Annals of thoracic surgery short reports最新文献

{"title":"Preoperative Shock in Acute Type A Aortic Dissection: Multicenter Study of Mortality and Transport Time","authors":"Ken Nakamura MD, PhD,&nbsp;Kentaro Akabane MD,&nbsp;Shusuke Arai MD,&nbsp;Shuto Hirooka MD,&nbsp;Atsushi Yamashita MD,&nbsp;Kotaro Suzuki MD,&nbsp;Takashi Kawashima MD,&nbsp;Cholsu Kim MD,&nbsp;Hideaki Uchino MD, PhD,&nbsp;Tetsuro Uchida MD, PhD","doi":"10.1016/j.atssr.2026.01.019","DOIUrl":"10.1016/j.atssr.2026.01.019","url":null,"abstract":"<div><h3>Background</h3><div>In acute type A aortic dissection (ATAAD), early surgical intervention is critical; however, prognostic determinants in geographically stable populations remain incompletely defined. We sought to identify key predictors of in-hospital mortality in a closed regional cohort.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients undergoing surgery for ATAAD between January 2022 and June 2025 at 3 tertiary centers in Yamagata Prefecture, Japan. Demographics, transport time, admission to surgery interval, preoperative status, and operative variables were evaluated. Independent predictors of mortality were assessed by Cox proportional hazards modeling.</div></div><div><h3>Results</h3><div>Of 164 patients (mean age, 66.3 ± 11.9 years; 50% male), surgical mortality was 8.5% and in-hospital mortality was 10.4%. Nonsurvivors more frequently presented with preoperative shock (41% vs 12%; <em>P</em> &lt; .001) and malperfusion (35% vs 15%; <em>P</em> = .05). In multivariable analysis, preoperative shock was the sole independent predictor of mortality (hazard ratio, 9.12; 95% CI, 2.88-28.8; <em>P</em> &lt; .001), whereas transport time and operative complexity were not significant.</div></div><div><h3>Conclusions</h3><div>In a geographically isolated, consistently managed cohort, preoperative shock was the dominant determinant of in-hospital mortality in ATAAD. These findings emphasize the importance of early recognition and stabilization before surgery rather than transport speed alone.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 737-741"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870828","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":"Bilateral Minithoracotomy Approach for Off-Pump Coronary Artery Bypass Grafting in a Patient With Retrosternal Gastric Tube Reconstruction","authors":"Shinichi Tsumaru MD, PhD,&nbsp;Yuki Wada MD,&nbsp;Akira Marui MD, PhD,&nbsp;Nobuhisa Ohno MD, PhD","doi":"10.1016/j.atssr.2026.03.008","DOIUrl":"10.1016/j.atssr.2026.03.008","url":null,"abstract":"<div><div>Retrosternal gastric tube reconstruction after esophagectomy can make coronary artery bypass grafting technically challenging because the gastric tube often occupies the retrosternal space and may lie close to major mediastinal structures. We report a case of multivessel coronary artery disease in a patient with previous esophagectomy and retrosternal gastric tube reconstruction. To avoid gastric tube injury and enable safe multivessel revascularization, off-pump coronary artery bypass grafting was performed through bilateral minithoracotomies, with proximal anastomosis through a right minithoracotomy and distal anastomoses through a left minithoracotomy.</div></div><div>Retrosternal gastric tube reconstruction after esophagectomy can make coronary artery bypass grafting technically challenging because the gastric tube often occupies the retrosternal space and may lie close to major mediastinal structures. We report a case of multivessel coronary artery disease in a patient with previous esophagectomy and retrosternal gastric tube reconstruction. To avoid gastric tube injury and enable safe multivessel revascularization, off-pump coronary artery bypass grafting was performed through bilateral minithoracotomies, with proximal anastomosis through a right minithoracotomy and distal anastomoses through a left minithoracotomy.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 809-812"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870876","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":"Intrapericardial Mature Cystic Teratoma","authors":"Madison A. Grasty MD, MS,&nbsp;John S. Riley MD,&nbsp;Anna M. Moran MD,&nbsp;Leslie A. Litzky MD,&nbsp;Michael Ibrahim MD, PhD,&nbsp;Taine T.V. Pechet MD","doi":"10.1016/j.atssr.2026.02.018","DOIUrl":"10.1016/j.atssr.2026.02.018","url":null,"abstract":"<div><div>Mediastinal masses are an uncommon and encompass a wide variety of lesions. Their diagnosis and management are often dependent upon the radiographic features, symptoms, and serologies. Germ cell tumors are exceedingly rare in this location. This case report describes a mediastinal mass in a 37-year-old man who presented with occasional chest pain. Pathology revealed an intrapericardial mature cystic teratoma that arose from the adventitia of the aorta. Mature teratomas are most commonly found outside the pericardium. This report describes the exceedingly rare diagnosis of a mature cystic teratoma arising from the aortic adventitia.</div></div><div>Mediastinal masses are an uncommon and encompass a wide variety of lesions. Their diagnosis and management are often dependent upon the radiographic features, symptoms, and serologies. Germ cell tumors are exceedingly rare in this location. This case report describes a mediastinal mass in a 37-year-old man who presented with occasional chest pain. Pathology revealed an intrapericardial mature cystic teratoma that arose from the adventitia of the aorta. Mature teratomas are most commonly found outside the pericardium. This report describes the exceedingly rare diagnosis of a mature cystic teratoma arising from the aortic adventitia.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 985-988"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871039","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":"Rib Plating of Recurrent, Nonunion Rib Stress Fractures in an Elite Athlete","authors":"Elaine Liang BA,&nbsp;Michael Ou MD,&nbsp;Jared Peter C. Sarinas BS,&nbsp;Amanda Soe BS,&nbsp;Adrian Valderrama MD,&nbsp;Barkha Trivedi,&nbsp;Ivana Vasic MD,&nbsp;Jeffrey B. Velotta MD","doi":"10.1016/j.atssr.2026.03.011","DOIUrl":"10.1016/j.atssr.2026.03.011","url":null,"abstract":"<div><div>Rib plating is well established for severe traumatic rib fractures, but its application in rib stress fractures (RSFs) remains poorly defined. We report the case of a Division I female collegiate rower presenting with recurrent anterior thoracic RSFs and pain refractory to conservative management. She underwent rib plating with chest wall reconstruction by a local muscle flap, with complete pain resolution reported 4 weeks postoperatively. This case suggests that for select patients, particularly those exposed to high thoracic stress loading, rib plating may represent an effective treatment strategy for refractory RSF-related pain.</div></div><div>Rib plating is well established for severe traumatic rib fractures, but its application in rib stress fractures (RSFs) remains poorly defined. We report the case of a Division I female collegiate rower presenting with recurrent anterior thoracic RSFs and pain refractory to conservative management. She underwent rib plating with chest wall reconstruction by a local muscle flap, with complete pain resolution reported 4 weeks postoperatively. This case suggests that for select patients, particularly those exposed to high thoracic stress loading, rib plating may represent an effective treatment strategy for refractory RSF-related pain.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 966-968"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870991","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":"The Cutting Edge: A Systematic Review of Artificial Intelligence and Machine Learning in Predicting Esophagectomy Outcomes","authors":"Divyaam Satija MD,&nbsp;Ahmed Aly MD, PhD,&nbsp;Theodore Dimitrov BS,&nbsp;Dev Mookerjee BS,&nbsp;Jeremy Chang BS,&nbsp;Junyi Liu MS,&nbsp;Robert E. Merritt MD, MBA,&nbsp;Yuan Xue PhD,&nbsp;Peter J. Kneuertz MD","doi":"10.1016/j.atssr.2026.02.002","DOIUrl":"10.1016/j.atssr.2026.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Esophagectomy carries high risks and complications. Traditional outcome prediction models often fail to account for the multifactorial nature of postoperative outcomes. This systematic review evaluates the use of artificial intelligence and machine learning (AI/ML) models in predicting outcomes after esophagectomy.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed and Embase was conducted to identify studies published from January 2014 to June 2024. Inclusion criteria were observational studies or clinical trials using AI/ML models to predict esophagectomy outcomes. Studies were assessed for quality, and data were extracted on study characteristics, patient demographics, AI/ML models used, and predictive outcomes.</div></div><div><h3>Results</h3><div>Of 187 studies identified, 19 met the inclusion criteria. These studies, conducted across various countries, employed models such as random forest, neural networks, and gradient boosting machines. The most common outcomes predicted were postoperative complications, long-term survival, and early recurrence and readmission. Random forest models frequently demonstrated strong predictive performance, with area under the curve values often exceeding 0.8. The studies demonstrated the potential of AI/ML in enhancing prediction accuracy but highlighted significant variability in models and methodologies.</div></div><div><h3>Conclusions</h3><div>AI/ML models show promise in enhancing the predictive accuracy of esophagectomy outcomes. However, the variability in methodologies underscores the need for standardization in model development and validation. Future research should focus on larger, multi-institutional studies to improve the generalizability and clinical applicability of these models.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1015-1022"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870539","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":"Interpretation of Drain Amylase After Esophagectomy: A Case of Pancreatitis Mimicking Anastomotic Leak","authors":"Dena Shehata MD,&nbsp;Elliot L. Servais MD","doi":"10.1016/j.atssr.2026.02.021","DOIUrl":"10.1016/j.atssr.2026.02.021","url":null,"abstract":"<div><div>Elevated pleural amylase is widely used as a sensitive, noninvasive screen for anastomotic leak after esophagectomy. We describe a 71-year-old man with mild rise in pleural amylase on postoperative day 7 despite a normal esophagram and clinical status. Elevated serum amylase and lipase confirmed acute pancreatitis as the source, rather than an anastomotic complication. Serum and drain amylase levels normalized with supportive care. This case demonstrates that modest elevations in pleural drain amylase, although highly useful for early leak detection, may occasionally represent false positives from alternative processes such as pancreatitis, underscoring the importance of an evaluation for nonanastomotic causes.</div></div><div>Elevated pleural amylase is widely used as a sensitive, noninvasive screen for anastomotic leak after esophagectomy. We describe a 71-year-old man with mild rise in pleural amylase on postoperative day 7 despite a normal esophagram and clinical status. Elevated serum amylase and lipase confirmed acute pancreatitis as the source, rather than an anastomotic complication. Serum and drain amylase levels normalized with supportive care. This case demonstrates that modest elevations in pleural drain amylase, although highly useful for early leak detection, may occasionally represent false positives from alternative processes such as pancreatitis, underscoring the importance of an evaluation for nonanastomotic causes.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1004-1006"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870541","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":"Type A Aortic Dissection in a Complex Pregnant Patient With Marfan Syndrome","authors":"Valeria Robayo BS,&nbsp;Philip Allen MD, MS,&nbsp;Paige Newell MD,&nbsp;Niyi Odewade MD,&nbsp;Katherine Economy MD,&nbsp;Megan Bunnell MD,&nbsp;Michael N. Singh MD,&nbsp;Borami Shin MD,&nbsp;Ashraf A. Sabe MD","doi":"10.1016/j.atssr.2026.01.011","DOIUrl":"10.1016/j.atssr.2026.01.011","url":null,"abstract":"<div><div>A 41-year-old woman with Marfan syndrome and a proximal aortic aneurysm presented with an acute type A aortic dissection at 27 weeks’ gestation. Emergent cesarean delivery, total arch repair, and aortic valve replacement were performed. The patient and baby were discharged from the hospital after a prolonged course. We present our institution’s strategy for the management of these high-risk patients.</div></div><div>A 41-year-old woman with Marfan syndrome and a proximal aortic aneurysm presented with an acute type A aortic dissection at 27 weeks’ gestation. Emergent cesarean delivery, total arch repair, and aortic valve replacement were performed. The patient and baby were discharged from the hospital after a prolonged course. We present our institution’s strategy for the management of these high-risk patients.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 763-765"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870686","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":"Underrepresentation of Patients From Racial and Ethnic Minorities in Immunotherapy Clinical Trials for Non-Small Cell Lung Cancer","authors":"Deepti Srinivasan BS,&nbsp;Camille Mathey-Andrews MD,&nbsp;Shivaek Venkateswaran BS,&nbsp;Ashley Sanchez BS,&nbsp;Alexandra L. Potter BS,&nbsp;Arian Mansur MD,&nbsp;Lana Schumacher MD,&nbsp;Chi-Fu Jeffrey Yang MD","doi":"10.1016/j.atssr.2026.03.019","DOIUrl":"10.1016/j.atssr.2026.03.019","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Landmark immunotherapy trials have transformed treatment of non-small cell lung cancer (NSCLC), yet underrepresentation of racial and ethnic minorities threatens the generalizability of trial findings. This study evaluated disparities in receipt of immunotherapy during clinical trial periods preceding regulatory approval.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Landmark immunotherapy trials have transformed treatment of non-small cell lung cancer (NSCLC), yet underrepresentation of racial and ethnic minorities threatens the generalizability of trial findings. This study evaluated disparities in receipt of immunotherapy during clinical trial periods preceding regulatory approval.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Using the National Cancer Database, we assessed receipt of immunotherapy by patients diagnosed with metastatic NSCLC between 2004 and 2015 and resectable stage II-IIIB NSCLC between 2004 and 2021, corresponding to immunotherapy clinical trial periods for metastatic and resectable disease, respectively. Multivariable adjusted logistic regression was used to evaluate associations between race and ethnicity and receipt of immunotherapy. Additional sensitivity analyses were performed among subgroups of patients with insurance, who reside in high-income areas, received treatment at academic facilities, have no comorbidities, and received chemotherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Using the National Cancer Database, we assessed receipt of immunotherapy by patients diagnosed with metastatic NSCLC between 2004 and 2015 and resectable stage II-IIIB NSCLC between 2004 and 2021, corresponding to immunotherapy clinical trial periods for metastatic and resectable disease, respectively. Multivariable adjusted logistic regression was used to evaluate associations between race and ethnicity and receipt of immunotherapy. Additional sensitivity analyses were performed among subgroups of patients with insurance, who reside in high-income areas, received treatment at academic facilities, have no comorbidities, and received chemotherapy.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In multivariable analyses of patients with metastatic disease, Black (odds ratio [OR], 0.81; 95% CI, 0.76-0.88), Asian (OR, 0.84; 95% CI, 0.74-0.95), and Hispanic (OR, 0.79; 95% CI, 0.71-0.89) patients were significantly less likely than non-Hispanic White patients to receive immunotherapy. Disparities persisted in sensitivity analyses, including of insured patients treated at academic centers in high-income areas. Notably, Black patients residing in the highest income areas remained less likely to receive immunotherapy than White patients residing in the lowest income areas (OR, 0.63; 95% CI, 0.42-0.96). Similar disparities were observed in the neoadjuvant setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;In multivariable analyses of patients with metastatic disease, Black (odds ratio [OR], 0.81; 95% CI, 0.76-0.88), Asian (OR, 0.84; 95% CI, 0.74-0.95), and Hispanic (OR, 0.79; 95% CI, 0.71-0.89) patients were significantly less li","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 895-902"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870945","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":"Mitral Stenosis and Regurgitation due to Late Prosthetic Aortic Valve Migration","authors":"Taro Nakazato MD, PhD,&nbsp;Daisuke Yoshioka MD, PhD,&nbsp;Tatsuya Ozaki MD,&nbsp;Mutsunori Kitahara MD, PhD","doi":"10.1016/j.atssr.2026.02.011","DOIUrl":"10.1016/j.atssr.2026.02.011","url":null,"abstract":"<div><div>We report a rare case of mitral stenosis and regurgitation after aortic valve replacement due to prosthetic valve migration. A 74-year-old woman underwent aortic valve replacement using a Carpentier-Edwards PERIMOUNT valve (Edwards Lifesciences) 9 years prior. Six years postoperatively, outpatient echocardiography incidentally revealed abnormal rocking motion of the bioprosthesis, with no signs of infection or paravalvular leak. Finally, the bioprosthetic valve interfered with the anterior mitral valve leaflet, causing severe mitral stenosis and regurgitation. Redo aortic valve replacement and mitral valve replacement with the commando procedure were performed, and pathologic findings revealed no evidence of connective tissue disease, aortitis, or infection.</div></div><div>We report a rare case of mitral stenosis and regurgitation after aortic valve replacement due to prosthetic valve migration. A 74-year-old woman underwent aortic valve replacement using a Carpentier-Edwards PERIMOUNT valve (Edwards Lifesciences) 9 years prior. Six years postoperatively, outpatient echocardiography incidentally revealed abnormal rocking motion of the bioprosthesis, with no signs of infection or paravalvular leak. Finally, the bioprosthetic valve interfered with the anterior mitral valve leaflet, causing severe mitral stenosis and regurgitation. Redo aortic valve replacement and mitral valve replacement with the commando procedure were performed, and pathologic findings revealed no evidence of connective tissue disease, aortitis, or infection.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 841-844"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870883","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":"Surgical Aortic Valve Replacement With Nicks Annular Enlargement and Partial Trimming of a Protruding Left Main Coronary Stent","authors":"Takuma Kobayashi MD,&nbsp;Hidetake Kawajiri MD, PhD,&nbsp;Kaichiro Manabe MD,&nbsp;Tatsuro Gondai MD,&nbsp;Tomohito Nakashima MD,&nbsp;Yusuke Yaku MD,&nbsp;Shinichiro Oda MD, PhD","doi":"10.1016/j.atssr.2026.03.007","DOIUrl":"10.1016/j.atssr.2026.03.007","url":null,"abstract":"<div><div>Protrusion of a coronary stent into the aortic root is rare and can complicate aortic valve replacement and future coronary access. We report the case of a 76-year-old woman with severe aortic stenosis and a left main coronary stent protruding approximately 1 cm into the aortic root. Given the small aortic annulus and the risk of mechanical interference, surgical aortic valve replacement with the Nicks annular enlargement was performed. The protruding stent segment was selectively trimmed while preserving the intraluminal portion, with concomitant coronary bypass grafting. The postoperative course was uneventful.</div></div><div>Protrusion of a coronary stent into the aortic root is rare and can complicate aortic valve replacement and future coronary access. We report the case of a 76-year-old woman with severe aortic stenosis and a left main coronary stent protruding approximately 1 cm into the aortic root. Given the small aortic annulus and the risk of mechanical interference, surgical aortic valve replacement with the Nicks annular enlargement was performed. The protruding stent segment was selectively trimmed while preserving the intraluminal portion, with concomitant coronary bypass grafting. The postoperative course was uneventful.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 820-823"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870887","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}