Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Echocardiographic assessment of a novel blood-guiding accessory for left ventricular assist devices in swine.","authors":"Michelle Costa Galbas, Florian Meissner, Hendrik Straky, Johanna Reuter, Marius Schimmel, Martin Czerny, Wolfgang Bothe","doi":"10.1093/icvts/ivaf168","DOIUrl":"https://doi.org/10.1093/icvts/ivaf168","url":null,"abstract":"<p><strong>Objectives: </strong>Left ventricular assist devices are part of the foundations of mechanical circulatory support. As such devices evolve in technology, so does their implantation techniques, becoming less invasive. We developed a novel blood-guiding accessory for less invasive implantation, redirecting the blood intracardially into the ascending aorta through a transaortic outflow.</p><p><strong>Methods: </strong>Ten healthy female swine (German Landrace, 104.4 ± 13.0 kg) underwent epicardial echocardiography before and after left ventricular assist device implantation. Cardiac geometry, aortic valve function and outflow positioning, were assessed before and after implantation.</p><p><strong>Results: </strong>Epicardial echocardiography revealed sufficient biventricular unloading after device implantation. The end-diastolic and end-systolic left ventricular diameters decreased by 16% and 20%, respectively. Retrograde unloading was displayed by smaller diameters in left and right atria at 22% and 25%, respectively. At baseline, one animal presented mild aortic regurgitation, unchanged under mechanical support, whereas one developed mild de novo insufficiency. The outflow graft was either well centered within the aortic valve (n = 3) or between two cusps.</p><p><strong>Conclusions: </strong>A left ventricular assist device with the accessory allowed sufficient ventricular unloading, preserving biventricular function. Although the outflow graft was well centered within the aortic valve in only 30% of the cases, no relevant aortic regurgitation was found in the acute setting. Chronic testing in larger samples is required to analyze results in long term.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276774","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":"Sleeve resection with or without parenchymal resection for proximal bronchial carcinoids: a retrospective analysis of recurrence and lymph node involvement.","authors":"Maxime Huriet, Matthieu Glorion, Alexandre Vallee, Pimnara Chuachao, Olaf Mercier, Justin Issard, Vincent Thomas DE Montpreville, Elisabeth Longchampt, Edouard Sage, Elie Fadel","doi":"10.1093/icvts/ivaf242","DOIUrl":"https://doi.org/10.1093/icvts/ivaf242","url":null,"abstract":"<p><strong>Objectives: </strong>Risk factors of recurrence in sleeve resection for endobronchial carcinoid tumors are well known. However, the impact of parenchymal sparing has not been studied. This study aims to determine whether associated parenchymal removal improves the oncologic outcomes.</p><p><strong>Methods: </strong>Between 2002 and 2022, 95 patients underwent a sleeve resection for carcinoid tumors in two centers, 29 a bronchial sleeve resection (BSR) without parenchymal resection and 66 a parenchymal sleeve resection (PSR). Similar lymph node dissection was performed in both groups.</p><p><strong>Results: </strong>The BSR group had more proximal tumors (p < 0.001) and higher NYHA class function (p < 0.001). The PSR group had more distal (p < 0.001) and larger tumors (p = 0.04). Preoperative bronchoscopic resection did not reduce \"complex\" sleeve resections, postoperative complications, or tumour recurrence rates. Ninety-day mortality was 0%. Postoperative complications, occurred in 18 patients (18.9%), with three bronchial fistulae (3.2%) and no anastomotic stenoses. All BSR patients were N0, while the PSR group had higher lymph node involvement (22.7% vs 0%; p = 0.004). Mean overall and recurrence-free survival were 104.1 and 100.9 months, respectively. Ten recurrences occurred, nine in the PSR group (p = 0.27). Associated parenchymal removal did not reduce risk of recurrence (p = 0.10). Atypical carcinoids and Ki-67 ≥ 5% were linked to lower recurrence-free survival in univariable analysis. Lymph node involvement was an independent risk factor for recurrence (p = 0.002) in multivariable analysis.</p><p><strong>Conclusions: </strong>Absence of parenchymal resection did not affect oncologic outcomes, with minimal morbidity. Lymph node involvement was an independent risk factor for recurrence highlighting the importance of lymph node dissection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276749","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":"\"Complex Aortic Valve Repair after en-Bloc Rotation of the Outflow Tracts\" - Case Report.","authors":"Rapagnani Andrea, El Khoury Gebrine, Momeni Mona, Poncelet Alain Jean","doi":"10.1093/icvts/ivaf240","DOIUrl":"https://doi.org/10.1093/icvts/ivaf240","url":null,"abstract":"<p><p>The En-bloc Rotation of the Outflow Tracts, as suggested by Anderson in 2016(1) is a surgical approach for complex congenital heart defects, particularly in patients with transposition of the great arteries (TGA) and associated ventricular septal defect (VSD) and left ventricular outflow tract (LVOT) obstruction (LVOTO). Despite its effectiveness, concerns have arisen following a study by Stoica et al.(2022), which reported that 16% of patients developed at least moderate aortic regurgitation (AR) post-surgery. The mechanisms behind this complication remain unclear. This case report presents a 4-year-old patient who developed significant AR (grade 3+/4), with left ventricular dilation (LVEDD : 43 mm), three years after an En-bloc Rotation, necessitating aortic valve repair. Initial echocardiography showed trivial AR, with progression of AR within 18 months and associated annular dilation (24 mm). The repair procedure involved plication of the left ventricular outflow tract (LVOT), annuloplasty, and leaflet adjustments. At discharge, residual AR was mild to moderate (1+/4). Seven months later, echocardiography revealed stable left ventricular dimensions and moderate AR (grade : 2+/4). This case emphasizes the need for early detection and intervention for AR in patients after En-bloc Rotation surgery. Further research is needed to identify predisposing factors and refine surgical strategies.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276719","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":"Propensity score analysis of stented vs rapid deployment aortic bioprostheses in patients with small aortic annulus.","authors":"Giorgia Cibin, Augusto D'Onofrio, Valentina Lombardi, Emma Bergonzoni, Giulia Lorenzoni, Elisa Gastino, Giuseppe Evangelista, Enrico Giuseppe Italiano, Irene Cao, Dario Gregori, Chiara Tessari, Gino Gerosa","doi":"10.1093/icvts/ivaf241","DOIUrl":"https://doi.org/10.1093/icvts/ivaf241","url":null,"abstract":"<p><strong>Objectives: </strong>Haemodynamic studies have demonstrated the excellent performance of rapid-deployment (RD) valves. This retrospective single-center study aimed to compare early and medium-term outcomes of RD bioprostheses versus conventional stented valves in patients with small aortic annuli.</p><p><strong>Methods: </strong>We included patients who underwent isolated or combined surgical aortic valve replacement (SAVR) with Magna Ease (ME) and Intuity (Edwards Lifesciences, Irvine, CA) sizes 19 and 21 at our institution between June 2016 and March 2022. Follow-up was conducted through scheduled visits and echocardiograms at the study site, or via telephonic interviews with patients and/or referring cardiologists. A propensity score weighting analysis was performed to account for baseline differences between the two cohorts.</p><p><strong>Results: </strong>A total of 666 consecutive patients underwent SAVR with the two devices. ME was implanted in 367 patients (55.1%), and Intuity in 299 (44.9%). ME size 19 or 21 was used in 105 patients (35.1%), and Intuity size 19 or 21 in 115 (31.3%). 220 patients were our study population. There were no significant differences in postoperative complications. Intuity demonstrated significantly lower gradients overall (mean gradients: 12 mmHg vs 16 mmHg, p < 0.001), and for size 21 (mean gradients: 12 mmHg vs 15 mmHg, p < 0.001). Mid-term survival and rehospitalization rates were similar between the two devices (5-year rehospitalization rate: 17% ME vs 20.9% Intuity, p = 0.57; 5-year survival: 81.9% ME vs 88% Intuity, p = 0.761).</p><p><strong>Conclusions: </strong>In patients with small aortic annuli, RD bioprostheses provide superior haemodynamic outcomes compared to conventional stented valves. However, perioperative outcomes, mid-term survival, and rehospitalization rates are similar between the two devices.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276763","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":"Comparative study of different minimally invasive aortic valve replacement techniques: A systematic review and network meta-analysis.","authors":"Theresia Feline Husen, Ananda Pipphali Vidya, Samuel Heuts, Alfian Prasetyo, Aqilla Katrita Zaira Nugroho, Roberto Lorusso, Elham Bidar, Bart Maesen, Peyman Sardari Nia","doi":"10.1093/icvts/ivaf244","DOIUrl":"https://doi.org/10.1093/icvts/ivaf244","url":null,"abstract":"<p><strong>Objectives: </strong>This investigation aimed to compare different minimally invasive techniques namely, mini-sternotomy (MS), mini-thoracotomy (MT), and totally thoracoscopic (TT) approaches for the surgical treatment of aortic valve disease, emphasizing their respective benefits and limitations to guide clinical decision-making.</p><p><strong>Methods: </strong>A systematic search was conducted in Medline, Web of Science, Scopus, Wiley Online Library, Google Scholar, and ProQuest. Studies were appraised using Newcastle-Ottawa Scale. A frequentist network meta-analysis with a random-effects model was employed to give reflective ranks and compare outcomes across techniques. Treatment ranking was based on p-scores, with mini-sternotomy as the reference. Higher p-scores indicate greater certainty of superiority over competing interventions. The primary outcome was mortality.</p><p><strong>Results: </strong>Twenty-five observational studies (n = 34,573 patients) were included. Mortality did not differ between techniques [p-score: MS (0.85) ∼ MT (0.34) ∼ TT (0.31)]. TT had longer cardiopulmonary bypass [Mean difference (MD): 41.04 (95% CI: 10.98; 71.10)] and cross-clamp times [MD: 30.31 (95% CI: 5.81; 54.80)] but offered the shortest intensive care unit (ICU) length of stay [p-score: TT (0.98) > MT (0.51) > MS (0.01); MD: -16.00 (95% CI: -26.62; -5.38)], reduced hospital stay [MD: -2.07 (95% CI: -3.77; -0.37)], and fewer complications, including neurological events [Odds ratio (OR): 1.79 (95% CI: 1.03; 3.13)], blood loss [MD: 208.85 mL (95% CI: 102.29; 315.40)] compared to MS. MT showed similar outcomes to MS, except for longer operative times [MD: 29.84 (95% CI: 8.35; 51.32)] and shorter ICU stays [MD: -5.88 (95% CI: -11.10; -0.67)].</p><p><strong>Conclusions: </strong>TT may offer advantages such as shorter hospital stays, reduced neurological complications, and less bleeding as compared to MS, although it is associated with longer operative times. However, as all included studies were observational, the findings should be interpreted with caution, and further NMA including only randomized trials are warranted.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276756","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":"Feasibility of robotic-assisted mitral ring annuloplasty using the continuous wrapping suture technique: A single-center experience.","authors":"Kazuki Noda, Yosuke Takahashi, Akimasa Morisaki, Kenta Nishiya, Goki Inno, Takumi Kawase, Yukihiro Nishimoto, Munehide Nagao, Ryo Nangoya, Toshihiko Shibata","doi":"10.1093/icvts/ivaf223","DOIUrl":"10.1093/icvts/ivaf223","url":null,"abstract":"<p><strong>Objectives: </strong>Robotic-assisted mitral ring annuloplasty is safe and effective; however, the use of conventional interrupted suture may prolong operative time. This study retrospectively evaluated the safety and feasibility of continuous wrapping suture for annuloplasty in robotic-assisted mitral valve (MV) repair.</p><p><strong>Methods: </strong>This study included 581 patients who underwent MV repair with annuloplasty ring replacement at our institution between 2010 and 2023. Among the 581 patients, 168 who underwent MV repair with the continuous wrapping suture technique were included in the main analysis. In the continuous wrapping suture technique, the ring was fixed at both the fibrous trigones of the anterior leaflet and was continuously sutured to wrap it circumferentially. The primary outcomes were perioperative procedure-related complications and ring dehiscence during the observation period.</p><p><strong>Results: </strong>The median follow-up duration was 2.7 years. There were no annuloplasty-related complications, including left circumflex artery (LCX) injury and prosthetic ring dehiscence. The 1-year and 3-year postoperative recurrence rates of moderate or severe MR were 1.8% and 2.2%, respectively. Moreover, In the whole 581 patients who underwent mitral ring annuloplasty, multivariable analysis confirmed that the wrapping suture technique was significantly associated with a reduction in the 1-year postoperative mean MV pressure gradient (mean ratio 0.802; 95% confidence interval [CI], 0.728-0.884; P < 0.001).</p><p><strong>Conclusions: </strong>The wrapping suture technique for robotic-assisted MV repair with ring annuloplasty is safe and effective, with no observed cases of LCX injury or ring dehiscence, and may serve as a reasonable alternative in anatomically challenging cases.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246004","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":"Detection of Sleep-Disordered Breathing Using Carbon Nanotube Sensors Predicts Complications After Lung Surgery.","authors":"Yasuhiro Nakashima, Masashi Kobayashi, Ayaka Asakawa, Katsutoshi Seto, Hironori Ishibashi, Shiro Sonoda, Tomoya Tateishi, Meiyo Tamaoka, Yasunari Miyazaki, Koshiro Okumoto, Haruka Horiuchi, Yoshikazu Nakajima, Kenichi Okubo","doi":"10.1093/icvts/ivaf229","DOIUrl":"10.1093/icvts/ivaf229","url":null,"abstract":"<p><strong>Objectives: </strong>Sleep-disordered breathing significantly affects perioperative outcomes; however, it remains frequently undiagnosed. We aimed to evaluate the utility of a novel carbon nanotube sensor system for detecting postoperative breathing abnormalities and investigated its association with postoperative complications following thoracic surgery.</p><p><strong>Methods: </strong>In this prospective study, 86 patients who underwent anatomical lung resection without previously diagnosed obstructive sleep apnoea were monitored using carbon nanotube sensors from the immediate postoperative period through the first postoperative day. Abnormal breathing was defined as an ≥30% reduction in the peak sensor signal from baseline lasting more than 10 s, in accordance with standard hypopnea criteria used in polysomnography. Patient characteristics and complications were compared using Fisher's exact and Mann-Whitney U test. Multivariate logistic regression identified predictors of major complications.</p><p><strong>Results: </strong>Twenty-three patients (26.7%) exhibited abnormal breathing events (sleep-disordered breathing). This group had a higher proportion of males (87% vs 61.9%, P = .035), had more difficult intubation (42.1% vs 13.5%, P = .018), and more frequently received epidural anaesthesia in addition to general anaesthesia (65.2% vs 36.5%, P = .027). Multivariate analysis identified sleep-disordered breathing as an independent predictor of major complications (Clavien-Dindo grade ≥3; odds ratio 4.41, 95% CI 1.14-13.8, P = .011) and prolonged air leakage (odds ratio 15.6, 95% CI 2.39-102, P = .004).</p><p><strong>Conclusions: </strong>The carbon nanotube sensor showed potential for detecting undiagnosed sleep-disordered breathing after thoracic surgery, independently associated with increased risk of major complications, particularly prolonged air leakage.</p><p><strong>Clinical trial registration: </strong>UMIN-CTR (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035066). Trial number: UMIN000031533.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152123","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":"Histological Analysis of Arterial and Venous Grafts Used in Coronary Bypass for Patients With Renal Insufficiency: A Prospective Multicentre Observational Study.","authors":"Valentina Grazioli, Michele Di Mauro, PierSilvio Gerometta, Barbara Parrella, Matteo Matteucci, Andrea Musazzi, Mauro Rinaldi, Marta Sannito, Paolo Panisi, Alfonso Agnino, Elizabeth Boulos Issa Sweidan, Debora Guareschi, Mario Gaudino, Domenico Corradi, Roberto Lorusso","doi":"10.1093/icvts/ivaf222","DOIUrl":"10.1093/icvts/ivaf222","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic kidney disease (CKD) is associated with metabolic dysfunctions that accelerate atherosclerosis, posing significant challenges for patients undergoing coronary artery bypass grafting (CABG). In this population, arterial calcification and reduced saphenous vein patency are common complications. This multicentre prospective study aims to evaluate the impact of renal dysfunction on the histological characteristics of arterial and venous grafts used in CABG.</p><p><strong>Methods: </strong>Vascular graft specimens collected during CABG were prospectively analysed and stratified into 3 groups based on renal function, according to established publications: Group 1 (glomerular filtration rate [GFR] ≥90 mL/min/1.73 m2), Group 2 (GFR 60-89 mL/min/1.73 m2), and Group 3 (GFR ≤59 mL/min/1.73 m2). Formalin-fixed samples were histologically assessed for intimal thickening (Grade 0-3), fibroelastosis, and vasa vasorum density.</p><p><strong>Results: </strong>A total of 324 arterial grafts (Group 1: 100; Group 2: 134; Group 3: 90) and 289 vein grafts (Group 1: 86; Group 2: 119; Group 3: 84) were analysed, including 5 arterial and venous grafts from dialysis patients. No significant structural differences were observed between groups. Intimal thickening rates were comparable across renal function stages. Fibroelastosis was more prevalent in venous grafts (56%-64%) than in arterial grafts (10%-15%).</p><p><strong>Conclusions: </strong>This study assesses graft histology in CABG patients stratified by renal function. At surgery, CKD does not appear to significantly alter graft structure. Further studies are warranted to explore long-term graft outcomes in this population.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The heart that took the scenic route: Europe's record-breaking 9-hours OCS journey.","authors":"Maria Nucera, Bruno Schnegg, Hansjoerg Jenni, David Reineke","doi":"10.1093/icvts/ivaf239","DOIUrl":"10.1093/icvts/ivaf239","url":null,"abstract":"<p><p>We report Europe's longest documented heart perfusion using the Transmedics Organ Care System (OCS) during a heart transplantation. A 55-year-old patient with end-stage heart failure received a donor heart after 536 min (8 h 55 min) of OCS perfusion and a total out-of-body time of 676 min (11 h 16 min). Due to adverse weather, air transport was not possible, necessitating an extended ground-based journey. Despite initial vasospasm, perfusion parameters remained stable. The heart demonstrated immediate post-transplant function without need of mechanical support. This case demonstrates the potential of the OCS to extend preservation times beyond conventional limits, increasing access to viable donor organs and optimizing transplantation outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234375","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":"Pulmonary Valve Replacement in Adults and Adolescents With Congenital Heart Disease: A United Kingdom and Ireland Survey.","authors":"Chris J Bond, Timothy J Jones, J Andreas Hoschtitzky, Nicola Viola, Mark H D Danton, Nigel E Drury","doi":"10.1093/icvts/ivaf214","DOIUrl":"10.1093/icvts/ivaf214","url":null,"abstract":"<p><strong>Objectives: </strong>Many models of bioprosthesis are available for pulmonary valve replacement in adults with congenital heart disease, but there is a lack of randomized evidence to guide practice. We surveyed congenital cardiac surgeons to establish current practice and willingness to change within a clinical trial.</p><p><strong>Methods: </strong>An online survey was sent to all consultant congenital cardiac surgeons in adult congenital centres in the United Kingdom and Ireland. Information was sought on preferred prostheses, factors influencing decision-making, implant technique, postoperative anticoagulation, practice variations in adolescents, and willingness to randomize patients to different prostheses within a trial.</p><p><strong>Results: </strong>Responses were obtained from 27 (69%) surgeons. A total of 19 (70%) preferred an Edwards bovine pericardial valve, most commonly the Inspiris Resilia (7, 26%). Only 2 (7%) favoured the Hancock II valve; the remaining 6 (22%) preferred pulmonary homografts. Data regarding long-term freedom from reintervention (23, 85%) was the most important factor influencing prosthesis choice. A total of 22 (81%) surgeons were willing to randomize adult patients to either a bovine pericardial valve or a porcine xenograft in a clinical trial, with Perimount Magna Ease and Hancock II being the most acceptable, respectively. Willingness to randomize dropped to 11 (41%) surgeons for adolescent patients.</p><p><strong>Conclusions: </strong>This survey demonstrates heterogeneity in the choice of pulmonary valve prosthesis. Combined with a lack of evidence from clinical trials, our findings support the presence of clinical equipoise. Most surgeons are willing to change practice, suggesting that a pragmatic, multicentre, randomized controlled trial comparing bovine pericardial versus porcine xenograft for pulmonary valve replacement in adults is feasible.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132768","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}