Brazilian journal of cardiovascular surgery最新文献_第5页

Effects of Harvesting Site and Incision Method on Surgical Wound Complications of No-Touch Saphenous Vein Grafts: A Retrospective Observational Study. 摘取部位和切口方式对无接触隐静脉移植物手术伤口并发症的影响：回顾性观察研究。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0098

Hironobu Sakurai, Dai Tasaki, Tomoya Yoshizaki

{"title":"Effects of Harvesting Site and Incision Method on Surgical Wound Complications of No-Touch Saphenous Vein Grafts: A Retrospective Observational Study.","authors":"Hironobu Sakurai, Dai Tasaki, Tomoya Yoshizaki","doi":"10.21470/1678-9741-2024-0098","DOIUrl":"10.21470/1678-9741-2024-0098","url":null,"abstract":"Introduction: Saphenous vein grafts are frequently used for coronary artery revascularization. However, harvesting veins is associated with infected surgical sites and other complications. The no-touch technique that includes harvesting saphenous vein grafts along with surrounding tissues improves graft patency but increases the frequency of wound complications. We harvested saphenous vein grafts using the no-touch technique and devised other options for sites and incision methods to prevent wound complications. This study aimed to determine the clinical outcomes of no-touch saphenous vein grafts as well as associations between harvesting methods and wound complications.Methods: We enrolled 132 patients who underwent isolated coronary artery bypass surgery with saphenous vein grafts harvested using the no-touch technique. Wound condition, general status, and graft patency were assessed during clinical follow-up.Results: We harvested 180 veins (lower legs, n = 69 veins; upper legs, n = 111) using longitudinal and skip incisions at 100 and 80 sites, respectively. Wound complications occurred at 35 sites. The frequency of complications was significantly lower in the upper, than in the lower legs (14.4% vs. 27.5%). Furthermore, wound complications were reduced more by skip, than by longitudinal skin incisions (16.3% vs. 20.0%).Conclusion: We devised a method to harvest no-touch saphenous vein grafts and determined the clinical outcomes of saphenous vein grafts and harvesting sites. Harvesting from the upper leg and via skip incisions reduced the frequency of wound complications.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240098"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188596","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}

引用次数: 0

Intrapericardial Extra-Anatomic Aorto-Aortic Bypass for Aortic Coarctation in Adults. 成人主动脉缩窄的心包内解剖外主动脉-主动脉搭桥术。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0185

Enrique Seguel Soto, Gustavo Barril Merino, Aleck Stockins Larenas, Roberto González Lagos, Rodrigo Reyes Melo

{"title":"Intrapericardial Extra-Anatomic Aorto-Aortic Bypass for Aortic Coarctation in Adults.","authors":"Enrique Seguel Soto, Gustavo Barril Merino, Aleck Stockins Larenas, Roberto González Lagos, Rodrigo Reyes Melo","doi":"10.21470/1678-9741-2024-0185","DOIUrl":"10.21470/1678-9741-2024-0185","url":null,"abstract":"Introduction: The preferred treatment for aortic coarctation is direct repair during childhood. However, some patients reach adulthood without being diagnosed. For these patients, an extra-anatomic bypass offers an alternative solution.Objective: To evaluate the surgical outcomes of adult patients with aortic coarctation treated with an extra-anatomic aorto-aortic bypass.Methods: This retrospective study includes adult patients who underwent an intrapericardial extra-anatomic bypass using a Dacron® tube from 2013 to 2021 (n=8). Clinical characteristics, surgical outcomes, survival rates, and the need for reinterventions were assessed up to March 31, 2024.Results: All patients were male, with an average age of 39.9 ± 10.8 years (range 23-51). All were hypertensive. Four patients had associated aortic valve disease, and one had coronary artery disease. The operative risk, calculated using the European System for Cardiac Operative Risk Evaluation II score, was 1.65%. Four patients underwent concurrent valve surgeries (two valve replacements, one David procedure, and one Bentall procedure), and one had coronary artery surgery. The average pump time was 119 minutes, with longer times for those undergoing additional procedures (157 vs. 82.5 minutes). There was no operative mortality. The mean follow-up period was 107.1 ± 32 months, during which all patients survived. One patient required reintervention on the 118th postoperative month due to aortic stenosis, necessitating valve replacement with a biological prosthesis.Conclusion: Intrapericardial extra-anatomic bypass is a viable option for treating aortic coarctation in adults, demonstrating excellent shortand long-term outcomes. It can be effectively combined with other surgical procedures.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188598","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}

引用次数: 0

Short-Term Outcomes of Patients with Non-Metastatic Malignant Solid Tumor after Coronary Artery Bypass Grafting: A Population-Based Study of National/Nationwide Inpatient Sample From 2015 To 2020. 冠状动脉旁路移植术后非转移性恶性实体瘤患者的短期预后：一项基于2015 - 2020年全国/全国住院患者样本的人群研究

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0202

Renxi Li, Deyanira J Prastein

{"title":"Short-Term Outcomes of Patients with Non-Metastatic Malignant Solid Tumor after Coronary Artery Bypass Grafting: A Population-Based Study of National/Nationwide Inpatient Sample From 2015 To 2020.","authors":"Renxi Li, Deyanira J Prastein","doi":"10.21470/1678-9741-2024-0202","DOIUrl":"10.21470/1678-9741-2024-0202","url":null,"abstract":"Introduction: Previous studies found that patients with a history of cancer either have similar outcomes or face an increased risk of early morbidity following cardiac surgery. However, the applicability of these findings to clinical practice may be constrained by the heterogeneity of cancer patients. To refine our understanding, this study focuses specifically on the in-hospital outcomes of patients with non-metastatic malignant solid tumors (NMST) undergoing coronary artery bypass grafting (CABG).Methods: Patients who underwent CABG were identified in National/Nationwide Inpatient Sample from Q4 2015-2020. Exclusion criteria included age < 18 years, concomitant procedures, and other malignancies. A 1:3 propensity-score matching was employed to address differences in demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and admission status between patients with and without NMST. In-hospital outcomes after CABG were evaluated.Results: There were 2,139 patients with NMST who underwent CABG and who were matched to 6,580 out of 164,351 patients without NMST. Patients with and without NMST had comparable mortality (2.25% vs. 2.16%, P=0.80). However, NMST patients have a higher risk of hemorrhage/hematoma (63.48% vs. 58.27%, P<0.01) and a higher rate of transfer out (28.75% vs. 25.36%, P<0.01). In addition, patients with NMST had longer time from admission to operation (P<0.01), a longer length of stay (P<0.01), and higher hospital charges (P<0.01).Conclusion: Patients with NMST have comparable short-term outcomes after CABG, except for a higher risk of postoperative bleeding. Thus, CABG could be performed safely for NMST patients, despite long-term prognosis of these patients may require further investigation.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240202"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188600","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}

引用次数: 0

A Paradigm Shift in Managing Carotid Artery Disease Associated with Coronary Artery Bypass Grafting. 冠状动脉搭桥术相关颈动脉疾病的治疗模式转变

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2025-0901

Luciano Cabral Albuquerque

引用次数: 0

Triple Arterial Minimally Invasive Direct Coronary Artery Bypass Grafting: Step-By-Step Technique Report. 三动脉微创直接冠状动脉旁路移植术：分步技术报告。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0193

Danko Grujic, Vojkan Aleksic, Tatjana Gazibara, Vladimir Milicevic, Radmila Karan

引用次数: 0

Simple Endocardial Running Suture Technique for Concealing Prosthetic Material in Mitral Valve Annulus Cerclage to Prevent Hemolysis. 二尖瓣环扎扎术中隐藏假体材料防止溶血的简单心内膜顺行缝合技术。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0309

Paulo José de, Antonio Carlos Menardi, Fabio Luis-Silva, Andre Luppi, Paulo Roberto B Evora

引用次数: 0

Clinical Impact of New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Replacement: Data from a Single-Center Retrospective Registry. 经导管主动脉瓣置换术后新发左束支传导阻滞的临床影响：来自单中心回顾性登记的数据。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0187

Aleksey A Baranov, Aram G Badoian, Dmitrii A Khelimskii, Aryuna Yu Tsydenova, Ivan S Peregudov, Vladimir V Beloborodov, Aleksey G Filippenko, Toyche U Khalkhozhaev, Oleg V Krestyaninov

{"title":"Clinical Impact of New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Replacement: Data from a Single-Center Retrospective Registry.","authors":"Aleksey A Baranov, Aram G Badoian, Dmitrii A Khelimskii, Aryuna Yu Tsydenova, Ivan S Peregudov, Vladimir V Beloborodov, Aleksey G Filippenko, Toyche U Khalkhozhaev, Oleg V Krestyaninov","doi":"10.21470/1678-9741-2024-0187","DOIUrl":"10.21470/1678-9741-2024-0187","url":null,"abstract":"Introduction: The clinical significance of new-onset left bundle branch block (LBBB) after transcatheter aortic valve replacement (TAVR) remains controversial. In the presented study, we aimed to assess the impact of new LBBB on clinical outcomes after TAVR.Methods: A total of 473 patients underwent TAVR for severe aortic stenosis between 2015 and 2023. According to the exclusion criteria, the study cohort comprised of 322 patients for analysis. The primary endpoint was cardiovascular death, with secondary endpoints including all-cause mortality and permanent pacemaker implantation (PPI) during follow-up.Results: Patients with new LBBB had a significantly smaller indexed aortic valve area (0.3 ± 0.1 vs. 0.4 ± 0.1, P < 0.01) and interventricular membranous septum length (6.2 ± 1.6 vs. 6.9 ± 1.8, P < 0.01). By multivariable analysis, new LBBB remained an independent predictor of cardiovascular death (hazard ratio [HR] 7.09, 95% confidence interval [CI] 1.16 - 43.50, P = 0.03) during the 2.9-year follow-up period. There were no significant differences in the incidence of all-cause mortality (HR 0.48, 95% CI 0.17 - 1.37, P = 0.16) and PPI (HR 2.61, 95% CI 0.85 - 0.80, P = 0.08) between patients with new LBBB compared to those without it.Conclusion: New LBBB after TAVR procedure is associated with an increased risk of death from cardiovascular causes, but it did not increase the risk of all-cause mortality and PPI over the long-term period.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240187"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188569","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}

引用次数: 0

Evaluation of Intraoperative and Postoperative Blood Cell Salvage Use in Cardiac Surgery with Cardiopulmonary Bypass. 体外循环心脏手术术中及术后血细胞回收应用的评价。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0244

Marco Antonio Araújo de Mello, Laís da Silva Pereira-Rufino, Antonio Alceu Dos Santos, Nelson Americo Hossne, Carlos Eduardo Panfilio, Albert Schiaveto de Souza, Isabel Cristina Céspedes

{"title":"Evaluation of Intraoperative and Postoperative Blood Cell Salvage Use in Cardiac Surgery with Cardiopulmonary Bypass.","authors":"Marco Antonio Araújo de Mello, Laís da Silva Pereira-Rufino, Antonio Alceu Dos Santos, Nelson Americo Hossne, Carlos Eduardo Panfilio, Albert Schiaveto de Souza, Isabel Cristina Céspedes","doi":"10.21470/1678-9741-2024-0244","DOIUrl":"10.21470/1678-9741-2024-0244","url":null,"abstract":"Introduction: Blood transfusion is associated with adverse clinical and surgical outcomes. Strategies like the Patient Blood Management program, which includes blood cell salvage, contribute to reducing the use of blood components. Blood cell salvage is very useful in heart surgeries where the patient's blood loss can be massive.Objective: The present study aimed to evaluate the impact of using the blood cell salvage in the intraoperative and postoperative periods (up to 24 hours) on the hemoglobin and hematocrit values, transfusion of red blood cells, infection rates, and postoperative length of stay in patients undergoing cardiac surgery with cardiopulmonary bypass.Methods: Forty-one patients who underwent cardiac surgery with cardiopulmonary bypass according to the inclusion criteria were selected in an observational study and separated into two groups: with the use of the blood cell salvage group (BCS, n = 21) and without the use of the blood cell salvage (WBCS, n = 20).Results: Patients in the group using blood cell salvage had higher postoperative hemoglobin (P = 0.018) and postoperative hematocrit levels (P = 0.009), lower consumption of red blood cells in the postoperative period and hospital discharge (P < 0.001), shorter postoperative length of stay (P = 0.020), and lower infection rates (P = 0.009).Conclusion: Patient Blood Management strategies, particularly the use of blood cell salvage in the intraoperative and immediate postoperative periods of patients undergoing cardiac surgery with cardiopulmonary bypass, are associated with less use of blood components and consequently better clinical outcomes.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240244"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188597","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}

引用次数: 0

The Ticking Clock of Aortic Root Replacement - Single-Center Experience After Urgent and Emergent Aortic Root Replacement Using the BioIntegral and Freestyle™ Bioconduits. 主动脉根部置换的滴答时钟-使用BioIntegral和Freestyle™bio导管进行紧急和紧急主动脉根部置换后的单中心体验。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0307

Konstantina Spetsotaki, Jingjing Shi, Ajay Moza, Matthias Menne, Ali Aljalloud

{"title":"The Ticking Clock of Aortic Root Replacement - Single-Center Experience After Urgent and Emergent Aortic Root Replacement Using the BioIntegral and Freestyle™ Bioconduits.","authors":"Konstantina Spetsotaki, Jingjing Shi, Ajay Moza, Matthias Menne, Ali Aljalloud","doi":"10.21470/1678-9741-2024-0307","DOIUrl":"10.21470/1678-9741-2024-0307","url":null,"abstract":"Introduction: Aortic root pathologies needing full aortic root replacement are challenging entities correlated to high morbidity and mortality due to their complexity and mostly refer to high-risk patients. In this retrospective study, we report our surgical experience and clinical results of patients undergoing a Bentall procedure as primary or reoperative surgery with the application of aortic bioconduits.Methods: Patients who underwent full aortic root replacement utilizing either BioIntegral (BI) or Medtronic Freestyle™ (FS) bioconduit in the Cardiothoracic Surgery Department of the University Hospital Aachen RWTH from January 2015 until September 2020, in an urgent or emergency setting, were analyzed and followed up until December 2023.Results: Twenty-six patients underwent aortic root replacement with bioconduits (N=11 with BI, N=15 with FS) in our center. Twenty-three cases were of infective cause, and three were of noninfective cause; 30.76% were urgent, and 69.23% were emergency cases. Two (7.70%) patients died during operation due to irreversible aortic root damage. In-hospital and 30-day mortality rates were four out 26 (15.4%) patients. The mean follow-up time for all the patients was 52.01 ± 39.41 months. Patients who received a primary aortic root replacement had significantly higher survival than redo cases. BI surgery needed longer cardiopulmonary bypass times.Conclusion: Clinical outcome was equal for both bioconduits. Further studies with larger cohorts are needed for deeper insights into this complex entity.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240307"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188601","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}

引用次数: 0

Del Nido vs. Blood Cardioplegia: A Comparative Analysis of Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting Patients. Del Nido与血停搏：冠状动脉搭桥术患者术后房颤的比较分析。

Brazilian journal of cardiovascular surgery Pub Date : 2025-05-30 DOI: 10.21470/1678-9741-2024-0071

Hasan Toz, Ali Aycan Kavala, Saygın Türkyılmaz, Yusuf Kuserli, Gülsüm Türkyılmaz, Mehmet Ali Yesiltas, Necdet Kılıçaslan

{"title":"Del Nido vs. Blood Cardioplegia: A Comparative Analysis of Postoperative Atrial Fibrillation in Coronary Artery Bypass Grafting Patients.","authors":"Hasan Toz, Ali Aycan Kavala, Saygın Türkyılmaz, Yusuf Kuserli, Gülsüm Türkyılmaz, Mehmet Ali Yesiltas, Necdet Kılıçaslan","doi":"10.21470/1678-9741-2024-0071","DOIUrl":"10.21470/1678-9741-2024-0071","url":null,"abstract":"Introduction: Cardioplegia solution, also called the del Nido solution, has been widely used in pediatric cardiac surgeries, and has recently started to be used in adult cardiac surgeries. In this context, this study aimed to investigate the relationship between the use of del Nido and blood cardioplegia solutions and postoperative atrial fibrillation rates in our clinic.Methods: The study sample comprised 140 patients who underwent coronary artery bypass grafting. The del Nido and blood cardioplegia solutions were used in 70 (50%) patients. The postoperative atrial fibrillation rates of both groups were compared. Additionally, patients' preoperative, intraoperative, and postoperative data were evaluated.Results: The cardiopulmonary bypass duration and defibrillation rate were lower in the del Nido cardioplegia group than in the blood cardioplegia group (P < 0.001). Atrial fibrillation rates on postoperative days one, five, and 30 were significantly lower in the del Nido cardioplegia group than in the blood cardioplegia group (P < 0.001, P < 0.001, and P = 0.007, respectively).Conclusion: The postoperative atrial fibrillation rate was significantly lower in the del Nido cardioplegia group than in the blood cardioplegia group. In addition, the del Nido cardioplegia solution did not interrupt the surgical flow, thus resulting in less total perfusion, shorter cross-clamping durations, and fewer defibrillation needs. In conclusion, the del Nido cardioplegia solution can be used safely and effectively in coronary artery bypass grafting surgeries.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"40 3","pages":"e20240071"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188595","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}

引用次数: 0