of 4 patients treated for AEF at a single tertiary care center was performed. Patients were treated between March 2020 and April 2024.</div></div><div><h3>Results</h3><div>Three patients underwent surgical repair of the AEF and 1 underwent a combination of endoscopic and percutaneous approaches. Two of the surgical patients underwent right thoracotomy, while the third was approached via median sternotomy on cardiopulmonary bypass followed by a right thoracotomy. The 3 patients who underwent surgical repair are alive and tolerating oral intake. The patient who underwent endoscopic/percutaneous AEF repair had a considerably higher surgical risk at baseline. The patient recovered from the initial interventions and was discharged home but represented with AEF progression and subsequently expired secondary to neurologic sequalae.</div></div><div><h3>Conclusions</h3><div>For AEF, open surgical management with or without the use of cardiopulmonary bypass has historically been the first-line treatment. Although successful management of AEF with endoscopic treatment has been documented in the literature, only surgical repair was successful in this case series. This series suggests that surgical management should be pursued for all patients except those with highly prohibitive surgical risk.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 728-733"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934348","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":"Robotic-Assisted Left Ventricular Epicardial Lead Placement in Patients With Prior Sternotomy","authors":"Aaron Kleinertz PA-C ,&nbsp;Benjamin Seadler MD ,&nbsp;Hannah Holland MD ,&nbsp;Mami Sow MD ,&nbsp;Ali Syed MS ,&nbsp;James Oujiri MD ,&nbsp;G. Hossein Almassi MD ,&nbsp;Stefano Schena MD, PhD ,&nbsp;Mario Gasparri MD","doi":"10.1016/j.atssr.2025.03.012","DOIUrl":"10.1016/j.atssr.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac resynchronization therapy (CRT) improves activity tolerance and slows decline in chronic heart failure patients with left ventricular (LV) dysfunction. Traditionally, biventricular lead-based pacing devices or defibrillators are placed intravenously, although some patients require surgical epicardial LV lead placement due to vascular anatomic abnormalities, endocardial fibrosis, or high risk for bacteremia. In patients with prior sternotomy, epicardial lead placement through a thoracotomy, despite a comparatively larger incisional burden, is often preferred over thoracoscopy given the presence of dense adhesions. Approaches that minimize chest wall dissection, however, may allow more patients to safely undergo CRT. This study describes our experience with robotic-assisted LV lead placement in patients with a prior sternotomy.</div></div><div><h3>Methods</h3><div>A single-institution, retrospective review was conducted of consecutive patients with a prior sternotomy referred for surgical epicardial lead placement between January 2018 and July 2023.</div></div><div><h3>Results</h3><div>The analysis included 6 patients with a mean age of 75 years. All leads were placed successfully with a robotic-assisted approach. One patient required conversion to thoracotomy due to significant mediastinal adipose tissue burden. The median length of stay was 2 days. Mortality at 30 days was 0%. One patient sustained unilateral phrenic nerve injury, and a wound infection developed in 1 patient that required subsequent CRT device explant.</div></div><div><h3>Conclusions</h3><div>Robotic LV lead placement is feasible in patients with prior sternotomy. Despite significant comorbidities, lengths of stay and perioperative complications were acceptable. Patients with relative contraindication to epicardial LV lead placement, such as those with a prior sternotomy, may benefit from a robotic-assisted approach.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 740-745"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934363","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":"Left Tracheal Sleeve Intrapericardial Pneumonectomy: A Single-Stage Approach","authors":"David Tse MD ,&nbsp;Christopher J. Mutrie MD ,&nbsp;Richard H. McAffee MD ,&nbsp;Randy J. Cima CRNA","doi":"10.1016/j.atssr.2025.02.008","DOIUrl":"10.1016/j.atssr.2025.02.008","url":null,"abstract":"<div><div>Left tracheal sleeve intrapericardial pneumonectomy can be performed safely in a single-stage approach incorporating a right posterolateral thoracotomy and left video-assisted thoracoscopy. We present a case that highlights the principles of optimal exposure and adequate ventilation with this single-stage approach.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 711-713"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933120","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":"Mitral Valve Repair Through a Right Mini-Thoracotomy After Retrosternal Esophageal Reconstruction","authors":"Koki Ikemoto MD, PhD ,&nbsp;Akiyuki Takahashi MD, PhD ,&nbsp;Kazunari Ohkawa MD ,&nbsp;Katsuhiko Oka MD ,&nbsp;Taichi Sakaguchi MD, PhD","doi":"10.1016/j.atssr.2025.01.014","DOIUrl":"10.1016/j.atssr.2025.01.014","url":null,"abstract":"<div><div>The median sternotomy approach presents significant challenges in patients who have a neo-esophageal conduit through the retrosternal route. We report a case of successful mitral valve repair through a right mini-thoracotomy to avoid injury to the neo-esophageal conduit in a 74-year-old man with a history of retrosternal reconstruction after esophagectomy. Intraoperative direct echocardiography was used to assess the severity of mitral valve regurgitation. Hence, the right mini-thoracotomy approach might be suitable in patients with a history of neo-esophageal reconstruction. In addition, direct intraoperative echocardiography might be useful when transesophageal echocardiography cannot be performed.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 633-636"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934204","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 Aortic Valve Repair for Chronic Aortic Regurgitation due to Spontaneous Avulsion of the Aortic Valve Commissure","authors":"Yuki Wada MD ,&nbsp;Yoshiharu Soga MD, PhD ,&nbsp;Akira Marui MD, PhD ,&nbsp;Nobuhisa Ohno MD, PhD","doi":"10.1016/j.atssr.2025.03.001","DOIUrl":"10.1016/j.atssr.2025.03.001","url":null,"abstract":"<div><div>Avulsion of the aortic valve commissure, defined as the detachment of the commissure from the aortic wall, is a rare cause of aortic regurgitation. It is frequently associated with bacterial endocarditis, blunt chest trauma, or ascending aortic dissection and often is manifested as an acute condition. Aortic valve replacement combined with aortic surgery is the most common treatment of such patients. Herein, we report a successful case of aortic valve repair for chronic aortic regurgitation caused by the spontaneous avulsion of the aortic valve commissure.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 640-642"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934206","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":"Thymectomy for Morvan Syndrome Associated With Thymoma","authors":"Daichi Kakibuchi MD ,&nbsp;Shunta Ishihara MD, PhD ,&nbsp;Masanori Shimomura MD, PhD ,&nbsp;Satoru Okada MD, PhD ,&nbsp;Tatsuo Furuya MD, PhD ,&nbsp;Masayoshi Inoue MD, PhD","doi":"10.1016/j.atssr.2025.03.016","DOIUrl":"10.1016/j.atssr.2025.03.016","url":null,"abstract":"<div><div>A 67-year-old man presented with lower back pain, numbness in the lower limbs, and general malaise. Over time, he experienced insomnia, abnormal behavior, muscle weakness, weight loss, orthostatic hypotension, and vesicorectal dysfunction. He was given a diagnosis of Morvan syndrome. Chest computed tomography revealed a 4.5-cm mass in the anterior mediastinum. He underwent steroid pulse therapy and therapeutic plasmapheresis, followed by robotic subxiphoid-optical extended thymectomy. His neurologic symptoms improved, and he was discharged 3 months after surgery. This case highlights the potential benefits of combining surgery with immunosuppressive therapy for managing Morvan syndrome and improving neurologic symptoms associated with thymoma.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 764-768"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934339","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}