Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Planning thoracoscopic segmentectomies with three-dimensional-reconstruction software improves outcomes.","authors":"Aljaz Hojski, Mohamed Hassan, Makhmudbek Mallaev, Nikolay Tsvetkov, Brigitta Gahl, Didier Lardinois","doi":"10.1093/icvts/ivaf043","DOIUrl":"https://doi.org/10.1093/icvts/ivaf043","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated whether preoperative reconstructions of the lung anatomy using 3D-reconstruction (3D) software based on HRCT-scans improve surgical and postoperative outcomes after video-assisted thoracoscopic (VATS) segmentectomies.</p><p><strong>Methods: </strong>We retrospectively collected data from 100 consecutive patients who signed the general research consent form and underwent VATS-segmentectomies between 2018 and 2023. The outcomes and complications of the surgeries planned with 3D were compared to the results of those performed without. We used propensity modelling and inverse probability of treatment weighting (IPTW) to analyse the data.</p><p><strong>Results: </strong>Thirty-seven of the 100 patients included underwent surgery planned with 3D. In the 3D group, complex segmentectomies were more frequent (89% vs 38%, P < 0.001), there were markedly fewer conversions to thoracotomy (P = 0.003). The IPT-weighted analysis showed fewer severe complications Clavien-Dindo grade III or IV, post-IPTW odds ratio 0.10 (95% CI 0.01 to 0.87), P = 0.037, no complication Clavien-Dindo grade V occurred.Additionally, surgery planning using 3D may influence procedural and postoperative parameters, such as the number of segments removed (1.9 ± 1.0 vs 1.7 ± 0.8, P = 0.40), duration of the chest tube placement (3.0 days, IQR 2.0-4.0 vs 2.0 days, IQR 1.0-3.0, P = 0.060), and stay in the intensive/intermediate care unit.</p><p><strong>Conclusions: </strong>The planning of complex anatomical VATS-segmentectomies with 3D significantly reduces the need for conversions to thoracotomy and postoperative complications rates. In addition, complex surgeries are thereby performed safely.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674465","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":"Impact of aortic root rotation angle on new-onset first-degree atrioventricular block following mitral valve surgery.","authors":"Kazuma Handa, Masashi Kawamura, Daisuke Yoshioka, Shunsuke Saito, Takuji Kawamura, Ai Kawamura, Yusuke Misumi, Sho Komukai, Tetsuhisa Kitamura, Shigeru Miyagawa","doi":"10.1093/icvts/ivaf046","DOIUrl":"10.1093/icvts/ivaf046","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to classify anatomical variations in aortic root rotation using preoperative three-dimensional transoesophageal echocardiography (3D-TEE), validate these findings with cardiac computed tomography (CT) in patients undergoing mitral valve surgery and evaluate the clinical impact on postoperative atrioventricular conduction disorders.</p><p><strong>Methods: </strong>A total of 126 patients with normal electrocardiograms who underwent isolated mitral valve surgery were included. Anatomical variation was diagnosed using 3D-TEE, and aortic root rotation angle was measured using cardiac CT. New-onset postoperative atrioventricular block (AVB) and bundle branch block were analysed.</p><p><strong>Results: </strong>Variations of aortic root rotation were classified by 3D-TEE into two categories: 'center rotation' (normal) (85.7%, n = 108/126), where the commissure of the left and non-coronary aortic leaflet was located at center of the anterior mitral leaflet, and 'lateral rotation' (14.3%, n = 18/126), rotated to the lateral trigone side. The aortic root rotation angle, where the interatrial septum was defined as a reference, measured by cardiac CT strongly correlated with 3D-TEE findings ('center rotation' vs 'lateral rotation': 51.6° vs 64.6°, P < 0.001). The incidence of new-onset conduction disorder, all presenting with first-degree AVB, was significantly higher in the 'lateral rotation' than in the 'center rotation' (38.9% [n = 7/18] vs 5.6% [n = 6/108], P < 0.001). Aortic root rotation angles were identified as significant risk factors for postoperative first-degree AVB (odds ratio, 1.05; 95% confidential interval, 1.01-1.09; P = 0.027), with cutoff values of 58.7° predicting persistent new-onset AVB.</p><p><strong>Conclusions: </strong>Aortic root rotation angle measured by cardiac CT validated 3D-TEE diagnosis of 'lateral rotation' of the aortic root. 'Lateral rotation' and larger aortic root rotation angles were significant risk factors for postoperative first-degree AVB following mitral valve surgery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560259","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":"Is segmentectomy potentially adequate for clinical stage IA3 non-small cell lung cancer.","authors":"Lin Huang, Alessandro Brunelli, Demetrios Stefanou, Edoardo Zanfrini, Abid Donlagic, Michel Gonzalez, René Horsleben Petersen","doi":"10.1093/icvts/ivaf064","DOIUrl":"10.1093/icvts/ivaf064","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify the feasibility of segmentectomy for clinical stage IA3 (cIA3) vs cIA1-2 non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>We retrospectively analysed data of consecutive patients with segmentectomy for cIA NSCLC across three centres between January 2017 and December 2022. The stabilized inverse probability of treatment-weighting (IPTW) was employed to minimize potential confounding in baseline characteristics. Recurrence-free survival (RFS) differences were examined using Kaplan-Meier estimator with the log-rank test. The Cox regression model was applied to assess the average treatment effect (ATE) between two groups in RFS. Subgroup and sensitivity analyses were performed.</p><p><strong>Results: </strong>Of a total of 589 patients who underwent segmentectomy, 478 presented with cIA1-2 NSCLC while 111 presented with cIA3 NSCLC. In comparison with cIA1-2 cases, the cIA3 cohort were significantly older with poorer lung function and more comorbidity. The cIA3 NSCLC presented significantly invasive characteristics, with extensive tissues dissected. After median follow-up of 24.0 (interquartile range 12.5-40.1) months, we did not observe significant difference in RFS (3-year 73.4% vs 78.5%, P = 0.490; ATE: 1.17) between the cIA3 vs cIA1-2 groups. These findings were corroborated following the stabilized IPTW. Preoperative characteristics in the cIA3 subgroup were not related to RFS. In the sensitivity analysis, no difference in RFS was found between the two groups stratified by peripheral and central localization.</p><p><strong>Conclusions: </strong>In well-selected patients with cIA3 NSCLC, segmentectomy leads to no statistical difference in oncologic outcomes compared to those observed in earlier stages in a relatively short follow-up period.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626631","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":"Compensatory sweating after thoracoscopic sympathectomy for primary focal hyperhidrosis: a series of 820 cases.","authors":"Tiago Silva Santos, Thiago Gangi Bachichi, Daniela Tamega Joaquim, Maria Helena De Sousa, Eduardo Vieira Ponte, José Ribas Milanez De Campos, Evaldo Marchi","doi":"10.1093/icvts/ivaf063","DOIUrl":"10.1093/icvts/ivaf063","url":null,"abstract":"<p><strong>Objectives: </strong>Primary hyperhidrosis is a functionally and socially limiting condition. Thoracoscopic sympathectomy is an effective treatment for hyperhidrosis. However, post-sympathectomy compensatory sweating remains a challenge in clinical practice.</p><p><strong>Methods: </strong>Record analysis of patients who underwent thoracoscopic sympathectomy between 2002 and 2020. Emphasis was given to demographic data, site of complaint, functional and social impairment, procedure performed, postoperative results and compensatory sweating.</p><p><strong>Results: </strong>A total of 820 patients were included (age 23.8 [7.3] years, body mass index-BMI 22.3 [3.0] kg/m2, 66.3% female). The palmoplantar (44.3%) and palmoplantar-axillary (41.6%) sites were the most affected, followed by the axillary (12.3%) and craniofacial sites (1.8%). On a 0-4 scale, functional impairment was significantly greater in the palmoplantar group (P < 0.001) and social impairment in the axillary, palmoplantar-axillary and craniofacial groups (P < 0.001). The degree of compensatory sweating after surgery was minimal in groups palmoplantar (74.9%), palmoplantar-axillary (70.4%), axillary (63.4%) and mild in the craniofacial group (66.7%). The bivariate analyses showed significant differences in the compensatory sweating variable for age, sex, BMI and site. The multiple analysis by logistic regression showed BMI, sex and the palmoplantar-axillary, axillary and craniofacial variables to be significant for compensatory sweating.</p><p><strong>Conclusions: </strong>Thoracoscopic sympathectomy was an effective procedure for controlling primary focal hyperhidrosis, with tolerable compensatory sweating in the patients analysed in this study.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626687","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":"Contribution of cardiac surgeons in transcatheter aortic valve replacement activity in France.","authors":"Gabriel Saiydoun, Saadé Saadé, Chadi Aludaat, Chloé Bernard, Guillaume Lebreton, Thomas Modine, Thierry Folliguet, Charles Juvin, Maroua Eid, Xavier-Benoit D'Journo, Louis Labrousse, Michel Kindo, Julien Guihaire, Jean-Marc Baste, Olivier Fouquet, Marylou Para, Johann Cattan, Mohammed Alghamdi, Guillaume Guimbretiere, Olivier Bouchot, André Vincentelli, Pascal Leprince, Jean-Philippe Verhoye","doi":"10.1093/icvts/ivaf068","DOIUrl":"10.1093/icvts/ivaf068","url":null,"abstract":"<p><strong>Objectives: </strong>This study provides a thorough analysis of cardiac surgeons' involvement in transcatheter aortic valve replacement (TAVR) activities in France, covering decision-making, procedural roles, training and outcome analysis.</p><p><strong>Methods: </strong>A nationwide survey was sent to all cardiac surgeons and all cardiac surgery trainees in France. Subgroup analysis was performed for age, status (established versus in-training) and type of practice facility.</p><p><strong>Results: </strong>A total of 172 surgeons from both private and public sectors responded to the survey. Most respondents (71%) had TAVR activity, and there were no significant differences between subgroups. Most respondents with TAVR activities (30%) had average access (once per week). Almost one-third of centres had >3 established surgeons with TAVR activity, whereas 19% had no in-training surgeons with TAVR activity. TAVR was the only structural practice for 67% of surgeons, while 33% practiced other structural procedures. When asked, 82% of surgeons were against establishing TAVR programmes in centres without a cardiac surgery programme. Most TAVR patients (72%) were discussed by the Heart Team, and only 9% of surgeons said their relationship with the interventional cardiologist was disrupted. Two-thirds of vascular complications were managed by cardiac surgery, and only 6% of cardiac surgeons admitted were unfit to handle any vascular complications.</p><p><strong>Conclusions: </strong>In France, cardiac surgeons are becoming increasingly involved in TAVR procedures as an integral part of the Heart Team.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635011","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":"Identifying the intersegmental line using a concave portion during upper lobe apical segmentectomies.","authors":"Hirohisa Kato, Masami Abiko, Kaito Sato","doi":"10.1093/icvts/ivaf022","DOIUrl":"10.1093/icvts/ivaf022","url":null,"abstract":"<p><strong>Objectives: </strong>The hilum approach of intersegmental division along the intersegmental vein is difficult in the case with central vein type during upper lobe apical segmentectomy. We aimed to explore the possibilities of the simple intersegmental division used the concave portion of the apical pleura with computed tomography images.</p><p><strong>Methods: </strong>We evaluated computed tomography images of patients who underwent anatomical lung resection between June 2020 and April 2024. The upper pulmonary vein branching pattern was categorized into apical, apico-central and central vein types. We evaluated whether the peripheral points of intersegmental veins (left V1 + 2a or right V1b) could be identified, on which portions (anterior-convex, concave and apical-convex) within the apical pleura in each branching pattern, using three-dimensional computed tomography images.</p><p><strong>Results: </strong>The peripheral points of the intersegmental veins of 175 subjected patients were concentrated in the anterior-convex, concave and apical-convex portions. In the left lung, the peripheral points were significantly concentrated in the concave (n = 106, 60.9%) and the anterior-convex portion of the right lung (n = 115, 67.2%). By contrast, the peripheral points were significantly identified in the concave portion of the central vein type (n = 9, 100%) in the left lung for each branching pattern of the upper pulmonary vein. There was no similar tendency in the right lung.</p><p><strong>Conclusions: </strong>Peripheral intersegmental points obtained from the intersegmental veins were concentrated in the three portions constituting the concave portion of the apical pleura and especially in the concave portion of the left lung, suggesting that they can serve as convenient intersegmental line markers during upper segmentectomy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470075","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":"Role of tricuspid valve repair in pulmonary atresia with intact ventricular septum: fresh autologous pericardium as a viable option.","authors":"Jae Hong Lee, Woong-Han Kim, Seung Min Baek, Chan Hyeong Kim, Hye Won Kwon, Sungkyu Cho, Jae Gun Kwak, Yoon Seong Lee","doi":"10.1093/icvts/ivaf062","DOIUrl":"10.1093/icvts/ivaf062","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the surgical outcomes of tricuspid valve (TV) leaflet augmentation using fresh autologous pericardium (FAP) in patients with pulmonary atresia with intact ventricular septum (PA-IVS).</p><p><strong>Methods: </strong>Nine patients with PA-IVS underwent TV leaflet augmentation (TVLA) using FAP between January 2017 and April 2024. Native TV failure was defined as significant (≥moderate) tricuspid regurgitation and/or stenosis (mean pressure gradient >5 mmHg). Clinical outcomes, including both TV and right ventricle (RV) size and functions, were evaluated using echocardiography and magnetic resonance imaging.</p><p><strong>Results: </strong>The median age and body weight at the time of surgery were 5.4 years and 21.2 kg, respectively. No operative mortality occurred. During the follow-up period, no late mortalities, reoperations or significant TV leaflet-related complications were observed; native TV failure was not observed in any patients, except one with significant tricuspid regurgitation. Biventricular repair was performed in all patients except one who had undergone preoperative one-and-a-half ventricle repair. After TVLA using FAP, the median TV annulus z-score remained within the normal ranges (preoperative -0.42 [-0.62 to 0.57] versus postoperative -0.51 [-0.95 to -0.13], mean difference: 0.231, 95% confidence interval: -0.338 to 0.800, P = 0.377) and tricuspid regurgitation improved significantly (mean difference: 2.111, 95% confidence interval: 1.510-2.712, P = 0.040). Postoperative magnetic resonance imaging showed that RV function, and cardiac output were preserved within acceptable ranges.</p><p><strong>Conclusions: </strong>TVLA using FAP could be a considerable and viable approach to optimize RV growth while preserving RV and TV functions in the long-term in young patients with PA-IVS.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665595","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":"Usefulness of serial N-terminal pro-B-type natriuretic peptide values after biventricular repair in patients with borderline hypoplastic left ventricle.","authors":"Takuya Osawa, Haonan Cheng, Jonas Palm, Carolin Niedermaier, Muneaki Matsubara, Thibault Schaeffer, Nicole Piber, Paul Philipp Heinisch, Christoph Röhlig, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono","doi":"10.1093/icvts/ivaf036","DOIUrl":"10.1093/icvts/ivaf036","url":null,"abstract":"<p><strong>Objectives: </strong>Biventricular repair (BVR) for patients with borderline hypoplastic left ventricle is challenging, and a predictor of failing BVR has not been clarified. This study aimed to analyse the z-log N-terminal pro-B-type natriuretic peptide and evaluate its usefulness in predicting outcomes after BVR.</p><p><strong>Methods: </strong>Patients who were diagnosed with borderline left heart hypoplasia and underwent BVR from 2012 to 2022 were included. Serial N-terminal pro-B-type natriuretic peptide values were evaluated using its age-adjusted z-score. The data were collected from the first admission to the last follow-up and compared between patients with failing BVR (defined as death and haemodynamic failure) and patients with haemodynamically good biventricular outcomes.</p><p><strong>Results: </strong>A total of 34 patients were included, and 7 patients (21%) developed adverse outcomes (5 deaths and 2 haemodynamic failures) following BVR. The mean value of z-log N-terminal pro-B-type natriuretic peptide before BVR was not significantly different between patients with failing BVR and those without (2.2 [1.5-3.2] vs 3.3 [2.2-3.9], P = 0.200). However, patients with failing BVR showed a continuous increase in N-terminal pro-B-type natriuretic peptide postoperatively. The value for patients with failing BVR was higher within 7 days after BVR (P = 0.016) and at the last follow-up (P = 0.003) than those without. Postoperative z-log N-terminal pro-B-type natriuretic peptide and endocardial fibroelastosis at birth were identified as associated factors of failing BVR.</p><p><strong>Conclusions: </strong>Elevated z-log N-terminal pro-B-type natriuretic peptide after BVR of borderline hypoplastic left ventricle seems to be a useful biomarker associated with poor outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665598","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":"Surgical management for caseous calcification of mitral annulus associated with coronary artery disease.","authors":"Shinji Kanemitsu, Shunsuke Sakamoto, Toru Mizumoto","doi":"10.1093/icvts/ivaf061","DOIUrl":"10.1093/icvts/ivaf061","url":null,"abstract":"<p><p>Mitral annular calcification (MAC) is a common finding, especially among the elderly or patients undergoing haemodialysis. Caseous calcification of the mitral annulus (CCMA) is a rare MAC variant with liquefied material at the calcified annulus. Surgical management of CCMA often involves wide excision and debridement, increasing the risk of perioperative stroke. We report a patient undergoing haemodialysis who developed an enlarged MAC, moderate mitral insufficiency and multivessel coronary artery disease. This case highlights the characteristic imaging features of CCMA. We performed a limited incision for complete drainage, followed by suture obliteration of the cavity and mitral valve repair, in conjunction with coronary artery bypass grafting. This technique was safe, preserved mitral valve function and was not associated with perioperative stroke. We herein report this approach reduces the risk of stroke while maintaining mitral valve function, offering a safer alternative to extensive excision.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617949","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":"Significance of measuring the severity of emphysema, in combination with spirometry, on the risk evaluation of patients undergoing major lung resection for cancer†.","authors":"Souichi Suzuki, Aya Harada-Takeda, Shoichiro Morizono, Koji Takumi, Tadashi Umehara, Go Kamimura, Masaya Aoki, Toshiyuki Nagata, Kazuhiro Ueda","doi":"10.1093/icvts/ivaf027","DOIUrl":"10.1093/icvts/ivaf027","url":null,"abstract":"<p><strong>Objectives: </strong>Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) and predicted postoperative diffusing capacity of the lungs for carbon monoxide (ppoDLco) are the two most significant parameters for predicting the risk of cardiopulmonary complications after major lung resection for lung cancer. Although the severity of pulmonary emphysema on computed tomography may be an important risk factor for postoperative complications, the clinical significance of measuring the severity of pulmonary emphysema, in combination with ppoFEV1 and ppoDLco, has never been evaluated.</p><p><strong>Methods: </strong>We measured the severity of pulmonary emphysema, representing the percentage of low-attenuation area (< -950 Hounsfield units), in the whole lung field, in addition to ppoFEV1 and ppoDLco, in 451 patients who underwent major lung resection for primary lung cancer. We also measured the volume of the upper and lower lobes of emphysematous and non-emphysematous lungs.</p><p><strong>Results: </strong>Postoperative cardiopulmonary complications developed in 60 patients (13.3%). According to a receiver operating characteristic curve analysis for the diagnostic potential of postoperative complications, the area under the curve was highest for the severity of emphysema, followed by ppoDLco and ppoFEV1. According to a stepwise multivariable logistic regression analysis, the severity of emphysema and ppoDLco was identified as independent risk factors for postoperative complications. Neither the heterogeneous distribution of emphysema nor that of non-emphysema was associated with the occurrence of complications in patients with upper lobe disease or in patients with lower lobe disease.</p><p><strong>Conclusions: </strong>The severity of emphysema on computed tomography is a relevant risk factor for cardiopulmonary complications after major lung resection.</p><p><strong>Clinical registration number: </strong>The study was approved by our institutional review board of No. 240077.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400900","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}