Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"7-year results for RESILIA tissue in bicuspid aortic valve replacement patients: Age and valve size considerations.","authors":"Michael Salna, Joseph E Bavaria, David Heimansohn, Thomas Beaver, Bartley Griffith, Lars G Svensson, Philippe Pibarot, Michael A Borger, Vinod H Thourani, Eugene H Blackstone, Lorraine D Cornwell, John D Puskas, Hiroo Takayama","doi":"10.1093/icvts/ivaf176","DOIUrl":"https://doi.org/10.1093/icvts/ivaf176","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with bicuspid aortic valve disease requiring surgical aortic valve replacement are often younger and want to avoid lifelong anticoagulation. A multicentre single-arm non-randomized study, the COMMENCE trial, studied outcomes of RESILIA tissue aortic valves in bicuspid aortic valve patients through 7 years of follow-up.</p><p><strong>Methods: </strong>Of 672 patients who underwent surgical replacement of native aortic valves, 214 had bicuspid and 458 had tricuspid aortic valves. Propensity score analyses with inverse probability of treatment weighting were utilized to minimize bias due to measured confounders. Linear mixed-effect models compared longitudinal changes in haemodynamic parameters.</p><p><strong>Results: </strong>Patients with bicuspid were significantly younger than those with tricuspid aortic valves (mean age of bicuspid: 59.8 (12.4) vs tricuspid: 70.2 (9.5) years; p < 0.001); 39/214 (18%) bicuspid aortic valve patients were <50 years old. There was no evidence of structural valve deterioration in any bicuspid aortic valve patients over 7 years of follow-up. At 7 years, there was no significant difference between bicuspid and tricuspid aortic valve patients in propensity score- and age-adjusted survival (91.9% vs 88.1%, respectively; p = 0.35), stroke, or reoperation. Among bicuspid aortic valve patients <65 years of age, there was no significant difference in prosthetic valve effective orifice areas and mean gradients between 3 months and 7 years postoperatively.</p><p><strong>Conclusions: </strong>Patients with bicuspid aortic valves had excellent outcomes with RESILIA tissue valves at 7 years with no evidence of structural valve deterioration. These results suggest a durable alternative for carefully selected younger patients wishing to avoid anticoagulation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765862","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":"Electrosurgical laceration and stabilization of clip followed by transapical mitral valve replacement after failed transcatheter edge to edge mitral valve repair: a promising alternative to surgery.","authors":"Fabio Pregaldini, Mevlüt Çelik, Maria Nucera, Selim Mosbahi, Kai Alexander Münker, Paul Potratz, Fabien Praz, David Reineke, Matthias Siepe, Clarence Pingpoh","doi":"10.1093/icvts/ivaf183","DOIUrl":"https://doi.org/10.1093/icvts/ivaf183","url":null,"abstract":"<p><strong>Objectives: </strong>The study analyzes perioperative outcomes in patients who underwent transcatheter electrosurgical laceration and stabilization of the clip (ELASTA-clip), followed by transapical mitral valve replacement or conventional mitral valve surgery after failed transcatheter edge-to-edge mitral valve repair.</p><p><strong>Methods: </strong>Consecutive patients who experienced failure of a transcatheter edge-to-edge mitral valve repair and subsequently underwent either the ELASTA-clip procedure followed by transapical mitral valve replacement, or conventional open mitral valve surgery, were retrospectively analyzed. Perioperative and mid-term outcomes including mortality, stroke, bleeding, pacemaker implantation, and the need for mechanical circulatory support were assessed descriptively.</p><p><strong>Results: </strong>A total of five patients were enrolled in the ELASTA group and 31 in the open surgery group, with median follow-up periods of 2 years [IQR: 1.2-2.1] and 1.4 years [IQR: 0.3-3.7], respectively. Procedural success was achieved in all ELASTA cases (100%) compared to 96% in the open surgery group. No in-hospital deaths occurred in the ELASTA group, whereas the surgical group had a mortality rate of 6.5% (n = 2). During follow-up, adverse events occurred in 20% (n = 1) of ELASTA patients and 54.8% (n = 17) of those who underwent surgery.</p><p><strong>Conclusions: </strong>Surgical intervention in patients with failed edge-to-edge mitral valve repair carries a high risk of complications. The ELASTA-clip technique, combined with transapical mitral valve replacement, offers a minimally invasive and safe alternative to conventional surgery, highlighting the need for further prospective studies with longer-term follow-up.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755275","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":"The role of computational modeling in enhancing thermal safety during cardiac ablation.","authors":"Leila Seidabadi, Indra Vandenbussche, Rowan Carter Fink, MacKenzie Moore, Bailey McCorkendale, Fateme Esmailie","doi":"10.1093/icvts/ivaf184","DOIUrl":"https://doi.org/10.1093/icvts/ivaf184","url":null,"abstract":"<p><strong>Objective: </strong>In this narrative review, we aim to provide an analysis of current cardiac ablation techniques, such as radiofrequency ablation (RF), cryoablation, and pulsed-field ablation (PFA), with a focus on the role of computational modeling in enhancing the precision, safety, and effectiveness of these treatments. Particular attention is given to thermal management, exploring how computational approaches contribute to understanding and controlling energy delivery, heat distribution, and tissue response during ablation procedures.</p><p><strong>Methods: </strong>We conducted this narrative review based on our expertise and a targeted search using over 50 keywords across major databases. We selected studies for their relevance, impact, and methodological rigor, and included additional references suggested during peer review. While we did not follow a systematic protocol, our approach ensured broad coverage of key developments and emerging trends in the field. We then presented the mechanisms, applications, and limitations of radiofrequency (RF) ablation, cryoablation, and pulsed field ablation (PFA). Additionally, we discussed the use of computational approaches, including numerical methods and artificial intelligence (AI)-based models, for evaluating energy distribution, lesion size, and tissue response during ablation procedures.</p><p><strong>Results: </strong>Computational methods can be used to predict ablation treatment outcomes and help optimize lesion size, ablation parameters, and procedural safety. However, these models are only reliable when properly validated and verified.</p><p><strong>Conclusion: </strong>Further research is essential to collect reliable in vivo data for validating computational models and integrating them into clinical practice to improve patient outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755276","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":"Effects of Ulinastatin on inflammation response and lung tissue injury in deep hypothermic circulatory arrest.","authors":"Qiang Hu, Yuan Teng, Yuan Yuan, Guodong Gao, Bingyang Ji","doi":"10.1093/icvts/ivaf177","DOIUrl":"https://doi.org/10.1093/icvts/ivaf177","url":null,"abstract":"<p><strong>Objectives: </strong>Deep hypothermic circulatory arrest (DHCA) is known to trigger a systemic inflammatory response and ischaemia-reperfusion injury, leading to exacerbated lung dysfunction. Ulinastatin (UTI) is a commonly used anti-inflammatory drug in clinical settings, but its protective effects may vary depending on the timing and dosage.</p><p><strong>Methods: </strong>A rat model of DHCA was established and two different doses of UTI (5/10 × 104 U/kg; low/high dose) were administered. We measured the levels of inflammatory factors using enzyme-linked immunosorbent assay kits and assessed the functional indicators of lung tissue injury. All rats (n = 18) underwent the standard cardiopulmonary bypass (CPB) procedure with DHCA.</p><p><strong>Results: </strong>Following rewarming, the levels of interleukin-6 (IL-6), IL-10, tumour necrosis factor (TNF)-α, and neutrophil elastase 2 (ELA-2) gradually increased in rats exposed to DHCA. Compared to the DHCA group, both the UTI groups exhibited significant reductions in IL-6 (DHCA vs DHCA+UTI-H, 8931.68 ± 650.31 vs 2498.05 ± 552.16), TNF-α (DHCA vs DHCA+UTI-H, 633.74 ± 74.53 vs 221.19 ± 31.63), and ELA-2 (DHCA vs DHCA+UTI-H, 4.94 ± 0.49 vs 3.29 ± 0.34), while remarkably increased the IL-10 (DHCA vs DHCA+UTI-H, 975.04 ± 110.33 vs 3081.27 ± 554.10) levels four hours after weaning from CPB (all P < 0.05). Interestingly, the high dose of UTI demonstrated a dose-dependent inhibition of inflammation. Meanwhile, we found that UTI contributed to maintain haemodynamic stability, improve tissue perfusion, and reduce hypoxia, as evidenced by elevated heart rate, blood pressure, hematocrit and oxygenation index, and decreased glucose and lactate. Reduced pathological changes in lung histopathology were also observed after UTI intervention, especially in 10 × 104 U/kg group.</p><p><strong>Conclusions: </strong>This study revealed that administration of low to high doses of UTI during DHCA could reduce the release of inflammatory factors, exert anti-inflammatory effects, and alleviate lung injury.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746300","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":"Objective assessment of ergonomics and performance of thoracic surgeons during real-life anatomical robotic pulmonary resections.","authors":"Ahmed G Elkhouly, Gowthanan Santhirakumaran, Ben Shanahan, Tim Batchelor, Henrietta Wilson, David Waller, Steven Stamenkovic, Kelvin Lau","doi":"10.1093/icvts/ivaf180","DOIUrl":"https://doi.org/10.1093/icvts/ivaf180","url":null,"abstract":"<p><strong>Objectives: </strong>Motion tracking tools have been used in the analysis of surgeons' technical expertise and posture in simulated endoscopic surgery. But its use in humans in real-life robotic surgery is limited. We analysed the effect of surgeons' ergonomics and posture on skill metrics for vascular dissection during anatomical pulmonary resection.</p><p><strong>Methods: </strong>In this observational study of vascular dissection/division during segmentectomy or lobectomy, we analysed the inter-group differences of those with more than (group-1) and less than (group-2) 100 robotic resections. The rapid upper limb assessment (RULA) scale used to estimate ergonomic risk. Operative performance and posture for RULA were measured using the Kinovea-0.9.5 system. Path length of moving instruments, instrument speed, time for task completion, and duration of instruments out of vision were calculated to objectively assess operator performance.</p><p><strong>Results: </strong>Group-1 (expert) comprised 2 males and 1 female, age 42-61 years. Group-2 (novice) comprised 4 males, age 31-52 years. 67 patients underwent robotic anatomical resection using the da Vinci Xi robotic platform, with 180 pulmonary vessels isolations/divisions (Group-1 = 95 vs Group-2 = 85). Group-1 had significantly better RULA ergonomic scores (4.3 vs 4.7, p < 0.001) which was associated with higher speed (2.8 ± 0.8 cm/sec vs 2.1 ± 0.2 cm/sec, p < 0.001), shorter task completion time (388 ± 278 vs 520 ± 322 sec, p = 0.001) and shorter duration of instruments out of vision (p < 0.001). There was no difference in path length (p = 0.8) and no significant correlation between RULA score and different parameters that assessed surgical performance.</p><p><strong>Conclusions: </strong>Video motion tracking software is an effective and unobtrusive method to evaluate surgical ergonomics and performance in robotic surgery. Better ergonomics were associated with increased surgical experience and improved surgical performance.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746302","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":"Major bleeding and thromboembolic events with the On-X mechanical aortic valve prosthesis: a SWEDEHEART study.","authors":"Ruixin Lu, Michael Dismorr, Magnus Dalén, Natalie Glaser, Ulrik Sartipy","doi":"10.1093/icvts/ivaf182","DOIUrl":"https://doi.org/10.1093/icvts/ivaf182","url":null,"abstract":"<p><strong>Objectives: </strong>Lifelong anticoagulation therapy is mandatory in patients with mechanical heart valves. The On-X aortic valve is currently the only mechanical heart valve approved for a lower (1.5-2.0) target international normalized ratio (INR) compared to the standard INR target 2.0-3.0. There is limited evidence demonstrating clinical benefits of the On-X valve over other mechanical aortic valves. We therefore investigated the risk of bleeding and thromboembolic events in patients with the On-X aortic valve.</p><p><strong>Methods: </strong>This nationwide, population-based cohort study, using the target trial emulation framework, included all adults who underwent primary mechanical aortic valve replacement in Sweden 2014-2022 from the SWEDEHEART register. The rates of major bleeding and thromboembolic events were obtained from national registers. Confounding was addressed by weighting.</p><p><strong>Results: </strong>Of 3047 patients, 656 patients (22%) received an On-X aortic valve and 2391 patients (78%) received other mechanical aortic valves. The mean age was 54 years and 23% were women. After 8 years, the weighted major bleeding cumulative incidence was 7.2% (95% CI: 4.8%-10.7%) in the On-X valve group versus 7.0% (95% CI: 5.5%-8.8%) in the other mechanical valves group, and the weighted cumulative incidence of thromboembolic events was 9.8% (95% CI: 7.3%-13.1%) in the On-X valve group versus 9.0% (95% CI: 8.0%-10.9%) in the other mechanical valves group.</p><p><strong>Conclusions: </strong>We found no clinically relevant difference in major bleeding or thromboembolic events in patients with the On-X aortic valve compared to patients with other mechanical aortic valves.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746301","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":"Early and late outcomes of redo procedure for total arch replacement after previous cardiovascular surgery: 10-year experience.","authors":"Ruojin Zhao, Weijing Wang, Yanxiang Liu, Yaojun Dun, Bowen Zhang, Luchen Wang, Sangyu Zhou, Xiaogang Sun","doi":"10.1093/icvts/ivaf179","DOIUrl":"https://doi.org/10.1093/icvts/ivaf179","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the early and late outcomes of the redo procedure for total arch replacement (TAR) following previous cardiovascular surgery.</p><p><strong>Methods: </strong>Between January 2013 and November 2023, 117 patients underwent total aortic arch replacement after previous cardiovascular surgery in our center. Surgical indication, perioperative data, postoperative complications and late outcomes were retrospectively analyzed.</p><p><strong>Results: </strong>The mean age of patients was 46.8 ± 13.0 years, and 32 were female (27.4%). Indications for redo procedure included aortic arch aneurysm (11, 9.4%), aneurysmal expansion of a chronic dissection (35, 29.9%), staged surgery in plan (3, 2.6%), aortitis (2, 1.7%) and iatrogenic reasons (16, 13.7%). In-hospital mortality was 6.8% with 13.7% major adverse events. Patients who received bilateral cerebral perfusion had significantly higher intraoperative temperatures [nasopharyngeal: 23.4 °C (20.4 °C-25.0 °C) vs 26.8 °C (25.0 °C-27.5 °C), P < 0.001; bladder: 25.5 ± 3.2 °C vs 28.8 ± 1.8 °C, P < 0.001] and required fewer platelet transfusions [median units: 1.0 (1.0-2.0) vs 1.00 (1.0-1.0), P = 0.003], with no significant differences in postoperative neurological deficits. Overall survival of the patients was 90.1% [95% confidence interval (CI): 84.2%-96.5%], 86.9% (95% CI: 79.8%-94.6%), and 80.0% (95% CI: 70.5%-90.8%) at 1, 3, and 5 years, respectively. During follow-up, 14 patients received aortic-related reinvention. The cumulative incidence of reinvention was 17.20% (95% CI: 7.22%-26.11%) at 5 years.</p><p><strong>Conclusions: </strong>Although redo total arch replacement is technically challenging, acceptable early and late results can be obtained through tailored surgical planning and end-organ protection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735891","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":"Surgical ablation by a right mini-thoracotomy versus a median sternotomy: A systematic review and meta-analysis of observational studies.","authors":"Leo Consoli, Francisco Javier Nino Gonzalez, Henri Bartolozzi, Namira Mohammed Ali, Oluwaseun Fagbamila, Massimo Baudo","doi":"10.1093/icvts/ivaf178","DOIUrl":"https://doi.org/10.1093/icvts/ivaf178","url":null,"abstract":"<p><strong>Objectives: </strong>A minimally invasive approach by a right minithoracotomy has been developed for surgical ablation of atrial fibrillation. However, the efficacy and safety compared to a median sternotomy remains unclear.</p><p><strong>Methods: </strong>We searched PubMed, Embase and the Cochrane Library for eligible studies. Meta-analysis was performed for primary (recurrence of atrial tachyarrhythmias at 1 and 2 years) and secondary (hospital and ICU stay, adverse events, 30-day mortality, cardiopulmonary bypass and aortic cross-clamp time) endpoints. We compared endpoints using risk ratio (RR) for binary outcomes and mean difference (MD) for continuous ones. We calculated 95% confidence intervals (CI) and used the random-effects model for all outcomes. We performed subgroup analysis for the main outcome based on lesion set, energy source, type of surgery, and propensity score matching.</p><p><strong>Results: </strong>We included 12 observational studies (n = 3122). No difference was found for the primary outcome at 1 (RR 0.8; [95% CI]: 0.62-1.03; p = 0.08) and 2 years (RR 0.9; [95% CI]: 0.74-1.13; p = 0.4). The thoracotomy group had lower complications (RR 0.72; [95% CI]: 0.55-0.97; p = 0.016), 30-day mortality (OR 0.26; [95% CI]: 0.10-0.70; p = 0.007), hospital stay (MD -5.35; [95% CI]: -7.94-2.77; p < 0.001) and ICU stay (MD -2.21; [95% CI]: -3.02-1.40; p < 0.001). Cardiopulmonary bypass and aortic clamping time were significantly higher in the thoracotomy group.</p><p><strong>Conclusion: </strong>This meta-analysis found that surgical ablation by a minithoracotomy might achieve similar rhythm control to a median sternotomy while possibly improving safety and promoting faster recovery. However, conclusions are limited by the observational nature of the evidence and randomized trials are warranted.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719248","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":"Endocarditis and other indications for open-heart surgery after transcatheter aortic valve implantation.","authors":"Torbjörn Ivert, Aninda Omar, Andreas Rück, Magnus Dalén","doi":"10.1093/icvts/ivaf173","DOIUrl":"https://doi.org/10.1093/icvts/ivaf173","url":null,"abstract":"<p><p>This retrospective observational single-centre analysis included 31 patients who underwent transcatheter aortic valve implantation (TAVI) between 2016 and 2024 and subsequent open-heart surgery between 2019 and 2024. They were admitted from infectious disease departments or cardiology clinics and accounted for 0.7% of heart operations performed in 2024. The incidence of definite endocarditis was 0.5% (17/3,226) of all TAVI procedures performed during this period. Of the 17 patients, nine (53%) with definite endocarditis underwent aortic valve replacement, with one early death (11%) from bowel ischaemia and liver failure. The two-year survival post-surgery for definite endocarditis was 76%. Open-heart surgery was contraindicated in all eight patients with definite endocarditis due to severe comorbidities and frailty. These patients died within two years of the infection or due to heart failure. Furthermore, ten patients classified as having endocarditis after TAVI were medically treated and had a two-year survival rate of 72%. The survival rate was 87% at two years after open-heart surgery for non-infectious indications performed up to five years after TAVI in 22 patients. In conclusion, heart surgery can be curative in selected patients with definite endocarditis after TAVI and lifesaving after rare TAVI complications.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719247","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":"Mid-term outcomes after aortic valve replacement in patients under 70: A comparative study of INSPIRIS RESILIA versus PERIMOUNT MAGNA EASE bioprostheses.","authors":"Gabriel Saiydoun, Elie Nassar, Saadé Saadé, Chadi Aludaat, Sylvain Rubin, Ibrahim Alqdeimat, Vito Giovanni Ruggieri","doi":"10.1093/icvts/ivaf169","DOIUrl":"https://doi.org/10.1093/icvts/ivaf169","url":null,"abstract":"<p><strong>Objectives: </strong>INSPIRIS RESILIA, launched in 2017, is a bioprosthetic aortic valve developed to improve durability and facilitate future valve-in-valve procedures. Despite its advanced design, many surgeons continue to use the PERIMOUNT MAGNA EASE valve, which has long-standing clinical validation. This study aimed to compare mid-term clinical and echocardiographic outcomes in patients under 70 undergoing aortic valve replacement with either prosthesis.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients who underwent surgical aortic valve replacement between January 2018 and May 2023 at the University Hospital of Reims. The primary outcome was all-cause mortality at one year following surgical aortic valve replacement. Secondary outcomes included haemodynamic parameters, left ventricular ejection fraction, and major postoperative complications such as reintervention, stroke, pacemaker implantation, mediastinitis, transfusion, and new-onset atrial fibrillation.</p><p><strong>Results: </strong>A total of 300 patients were included: 52 received the INSPIRIS RESILIA valve and 248 received the PERIMOUNT MAGNA EASE valve. After matching, 52 patients from each group were compared. All-cause mortality at three years was 0% in the INSPIRIS group and 1.9% in the PERIMOUNT group. Mean transvalvular gradients were similar at one year (11.3 vs 11.2 mmHg) and three years (12.9 mmHg for both). Two cases of endocarditis-related reoperation occurred in the INSPIRIS group. No structural valve degeneration requiring surgery was observed. Postoperative aortic regurgitation was trivial or absent. Transfusion rates were lower in the INSPIRIS group (46.1% vs 69.2%, p = 0.017).</p><p><strong>Conclusions: </strong>INSPIRIS RESILIA and MAGNA EASE valves offer similar mid-term safety and performance in patients under 70 years of age.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715235","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}