Interdisciplinary cardiovascular and thoracic surgery最新文献_第3页

Predictive role of cardiopulmonary bypass exposure indexed to body surface area on postoperative organ dysfunction: a retrospective cohort study. 以体表面积为指标的心肺旁路暴露对术后器官功能障碍的预测作用：一项回顾性队列研究。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae171

Florian Falter, Ryan Salter, Jose Fernandes, Christiana Burt, Kate Drummond, Ganesh Ramalingam, Samer Nashef

{"title":"Predictive role of cardiopulmonary bypass exposure indexed to body surface area on postoperative organ dysfunction: a retrospective cohort study.","authors":"Florian Falter, Ryan Salter, Jose Fernandes, Christiana Burt, Kate Drummond, Ganesh Ramalingam, Samer Nashef","doi":"10.1093/icvts/ivae171","DOIUrl":"10.1093/icvts/ivae171","url":null,"abstract":"Objectives: Long cardiopulmonary bypass times are associated with adverse postoperative outcomes and increased healthcare resource use. It is likely that this effect is pronounced in smaller patients. Previous studies have been criticized for not taking into consideration that prolonged bypass times are often due to higher complexity. The purpose of this study was to investigate the relationship between bypass index (bypass time/body surface area) and adverse postoperative events.Methods: Single-centre, retrospective cohort study including 2413 patients undergoing cardiac surgery on cardiopulmonary bypass from June 2018 to April 2020. Length of hospital stay, as surrogate marker of postoperative morbidity, was selected as primary outcome. The strength of association between bypass index and the primary outcome was assessed with linear regression analysis. Secondary outcomes included new onset renal, pulmonary or cardiac rhythm dysfunction. The predictive value of bypass index was assessed with linear regression analysis; univariate and multiple regression were used to assess the strength of association between Bi and the secondary outcomes.Results: Bypass index was predictive for length of stay at univariate (Relative Risk (RR): 1.004, P < 0.001) and at multivariable (RR: 1.003, P < 0.001) analysis. The association between bypass index and new renal (mean difference: 14.1 min/m2, P < 0.001) and cardiac rhythm dysfunction (mean difference: 12.6 min/m2) was significant. This was not true of postoperative lung dysfunction (mean difference: -1.5 min/m2, P = 0.293).Conclusions: Bypass index, calculated as total bypass time/patient body surface area, is predictive of postoperative morbidity and resource utilization after cardiac surgery on pump.","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/PMC11483134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395740","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}

引用次数: 0

Hybrid repair of complicated acute aortic arch intramural haematoma with the Castor single-branch stent graft. 用蓖麻单支支架移植物混合修复复杂的急性主动脉弓膜内血肿。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae163

Antonio Rizza, Cataldo Palmieri, Silvia Di Sibio, Michele Murzi

引用次数: 0

Small cardiac vein draining into the inferior vena cava. 排入下腔静脉的心脏小静脉。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae162

Filippos-Paschalis Rorris, Spyridoula Katsilouli, Dimitrios Bobos, Meletios Kanakis

引用次数: 0

Venous obstruction of the upper extremity caused by subclavian vein valve hypertrophy. 锁骨下静脉瓣膜肥大导致上肢静脉阻塞。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae165

Jianyu Liao, Zhoupeng Wu

引用次数: 0

Moderate hypothermia circulatory arrest as a brain-protective strategy for type A aortic dissection. 将中度低体温循环停止作为主动脉夹层的脑保护策略。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae166

Hodaka Wakisaka, Shunta Miwa, Yuji Matsubayashi, Yotaro Mori, Junghun Lee, Kenichi Kamiya, Noriyuki Takashima, Tomoaki Suzuki

{"title":"Moderate hypothermia circulatory arrest as a brain-protective strategy for type A aortic dissection.","authors":"Hodaka Wakisaka, Shunta Miwa, Yuji Matsubayashi, Yotaro Mori, Junghun Lee, Kenichi Kamiya, Noriyuki Takashima, Tomoaki Suzuki","doi":"10.1093/icvts/ivae166","DOIUrl":"10.1093/icvts/ivae166","url":null,"abstract":"Objectives: Brain-protective strategies for acute type A aortic dissection (TAAD) remain controversial. Moderate hypothermia circulatory arrest (MHCA) without cerebral perfusion is not commonly used. However, we aimed to assess its safety and efficacy in 358 patients who underwent hemiarch replacement with MHCA for acute type A aortic dissection at our institution from August 2012 to August 2022.Methods: Clinical outcomes were compared according to circulatory arrest time [≤15 min (S group, n = 52) vs ≥16 min (L group, n = 306)]. The primary outcome was postoperative stroke.Results: The S group had more older patients (72.5 vs 68.8 years; P = 0.04), a greater incidence of carotid artery malperfusion (21% vs 11%; P = 0.043) and a lower body mass index (21.7 vs 23.6 kg/m2; P < 0.01) and hemodynamic instability (3.8% vs 16%; P = 0.02) than the L group. The incidence of postoperative stroke (7.7% vs 12%; P = 0.33) and the rate of 30-day mortality (5.8% vs 6.5%; P = 0.83) did not significantly differ between groups. After adjusting for all potential confounding factors pre- and intraoperatively, there was no significant difference in postoperative outcomes between groups.Conclusions: MHCA alone for TAAD had comparable postoperative outcomes with circulatory arrest times under and over 15 min. However, longer arrest times were associated with a higher risk of stroke.","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/PMC11474003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367740","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}

引用次数: 0

Treatment of degenerated mitral bioprosthesis using inovare alpha rapid deployment balloon-expandable prosthesis-a minimally invasive approach. 使用 Inovare alpha 快速展开球囊扩张假体治疗退化的二尖瓣生物前列腺--一种微创方法。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae160

Ricardo Barros Corso, Marcus Vinicius Nascimento Dos Santos, Glauco Kalil da Silva Pina, João Carlos Ferreira Leal

引用次数: 0

Last minute cancellation of elective lung cancer surgery is associated with poorer survival. 最后一刻取消肺癌择期手术与生存率较低有关。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae172

Marco Nardini, Nilanjan Chaudhuri, Joshil Lodhia, Richard Milton, Peter Tcherveniakov, Elaine Teh, Alessandro Brunelli

{"title":"Last minute cancellation of elective lung cancer surgery is associated with poorer survival.","authors":"Marco Nardini, Nilanjan Chaudhuri, Joshil Lodhia, Richard Milton, Peter Tcherveniakov, Elaine Teh, Alessandro Brunelli","doi":"10.1093/icvts/ivae172","DOIUrl":"https://doi.org/10.1093/icvts/ivae172","url":null,"abstract":"Objectives: Our objective was to assess the incidence and reason of last-minute cancellations before surgery for lung cancer and their association with outcomes.Methods: Retrospective analysis on all consecutive patients booked for elective lung cancer surgery from January 2017 through December 2022 in a single centre.Last minute cancellation: a cancellation occurring within the last 24 hours from the planned operation. Cancellation categories: process-related and patient-related.The short-term and long-term outcomes of patients who experienced a last-minute cancellation were analysed.Results: 197 patients of 1587 (12%) had a last-minute cancellation: 156 (79%) were process-related and 41 (21%) were patient-related.3% (5/156) of patients cancelled for process reasons did not receive surgery vs 39% (16/41) of those cancelled for patient-related reasons, p < 0.0001.The 90-day mortality rates of cancelled and non-cancelled patients were similar (4.6% vs 4.7%, p = 1).Five-year overall survival of patients with cancellation was 58% (95% CI 49-66) vs 69% (95% CI 66-71) of those without cancellations, p = 0.022.Among those who had a cancellation, the 5-year OS of those with process-related cancellations was 61% (52-60) vs 35% (14-58) of those with patient-related cancellations (adjusted p value for multiple comparisons = 0.14).Cox regression analysis showed that surgery cancellations within the last 24 hours for patient-related (HR 1.87, 95% CI 1.02-3.42, p = 0.043) reasons remained a factor associated with poorer overall survival after adjusting for clinical stage, type of operation and patient related variables.Conclusions: Implementing the patient's preoperative clinical evaluation to reduce the occurrence of related last-minute cancellations might mitigate its negative impact on survival.","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":"142395739","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}

引用次数: 0

Repair of mitral paravalvular leak using left atrial appendage tissue. 利用左心房阑尾组织修复二尖瓣口旁漏。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae161

Ryohei Otsuka, Shunei Saito, Tsukasa Ohno, Ken Miyahara

引用次数: 0

Clinical impact of multiple pectus bars on surgical outcomes following pectus excavatum repair. 多条褶皱条对切除褶皱修复术后手术效果的临床影响。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae168

Naoyuki Oka, Kyohei Masai, Yu Okubo, Kaoru Kaseda, Tomoyuki Hishida, Keisuke Asakura

{"title":"Clinical impact of multiple pectus bars on surgical outcomes following pectus excavatum repair.","authors":"Naoyuki Oka, Kyohei Masai, Yu Okubo, Kaoru Kaseda, Tomoyuki Hishida, Keisuke Asakura","doi":"10.1093/icvts/ivae168","DOIUrl":"10.1093/icvts/ivae168","url":null,"abstract":"Objectives: The Nuss procedure, a minimally invasive surgery for pectus excavatum, has undergone various improvements. However, the impact of using multiple bars on thoracic shape changes and surgical outcomes remains unclear.Methods: We retrospectively evaluated patients who underwent the Nuss procedure for pectus excavatum between August 2014 and September 2021. We divided the patients into 2 groups based on the number of bars placed and identified differences in surgical outcomes and morphological characteristics.Results: A total of 225 patients were evaluated, of whom 132 were classified into the ≤2 bar group (using 1 or 2 bars) and 93 into the ≥3 bar group (using 3 or more bars). There was no difference in the preoperative Haller index [median (interquartile range), 4.59 (3.67-6.16) vs 4.67 (4.12-6.14), P = 0.227], and asymmetric excavatum was more frequently observed in the ≥3 bar group (81% vs 51%, P < 0.001). The preoperative sternal torsion angle was larger in the ≥3 bar group, but no difference was found between the 2 groups postoperatively. The incidence of postoperative complications (≥grade 3) was comparable between groups (10% vs 17%, P = 0.105); however, postoperative pleurisy was more frequently observed in the ≥3 bar group (12% vs 4%, P = 0.021). In univariable and multivariable analyses, ≥3 bar placement was the only risk factor for postoperative pleurisy.Conclusions: The placement of multiple bars (≥3 bars) is useful for the correction of asymmetric pectus excavatum, but attention should be paid to the potential risk of postoperative pleurisy.","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/PMC11479710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367738","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}

引用次数: 0

A novel miniaturized roller pump circuit for simulation of extracorporeal circulation. 用于模拟体外循环的新型微型滚轴泵电路。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-09-18 DOI: 10.1093/icvts/ivae156

Anders Karl Hjärpe,Anders Jeppsson,Lukas Lannemyr,Fredrik Pernbro,Camilla Hesse,Birgitta Romlin

{"title":"A novel miniaturized roller pump circuit for simulation of extracorporeal circulation.","authors":"Anders Karl Hjärpe,Anders Jeppsson,Lukas Lannemyr,Fredrik Pernbro,Camilla Hesse,Birgitta Romlin","doi":"10.1093/icvts/ivae156","DOIUrl":"https://doi.org/10.1093/icvts/ivae156","url":null,"abstract":"OBJECTIVESExtracorporeal circulation induces pronounced effects on haemostasis and rheology. To study these, an ex vivo simulation model is an attractive alternative but often requires large amounts of blood. We sought to create a miniaturized roller pump circuit requiring minimal amounts of blood and to test if the circuit could be used to compare coagulation, platelet function and blood rheology between a dextran-based and a crystalloid-based priming solution.METHODSA miniaturized roller pump circuit requiring only 27 ml of blood was created. Blood samples from eight cardiac surgery patients were mixed with either a dextran-based or a crystalloid-based solution and circulated for 60 min. Coagulation was assessed by rotational thromboelastometry (ROTEM), and platelet function by impedance aggregometry and flow cytometry, before and at 5 and 60 min of circulation.RESULTSA time-dependent impairment of coagulation was observed in both groups. Maximum clot firmness was lower with dextran-based than with crystalloid-based priming at 5 min (HEPTEM 37 ± 4 vs 43 ± 4 mm, p < 0.001; EXTEM 37 ± 4 vs 43 ± 4 mm, p < 0.001; FIBTEM 3 ± 2 vs 9 ± 2 mm, p < 0.001) and at 60 min (HEPTEM 29 ± 9 vs 38 ± 5 mm, p < 0.001; EXTEM 30 ± 7 vs 39 ± 5 mm, p < 0.001; FIBTEM 3 ± 2 vs 8 ± 3 mm, p = 0.002). The EXTEM clotting time was longer with dextran-based solution at 5 (109 ± 19 vs 63 ± 7 sec, p < 0.001) and at 60 min (176 ± 72 vs 73 ± 7 sec, p = 0.004).CONCLUSIONSThe novel miniaturized roller pump circuit can be used to mimic extracorporeal circulation for selected research questions. Dextran-based priming caused a significant impairment in haemostasis compared with a standard crystalloid solution.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262530","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}

引用次数: 0