Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Long-term mortality after coronary surgery in women patients depend on diabetes and age.","authors":"Victor Dayan, Juan Andres Montero, Maximiliano Hernandez, Carolina Sosa, Santiago Cubas, Stefano Urso, Rafael Sadaba, Nick Freemantle","doi":"10.1093/icvts/ivaf069","DOIUrl":"10.1093/icvts/ivaf069","url":null,"abstract":"<p><strong>Objectives: </strong>There is general consensus of the higher short-term risk in women after coronary artery bypass grafts (CABG), nonetheless, long-term survival is a matter of debate. We aimed to compare in a national database with over 10 years of follow-up long-term survival in women versus men and its interaction with diabetes and age.</p><p><strong>Methods: </strong>This is a national retrospective cohort study from Uruguay. Patients were included if they underwent isolated CABG between 1 January 2002 and 31 December 2022. The primary outcome was survival. The secondary outcome was a composite of operative mortality, postoperative stroke, deep sternal wound infection and kidney failure requiring dialysis. Interaction of age and diabetes was explored in the survival analysis after adjusting for baseline characteristics.</p><p><strong>Results: </strong>During the included study period, 21 959 patients (5778 were women) underwent isolated CABG in Uruguay. Among people with diabetes, women had worse survival, while no differences between gender were found in the non-diabetic population. Survival at 1 year after CABG was significantly lower in women (hazard ratio (HR) = 1.20; 95% confidence interval (CI): 1.07, 1.35; P = 0.002). Survival after 1-year was higher in women (P < 0.001). Absence of diabetes improved survival (HR = 0.83; 95% CI: 0.77, 0.89; P < 0.001), while presence of diabetes made survival between men and women similar (HR = 1.00; 95% CI: 0.92, 1.09; P = 0.946). Interaction between age and gender showed that women older than 60 years old had better survival than men. Composite outcome was worse in women (OR = 1.47; 95% CI: 1.24, 1.75).</p><p><strong>Conclusions: </strong>Women patients have worse overall mortality but better long-term survival than men. Diabetes and age have significant interaction with the long-term outcomes. Better survival is seen in women older than 60 years old.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733466","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":"Spontaneous ruptured congenital bronchial diverticulum presenting with total lung collapse and chronic empyema thoracic.","authors":"Padungkiat Tangpiroontham","doi":"10.1093/icvts/ivaf060","DOIUrl":"10.1093/icvts/ivaf060","url":null,"abstract":"<p><p>Spontaneous rupture of a congenital bronchial diverticulum resulting in total lung collapse and chronic empyema thoracis is a rare condition that presents considerable challenges in preoperative diagnosis and perioperative management. Thorough interpretation of imaging studies and bronchoscopy is crucial for effective surgical planning. This article describes a successful surgical intervention employing primary repair in conjunction with decortication.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733500","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":"Clinical results of combined aortic valve-sparing root replacement and mitral valve repair.","authors":"Veronica Lorenz, Jama Jahanyar, Stefano Mastrobuoni, Antonio Segreto, Luca Zanella, Gaby Aphram, Matteo Pettinari, Gebrine El Khoury, Laurent De Kerchove","doi":"10.1093/icvts/ivaf067","DOIUrl":"10.1093/icvts/ivaf067","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic valve-sparing root replacement using the reimplantation technique and mitral valve (MV) repair are well-established surgical approaches for the treatment of aortic root pathologies and mitral valve insufficiency. However, the management of concomitant diseases with a dual valve-preserving strategy remains poorly described. Therefore, the aim of this study is to evaluate the long-term outcomes of concomitant valve-sparing surgery and MV repair.</p><p><strong>Methods: </strong>This case series includes all the patients who underwent combined valve-sparing root replacement and MV repair at Cliniques Universitaires Saint-Luc (Brussels, Belgium) between January 2000 and June 2022. Actual survival rate and freedom from reoperation were calculated by the Kaplan-Meier method, and the log rank test was used for statistical evaluation.</p><p><strong>Results: </strong>Forty-five patients were included in the study; they were divided into two groups (13 patients with and 32 patients without connective tissue disorders). There was no hospital mortality. Three patients (7%) required pacemaker implantation. Overall survival at 10 years was 90% (95% confidence interval [CI]: 64-97%). Furthermore, freedom from all reoperations at 10 years was 84% (95% CI: 64-93%). Analysing the two subgroups, we found no statistically significant difference in terms of 10-year survival (log rank P = 0.146). However, freedom from reoperation at 10 years was significantly lower in the connective tissue disorder group (63% vs 91%, log rank P = 0.031). Most patients treated with transaortic edge-to-edge repair required MV reoperation.</p><p><strong>Conclusions: </strong>Combined valve-sparing root replacement with the reimplantation technique and MV operations are complex surgeries. However, they can be performed safely, with excellent long-term survival and repair durability. Applying standard Carpentier techniques for MV repair is crucial, especially in patients with connective tissue disorders.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626682","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":"Prospective evaluation of the Moleculight i:X™ in the early detection of driveline infections.","authors":"Angelina Olbrich, Arash Motekallemi, Heinz Deschka, Heinrich Rotering, Jürgen Sindermann, Nana-Maria Wagner, Henryk Welp, Angelo M Dell'Aquila","doi":"10.1093/icvts/ivae215","DOIUrl":"10.1093/icvts/ivae215","url":null,"abstract":"<p><strong>Objectives: </strong>Driveline infection (DLI) is a common complication in patients with left ventricular assist devices. This complication can seriously undermine quality of life while on left ventricular assist devices. Current diagnosis of a DLI in the outpatient setting is based on clinical examination and later bacteria isolation. The Moleculight i:XTM is a handheld fluorescence imaging device capable to visualize bacterial colonization in real-time. We here evaluated the performance of the Moleculight i:XTM for diagnosis of DLIs as this device may have the potential advantage to rapidly identify infection and therefore promptly influence therapy.</p><p><strong>Methods: </strong>A total of 107 examinations in patients with suspected DLIs were prospectively included in this study. All examinations took place in the outpatient setting. In addition to the standard treatment, Moleculight fluorescence images were captured and swabs were taken at the area of maximal luminosity. Wounds and pictures were reviewed and classified as positive or negative by a wound specialist and two heart surgeons independently from microbiological results.</p><p><strong>Results: </strong>The Moleculight i:XTM showed positive results (red fluorescence) in 19 cases (17.76%), whereas microbiological examination was positive for microorganisms in 74 cases (69.16%). The most common bacteria was Staphylococcus aureus. The findings resulted in a sensitivity of 13.51% and a specificity of 72.73%. The positive predictive value was 52.63% and the negative predictive value was 27.27%. Sub-analyses of different wound dressings or previous antibiotic treatment did not show any relevant difference.</p><p><strong>Conclusions: </strong>The results of the Moleculight i:X show a low sensitivity and specificity when being used to detect DLIs in the outpatient setting. Clinical examination and swabs should remain the gold standard despite the delay for bacteria isolation and consequent antibiotic treatment. Sensitivity and specificity of the Moleculight i:X in open wounds after surgical revision of the driveline remain to be clarified.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733468","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":"Impact of diaphragm paralysis and its surgical interventions on outcomes after the staged Fontan procedure.","authors":"Ruxandra Dumitru, Muneaki Matsubara, Thibault Schaeffer, Takuya Osawa, Jonas Palm, Carolin Niedermaier, Nicole Piber, Paul Philipp Heinisch, Bettina Ruf, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono","doi":"10.1093/icvts/ivaf072","DOIUrl":"10.1093/icvts/ivaf072","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the incidence of diaphragm paralysis and its impact on outcomes after the Fontan procedure in patients with single ventricles.</p><p><strong>Methods: </strong>Patients undergoing staged Fontan palliation between 1994 and 2023 were reviewed. Patients who had diaphragm paralysis were identified, and the impact of diaphragm paralysis on outcomes after Fontan completion was evaluated.</p><p><strong>Results: </strong>Among 601 patients who underwent staged Fontan completion during the study period, diaphragm paralysis was observed in 79 patients (13.1%) before Fontan (33 after stage I palliation and 46 after Glenn) and in 32 patients (5.3%) after the Fontan. Among 111 patients with diaphragm paralysis, 77 had spontaneous recovery, 13 recovered after plication and 21 remained without recovery. Patients with diaphragm paralysis before the Fontan demonstrated higher pulmonary arterial pressure (median 10 vs 9 mmHg, P = 0.045) and lower pulmonary artery symmetry index (median 0.54 vs 0.59, P = 0.046) than those without diaphragm paralysis. The use of an autologous pericardial patch in stage 1 was a risk factor for diaphragm paralysis development (odds ratio: 2.61, P = 0.012). Diaphragm paralysis was associated with an increased risk of protein-losing enteropathy (hazard ratio: 2.31, P = 0.003), particularly in patients without recovery after plication (hazard ratio: 4.85, P = 0.031).</p><p><strong>Conclusions: </strong>Diaphragm paralysis following Fontan completion significantly increases the risk of protein-losing enteropathy and long-term mortality, particularly in patients who fail to recover after plication. Early identification and appropriate management of diaphragm paralysis may be crucial for optimizing outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665592","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":"First reported surgical explantation of infected thoracic branched endograft requiring complex arch and descending thoracic aortic repair.","authors":"Michael A Catalano, Cecillia Chin, Nimesh D Desai, Kendall M Lawrence","doi":"10.1093/icvts/ivaf073","DOIUrl":"10.1093/icvts/ivaf073","url":null,"abstract":"<p><p>We present a 51-year-old woman with thoracic aortitis and rapidly enlarging descending thoracic aortic aneurysm in the setting of Clostridium septicum bacteraemia. After antibiotic treatment, she underwent left carotid-subclavian transposition and endovascular repair with thoracic branched endograft (TBE) with left carotid artery coverage. Three months postoperatively, she developed endograft infection, with a rapidly enlarging pseudoaneurysm at the proximal landing zone. She underwent TBE explant and descending thoracic aortic reconstruction. This report illustrates a rare complication and the first described surgical TBE explantation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694611","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 García-Villarreal.","authors":"William F McIntyre, Jeff S Healey, Richard P Whitlock","doi":"10.1093/icvts/ivaf057","DOIUrl":"10.1093/icvts/ivaf057","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744446","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":"Vasoplegic syndrome in cardiac surgery: bridging therapeutic gaps with best practices and future research.","authors":"Dragana Unic-Stojanovic, Andreas Koster, Gabor Erdoes, Milan Milojevic","doi":"10.1093/icvts/ivaf075","DOIUrl":"https://doi.org/10.1093/icvts/ivaf075","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"40 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782186","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":"Real-time thermal coronary angiography in coronary artery bypass grafting.","authors":"Rakan I Nazer, Ali M Albarrati","doi":"10.1093/icvts/ivaf078","DOIUrl":"https://doi.org/10.1093/icvts/ivaf078","url":null,"abstract":"<p><p>Intraoperative graft interrogation is crucial for ensuring graft patency and optimizing surgical outcomes in coronary artery bypass grafting (CABG). Various intraoperative imaging techniques aid in assessing graft function, allowing for immediate correction of technical issues and reducing postoperative complications. A 38-year-old male smoker presented with acute coronary syndrome, characterized by central chest pain radiating to the left shoulder and ST-segment depression on ECG. Elevated troponin confirmed the diagnosis, and coronary angiography revealed significant three-vessel disease. The patient underwent urgent coronary artery bypass grafting (CABG) using bilateral internal mammary arteries as a Y-graft to the left anterior descending artery and the first diagonal branch. Additional grafts to the posterior descending artery and first obtuse marginal branch were performed using saphenous vein segments. Intraoperative graft patency was assessed using a real-time thermal imaging camera, providing non-invasive visualization of myocardial blood flow without contrast agents or disruption of the surgical workflow. This unique technique allowed immediate confirmation of graft functionality, ensuring quality assurance during CABG. Thermal imaging potentially represents a state-of-the-art tool for improving graft quality and surgical outcomes, offering a simple, effective alternative to conventional intraoperative imaging methods.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744440","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":"Letter to the editor: prognostication and prediction of spread through air spaces in non-small cell lung cancer.","authors":"Zamaan Hooda, Mara B Antonoff","doi":"10.1093/icvts/ivaf077","DOIUrl":"https://doi.org/10.1093/icvts/ivaf077","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733464","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}