Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Association between pre-transplant psoas sarcopenia and perioperative outcomes in lung transplant recipients: a single-center retrospective cohort study.","authors":"Garance Vaillant, Nathalie Zappella, Elie Kantor, Kinan El Husseini, Loukbi Saker, Enora Atchade, Philippe Montravers, Linda Hajouji, Hervé Mal, Pierre Mordant, Antoine Khalil, Jonathan Messika, Vincent Bunel","doi":"10.1093/icvts/ivag135","DOIUrl":"https://doi.org/10.1093/icvts/ivag135","url":null,"abstract":"<p><strong>Objectives: </strong>Lung transplantation (LTx) is the solid organ transplantation with the comparatively worst prognosis. Therefore, improving candidate selection and risk stratification for these patients has become a high-priority research focus. Incorporating objective markers of frailty such as sarcopenia in the pre-transplant evaluation may help achieve this goal. We evaluated the association between CT-measured psoas muscle sarcopenia and early LTx outcomes.</p><p><strong>Methods: </strong>We performed a retrospective study including patients who underwent LTx from 2014 to 2018 at our institution with available chest and abdominal CT scans in the year prior to LTx. Psoas cross-sectional area was measured, and previously established sex-specific cutoffs were used to define sarcopenia. We compared sarcopenic and non-sarcopenic LTx recipients regarding 1-year mortality and perioperative outcomes.</p><p><strong>Results: </strong>A total of 140 patients were included, who received LTx primarily for interstitial lung disease (ILD) (n = 75, 53%) or chronic obstructive pulmonary disease (n = 54, 39%). Forty-six (33%) were sarcopenic. We found no association between psoas sarcopenia and 1-year all-cause mortality (multivariable p=0.13) nor perioperative complications or FEV1 at 1-year post-LTx. Exploratory subgroup analysis revealed an association between psoas sarcopenia and 1-yer all-cause mortality in patients with ILD (multivariable p = 0.042).</p><p><strong>Conclusions: </strong>Pre-established sex-specific cutoffs for psoas sarcopenia did not reach statistical significance for 1-year mortality or perioperative outcomes in the overall cohort; given limited statistical power, a clinically meaningful association cannot be excluded. An exploratory signal in ILD patients warrants further investigation. Future studies may benefit from disease-specific threshold validation and the integration of muscle strength and physical performance alongside muscle mass assessment.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857603","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":"Three-Dimensional Computed Tomography Metrics Reveal Divergent Functional-Structural Adaptation After Lobectomy in Chronic Obstructive Pulmonary Disease.","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1093/icvts/ivag122","DOIUrl":"10.1093/icvts/ivag122","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791127","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":"Valve-Sparing Aortic Root Replacement: Comparison of Long-Term Outcomes Between the David and Yacoub Procedure in Denmark.","authors":"Emil Johannes Ravn, Lytfi Krasniqi, Poul Erik Mortensen, Bo Juel Kjeldsen, Jens Lund, Oke Gerke, Morten Holdgaard Smerup, Ivy Susanne Modrau, Jordi Sanchez Dahl, Lars Peter Schødt Riber","doi":"10.1093/icvts/ivag107","DOIUrl":"10.1093/icvts/ivag107","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to compare long-term outcomes of the David and Yacoub valve-sparing aortic root replacement (VSARR) procedures in a nationwide, low-volume setting.</p><p><strong>Methods: </strong>All patients undergoing elective VSARR in Denmark between January 2010 and April 2022 were identified using the Danish registries. The primary end-point was all-cause death. Secondary end-points included stroke, reoperation, a composite of death or reoperation, and long-term echocardiographic outcomes. Analyses were performed in both crude and propensity score-matched (PSM) populations and compared with outcomes from a control group comprised of all elective composite root replacement procedures performed at the contributing centres in the study period.</p><p><strong>Results: </strong>A total of 160 patients underwent VSARR (median age; David vs Yacoub; 49.7 [SD 14.1] years vs 51.5 [SD 14.3] years; P = .42) with the David (n = 92, 57.5%; median follow-up 8.2 [SD 3.6] years) or Yacoub (n = 68, 42.5%; median follow-up 7.1 [SD 2.4] years) procedure. Ten-year all-cause death was similar (David 9.3% [95% CI: 2.3-15.2] vs Yacoub 8.8% [95% CI: 3.6-20.6]; log-rank P = .54). Reoperation rates (log-rank P = .12), stroke incidence (P = .41), and the composite end-point of death or reoperation (log-rank P = .63) were comparable, with consistent findings in the PSM cohort. Long-term echocardiographic follow-up demonstrated no difference in recurrent regurgitation, stenosis, or valve-related complications. Compared to elective composite root replacement (CRR) (n = 486), VSARR demonstrated lower rate of all-cause death (P = .027) and stroke (P = .026), while reoperation rate was higher (13.8% vs 4.3%; P < .001). However, the risk of reoperation was comparable between procedures when accounting for competing risk of death (log-rank P = .17).</p><p><strong>Conclusions: </strong>Long-term outcomes following elective VSARR using the David and Yacoub procedure were comparable. VSARR was associated with lower risk of all-cause death and stroke compared to elective CRR, supporting the two VSARR procedures as durable options when performed in experienced centres with careful patient selection, even in low-volume settings.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679207","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":"Comparing Early and Long-Term Outcomes of \"Truly Autonomous\" Senior Resident-Led with Consultant-Led Cardiac Surgery: A 10-Year Propensity-Matched Study.","authors":"Ujjawal Aditya Kumar, Eteesha Rao, Fadi Ibrahim Al-Zubaidi, Aravinda Page, Harry Smith, Daniel Sitaranjan, Ravi De Silva, Shakil Farid","doi":"10.1093/icvts/ivag099","DOIUrl":"10.1093/icvts/ivag099","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac surgery demands substantial technical skill and intraoperative judgement. Residents must develop operative autonomy in preparation for independent consultant practice. However, current challenges, including working hour restrictions, shorter training programmes, reduced operative exposure, and increasing case complexity, limit opportunities for skill development. This study evaluated the safety of \"truly autonomous\" cardiac surgery performed by senior residents without direct consultant supervision.</p><p><strong>Methods: </strong>Data for all adult cardiac surgeries between January 2015 and December 2024 were extracted from our institutional database. All resident-led cases undertaken without direct consultant supervision (group R) were identified and 1:1 propensity-score matched with consultant-led cases (group C) using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II covariates. In-hospital outcomes (mortality, complications, length of stay) and long-term survival were compared.</p><p><strong>Results: </strong>A total of 16 945 procedures were undertaken during the study period. After applying inclusion and exclusion criteria, matching yielded 803 pairs, giving a study population of 1 606 patients. Groups had comparable demographics, preoperative characteristics, risk scores and cardiopulmonary bypass and cross-clamp times. Consultants undertook significantly more combined and aortic cases, with residents performing more isolated CABG and isolated valve procedures. Groups had similar in-hospital outcomes and long-term survival. In a subgroup analysis of emergency operations, groups had similar outcomes.</p><p><strong>Conclusions: </strong>Truly autonomous cardiac surgery by senior residents demonstrated comparable in-hospital and post-discharge outcomes to consultant-led cases. Even in emergency procedures, senior residents achieved comparable outcomes to matched consultant-led cases. Our study shows truly autonomous operating in appropriately selected cases to be feasible and safe, providing evidence-based justification for progressive independence in cardiac surgical training.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679090","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":"Injection Laryngoscopy as a means of resolving symptomatic vocal cord immobility after congenital heart surgery.","authors":"Mitchell C Haverty, Courtney Long, Alyssia Venna, Manan Desai, Aybala Tongut, Bao N Puente, Yves d'Udekem, Pamela Mudd","doi":"10.1093/icvts/ivag130","DOIUrl":"https://doi.org/10.1093/icvts/ivag130","url":null,"abstract":"<p><strong>Objectives: </strong>Vocal cord immobility immediately following cardiac surgery is associated with reduced airway protection, dysphagia and aspiration in infant and paediatric populations. Early vocal medialization shows promise in optimizing feeding outcomes and swallowing mechanics. We aim to demonstrate the outcomes of injection laryngoscopy in patients with symptomatic vocal cord immobility after paediatric cardiac surgery.</p><p><strong>Methods: </strong>Data from cardiac surgery patients who underwent injection laryngoscopy between January 2021 and December 2024 at a single center institution were reviewed. Data was analyzed following the implementation of a vocal cord injury protocol including laryngeal ultrasound screening, preoperative dysphagia assessment, injection laryngoscopy and postoperative dysphagia evaluation as medically appropriate.</p><p><strong>Results: </strong>Thirty-one patients underwent injection laryngoscopy after diagnosis of symptomatic unilateral vocal cord immobility with objectively identified dysphagia a median of 10 days (2-63) after surgery. A postoperative endoscopic or fluoroscopic swallow study was conducted with dysphagia improving or resolving in 26 of 31 patients post injection. Four patients were discharged with gastrostomy tubes. Seven patients had a documented complication including stridor, escalation of care setting, and additional required procedures. These were short-lived and often associated with underlying congenital heart disease and unrelated to vocal cord injection.</p><p><strong>Conclusions: </strong>Injection laryngoplasty as an intervention for vocal immobility and dysphagia following cardiovascular surgery is a low-risk procedure allowing safer advance of oral diet in most patients prior to discharge. We postulate it also improves dysphagia in the subacute phase and may lead to longer term benefit in glottic protection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847047","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":"Reply to Mahida et al.","authors":"Takuya Tokunaga, Go Kamimura, Masaya Aoki, Kazuhiro Ueda","doi":"10.1093/icvts/ivag119","DOIUrl":"10.1093/icvts/ivag119","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791146","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":"Corynebacterium striatum Infection in Incision and Thoracic Cavity with Concurrent CRKP Colonization Following Lung and Bladder Tumor Resection.","authors":"Xiaorong Li, Lindan Liao","doi":"10.1093/icvts/ivag121","DOIUrl":"10.1093/icvts/ivag121","url":null,"abstract":"<p><p>Corynebacterium striatum, a commensal of skin and mucosa, is an emerging opportunistic pathogen. We report a rare case of postoperative incision and thoracic infection caused by C. striatum with concurrent pulmonary colonization by carbapenem-resistant Klebsiella pneumoniae (CRKP). Following resection of lung and bladder tumours, the patient developed fever, pleural effusion, and poor wound healing. Sputum cultures suggested CRKP colonization, while pleural fluid cultures identified C. striatum as the true pathogen. Clinical pharmacy consultation was pivotal in resolving this diagnostic dilemma. Guided by literature review and clinical presentation, targeted vancomycin therapy against C. striatum was initiated, leading to successful infection control. This case highlights that C. striatum should be considered a potential pathogen in postoperative patients with malignancy or invasive procedures. It is often multidrug-resistant but susceptible to glycopeptides like vancomycin. When multidrug-resistant organisms such as CRKP are also present, a comprehensive assessment integrating clinical, microbiological, and imaging data is essential to distinguish colonization from infection. This precision prevents unnecessary broad-spectrum antibiotic use, curbs resistance, and underscores the critical role of clinical pharmacists in managing complex infections through multidisciplinary collaboration.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730793","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":"Reply to Fatih Kizilyel and Bedirhan Bugra Bayici.","authors":"Fleur Sampon, Ferdi Akca","doi":"10.1093/icvts/ivag123","DOIUrl":"10.1093/icvts/ivag123","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791116","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":"Benchmarking Sternotomy in Isolated Left Anterior Descending Disease: The Need to Account for the Full Selection Pathway.","authors":"Fatih Kizilyel, Bedirhan Bugra Bayici","doi":"10.1093/icvts/ivag124","DOIUrl":"10.1093/icvts/ivag124","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791079","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":"On the Appropriate Classification of Discriminative Power Categories When Performing the Receiver Operating Characteristic Curve Analysis.","authors":"Dusko Nezic","doi":"10.1093/icvts/ivag117","DOIUrl":"10.1093/icvts/ivag117","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724667","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}