Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Myocardial revascularization in patients with chronic kidney disease: a systematic review and meta-analysis of surgical versus percutaneous coronary revascularization.","authors":"Valentina Grazioli, Michele Di Mauro, Giacomo Perocchio, Piersilvio Gerometta, Alfonso Agnino, Maurizio Pin, Paolo Meani, Matteo Matteucci, Daniele Ronco, Giulio Massimi, Jos Maessen, Domenico Corradi, Mario Gaudino, Roberto Lorusso","doi":"10.1093/icvts/ivaf021","DOIUrl":"10.1093/icvts/ivaf021","url":null,"abstract":"<p><strong>Objectives: </strong>To compare outcomes of two different revascularization strategies in chronic kidney disease (CKD) patients: coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We conducted this meta-analysis according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered with PROSPERO (CRD42021238659), evaluated studies comparing CABG and PCI in patients with CAD and CKD (defined by KDIGO guidelines). Data were extracted from PubMed, EMBASE and Cochrane from 2000 to 2023. The primary end-point was long-term major adverse cardiovascular and cerebrovascular event rates, with secondary end-points including 30-day mortality, stroke, myocardial infarction (MI) and repeat revascularization. Statistical analyses included Kaplan-Meier estimations, Cox regression, and meta-regression to address heterogeneity. Publication bias was assessed via funnel plots. No funding was received, and the authors report no conflicts of interest.</p><p><strong>Results: </strong>We included 33 studies with 402 300 patients (eGFR <60 ml/min/1.73 m2). The cohort comprised 132 314 coronary artery bypass graft and 269 986 PCI patients. Over 3 years, coronary artery bypass group provided protection against major adverse cardiac and cerebrovascular events, MI, and repeat revascularization compared to PCI. However, PCI showed better short-term outcomes, including lower 30-day mortality. Coronary artery bypass group was linked to a higher stroke risk over the 3-year follow-up.</p><p><strong>Conclusions: </strong>Revascularization strategies for CKD and coronary artery disease patients should balance PCI's short-term benefits with CABG's long-term advantages.</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/PMC11897794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451165","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":"Long-term outcomes of the largest (29) Epic Supra aortic valve bioprosthesis: comparing recommended with upsizing implantation.","authors":"Murat Mukharyamov, Hristo Kirov, Maria Golovina, Tulio Caldonazo, Torsten Doenst","doi":"10.1093/icvts/ivaf050","DOIUrl":"10.1093/icvts/ivaf050","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate outcomes of aortic valve replacement with the largest available Epic Supra bioprosthesis (size 29).</p><p><strong>Methods: </strong>We reviewed all patients who received an Epic Supra bioprosthesis between 2011 and 2023 and selected all 29 size prostheses that were implanted either into patients with an aortic annulus of at least 29 mm (sizing as recommended by the manufacturer) or into patients with smaller annuli (upsizing). Short- and long-term results were assessed. Propensity score matching was employed to improve comparability between groups. Kaplan-Meier and log-rank tests were performed to compare survival.</p><p><strong>Results: </strong>Epic Supra bioprostheses were implanted into 1845 patients between 2011 and 2023. Mean age was 69.7 (11.2) years and 79.2% were male. Size 29 was implanted in 360 patients (mean age 68 (8.9) years), and 97.2% were male. EuroScore II was 5.1 (1.3; 6.6). One quarter of cases were performed via parasternal minithoracotomy. Mortality at 30 days was 2.8%, with no significant differences. Need for re-exploration was 3.3% and permanent pacemaker implantation was 4.7% (no statistically significant differences). Longest follow-up was 10 years with a mean of 50 (41) months. Mean prosthetic pressure gradients were 11.3 (16.7) mmHg and aortic valve reoperations/interventions were required in 5 patients (1.4%), all due to infective endocarditis.</p><p><strong>Conclusions: </strong>This is the largest experience of Epic Supra 29 implantation worldwide. Our results illustrate exemplary clinical and haemodynamic performance. In addition, the 29 size prosthesis can safely be implanted into patients with smaller than 29 mm annulus, which may improve future valve-in-valve options.</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/PMC11928935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569102","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":"In silico analysis of pressure distribution and flow profiles across an experimental left ventricular assist device accessory.","authors":"Anna Osypka, Florian Meissner, Deniz Ozturk, Roxane Windisch, Heiko Vestner, Michelle Costa Galbas, Martin Czerny, Wolfgang Bothe","doi":"10.1093/icvts/ivaf031","DOIUrl":"10.1093/icvts/ivaf031","url":null,"abstract":"<p><strong>Objectives: </strong>Implantation of left ventricular assist devices conventionally requires a sternotomy and cardiopulmonary bypass. An experimental accessory was designed to redirect the device's outflow graft through the left ventricle into the ascending aorta. This design allows for implantation via left thoracotomy only but resulted in significant pressure loss both in vitro and in vivo. We evaluated the reasons for the pressure loss of the experimental accessory by quantifying pressure distribution and flow profiles using computational fluid dynamics simulation tools.</p><p><strong>Methods: </strong>A computational fluid dynamics model based on the accessory's geometry was used to simulate nominal blood flow through the model. Quantities of interest included pressure and flow velocity. Pressure differences between the pump inlet and outlet were calculated at different rotational speeds (4000, 5200, 6400 rpm) and pump flow rates (1, 5, 8.4 L/min). Results were compared with simulations of a generic left ventricular assist device to determine the accessory's impact.</p><p><strong>Results: </strong>Natural pump characteristics were observed, as increased rotational speed caused an increase in pressure head with a constant flow rate. For all cases, a greater decrease in pressure head was seen between 5 and 8.4 L/min than between 1 and 5 L/min. Curvature intensity and channel bifurcation in the outflow were the main contributors to downstream pressure loss.</p><p><strong>Conclusions: </strong>The next iteration of the left ventricular assist device accessory should focus on minimizing curvatures and avoiding bifurcations in the outflow. Further development may allow for less invasive left ventricular assist device implantation with negligible alterations in pump performance.</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/PMC11882303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506538","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":"Every jump is a leap of faith-just ask Evel Knievel!","authors":"Vicente Orozco-Sevilla, Joseph S Coselli","doi":"10.1093/icvts/ivae197","DOIUrl":"10.1093/icvts/ivae197","url":null,"abstract":"","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/PMC11882299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560250","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":"Delayed visceral malperfusion caused by kinking of a four-branched integrated frozen elephant trunk graft.","authors":"Takuya Matsushiro, Tomoki Tamura, Nobuyuki Inoue, Tadashi Kitamura","doi":"10.1093/icvts/ivaf052","DOIUrl":"10.1093/icvts/ivaf052","url":null,"abstract":"<p><p>An integrated frozen elephant trunk with a four-branched vascular graft may shorten the circulatory arrest time during open distal anastomosis. We report a case of acute type A aortic dissection where postoperative graft kinking led to acute liver failure, kidney injury and lower limb ischaemia corrected by thoracic endovascular aortic repair.</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/PMC11890289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560272","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 impact of aortic root rotation on the position of the fibrous trigones on the mitral annulus.","authors":"Atsushi Sugaya, Shingo Hirao, Go Yamashita, Jiro Sakai, Tatsuhiko Komiya","doi":"10.1093/icvts/ivaf047","DOIUrl":"10.1093/icvts/ivaf047","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic root (AoR) rotation is a significant factor influencing the structures around the aortic valve and the atrioventricular conduction system. However, its relationship with the mitral valve remains unexplored. The goal of this study was to investigate the impact of AoR rotation on the mitral annulus, particularly the fibrous trigones, and on the atrioventricular conduction system following mitral valve surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed 100 patients who underwent mitral valve surgery in which electrocardiography-gated computed tomography angiography scans were used to identify rotational variants of the AoR. AoR rotation was classified as clockwise, central or counterclockwise relative to the atrial septum. The positions of the fibrous trigones and postoperative atrioventricular conduction disturbances were analysed.</p><p><strong>Results: </strong>The distance from the right fibrous trigone to the right edge of the mitral annulus was shortest in the clockwise group and longest in the counterclockwise group (clockwise vs central vs counterclockwise: 6.1 ± 2.0 mm vs 7.4 ± 1.9 mm vs 8.7 ± 1.5 mm, P < 0.001). The incidence of new-onset atrioventricular and bundle branch blocks was significantly higher in patients with AoR rotation (clockwise vs central vs counterclockwise: 63.2% vs 4.1% vs 21.9%, P < 0.001).</p><p><strong>Conclusions: </strong>AoR rotation influences the position of the fibrous trigone and is a risk factor for postoperative atrioventricular conduction disturbances. Computed tomography is a valuable tool for assessing AoR rotation and mitral annulus morphology.</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":"143560288","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":"Setting the records straight: surgical ablation misinterpreted and misrepresented in prophylactic studies.","authors":"Ovidio A García-Villarreal","doi":"10.1093/icvts/ivaf055","DOIUrl":"10.1093/icvts/ivaf055","url":null,"abstract":"","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/PMC11904303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560285","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":"A case of aortic root replacement for acute type A dissection in Marfan syndrome with twin pregnancy.","authors":"Yi Yang, Bo Jia, Chengnan Li, Junming Zhu","doi":"10.1093/icvts/ivaf039","DOIUrl":"10.1093/icvts/ivaf039","url":null,"abstract":"<p><p>Type A aortic dissection is a life-threatening condition requiring urgent surgery. However, clinical experience with type A aortic dissection during twin pregnancy is extremely limited. We report a case of a 32-year-old woman with Marfan syndrome who was diagnosed with type A aortic dissection at 37 weeks of gestation with boy-girl twins. The patient successfully underwent caesarean delivery followed by aortic root replacement. Both the mother and twins were discharged without complications.</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/PMC11893149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569094","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":"New technique for endobronchial targeting of the segmental bronchus during thoracoscopic segmentectomy.","authors":"Hirohisa Kato, Masami Abiko, Kaito Sato","doi":"10.1093/icvts/ivaf038","DOIUrl":"10.1093/icvts/ivaf038","url":null,"abstract":"<p><p>During thoracoscopic pulmonary segmentectomy, identification of the target segmental bronchus can occasionally be difficult. We devised a new method to overcome this difficulty. Immediately before surgery, the target segmental bronchus was marked with indocyanine green using bronchoscopy and identified intraoperatively using near-infrared fluorescence thoracoscopic imaging. Eleven consecutive patients underwent thoracoscopic segmentectomy between August 2023 and April 2024. The target segmental bronchi were successfully marked with indocyanine green in 10 cases (success rate: 90.9%) and clearly identified during surgery. In all cases, the target segmental bronchi were correctly divided without the use of intraoperative bronchoscopy; thus, the planned segmentectomies were accomplished without conversion to lobectomy. This novel technique using indocyanine green can facilitate identification of the target segmental bronchus during thoracoscopic 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":"143560280","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":"Reply to Macé et al.","authors":"Joeri Van Puyvelde, Filip Rega, Bart Meyns","doi":"10.1093/icvts/ivaf058","DOIUrl":"10.1093/icvts/ivaf058","url":null,"abstract":"","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/PMC11919444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626856","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}