Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"The prognostic significance of modified frailty index-5 in patients undergoing pneumonectomy for lung cancer.","authors":"Muhammet Sayan, Bengisu Artiran, Funda Ozturk, Mahir Fattahov, Irmak Akarsu, Muhammet Tarik Aslan, Gunel Ahmadova, Aysegul Kurtoglu, Ismail Cuneyt Kurul, Ali Celik","doi":"10.1093/icvts/ivae179","DOIUrl":"10.1093/icvts/ivae179","url":null,"abstract":"<p><strong>Objectives: </strong>In some centrally located lung cancers, complete excision of the mass cannot be achieved with parenchymal-sparing procedures and pneumonectomy may be required. The mortality and morbidity rates of pneumonectomy were reported to be considerably high. Here, we investigated the effectivity of modified frailty index-5 (MFI-5) in patients undergoing pneumonectomy for non-small cell lung cancer.</p><p><strong>Methods: </strong>Data of patients who underwent pneumonectomy for non-small cell lung cancer between January 2018 and December 2023 were reviewed retrospectively. The MFI-5 score was determined by preoperative diabetes mellitus, hypertension, chronic obstructive pulmonary diseases, congestive heart failure and functional status. The effectiveness of the MFI-5 score for the presence of postoperative major complications and 30-day mortality was investigated by multivariate logistic regression analysis. A P-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 107 patients who met the inclusion criteria were included in the study. Eight (7.5%) of patients were female, and the mean age was 61.4 ± 8.7. The MFI-5 score was 0 in 48 patients (44.9%), 1 in 27 patients (25.2%) and 2 in 20 patients (18.7%). Postoperative 30-day mortality was detected in 4 patients (3.7%), and the major complications occurred in 42 patients (39.3%). In multivariate analysis, an MFI-5 score of 2 or higher (P = 0.008, OR: 4.9) was statistically significant for complications, whereas age, gender, side of the operation, <2 MFI-5 score, tumor diameter, type of surgery and lymph node metastasis status were not statistically significant (P > 0.05).</p><p><strong>Conclusions: </strong>The MFI-5 score is a significant indicator for predicting major postoperative events in patients who underwent pneumonectomy for non-small cell lung cancer.</p><p><strong>Clinical registration number: </strong>2024-323, approved by Gazi University Local Ethics Committee.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549316","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":"Feasibility, safety and quality of complex mitral valve repair in the early phase of a robotic surgery programme.","authors":"Kei Kobayashi, Yizhan Guo, Thomas E Rubino, Luis E Ramirez, Stephen D Waterford, Ibrahim Sultan, Victor D Morell, Johannes Bonatti","doi":"10.1093/icvts/ivae182","DOIUrl":"10.1093/icvts/ivae182","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility, safety and quality of robotic-assisted mitral valve repair in complex versus non-complex cases during the early phase of a programme.</p><p><strong>Methods: </strong>Since the programme launch in September 2021 until February 2024, 100 patients underwent robotic-assisted mitral valve repair. Of them, 21 patients had complex repairs, while 79 had non-complex repairs. The median age was 58 years for complex cases and 61 years for non-complex cases (P = 0.36).</p><p><strong>Results: </strong>Bileaflet prolapse was significantly more prevalent in the complex group (52.4% vs 12.7%, P < 0.001). Neochord placement (61.9% vs 13.9%, P < 0.001) and commissuroplasty (28.6% vs 5.1%, P = 0.005) were more frequent in the complex group. The complex group had longer cardiopulmonary bypass times (161 vs 141 min, P < 0.001), aortic cross-clamp times (123 vs 102 min, P < 0.001) and leaflet repair times (43 vs 24 min, P < 0.001). Second pump runs were required more often for complex cases (23.8% vs 3.8%, P = 0.01). All patients left the operating room with residual mitral regurgitation of mild or less. Fewer complex patients were extubated in the operating room (42.9% vs 70.9%, P = 0.02), yet hospital stay was similar (4 vs 4 days, P = 0.56). There were no significant differences in postoperative adverse events. There were no differences in mitral regurgitation of mild or less 4 weeks post-surgery (95.2% vs 98.7%, P = 0.47).</p><p><strong>Conclusions: </strong>Complex mitral valve repair can be safely and effectively performed with robotic assistance, even in the early phase of a programme. Despite longer operative and ventilation times in the complex group, hospital stay and postoperative adverse events remained similar.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669427","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":"Right ventricular outlet tract reconstruction for tetralogy of fallot: systematic review and network meta-analysis.","authors":"Akira Yamaguchi, Tomonari Shimoda, Hiroo Kinami, Jun Yasuhara, Hisato Takagi, Shinichi Fukuhara, Toshiki Kuno","doi":"10.1093/icvts/ivae180","DOIUrl":"https://doi.org/10.1093/icvts/ivae180","url":null,"abstract":"<p><strong>Objectives: </strong>Concerns persist regarding pulmonary regurgitation after transannular patch repair (TAP) for Tetralogy of Fallot. Despite various architectural preservation techniques being introduced, the optimal strategy remains controversial. We aimed to compare different right ventricular outlet tract reconstruction techniques.</p><p><strong>Methods: </strong>PubMed, EMBASE and Cochrane Central were searched through March 2024 to identify comparative studies on right ventricular outlet tract reconstruction techniques (PROSPERO ID: CRD42024519404). The primary outcome was mid-term pulmonary regurgitation, with secondary outcomes including postoperative mortality, postoperative pulmonary regurgitation, length of intensive care unit stays, postoperative right ventricular outlet tract pressure gradient, and mid-term mortality. We performed a network meta-analysis to compare outcomes among TAP, valve-repairing (VR), TAP with neo-valve creation (TAPN), and valve-sparing (VS).</p><p><strong>Results: </strong>Two randomized controlled studies and 32 observational studies were identified with 8,890 patients. TAP carried a higher risk of mid-term pulmonary regurgitation compared to TAPN (HR, 0.53; 95％CI [0.33; 0.85]) and VS (HR, 0.27; 95% CI [0.19; 0.39]), with no significant difference compared to VR. VS was also associated with reduced postoperative mortality compared to TAP (RR, 0.31; 95% CI [0.18; 0.56]), in addition to reduced ventilation time. TAP also carried an increased risk of postoperative pulmonary regurgitation compared to the other groups. The groups were comparable in terms of length of intensive care unit stay, right ventricular outlet tract pressure gradient, and mid-term mortality.</p><p><strong>Conclusions: </strong>VR was associated with a reduced risk of postoperative pulmonary regurgitation, while TAPN was associated with reduced risks of both postoperative and mid-term pulmonary regurgitation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585170","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":"2024 EACTS/EACTAIC Guidelines on patient blood management in adult cardiac surgery in collaboration with EBCP.","authors":"Filip P A Casselman, Marcus D Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Gerhardus Haumann, Anders Jeppsson, Hendrik J van der Merwe, Erik Ortmann, Mate Petricevic, Luca Paolo Weltert, Milan Milojevic","doi":"10.1093/icvts/ivae170","DOIUrl":"https://doi.org/10.1093/icvts/ivae170","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395738","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":"Vasa vasorum of the no-touch saphenous vein graft observed using frequency-domain optical coherence tomography.","authors":"Akira Sugaya, Satoshi Uesugi, Masayuki Doi, Ryohei Horikoshi, Norihiko Oka, Shuta Imada, Kenji Komiya, Masanori Nakamura, Koji Kawahito","doi":"10.1093/icvts/ivae167","DOIUrl":"10.1093/icvts/ivae167","url":null,"abstract":"<p><strong>Objectives: </strong>One possible reason for the long-term patency of no-touch (NT) saphenous vein grafts (SVG) is the preservation of the vasa vasorum in the adventitia/perivascular adipose tissue (PAT). We investigated the vasa vasorum of the NT SVG in vivo using frequency-domain optical coherence tomography (FD-OCT), performed qualitative and quantitative analyses and compared them with the conventional SVG.</p><p><strong>Methods: </strong>An FD-OCT study was performed on 14 SVG at the postoperative coronary angiography 1-2 weeks postoperatively (NT group, n = 9; conventional group, n = 5).</p><p><strong>Results: </strong>Many signal-poor tubular lumen structures that can be recognized in the cross-sectional and longitudinal profiles, which indicates the vasa vasorum, were observed in the adventitial/PAT layer in the NT SVG. In contrast, the vasa vasorum were less abundant in the conventional SVG. The volume of vasa vasorum per millimetre of graft in the no-touch group was significantly higher than in the conventional group [0.0020 (0.0017, 0.0043) mm3 and 0.0003 (0.0000, 0.0006) mm3, P = 0.023].</p><p><strong>Conclusions: </strong>FD-OCT showed abundant vasa vasorum in the thick adventitia/PAT layer of NT saphenous veins in vivo. In contrast, few vasa vasorum were observed in the conventional SVG.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367741","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":"Uniportal thoracoscopic plication of diaphragmatic eventration: loop needle technique for better visualization.","authors":"Ryosuke Kumagai, Shinsaku Kabemura, Fumitsugu Kojima, Toru Bando","doi":"10.1093/icvts/ivae164","DOIUrl":"10.1093/icvts/ivae164","url":null,"abstract":"<p><p>Symptomatic unilateral diaphragmatic eventration require surgical intervention. A 56-year-old woman complained of dyspnoea on exertion and was noted to have left diaphragm elevation on chest radiographs. Dynamic magnetic resonance imaging showed paradoxical movement of the left diaphragm. We performed diaphragmatic plication by uniportal thoracoscopy with knifeless endostaplers and a loop needle device. Her symptoms significantly improved immediately after the operation, and this condition had been maintained for 6 months. We thus suggest this minimally invasive technique as an easy and safe method for diaphragmatic plication.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333878","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":"Lateral atrial septal defect closure with induced ventricular fibrillation versus cardioplegic arrest.","authors":"Henning Carstens, Daniel Biermann, Jörg Sachweh, Martin Munz, Ida Hüners, Rainer Kozlik-Feldmann, Michael Hübler","doi":"10.1093/icvts/ivae128","DOIUrl":"10.1093/icvts/ivae128","url":null,"abstract":"<p><p>Minimally invasive surgical closure of atrial septal defects is gaining widespread acceptance and can be performed via a right midaxillary thoracotomy. In addition, the procedure can be performed in ischaemic cardiac arrest or fibrillation with a core body temperature between 34°C and 36°C.</p><p><strong>Objectives: </strong>We present our single-centre results of paediatric patients who underwent surgical atrial septal defect II closure via lateral thoracotomy.</p><p><strong>Methods: </strong>Retrospective analysis. Patients were divided into a cardiac arrest group and a cardiac fibrillation group. All procedures were performed via right midaxillary thoracotomy through a single incision without side ports.</p><p><strong>Results: </strong>All 37 consecutive patients between March 2019 and August 2022 (median age 3 years; percentile 25th: 2; 75th: 5 years) in both groups were free of mortality and postoperative morbidity such as haemodynamically relevant residual shunt or malignant arrhythmias. Cardiopulmonary bypass time was significantly shorter in the fibrillation group (mean: 34.7 min vs 52.6 min, P = 0.01), and all patients were weaned off the ventilator immediately postoperatively. Length of the intensive care unit stay was not different between the 2 groups. Postoperative hospital stay was significantly longer in patients with cardiac arrest (mean: 5.6 days vs 4.9 days, P = 0.04). Postoperative laboratory parameters did not differ between the 2 groups. All patients were discharged with normal left ventricular function and normalized cardiac enzymes.</p><p><strong>Conclusions: </strong>Minimally invasive closure of an atrial septal defect during atrial fibrillation is a safe procedure with results comparable to those of an induced cardiac arrest procedure.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367739","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":"Left-handed cardiac surgery and training: a survey-based assessment.","authors":"Eric E Vinck, Peyman Sardari Nia","doi":"10.1093/icvts/ivae174","DOIUrl":"10.1093/icvts/ivae174","url":null,"abstract":"<p><strong>Objectives: </strong>There is a lack of guidance and scant learning resources for left-handed (LH) cardiac surgery residents and surgeons. No objective data exists to evaluate the reality of the training experience of LH cardiac surgeons and residents.</p><p><strong>Methods: </strong>A 32-question survey was designed for LH cardiac surgeons and residents. The survey questions were aimed towards understanding the experiences of LH cardiac surgeons and residents in order to identify and determine where the challenges of LH in cardiac surgery lie. The survey was disseminated by the European Association for Cardio-thoracic Surgery (EACTS) through online platforms, social media and the EACTS website.</p><p><strong>Results: </strong>74 total responses were gathered from the survey; 73% were true LH operators. During residency, 78.1% of LH cardiac surgery residents had no access to LH faculty. Of those with LH mentors, only 53.3% were supportive and helped teach LH techniques. As trainees, 49.3% considered coronary artery bypass grafting anastomosis to be the most difficult portion of LH technique. Upon initiating independent practice, LH cardiac surgeons consider being LH an advantage in comparison to residency.</p><p><strong>Conclusions: </strong>In LH cardiac surgery, there is a lack of tailored surgical exposure, training guidance, standardization, learning tools and teaching resources. Training resources for LH cardiac surgeons and residents should be developed.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482373","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: Y-shaped graft replacement of an isolated innominate artery aneurysm via the transmanubrial approach.","authors":"","doi":"10.1093/icvts/ivae173","DOIUrl":"https://doi.org/10.1093/icvts/ivae173","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"39 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482374","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":"Bilateral lung volume reduction surgery outperforms the unilateral approach in functional improvement.","authors":"Özlem Okumus, Gernot Seebacher, Daniel Valdivia, Alexis Slama, Kaid Darwiche, Rüdiger Karpf-Wissel, Johannes Wienker, Stephane Collaud, Sandra Kampe, Balazs Hegedüs, Clemens Aigner","doi":"10.1093/icvts/ivae169","DOIUrl":"10.1093/icvts/ivae169","url":null,"abstract":"<p><strong>Objectives: </strong>Lung volume reduction surgery (LVRS) is an established treatment approach for patients with severe pulmonary emphysema, enhancing lung function and quality of life in selected patients. Functional benefits and outcomes after uni- versus bilateral lung volume reduction remain a topic of debate.</p><p><strong>Methods: </strong>A retrospective analysis of patients undergoing LVRS from January 2018 to October 2022 was conducted. After encouraging initial results, the standard unilateral LVRS approach was switched to bilateral. The goal of this study was to assess the impact on functional outcomes at 3 and 6 months post-surgery compared to preoperative levels for the uni- versus the bilateral approach.</p><p><strong>Results: </strong>A total of 83 patients were included (43 bilateral, 40 unilateral). Baseline demographic and functional parameters were comparable between groups. The most common complication was prolonged air leak in 19 patients (11 in the unilateral group, 8 in the bilateral group). Two patients died perioperatively (2.4%). Overall, LVRS improved forced expiratory volume in 1 s by 8.3% after 3 and 12.5% after 6 months postoperatively compared to baseline. Bilateral surgery presented significantly superior forced expiratory volume in 1 s improvement than unilateral approach at both 3 (29.2% versus 2.9%; P = 0.0010) and 6 months (21.5% versus 3%; P = 0.0310) postoperatively. Additionally, it reduced hyperinflation (residual volume) by 23.1% after 3 months and by 17.5% after 6 months, compared to reductions of 16% and 9.1% in the unilateral group.</p><p><strong>Conclusions: </strong>Bilateral approach resulted in better functional outcomes 3 and 6 months postoperatively compared to unilateral surgery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367721","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}