Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Postoperative C-Reactive Protein Resolution Patterns in Patients With and Without Postoperative Atrial Fibrillation After Cardiac Surgery.","authors":"Melina Heine, Felix Ulbrich, Samuel Justice, Babak Saravi, Simon A Amacher, Julian Hubrich, Leonard Simeth, Charles N Serhan, Jochen D Muehlschlegel, Jakob Wollborn","doi":"10.1093/icvts/ivag179","DOIUrl":"10.1093/icvts/ivag179","url":null,"abstract":"<p><strong>Objectives: </strong>Postoperative atrial fibrillation is common after cardiac surgery. Effective preventative measures are lacking, partly due to an incomplete understanding of its pathogenesis. Inflammation is a major contributor to postoperative atrial fibrillation development. This study aims to further characterize the association between systemic inflammation and postoperative atrial fibrillation.</p><p><strong>Methods: </strong>A secondary analysis was conducted on a single-center cohort of patients undergoing cardiac surgery. The original study enrolled 405 cardiac surgery patients. After exclusion of patients with a history of persistent or permanent atrial fibrillation, patients undergoing heart transplantation, and patients with incomplete interleukin measurements, 319 patients were included in the present analysis. Postoperative atrial fibrillation was identified through chart review and was defined as at least 1 AF episode lasting more than 30 s, as documented by telemetry or a 12-lead electrocardiogram during the patient's initial hospitalization. Perioperative levels of interleukins and C-reactive protein were measured. The decline in C-reactive protein levels between postoperative days 3 and 10 was modeled using a linear regression. The association with postoperative atrial fibrillation and other outcomes after cardiac surgery was assessed using logistic and Tobit regression models.</p><p><strong>Results: </strong>Of the 319 patients included in the study, 51% developed postoperative atrial fibrillation, most commonly on postoperative days 2 and 3. Cardiopulmonary bypass and intraoperative ventilation time were significantly associated with an increased risk of postoperative atrial fibrillation. Patients with postoperative atrial fibrillation had longer intensive care unit stays and longer times to extubation. C-reactive protein levels peaked on postoperative day 3 and declined more slowly in postoperative atrial fibrillation patients. A slower C-reactive protein decline was independently associated with postoperative atrial fibrillation (odds ratio: 1.71, P = .046), prolonged postoperative intensive care unit length of stay, and time to extubation. Interleukin-10 levels were significantly higher in patients with postoperative atrial fibrillation (mean ratio: 1.28, P < .001).</p><p><strong>Conclusions: </strong>Postoperative atrial fibrillation is a prevalent complication after cardiac surgery and correlates with a slower postoperative C-reactive protein decline. This study suggests that postoperative atrial fibrillation is associated with delayed resolution of postoperative inflammation.</p><p><strong>Trial registration number: </strong>German Clinical Trials Registry (DRKS No. 00017057), Date of registration April 5, 2019, www.drks.de.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354917","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":"Minimally Invasive Valve Repair and Hybrid Treatment for Racemose Bronchial Artery Malformation With Coronary Arterial Inflow.","authors":"Makoto Matsuura, Toshiaki Ito, Satoshi Ariumura, Motoki Nagatsuka","doi":"10.1093/icvts/ivag202","DOIUrl":"10.1093/icvts/ivag202","url":null,"abstract":"<p><p>Racemose haemangioma of the bronchial artery is a rare vascular malformation characterized by abnormal communication between the bronchial and pulmonary vasculature. Coronary arterial inflow may further complicate minimally invasive cardiac surgery because excessive collateral flow can impair myocardial protection and increase intracardiac return during cardiac arrest. We report a case of atrial functional mitral regurgitation and tricuspid regurgitation associated with racemose bronchial artery malformation with coronary arterial inflow from the left circumflex artery. Preoperative embolization of systemic feeders from the bronchial and left subclavian arteries was followed by minimally invasive valve repair and surgical ligation of the coronary inflow vessel. The postoperative course was uneventful. A staged hybrid strategy may be effective for managing racemose bronchial artery malformation with coronary arterial inflow.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537651","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":"Aortic Root Geometry and Valve Competence After Aortic Valve Neocuspidization: Insights From the Sinotubular Junction-to-Annulus Ratio.","authors":"Hirofumi Kasahara, Yoshito Inoue, Koji Funaishi, Sohsyu Kotani","doi":"10.1093/icvts/ivag182","DOIUrl":"10.1093/icvts/ivag182","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic valve neocuspidization, or the Ozaki procedure, is an alternative to prosthetic valve replacement. However, the association between native aortic root geometry, particularly the sinotubular junction-to-annulus ratio, and postoperative valve competence remains unclear. This study was designed to investigate the association between the sinotubular junction-to-annulus ratio and postoperative aortic regurgitation severity.</p><p><strong>Methods: </strong>We retrospectively analysed 139 patients who underwent aortic valve neocuspidization between 2012 and 2023. At 1 year, the patients were stratified into either moderate or less-than-moderate aortic regurgitation groups. Intraoperative sinotubular junction and annulus diameters were measured using transoesophageal echocardiography. Logistic regression and receiver operating characteristic analyses were performed.</p><p><strong>Results: </strong>At 1 year, 11 (7.9%) patients developed moderate aortic regurgitation, while 128 (92.1%) had less-than-moderate aortic regurgitation. Patients with moderate aortic regurgitation had higher sinotubular junction-to-annulus ratios (moderate group: median, 1.40; less-than-moderate group: median, 1.19). Receiver operating characteristic analysis showed excellent discrimination, with an optimal cut-off of 1.30. Each 0.1-unit increase in the ratio was associated with a 3.65-fold increase in the risk of developing moderate aortic regurgitation. Preoperative aortic regurgitation severity was associated with univariable analysis outcomes but lost significance after adjustment for the sinotubular junction ratio.</p><p><strong>Conclusions: </strong>An increased sinotubular junction-to-annulus ratio may be associated with the development of postoperative aortic regurgitation after aortic valve neocuspidization. These findings suggest that the geometric association between the sinotubular junction and the annulus may play a role in valve competence after aortic valve neocuspidization.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400240","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 and Echocardiographic Outcomes After Aortic Valve Neocuspidization: Insights from a Large Multicentre Cohort.","authors":"Kazuhiro Ueno, Tomoyuki Wada, Toshihiko Shibata, Kazuo Abe, Takashi Murakami, Shigeharu Sawa, Yoshito Inoue, Tamiyuki Obayashi, Kazushige Kanki, Shoichi Takahashi, Shinji Miyamoto","doi":"10.1093/icvts/ivag175","DOIUrl":"10.1093/icvts/ivag175","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic valve neocuspidization (AVNeo) has gained widespread recognition in clinical practice; however, multicentre data describing its mid-term functional durability in real-world populations remain limited. This study aimed to evaluate the clinical and echocardiographic outcomes of AVNeo in a large multicentre cohort with extended follow-up.</p><p><strong>Methods: </strong>This retrospective multicentre study included 672 patients who underwent AVNeo at 16 institutions. The study population was characterized by advanced age, small body size, and a substantial burden of comorbidities. Mid-term outcomes included overall survival, freedom from reoperation, and longitudinal echocardiographic performance assessed from discharge through mid-term follow-up. Survival analyses were performed using the Kaplan-Meier method, and temporal echocardiographic changes were evaluated using linear mixed-effects models accounting for repeated measurements and centre-level clustering.</p><p><strong>Results: </strong>Early postoperative outcomes demonstrated acceptable procedural safety, with a 30-day mortality of 3.0%. Echocardiographic assessment showed functional optimization during the first postoperative year, while effective orifice area remained stable. Beyond 1 year, transvalvular gradients, peak velocity, valve area, and ventricular function remained stable up to 7 years after surgery. Estimated overall survival was 91.7% at 1 year and 79.5% at 5 years, while freedom from reoperation remained high at 99.4% at 1 year and 96.5% at 5 years.</p><p><strong>Conclusions: </strong>In this large multicentre real-world cohort, AVNeo demonstrated stable mid-term valve performance without evidence of clinically significant progressive deterioration. These findings support the durability and reproducibility of AVNeo in routine clinical practice.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310684","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":"Late-Onset Familial Primary Cardiac Angiosarcoma in Two Sisters.","authors":"Hiroto Kawakami, Hiroshi Tsuneyoshi, Shoichi Kyo, Makoto Suzuki","doi":"10.1093/icvts/ivag114","DOIUrl":"10.1093/icvts/ivag114","url":null,"abstract":"<p><strong>Introduction: </strong>Primary cardiac angiosarcoma is an exceptionally rare malignancy. Familial occurrences are even less common and associated with hereditary cancer syndromes; notably, all previously reported familial cases occurred in young individuals.</p><p><strong>Case: </strong>We encountered 2 elderly sisters who both developed morphologically similar primary cardiac angiosarcomas arising from the right atrium. The elder sister presented with nocturnal wheezing, and a large right atrial tumour was found at age 70. She underwent surgical resection followed by radiotherapy. The younger sister presented with a similar cough, and screening transthoracic echocardiography revealed a right atrial mass at age 74. She received similar treatment.</p><p><strong>Discussion: </strong>These cases suggest a potential hereditary predisposition and further highlight that familial occurrence of primary cardiac angiosarcoma can manifest even at advanced age, challenging the conventional understanding of this disease.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537602","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":"Cardiac Remodelling After Transcatheter and Surgical Aortic Valve Replacement: A Tough Call.","authors":"Bianca Profire, Victoria Delgado","doi":"10.1093/icvts/ivag203","DOIUrl":"10.1093/icvts/ivag203","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 7","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632931","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":"Perfusion Interval and Myocardial Injury in Minimally Invasive Mitral Valve Surgery: The Modifying Role of Aortic Cross-Clamp Duration.","authors":"Chengying Shao, Wenshuai Mao, Lijun Guo, Zhiwei Liu, Xujie Hu, Jue He, Yong Cui, Zhibin Hu","doi":"10.1093/icvts/ivag174","DOIUrl":"10.1093/icvts/ivag174","url":null,"abstract":"<p><strong>Objectives: </strong>To assess how perfusion interval relates to myocardial injury and whether this is modified by aortic cross-clamp (ACC) duration in minimally invasive mitral valve surgery.</p><p><strong>Methods: </strong>We retrospectively analysed 556 patients receiving blood-enriched modified del Nido cardioplegia. The primary exposure and outcome were longest perfusion interval and base-10 logarithm-transformed peak cardiac troponin I (cTnI) within 48 hours. Analyses included multivariable regression, interaction and subgroup analysis, restricted cubic splines, sensitivity analysis, and logistic regression.</p><p><strong>Results: </strong>Longer perfusion intervals were initially associated with higher cTnI (regression coefficient 0.0097, 95% confidence interval [CI], 0.0035-0.0159; P = .002). This association disappeared after adjustment for factors including ACC time and number of perfusions (regression coefficient -0.0006, 95% CI, -0.0109 to 0.0097; P = .913). Aortic cross-clamp time remained independently associated with cTnI (regression coefficient 0.0099, 95% CI, 0.0013-0.0185; P = .024). In patients with prolonged ACC time, exploratory analysis suggested a non-linear increase beyond 80 minutes. In patients with ACC time of 90 minutes or less, perfusion interval was not clearly associated with peak cTnI. No significant associations were found with the composite of adverse events.</p><p><strong>Conclusions: </strong>The association between perfusion interval and myocardial injury depended on ACC duration. Single-dose blood-enriched modified del Nido cardioplegia appeared adequate when ACC time was 90 minutes or less. Longer intervals in prolonged procedures may matter, but the 80-minute threshold remains exploratory. These findings support a context-dependent myocardial protection strategy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310747","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":"Corrigendum to: Kidney protection during surgery on the thoracoabdominal aorta: a systematic review.","authors":"","doi":"10.1093/icvts/ivag199","DOIUrl":"10.1093/icvts/ivag199","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 7","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622998","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":"Surgery After Induction Immuno-Chemotherapy in Stage III-N3 Non-Small Cell Lung Cancer: A Single-Centre Retrospective Cohort Study.","authors":"Xiaoping Zeng, Qianxin Zhou, Suyu Wang, Lu Han, Peng Zhang, Ziyun Shen, Yiming Zhou, Jing Zhang","doi":"10.1093/icvts/ivag166","DOIUrl":"10.1093/icvts/ivag166","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to preliminarily evaluate the efficacy of a surgical procedure following induction immuno-chemotherapy and nodal downstaging in patients with stage III-N3 non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with stage III-N3 NSCLC who received induction immuno-chemotherapy at Shanghai Pulmonary Hospital from August 2019 to May 2023. Patients who achieved confirmed N3 lymph node downstaging, had resectable tumours, and maintained adequate performance status subsequently underwent a surgical procedure after induction therapy. In this post-induction comparative analysis, baseline characteristics and oncological outcomes were compared between patients who underwent surgical procedures and those who did not.</p><p><strong>Results: </strong>After induction therapy, 28 (24.6%) patients underwent a surgical procedure, while 78 (73.6%) did not. The patients in the surgical group were younger (P = .012), had a higher body mass index (P = .032), and exhibited a higher proportion of contralateral mediastinal or hilar lymph node involvement (P = .024). Compared with those who did not undergo a surgical procedure, patients who did undergo a surgical procedure showed better progression-free survival (hazard ratio [HR] = 0.46, 95% CI, 0.23-0.92) and overall survival (HR = 0.31, 95% CI, 0.11-0.88). However, in the biopsy subgroup, patients who underwent a surgical procedure had better overall survival (HR = 0.64, 95% CI, 0.19-2.20) but similar progression-free survival (HR = 0.97, 95% CI, 0.42-2.23) compared with those who did not undergo a surgical procedure.</p><p><strong>Conclusions: </strong>These real-world findings provide early positive signals that a surgical procedure after induction immuno-chemotherapy may be feasible in carefully selected patients with stage III-N3 NSCLC.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430987","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":"Totally Endoscopic Mitral Valve Repair for Mitral Regurgitation in Double-Orifice Mitral Valve.","authors":"Nami Omori, Minoru Tabata","doi":"10.1093/icvts/ivag178","DOIUrl":"10.1093/icvts/ivag178","url":null,"abstract":"<p><strong>Background: </strong>Double-orifice mitral valve (DOMV) is a rare congenital anomaly. Repair strategies for mitral valve prolapse in the setting of DOMV remain technically challenging.</p><p><strong>Case summary: </strong>We report a case of DOMV presenting with severe mitral regurgitation (MR) due to chordal rupture and annular dilatation, successfully treated with totally endoscopic mitral valve repair. Regarding the surgical approach, preserving the fibrous bridge, we repaired a DOMV via an endoscopic approach with neochords and an edge-to-edge stitch for leaflet prolapse, and a flexible band for annular dilatation, achieving trivial MR without stenosis.</p><p><strong>Conclusion: </strong>This case demonstrates minimally invasive mitral valve repair for DOMV, in which the regurgitation was successfully controlled while preserving the fibrous bridge and avoiding mitral stenosis.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354959","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}