Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Surgical audience focused on multimodality treatment for lung cancer.","authors":"Francesca Rita Ogliari, Sarah Debakker, Tom van Zwieten, Koen J Hartemink, Jonas Willmann, Anna M Sadowska, Lizza Hendriks","doi":"10.1093/icvts/ivaf151","DOIUrl":"10.1093/icvts/ivaf151","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"40 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593066","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":"Assessment of short- and long-term outcomes of aortic valve-sparing operation at concomitant aortic root and arch repair.","authors":"Yu Hohri, Megan M Chung, Kavya Rajesh, Dov Levine, Christopher He, Elizabeth L Norton, Bradley Leshnower, Yanling Zhao, Paul Kurlansky, Edward P Chen, Hiroo Takayama","doi":"10.1093/icvts/ivaf045","DOIUrl":"10.1093/icvts/ivaf045","url":null,"abstract":"<p><strong>Objectives: </strong>Concomitant aortic root and arch replacement is a complex procedure. Although valve-sparing root replacement may offer advantages over valve prostheses, the decision to spare the valve may increase the risk profile of this procedure. This study examines the safety of aortic valve-sparing operation in such settings.</p><p><strong>Methods: </strong>All patients who underwent concomitant aortic root and arch replacement between 2004 and 2021 at two aortic centres were reviewed. Patients with aortic stenosis, endocarditis or a history of previous cardiac surgery were excluded. Inverse probability treatment weighting yielded well-balanced cohorts. The primary end-points were mortality and complications during the index hospital stay, and secondary end-points were long-term survival and aortic valve reintervention rate.</p><p><strong>Results: </strong>A total of 764 patients who underwent concomitant aortic root and arch replacement, including valve-sparing root replacement (n = 311) or composite valve graft root replacement (n = 453), were analysed. Surgical indication was dissection in 155 (20.2%), and distal extension was total arch replacement in 50 (6.5%). Cardiopulmonary bypass and cross-clamp times were longer in valve-sparing root replacement (P = 0.006 and P < 0.001, respectively). Valve-sparing root replacement demonstrated comparable in-hospital mortality rates (2.5% vs 4.9%, P = 0.195) and showed higher long-term survival rates (P = 0.04) (12-year survival rate; 78.5% [71.7-86.1%] vs 64.2% [57.4-71.6%]), which was reconfirmed on multivariable Cox regression analysis (hazard ratio: 0.505 [0.348-0.734], P < 0.001). The cumulative incidence of reintervention was similar in both groups (P = 0.62).</p><p><strong>Conclusions: </strong>In appropriately selected patients requiring aortic root and arch replacement, a valve-sparing operation may be performed safely without increased operative risk.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560270","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":"The reduction of ectopic burden after mitral valve surgery in patients with mitral annular disjunction.","authors":"Serkan Ertugay, Ayşen Yaprak Engin, Zehra Ünlü, Sedat Karaca, Evrim Şimşek, Emrah Oğuz, Mustafa Özbaran","doi":"10.1093/icvts/ivaf155","DOIUrl":"10.1093/icvts/ivaf155","url":null,"abstract":"<p><strong>Objectives: </strong>Mitral annular disjunction is a recognized risk factor for malignant ventricular arrhythmias in patients with mitral valve prolapse. This study aimed to evaluate the impact of mitral valve surgery on the burden of supraventricular and ventricular ectopic activity in patients with mitral annular disjunction.</p><p><strong>Methods: </strong>Data from 32 patients who underwent mitral valve surgery between 2017 and 2024 were retrospectively analysed. The primary end-point was the change in the burden of supraventricular and ventricular ectopy following surgery. The secondary end-point was to assess whether this change differed according to the extent of the mitral annular disjunction distance.</p><p><strong>Results: </strong>The mean age of the patients was 38.8 ± 14 years, and 53.1% were female. The vast majority (96.9%) underwent successful mitral valve repair. The mean cardiopulmonary bypass and aortic cross-clamp times were 133.3 ± 38 min and 95.8 ± 32 min, respectively. Postoperatively, the mean burden of supraventricular ectopy decreased from 13.8% to 3.7%, and ventricular ectopy burden decreased from 7.1% to 2.1%. Among patients with a mitral annular disjunction distance ≥8.5 mm, both supraventricular and ventricular ectopic activity significantly declined. In contrast, for those with a mitral annular disjunction distance <8.5 mm, a significant reduction was observed only in ventricular ectopy, with no statistically significant change in supraventricular ectopy.</p><p><strong>Conclusions: </strong>Mitral valve surgery is associated with a substantial reduction in both supraventricular and ventricular ectopic activity in patients with mitral annular disjunction. Furthermore, a mitral annular disjunction distance greater than 8.5 mm appears to be a predictor of a more pronounced reduction in arrhythmic burden following surgery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531446","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":"Fit2Perform: European society of thoracic surgery survey on member well-being.","authors":"Fabrizio Minervini, Pietro Bertoglio, Willem Hans Steup, Stijn Vanstraelen, Sridhar Rathinam, Nuria Maria Novoa, Hermien Schreurs","doi":"10.1093/icvts/ivaf140","DOIUrl":"10.1093/icvts/ivaf140","url":null,"abstract":"<p><strong>Objectives: </strong>A certain level of physical and psychological well-being is essential for surgeons to achieve optimal performance and patients' outcomes. This study presents the results of a survey conducted by the European Society of Thoracic Surgeons (ESTS) 'Fit2Perform' (F2P) Working Group, aimed at evaluating the overall well-being of the thoracic surgical community.</p><p><strong>Methods: </strong>A 50-item survey was designed by the ESTS F2P Working Group and distributed to ESTS members between January and February 2024 anonymously. Descriptive data were presented as frequencies with absolute number and percentages. Subgroup analysis and interactions between variables were performed with Chi-square test, t-test and analysis of variance (ANOVA) as appropriate.</p><p><strong>Results: </strong>Among 1653 active members of 26 countries, 215 (13%) members responded. Most of them had more than 5 years' experience (89.8%) and were based in academic hospitals (69.3%). A significant higher satisfaction in the perception of work-life balance was found in respondents who were working less than 50 hours (P < 0.001) and in surgeons >50 years old (P < 0.001). Younger thoracic surgeons had increased risk of depression (P < 0.001), reduced quality of life scores (P = 0.005) together with an increased higher degree of emotional exhaustion (P < 0.001), depersonalization (P = 0.019) and lower degree of personal accomplishment (P = 0.004).</p><p><strong>Conclusions: </strong>Our survey identified that young thoracic surgeons are at increased risk of depression, lower quality of life, emotional exhaustion, depersonalization and personal accomplishment. These issues warrant further attention and analysis in order to identify underlying causes and to develop targeted strategies to improve surgeon well-being.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512885","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 low cardiac function and diabetes mellitus on survival and causes of death following coronary artery surgery.","authors":"Sadayuki Moriyama, Akihiro Higashino, Yuya Tsuruta, Sumio Miura, Tsuyoshi Taketani, Minoru Ono, Takayuki Ohno","doi":"10.1093/icvts/ivaf144","DOIUrl":"10.1093/icvts/ivaf144","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the differential impact of low cardiac function (ejection fraction [EF] ≤ 35%) and diabetes mellitus (DM) on survival and to identify causes of death after coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>Overall, 1036 patients who underwent isolated CABG between 2009 and 2022 were divided into four groups based on EF and DM. Kaplan-Meier analysis was performed to calculate each group's estimated survival. Inter-group multivariate Cox regression was performed with the reference group showing EF > 35% and DM (-). Additional Cox regressions were performed to investigate the associations of EF ≤ 35% and DM (+) with death from heart failure, myocardial infarction, cancer, pneumonia, cerebrovascular disease and renal failure.</p><p><strong>Results: </strong>Off-pump techniques were used in 980 patients (95%). Patient population and estimated 10-year postoperative survival were as follows: EF > 35% DM (-), 430, 75.1%; EF > 35% DM (+), 456, 66.3%; EF ≤ 35% DM (-), 73, 62.5%; and EF ≤ 35% DM (+), 77, 53.5%. Hazard ratios (HRs) (P values) for the three groups were as follows: EF > 35% DM (+), 1.53 (0.006); EF ≤ 35% DM (-), 1.84 (0.017); and EF ≤ 35% DM (+), 2.23 (0.001). For death from heart failure, HR (P value) for EF ≤ 35% versus EF > 35% was 3.62 (0.012). For deaths from cancer and pneumonia, HRs (P values) for DM (+) versus DM (-) were 1.73 (0.097), and 2.72 (0.046), respectively.</p><p><strong>Conclusions: </strong>EF ≤ 35% and DM (+) are associated with worse post-CABG survival. Each is associated with specific causes of death.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512886","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":"Ultra-high-resolution and dual-energy computed tomography of carotid artery plaques differentiate symptomatic and asymptomatic patients by novel volumetric analysis.","authors":"Roland-Richard Macharzina, Simon Stemmler, Werner Vach, Thomas Winker, Jana Taron, Christopher L Schlett, Michael Weinbeck, Matthias Siepe, Martin Czerny, Fabian Bamberg, Thomas Zeller, Dirk Westermann, Martin Soschynski","doi":"10.1093/icvts/ivaf158","DOIUrl":"10.1093/icvts/ivaf158","url":null,"abstract":"<p><strong>Objectives: </strong>The indication for carotid endarterectomy (CEA) mainly relies on the degree of stenosis and neurological symptoms. Plaque vulnerability has been associated with stroke risk, but identification on single-energy computed tomography (CT) has yielded heterogeneous results and is not routinely applied to clinical diagnostics. Hence, we intended to analyse CEA specimens for vulnerability features using dual-source CT and correlate these features with the presence of preprocedural symptoms.</p><p><strong>Methods: </strong>CT was performed on 187 carotid plaque specimens using ultra-high-resolution and dual-energy imaging on a dual-source scanner. Plaques were separated into calcified versus non-calcified volumes and analysed concerning HU-density, calcifications and volumetric dual-energy indices (DEIs). Comparative statistical analysis of plaque characteristics was performed with respect to the presence of neurological symptoms.</p><p><strong>Results: </strong>The degree of stenosis of symptomatic and asymptomatic plaques was indifferent (69.2 ± 12.3% vs 66.3 ± 13.7%). The highest diagnostic accuracies were obtained by the % calcified volume (AUC 0.63 (0.54-0.71)), average whole plaque HU (AUC 0.71 (0.64-0.79)), profound calcification (AUC 0.74 (0.66-0.81)), calcification spots <1 mm (AUC 0.71 (0.63-0.79)) and spotty calcification (AUC 0.74 (0.66-0.82)). The diagnostic accuracy for symptomatic plaques was insignificant using average non-calcified plaque HU (AUC 0.59 (0.48-0.65)), but significant using average non-calcified plaque DEI (AUC 0.66 (0.58-0.74)).</p><p><strong>Conclusions: </strong>Symptomatic plaques were identified best by measuring density of the whole, calcified or non-calcified plaque and via spotty, profoundly localized and less dense calcification. A volumetric DEI identifies symptomatic plaques with non-calcified plaque characteristics more accurately than single-energy CT. Future clinical studies are necessary to confirm these findings in patients.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531447","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":"Total Arch With Hybrid Frozen Elephant Trunk Versus Branched Stented Anastomosis Frozen Elephant Trunk Repair.","authors":"Aakash Shah, Joshua Leibowitz, Jeffrey Lu, Douglas Tran, Julia Stallings, Shahab Toursavadkohi, Bradley Taylor, Mehrdad Ghoreishi","doi":"10.1093/icvts/ivaf164","DOIUrl":"10.1093/icvts/ivaf164","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the short-term outcomes of total arch replacement using 2 techniques: the branched stented anastomosis frozen elephant trunk repair (B-SAFER) under moderate hypothermia (25-28 °C), and a simplified total arch and hybrid arch frozen elephant trunk (HA-FET) reconstruction using the Thoraflex stent graft under mild hypothermia (>32 °C).</p><p><strong>Methods: </strong>Sixty-one patients underwent total arch replacement between June 2020 and March 2024. 25 received HA-FET, and 36 received B-SAFER. Central cannulation and cerebral debranching of the innominate and left common carotid arteries were performed before circulatory arrest in both groups. Axillary cannulation led to debranching after circulatory arrest. In the HA-FET group, snares were placed circumferentially in zone 1 and zone 2 prior to circulatory arrest and deployment of FET graft; in B-SAFER, antegrade thoracic stent graft was deployed in zone 2 with left subclavian fenestration and stenting.</p><p><strong>Results: </strong>Mean age 57.4 ± 13.1 years, with 74% male. Acute type A was the pathology in 60% of HA-FET and 58% of B-SAFER patients. HA-FET had significantly shorter circulatory arrest times (9 vs 40 minutes, P < .001) but similar cardiopulmonary bypass and cross-clamp times. The rate of concomitant major cardiac procedure was higher in HA-FET group (13/25, 52% vs 10/36, 27%, P = .066). Neurologic dysfunction (4% vs 5.4%, P = 1) and in-hospital mortality (4% vs 8.1%, P = .64) were similar. No paraplegia occurred, and renal failure requiring dialysis occurred in 12% of HA-FET and 8.1% of B-SAFER patients (P = .68).</p><p><strong>Conclusions: </strong>Both mild hypothermic total arch with hybrid FET repair and hypothermic total arch replacement utilizing B-SAFER technique provide safe and favourable short-term outcomes. Further studies with larger cohorts and long-term follow-up are required.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612665","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":"Superior Safety and Surgical Efficiency by Automated Vacuum-Assisted Venous Drainage Over Conventional, Survey-Based Evaluation.","authors":"Youssef El Dsouki, Ignazio Condello","doi":"10.1093/icvts/ivaf165","DOIUrl":"10.1093/icvts/ivaf165","url":null,"abstract":"<p><p>The evolution of cardiopulmonary bypass (CPB) techniques has been significantly enhanced by the integration of vacuum-assisted venous drainage (VAVD). Vacuum-assisted venous drainage improves venous return in minimally invasive, paediatric, and complex cardiac surgeries by reducing priming volumes and minimizing hemodilution. However, excessive negative pressure can lead to risks, such as air embolism, hemolysis, and circuit collapse. This study aimed to compare automated and manual (conventional) VAVD systems regarding key safety and performance parameters: (1) pressure stability under varying venous return conditions, (2) incidence of air embolism and vacuum-related complications, (3) alarm response times, and (4) hemolysis. A survey was conducted across 23 cardiac surgery centres, although 3 centres did not specify the type of VAVD device used and were excluded from data analysis. The final analysis included 20 centres: 10 using automated systems and 10 using conventional systems. Data were collected using a standardized checklist assessing real-time vacuum control, safety alarms, and complication rates. Results demonstrated that automated VAVD systems provided more consistent pressure stability (98%), reduced hemolysis rates (<3%), improved alarm response times (<2 seconds), and fewer air embolism events compared to manual systems.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692688","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":"Evaluation of coronary heights after Bio-Bentall using Piehler technique.","authors":"Kimihiro Kobayashi, Yoshinori Kuroda, Masahiro Mizumoto, Jun Hayashi, Shuto Hirooka, Kentaro Akabane, Tomonori Ochiai, Tetsuro Uchida","doi":"10.1093/icvts/ivaf150","DOIUrl":"10.1093/icvts/ivaf150","url":null,"abstract":"<p><p>The valve-in-valve procedure is an alternative to the redo surgery for structural valve deterioration following the Bio-Bentall. However, the risk of coronary obstruction and the feasibility of this approach remain unclear. Using computed tomography, we compared the aortic root geometry of 14 consecutive patients (13 true aortic aneurysms) with Bio-Bentall between April 2011 and April 2024 preoperatively and postoperatively. The Piehler technique was used in all coronary artery reconstructions. During the follow-up period, no reconstructive coronary events or valve-related reoperations were observed. The coronary height was 17.7 ± 5.6 mm preoperatively versus 18.8 ± 4.4 mm postoperatively for the left coronary artery (P =  0.49) and 15.4 ± 9.6 mm preoperatively versus 22.6 ± 7.4 mm postoperatively for the right coronary artery (P <  0.01). No patients at risk of coronary obstruction associated with valve-in-valve were identified. One case of severe aortic graft kinking due to excessive graft length, which could contraindicate the valve-in-valve procedure, was observed. Our findings suggested that the Piehler technique may facilitate future valve-in-valve implantation after Bio-Bentall because it allows for a higher-positioned orifice of the reconstructive coronary artery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499740","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":"National outcomes of surgical ablation for atrial fibrillation at the time of mitral surgery.","authors":"Aminah Sallam, Derrick Y Tam, Qiudong Chen, Allen A Razavi, Michael E Bowdish, Armin Kiankhooy, Joanna Chikwe","doi":"10.1093/icvts/ivaf133","DOIUrl":"10.1093/icvts/ivaf133","url":null,"abstract":"<p><strong>Objectives: </strong>Current guidelines recommend concomitant surgical ablation at the time of mitral surgery for patients with atrial fibrillation; however, there is a paucity of data on long-term outcomes in this population. We sought to assess long-term clinical outcomes in patients undergoing concomitant surgical ablation at the time of mitral surgery.</p><p><strong>Methods: </strong>The United States Centers for Medicare and Medicaid data were used to identify patients undergoing mitral repair or replacement from 2015 to 2019. After excluding prior cardiac surgery, endocarditis and emergencies, we identified 11 410 patients undergoing isolated mitral repairs or replacement with pre-operative atrial fibrillation. Of these, 3268 (29%) received surgical ablation and 8142 (71%) did not. Propensity score matching was performed on 27 baseline characteristics. The primary outcome was freedom from death or stroke at 4 years. The secondary outcome was all-cause mortality at 4 years. Both were assessed using Cox-proportional hazard models.</p><p><strong>Results: </strong>Propensity matching yielded 3268 well-matched patient pairs (mean age: 74, 53% female, median CHA2DS2-Vasc score 4). There was no difference in all-cause mortality at 30 days (2.7% with concomitant ablation vs 2.8% without, P = 0.762). Patients undergoing concomitant ablation at the time of surgery had significantly higher freedom from death or stroke at 4 years (81% vs 77%, HR: 0.84, 95% CI 0.74-0.96). However, overall freedom from death between groups was not statistically significant (84% with concomitant ablation vs 82% without, HR: 1.14, 95% CI 0.76-1.01).</p><p><strong>Conclusions: </strong>Surgical ablation at the time of isolated mitral surgery is underutilized but associated with improved long-term outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602443","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}