Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Empowering women in thoracic surgery: findings from a cross-sectional survey of the ests women in general thoracic surgery academy survey.","authors":"Melek Ağkoç, Hanna Tihanyi, Sara Lo Torto, Sara Sakowitz, Mara B Antonoff, Nuria Novoa Valentin, Paula Duarte D'Ambrosio, Isabelle Opitz, René Horsleben Petersen, Giulia Veronesi, Cristina Viola, Sri Subramaniam, Cecilia Pompili","doi":"10.1093/icvts/ivag248","DOIUrl":"https://doi.org/10.1093/icvts/ivag248","url":null,"abstract":"<p><strong>Objectives: </strong>The Women in General Thoracic Surgery (WGTS) Academy, organized by the European Society of Thoracic Surgeons (ESTS), supports early and mid-career women thoracic surgeons through mentorship, leadership development, and clinical immersions in a gender-equitable environment.</p><p><strong>Methods: </strong>We conducted a prospective cross-sectional survey-based evaluation of all fellows participating in the WGTS Academy between 2023 and 2025. The survey addressed the value of face-to-face meetings, simulation training, and clinical immersions, as well as professional connections, challenges faced, and suggestions for future improvements.</p><p><strong>Results: </strong>Twenty-nine women Academy fellows were invited, and 24 completed the survey (82.8%). Thirteen participants (54.2%) worked in academic or university hospitals. Face-to-face meetings during clinical immersions were highly valued (62.5% rating them 10/10). Simulation training was considered valuable by 23 participants (95.8%). The most appreciated topics were mentorship, leadership, robotic surgery, gender-related discussions, and opportunities to interact with women leaders. Participants identified key benefits such as international networking, mentorship, professional development, emotional support, and friendships. Regarding clinical impact, 8 participants (33.3%) reported changes in their practice, and 11 (45.8%) planned to implement changes. Six participants (25.0%) had already assumed leadership roles, and seven participants (29.2%) were engaged in research. Overall, 23 participants (95.8%) would recommend the Academy, and 21 (87.5%) expressed willingness to participate in future activities.</p><p><strong>Conclusion: </strong>The WGTS Academy was highly valued by participants, who reported perceived benefits related to mentorship, networking, leadership development, and clinical practice. Participants identified opportunities for further program development, particularly in hands-on training and research support.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082997","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":"Percutaneous decannulation with a suture-mediated closure device versus open surgical repair for peripheral veno-arterial extracorporeal membrane oxygenation: A systematic review and meta-analysis.","authors":"Joshua J Hon, Marco Lizwan, Jen Yong Niam, Khi Yung Fong, Stanley E K Loh, Andrew M T L Choong, Jun Jie Ng","doi":"10.1093/icvts/ivag274","DOIUrl":"https://doi.org/10.1093/icvts/ivag274","url":null,"abstract":"<p><strong>Objective: </strong>Peripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) is commonly used to treat patients with severe cardiorespiratory dysfunction. Percutaneous decannulation (PD) using suture-mediated closure devices has emerged as an alternative to open surgical repair (OSR) following peripheral VA-ECMO. We performed a systematic review and meta-analysis to review and compare outcomes after VA-ECMO decannulation using PD versus OSR.</p><p><strong>Methods: </strong>Six electronic databases were searched to 25 December 2025 for comparative studies evaluating PD versus OSR. Primary outcomes were access-related wound and vascular complications; secondary outcomes were inpatient mortality and procedure time. Outcomes were pooled as risk ratios (RRs) using random-effects models with the Hartung-Knapp adjustment, and are reported with 95% confidence intervals (CIs) and prediction intervals.</p><p><strong>Results: </strong>Ten comparative studies comprising 829 patients (438 PD, 391 OSR) were included. PD was associated with fewer access-related wound complications than OSR (RR 0.26, 95% CI 0.12-0.56, I2=20.7%), although the 95% prediction interval (0.07-1.01) reached unity. Vascular complications did not differ significantly (RR 0.71, 95% CI 0.47-1.08, I2=0%), nor did inpatient mortality (RR 0.71, 95% CI 0.40-1.28, I2=40.9%). Procedure time was shorter with PD in all four studies reporting it, although the pooled estimate was heterogeneous and imprecise (mean difference -41.6 minutes, 95% CI -75.5 to -7.7, I2=95.0%).</p><p><strong>Conclusion: </strong>PD for VA-ECMO is associated with a lower incidence of access-related wound complications than OSR. Given the observational designs, clinical heterogeneity, and non-standardised outcome definitions of the available evidence, PD is best regarded as a reasonable option in carefully selected patients at centres with appropriate endovascular expertise, rather than as a default strategy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066046","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":"Unwarranted variation in training in isolated coronary artery bypass grafting in the United Kingdom.","authors":"Jeremy Chan, Maria Comanici, Tim Dong, Pradeep Narayan, Gianni D Angelini","doi":"10.1093/icvts/ivag270","DOIUrl":"https://doi.org/10.1093/icvts/ivag270","url":null,"abstract":"<p><strong>Objective: </strong>Several studies have reported comparable outcomes between trainees and consultants performing isolated coronary artery bypass grafting (CABG). However, the extent to which trainee operating opportunities vary between consultants and hospitals after accounting for patient risk profile remains unclear.</p><p><strong>Methods: </strong>Adult patients undergoing first-time, elective or urgent isolated CABG in the United Kingdom between 2010 and 2019 were identified from the National Adult Cardiac Surgery Audit database. Procedures in which a trainee was recorded as the primary operator were compared with those with consultant. Three-level multilevel logistic regression models quantified hospital- and consultant-level variation after adjustment for perioperative factors.</p><p><strong>Results: </strong>A total of 127,795 patients were included; a trainee was recorded as the primary operator in 32,997 cases (25.8%). After propensity score matching, trainee primary operator cases had longer bypass and cross-clamp times (85 vs 81 minutes and 50 vs 48 minutes, respectively; both p < 0.001) but were not associated with higher in-hospital mortality (0.9% vs 1.2%), postoperative dialysis (1.4% vs 1.8%), or return to theatre (3.7% vs 3.8%).In the final multilevel model, residual variation in trainee primary operator status was observed at both hospital and consultant levels. Hospitals accounted for a larger proportion of variation (variance partition coefficient [VPC] 43.7%) than consultants (VPC 25.1%), with the rest of the variation attributed to patient preoperative characteristics. The median odds ratio (MOR) was 7.76 at the hospital level and 4.72 at the consultant level, indicating that, for two otherwise similar patients, moving from a lower- to a higher-training hospital would multiply the odds of trainee primary operator involvement by almost eight.</p><p><strong>Conclusions: </strong>Substantial unwarranted variation exists in trainee operating opportunities for isolated CABG at the hospital and consultant levels in the United Kingdom. This variation persists after adjustment for patient case mix and operative factors, supporting the need for more standardised, transparent, and equitable monitoring of operative exposure across institutions.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042290","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":"Distal anastomotic new entries after acute type A aortic dissection surgery: a retrospective cohort study.","authors":"Stefan R van Dinter, Pim S van Sambeeck, Nesar A Hasami, Amir H Sadeghi, Michel W A Verkroost, Tychon E A Geeraedts, Jan Jaap Janssen, Foeke J H Nauta, Nabil Saouti, Robin H Heijmen","doi":"10.1093/icvts/ivag262","DOIUrl":"https://doi.org/10.1093/icvts/ivag262","url":null,"abstract":"<p><strong>Objectives: </strong>Distal anastomotic new entry (DANE) after acute type A aortic dissection repair may contribute to adverse downstream aortic remodelling. This study evaluated the incidence of postoperative DANE and its association with distal aortic growth, reintervention, and clinical outcomes.</p><p><strong>Methods: </strong>All consecutive patients undergoing type A aortic dissection repair with residual downstream dissection (DeBakey I) between 2011 and 2024 were retrospectively analysed. Computed tomography angiography was systematically reviewed for DANE using two-plane distal anastomosis alignment. Longitudinal descending thoracic aortic maximum diameters were analysed using linear mixed-effects models. Univariable logistic regression, Kaplan-Meier estimates, and Cox proportional hazards analyses were performed.</p><p><strong>Results: </strong>A total of 164 patients were included, of whom 77 (47.0%) had postoperative DANE. Patients with DANE demonstrated larger distal aortic diameters over time compared with patients without DANE, while baseline diameters were similar (37.6 versus 37.3, p = 0.77). At 3-5 years, estimated maximum descending thoracic aortic diameter was 51.6 mm versus 42.7 mm, respectively (p < 0.001). DANE was associated with ≥10 mm downstream aortic growth, ≥55 mm maximum diameter and reintervention during 5-year follow-up (combined odds ratio 5.60 [2.48-12.65], p < 0.001). Overall survival did not differ between groups (hazard ratio 2.04 [0.80-5.18], p = 0.13). Cox regression demonstrated higher hazard ratios with DANE for reintervention (2.01 [1.01-3.97], p = 0.04) and reaching ≥55 mm aortic diameter (5.59 [2.33-13.42], p < 0.001).</p><p><strong>Conclusions: </strong>DANE occurred frequently after type A aortic dissection repair and was strongly associated with accelerated downstream aortic growth and reintervention. Routine postoperative assessment and strategies aimed at preventing or treating DANE may improve long-term aortic outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066044","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":"Massive hemoptysis from embolization coils after chemo-immunotherapy.","authors":"Alfonso Fiorelli, Vincenzo Di Filippo, Felicia Di Perna, Francesco Coppolino","doi":"10.1093/icvts/ivag266","DOIUrl":"https://doi.org/10.1093/icvts/ivag266","url":null,"abstract":"<p><p>Herein, we report the case of a massive hemoptysis caused by vascular embolization coils following tumor necrosis induced by chemo-immunotherapy, which was successfully managed via emergency surgical resection. No postoperative recurrence of hemoptysis was observed, allowing the patient to safely resume systemic therapy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042087","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":"Postoperative Atrial Fibrillation and Long-Term Outcomes After Isolated Coronary Artery Bypass Grafting.","authors":"Henrique Soares Moreira, Beatriz Brandão, Armando Abreu, Adelino Leite-Moreira, José Máximo, Marta Andrade, Patrícia Bastos, João Ferreira","doi":"10.1093/icvts/ivag258","DOIUrl":"https://doi.org/10.1093/icvts/ivag258","url":null,"abstract":"<p><strong>Objectives: </strong>New-onset postoperative atrial fibrillation is the most common complication after cardiac surgery. This study aimed to evaluate the association between postoperative atrial fibrillation and short-term and long-term clinical outcomes after isolated coronary artery bypass grafting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults who underwent isolated coronary artery bypass grafting between 2000 and 2015 at a tertiary care centre. Baseline differences between patients who developed postoperative atrial fibrillation and those who did not were adjusted using inverse probability weighting based on propensity scores derived from demographic, clinical and procedural variables. In-hospital outcomes were analysed using weighted regression models, and long-term all-cause mortality was assessed using weighted Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 5,170 included patients, postoperative atrial fibrillation occurred in 652 (13%). After inverse probability weighting, postoperative atrial fibrillation was associated with a higher risk of perioperative stroke (odds ratio 2.59, 95% confidence interval 1.19-5.64), prolonged mechanical ventilation (odds ratio 1.73, 95% confidence interval 1.22-2.45) and longer hospital stay (mean difference 2.4 days, 95% confidence interval 1.6-3.3). During a median follow-up of 12.8 years, postoperative atrial fibrillation was also associated with higher long-term all-cause mortality (hazard ratio 1.31, 95% confidence interval 1.23-1.51).</p><p><strong>Conclusions: </strong>In patients undergoing isolated coronary artery bypass grafting, postoperative atrial fibrillation was associated, after inverse probability weighting, with major perioperative complications and reduced long-term survival. These findings suggest that postoperative atrial fibrillation may represent a marker of increased postoperative and long-term risk.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042259","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":"Association of computed tomography-quantified low-attenuation plaque area with cerebral infarction beyond morphology-based atheroma grading in aortic arch repair: a retrospective cohort study.","authors":"Fumio Yamana, Kazuo Shimamura, Ryoto Sakaniwa, Koichi Maeda, Yoshiki Watanabe, Takashi Shirakawa, Satoshi Sakakibara, Daisuke Yoshioka, Shigeru Miyagawa","doi":"10.1093/icvts/ivag206","DOIUrl":"https://doi.org/10.1093/icvts/ivag206","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether preoperative computed tomography quantification of low-attenuation plaque in the aortic arch improves perioperative cerebral infarction risk stratification beyond morphology-based atheroma grading.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients who underwent open or hybrid aortic arch repair with postoperative brain magnetic resonance imaging between January 2016 and December 2024. Preoperative computed tomography measured low-attenuation plaque area in the aortic arch (0 to 60 Hounsfield units) and arch atheroma grade. Low-attenuation plaque area was modeled as a continuous variable (per 10 mm2) in multivariable logistic regression with prespecified covariates, and discrimination was internally validated using 1,000 bootstrap resamples. Receiver operating characteristic and decision tree analyses were performed only as exploratory descriptive analyses; restricted cubic spline modeling was used to assess potential non-linearity.</p><p><strong>Results: </strong>A total of 158 patients were analyzed. New cerebral infarction lesions occurred in 84 patients (53.2%), including 15 symptomatic strokes (9.5%). Low-attenuation plaque area was independently associated with new cerebral infarction lesions (adjusted odds ratio per 10 mm2, 1.69; 95% confidence interval, 1.34 to 2.22). Discrimination was acceptable (area under the curve, 0.82; 95% confidence interval, 0.75 to 0.88) with minimal optimism after bootstrap validation (optimism-corrected area under the curve, 0.79). In exploratory descriptive analyses stratified by atheroma grade and LAP burden, NCIL incidence was substantially higher in higher-LAP strata within atheroma grades III (78.6% vs. 25.0%) and IV (64.9% vs. 25.0%).</p><p><strong>Conclusions: </strong>Computed tomography-quantified low-attenuation plaque area in the aortic arch is independently associated with perioperative magnetic resonance imaging-detected cerebral infarction and may provide complementary information beyond morphology-based atheroma grading, while exploratory stratified analyses suggested heterogeneity in embolic vulnerability within intermediate atheroma grades.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042107","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":"Physiological impact of coronary artery bypass surgery on chronic total occlusion: a functional evaluation using coronary flow reserve.","authors":"Kentaro Honda, Hideki Kunimoto, Ryo Nakamura, Takahiro Fujimoto, Yu Kajimoto, Mizuho Ikuchi, Kota Agematsu, Yoshiharu Nishimura","doi":"10.1093/icvts/ivag273","DOIUrl":"https://doi.org/10.1093/icvts/ivag273","url":null,"abstract":"<p><strong>Aims: </strong>This study evaluated the physiological impact of CABG for left anterior descending (LAD) artery chronic total occlusion (CTO) using postoperative coronary flow reserve (CFR).</p><p><strong>Methods: </strong>We retrospectively analyzed 1,149 patients undergoing isolated CABG, comparing LAD-CTO (n = 164) and non-CTO (n = 985) groups. Postoperative CFR was measured in 685 patients. The CTO group was stratified by preoperative Rentrop collateral classification.</p><p><strong>Results: </strong>In the entire cohort (n = 1,149), early mortality (3.7% vs. 1.7%, p = 0.1018) and LAD graft patency (97.8% vs. 98.6%, p = 0.4595) were comparable between groups. In the CFR cohort (n = 685), the CTO group showed lower CFR values than the non-CTO group (2.76 ± 0.90 vs. 3.04 ± 0.88, p = 0.0012). However, mean CFR exceeded 2.0 across all CTO subgroups, regardless of collateral status (Poor: 2.66 ± 0.7; Moderate: 2.76 ±0.94; Good: 2.78 ± 1.00; p = 0.763).</p><p><strong>Conclusions: </strong>CABG achieves reliable physiological improvement (CFR > 2.0) and favorable outcomes for LAD-CTO revascularization, independent of preoperative Rentrop collateral grade.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026992","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":"Permanent pacemaker implantation after sutureless aortic valve replacement with the perceval valve: predictors and clinical implications.","authors":"Jung-Hoon Shin, Iksung Cho, Chi-Young Shim, Sak Lee, Geu-Ru Hong, Seung-Hyun Lee","doi":"10.1093/icvts/ivag232","DOIUrl":"https://doi.org/10.1093/icvts/ivag232","url":null,"abstract":"<p><strong>Objectives: </strong>Permanent pacemaker implantation (PPI) remains a concern after sutureless aortic valve replacement (S-AVR) with the Perceval valve. This study aimed to identify preoperative predictors of PPI and evaluate its impact on mid-term survival in a large single-center cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 334 patients who underwent S-AVR using the Perceval valve between January 2017 and December 2023. Patients were stratified according to the occurrence of postoperative PPI. Independent predictors of PPI were identified using multivariable logistic regression. Overall survival was assessed using Kaplan-Meier analysis and Cox proportional hazards modeling.</p><p><strong>Results: </strong>PPI occurred in 21 patients (6.2%). Preoperative right bundle branch block (RBBB) was significantly more prevalent among patients requiring PPI (66.7% vs. 11.2%, P < 0.001). In multivariable logistic regression analysis, preoperative RBBB (Odds ratio [OR] 44.42; P < 0.001), hypertension, and QRS duration (per 10-ms increase) were independently associated with PPI. The association between RBBB and PPI remained significant in Firth penalized logistic regression analysis (OR, 32.77; P < 0.001).</p><p><strong>Conclusions: </strong>Preoperative RBBB is independently associated with PPI after Perceval S-AVR and demonstrated the strongest observed association among the evaluated variables. Careful preoperative risk stratification and postoperative rhythm surveillance may help identify patients at increased risk for conduction-related complications.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018942","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":"Left atrial appendage clip causing left main coronary artery occlusion and mortality despite removal.","authors":"Stephen D Waterford","doi":"10.1093/icvts/ivag267","DOIUrl":"https://doi.org/10.1093/icvts/ivag267","url":null,"abstract":"<p><p>An 80 year old man underwent coronary bypass to the left anterior descending and posterior descending arteries, ablation and left atrial appendage clipping. Weaning from bypass was complicated by global left ventricular dysfunction, and the clip was removed with improvement in ventricular function. The clip had been placed away from the circumflex artery and was not at or below the base of the appendage. The patient had recurrent low cardiac output postoperatively, and cardiac catheterization showed midshaft occlusion of the left main coronary artery where the removed appendage clip had damaged the artery. This report is the first to show that even removed left atrial appendage clips can result in lasting coronary artery damage including to the left main, and that any clip-related hemodynamic problems in the operating room should be followed by prompt cardiac catheterization. This report also shows that it is not only circumflex injury, but left main coronary injury, that can result from left atrial appendage clips.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018966","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}