Annals of thoracic surgery short reports最新文献

{"title":"Triple Cardiac Procedure Through Left Periareolar Incision: Coronary Artery Bypass, Mitral Valve Repair, and Ventricular Pseudoaneurysm Repair","authors":"Hemn Abdulrahman Abdullah FIBMS,&nbsp;Darya Nadir Saeed FKBMS,&nbsp;Jwan Ali Ahmed AlSofi MBChB,&nbsp;Marwan Abdullah Barzani MBChB","doi":"10.1016/j.atssr.2026.01.016","DOIUrl":"10.1016/j.atssr.2026.01.016","url":null,"abstract":"<div><div>Minimally invasive techniques offer advantages over sternotomy for cardiac surgery. We report a triple combined procedure—coronary artery bypass grafting, mitral valve repair, and left ventricular pseudoaneurysm repair—performed through a single left periareolar incision by using an endoscopic-assisted approach in a 54-year-old man with ischemic cardiomyopathy. The operation and recovery were uneventful. Postoperative imaging confirmed competent valve function, improved ejection fraction, restored ventricular geometry, and graft patency. At 30 days, the patient showed stable cardiac function and excellent cosmetic healing. This case demonstrates the feasibility and potential benefits of extending the periareolar approach to complex cardiac procedures with favorable outcomes.</div></div><div>Minimally invasive techniques offer advantages over sternotomy for cardiac surgery. We report a triple combined procedure—coronary artery bypass grafting, mitral valve repair, and left ventricular pseudoaneurysm repair—performed through a single left periareolar incision by using an endoscopic-assisted approach in a 54-year-old man with ischemic cardiomyopathy. The operation and recovery were uneventful. Postoperative imaging confirmed competent valve function, improved ejection fraction, restored ventricular geometry, and graft patency. At 30 days, the patient showed stable cardiac function and excellent cosmetic healing. This case demonstrates the feasibility and potential benefits of extending the periareolar approach to complex cardiac procedures with favorable outcomes.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 798-801"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870886","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":"A Rare Case of Rosai-Dorfman Disease Involving Great Vessels of the Heart Mimicking Breast Cancer Recurrence","authors":"Nour Chres MD,&nbsp;Giovanni Mattioni MD,&nbsp;Luca Pogliani MD,&nbsp;Eleonora Poirè MD,&nbsp;Marco Reda MD,&nbsp;Giacomo Grisorio MD,&nbsp;Serena Conforti MD,&nbsp;Arash Astaneh MD","doi":"10.1016/j.atssr.2026.03.010","DOIUrl":"10.1016/j.atssr.2026.03.010","url":null,"abstract":"<div><div>Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytosis, with cardiovascular involvement in &lt;0.1% of cases. We report the case of a 69-year-old woman with history of breast cancer found to have mediastinal nodules involving the superior vena cava and pulmonary veins. Imaging suggested recurrence of malignant disease, and multiple biopsies were nondiagnostic. Definitive diagnosis was achieved after median sternotomy under cardiopulmonary bypass with superior vena cava resection and prosthetic reconstruction. Histopathologic analysis confirmed RDD with abundant IgG4-positive plasma cells. This case illustrates the diagnostic complexity of extranodal RDD and the role of surgery in cardiovascular involvement.</div></div><div>Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytosis, with cardiovascular involvement in &lt;0.1% of cases. We report the case of a 69-year-old woman with history of breast cancer found to have mediastinal nodules involving the superior vena cava and pulmonary veins. Imaging suggested recurrence of malignant disease, and multiple biopsies were nondiagnostic. Definitive diagnosis was achieved after median sternotomy under cardiopulmonary bypass with superior vena cava resection and prosthetic reconstruction. Histopathologic analysis confirmed RDD with abundant IgG4-positive plasma cells. This case illustrates the diagnostic complexity of extranodal RDD and the role of surgery in cardiovascular involvement.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1000-1003"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871036","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":"Novel Musculocutaneous Flap for Salvage Esophageal Reconstruction","authors":"Talia G. Meidan BS,&nbsp;Mohamad K. Abou Chaar MD,&nbsp;Frank Corl MS,&nbsp;Carlos A. Puig MD,&nbsp;Julina Ongkasuwan MD,&nbsp;Michael J. Klebuc MD,&nbsp;Andrew T. Huang MD,&nbsp;N. Eddie Liou MD,&nbsp;Shawn S. Groth MD,&nbsp;Shanda H. Blackmon MD, MPH","doi":"10.1016/j.atssr.2026.02.013","DOIUrl":"10.1016/j.atssr.2026.02.013","url":null,"abstract":"<div><div>We present a novel surgical approach for salvage reconstruction of the esophagus in a heavily irradiated field. A tracheoesophageal fistula developed in our patient after laryngectomy and tracheoesophageal puncture for laryngeal cancer. After multiple repairs failed and life-threatening complications, we developed an innovative musculocutaneous flap with extended blood supply from the axillary vessels through a matured saphenous vein loop graft. We term this the \"Bring Your Own Blood (BYOB) supply\" flap. This case demonstrates the viability of this approach as a last-resort option for esophageal reconstruction in heavily irradiated tissue and highlights important anatomical considerations for patients with vascular anomalies.</div></div><div>We present a novel surgical approach for salvage reconstruction of the esophagus in a heavily irradiated field. A tracheoesophageal fistula developed in our patient after laryngectomy and tracheoesophageal puncture for laryngeal cancer. After multiple repairs failed and life-threatening complications, we developed an innovative musculocutaneous flap with extended blood supply from the axillary vessels through a matured saphenous vein loop graft. We term this the \"Bring Your Own Blood (BYOB) supply\" flap. This case demonstrates the viability of this approach as a last-resort option for esophageal reconstruction in heavily irradiated tissue and highlights important anatomical considerations for patients with vascular anomalies.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 981-984"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871038","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":"Damus-Ratelli Procedure for Double Outlet Right Ventricle With Doubly-Committed Subarterial Ventricular Septal Defect","authors":"Hayato Konishi MD, PhD,&nbsp;Akiyo Suzuki MD,&nbsp;Kanta Kishi MD, PhD,&nbsp;Takamichi Uchiyama MD, PhD,&nbsp;Takahiro Katsumata MD, PhD,&nbsp;Shintaro Nemoto MD, PhD","doi":"10.1016/j.atssr.2026.01.003","DOIUrl":"10.1016/j.atssr.2026.01.003","url":null,"abstract":"<div><div>To prevent interventricular rerouting tunnel obstruction after biventricular repair for double outlet right ventricle, it is essential to create a sufficiently straight and wide interventricular rerouting. In cases of the ventricular septal defect extending under both semilunar valves arranged side by side and perpendicular to the outlet septum, conventional rerouting to one semilunar valve may obstruct the other. Herein, we describe our technique for creating an interventricular rerouting tunnel in this rare anatomical configuration by combining rerouting from ventricular septal defect to both semilunar valves and Damus anastomosis. Upon completion, the Rastelli procedure without a conduit was performed.</div></div><div>To prevent interventricular rerouting tunnel obstruction after biventricular repair for double outlet right ventricle, it is essential to create a sufficiently straight and wide interventricular rerouting. In cases of the ventricular septal defect extending under both semilunar valves arranged side by side and perpendicular to the outlet septum, conventional rerouting to one semilunar valve may obstruct the other. Herein, we describe our technique for creating an interventricular rerouting tunnel in this rare anatomical configuration by combining rerouting from ventricular septal defect to both semilunar valves and Damus anastomosis. Upon completion, the Rastelli procedure without a conduit was performed.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 885-888"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870948","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 Interval as a Risk Factor for Postoperative Complications After Repeated Lung Cancer Resection: A Retrospective Cohort Study","authors":"Yuka Kadomatsu PhD,&nbsp;Keita Nakanishi PhD,&nbsp;Harushi Ueno MD,&nbsp;Taketo Kato PhD,&nbsp;Shota Nakamura PhD,&nbsp;Tetsuya Mizuno PhD,&nbsp;Toyofumi Fengshi Chen-Yoshikawa PhD","doi":"10.1016/j.atssr.2026.03.004","DOIUrl":"10.1016/j.atssr.2026.03.004","url":null,"abstract":"<div><h3>Background</h3><div>With improved survival after initial surgery, repeated pulmonary resections are increasingly performed. However, the clinical effect of the interval between operations remains unclear.</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed data from patients who underwent only contralateral repeated pulmonary resection for lung cancer at a single institution between 2002 and 2024, assessing 30-day postoperative complications. Surgical interval was categorized as ≤3 months and &gt;3 months. Multivariable logistic regression was employed to identify risk factors for morbidity.</div></div><div><h3>Results</h3><div>The final cohort comprised 246 contralateral second resections in 123 patients. The mean surgical interval was 40.2 months (median, 27 months). Approximately 40% of second resections occurred within 12 months of the first, half of which were within 3 months. Postoperative complications developed in 25 (20.3%; n = 25/123) patients who were frequently male, had a lower body mass index, and more commonly underwent anatomic resection. Multivariable analysis revealed age (odds ratio [OR], 1.15; 95% CI, 1.04-1.28), male sex (OR, 0.09; 95% CI, 0.02-0.40), anatomic resection (OR, 11.0; 95% CI, 2.08-58.3), and ≤3-month surgical interval (OR, 3.36; 95% CI, 1.01-11.3) as independently associated with postoperative complications. The overall morbidity rate was significantly higher in patients with a ≤3-month interval compared with longer intervals (36.0% [n = 9/25] vs 16.3% [n = 16/98]; <em>P</em> = .029).</div></div><div><h3>Conclusions</h3><div>Contralateral repeated pulmonary resection is feasible, but a ≤3-month surgical interval is associated with greater postoperative morbidity. The surgical interval should be considered an important factor in operative planning.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 927-931"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870950","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":"Modified Negative Pressure Wound Therapy After Open-Window Thoracostomy for Empyema","authors":"Toshio Shiotani MD, PhD,&nbsp;Noriaki Shiraha MD,&nbsp;Mototsugu Watanabe MD, PhD","doi":"10.1016/j.atssr.2026.02.027","DOIUrl":"10.1016/j.atssr.2026.02.027","url":null,"abstract":"<div><div>Open-window thoracostomy is an effective surgical procedure for empyema but is often associated with prolonged hospitalization and residual dead space in the thoracic cavity. Although negative pressure wound therapy after open-window thoracostomy is beneficial, its application is challenging in the presence of major air leakage. We present a modified negative pressure wound therapy technique using a suction tube and low-pressure continuous suction that enables treatment regardless of air leakage. This method provides effective drainage, promotes lung reexpansion, and facilitates infection control with reduced medical material costs.</div></div><div>Open-window thoracostomy is an effective surgical procedure for empyema but is often associated with prolonged hospitalization and residual dead space in the thoracic cavity. Although negative pressure wound therapy after open-window thoracostomy is beneficial, its application is challenging in the presence of major air leakage. We present a modified negative pressure wound therapy technique using a suction tube and low-pressure continuous suction that enables treatment regardless of air leakage. This method provides effective drainage, promotes lung reexpansion, and facilitates infection control with reduced medical material costs.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 969-971"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870992","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":"Universal Principles During Unicuspid Aortic Valve Repair","authors":"Marek J. Jasinski MD","doi":"10.1016/j.atssr.2026.04.016","DOIUrl":"10.1016/j.atssr.2026.04.016","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Page 855"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870827","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":"Age-Based Outcomes of Total Arterial Grafting","authors":"Jasleen Nagi BSc,&nbsp;Maria Comanici MD,&nbsp;Nandor Marczin PhD,&nbsp;Sunil K. Bhudia FRCS(CTh),&nbsp;Shahzad G. Raja FRCS(CTh),&nbsp;Cardiac Outcomes Research Group and Initiative (CORGI)","doi":"10.1016/j.atssr.2026.02.016","DOIUrl":"10.1016/j.atssr.2026.02.016","url":null,"abstract":"<div><h3>Background</h3><div>Total arterial grafting (TAG) may improve graft patency and long-term outcomes in coronary artery bypass surgery. However, the influence of age on TAG outcomes remains unclear. This study compared early complications and long-term survival in patients aged ≤60 years vs &gt;60 years who underwent TAG.</div></div><div><h3>Methods</h3><div>A total of 1,876 patients who underwent TAG were retrospectively analyzed, stratified by age (≤60 years, n = 870; &gt;60 years, n = 1006). Propensity score matching yielded 759 well-balanced pairs. Early outcomes were compared, and 27-year survival was assessed by Kaplan-Meier analysis, log-rank testing, and Cox hazards regression. Significant univariable covariates (<em>P</em> &lt;.05) were entered into a multivariable model.</div></div><div><h3>Results</h3><div>Older patients had more comorbidities, including diabetes, vascular disease, atrial fibrillation, renal impairment, and triple-vessel disease, but they smoked less. Rates of deep sternal wound infection and 30-day mortality were higher in older patients before matching; after matching, only wound infection remained significant (3.3% vs 1.6%; <em>P</em> = .046). Kaplan-Meier analysis showed superior survival in younger patients in both unmatched cohorts (χ² = 89.3; <em>P</em> &lt; 2 × 10^-16) and matched cohorts (χ² = 89.3; <em>P</em> &lt; 2 × 10^-16). Multivariable Cox regression identified age &gt;60 years as an independent mortality predictor (hazard ratio, 2.436; 95% CI, 1.99-2.98; <em>P</em> &lt; .001), along with previous cardiac surgery, diabetes, and previous myocardial infarction.</div></div><div><h3>Conclusions</h3><div>These findings suggest that the prognostic effect of age persists beyond operative risk, thus supporting a judicious approach to TAG in older patients while reinforcing its long-term advantage in younger cohorts. Greater emphasis on age-informed prognostic discussions and tailored postoperative care may help optimize outcomes as surgical practices evolve to accommodate an aging patient population.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 793-797"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870880","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":"Bicuspidization of the Unicuspid Aortic Valve: Neocommissure Reconstruction Preserving the Native Free Margin","authors":"Ryo Kawabata MD,&nbsp;Kotaro Tsunemi MD, PhD,&nbsp;Takanori Oka MD,&nbsp;Yutaka Okita MD, PhD","doi":"10.1016/j.atssr.2026.01.002","DOIUrl":"10.1016/j.atssr.2026.01.002","url":null,"abstract":"<div><div>This report presents a bicuspidization technique for unicuspid aortic valve repair. To enhance long-term durability, the native free margin was preserved, and a portion was used to construct a new commissure, thereby minimizing the use of the patch in regions subjected to high mechanical stress. At 6.5 years postoperatively, the valve function remains excellent.</div></div><div>This report presents a bicuspidization technique for unicuspid aortic valve repair. To enhance long-term durability, the native free margin was preserved, and a portion was used to construct a new commissure, thereby minimizing the use of the patch in regions subjected to high mechanical stress. At 6.5 years postoperatively, the valve function remains excellent.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 849-852"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870885","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":"Exostotic Compression of the Heart Mimicking Angina: A Rare Thoracic Osteochondroma","authors":"Ashley M. Aldridge MD,&nbsp;Peter J. Kneuertz MD,&nbsp;Desmond M. D’Souza MD,&nbsp;Robert E. Merritt MD, MBA,&nbsp;Ioana Baiu MD, MPH","doi":"10.1016/j.atssr.2026.02.020","DOIUrl":"10.1016/j.atssr.2026.02.020","url":null,"abstract":"<div><div>Primary tumors of the bony chest wall are rare. A young ultramarathon runner presented with angina-like chest pain with normal findings on cardiac workup. Cross-sectional imaging revealed a 4.2-cm lesion abutting the pericardium concerning for an osteochondroma. This case illustrates how exostotic compression from a rib lesion can mimic angina and prompt extensive cardiac evaluation while the true cause remains unrecognized, highlighting the need for timely cross-sectional imaging and early surgical intervention. Video-assisted thoracoscopic surgery confirmed a 4.2-cm mass impinging on the pericardium, and resection with reconstruction provided complete symptom resolution and a return to running.</div></div><div>Primary tumors of the bony chest wall are rare. A young ultramarathon runner presented with angina-like chest pain with normal findings on cardiac workup. Cross-sectional imaging revealed a 4.2-cm lesion abutting the pericardium concerning for an osteochondroma. This case illustrates how exostotic compression from a rib lesion can mimic angina and prompt extensive cardiac evaluation while the true cause remains unrecognized, highlighting the need for timely cross-sectional imaging and early surgical intervention. Video-assisted thoracoscopic surgery confirmed a 4.2-cm mass impinging on the pericardium, and resection with reconstruction provided complete symptom resolution and a return to running.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 957-960"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870989","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}