Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Coronary artery bypass grafting outcomes in patients with prior percutaneous coronary intervention: A retrospective cohort study.","authors":"Joseph Kletzer, Maximilian Kreibich, Laurin Micek, Albi Fagu, Matthias Eschenhagen, Kilian Franke, Tau Hartikainen, Mirjam Wild, Ulrich Franke, Martin Czerny, Tim Berger","doi":"10.1093/icvts/ivag265","DOIUrl":"https://doi.org/10.1093/icvts/ivag265","url":null,"abstract":"<p><strong>Objective: </strong>The clinical significance of prior percutaneous coronary intervention (PCI) in patients undergoing coronary artery bypass grafting (CABG) remains debated, particularly regarding long-term mortality, need for repeat revascularization, and the prognostic value of intraoperative graft flow.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, 3,591 patients who underwent isolated CABG between 2005 and 2023 were analyzed and stratified by prior PCI status. Baseline, surgical, and follow-up data were collected, with multivariable regression and interaction analyses performed to investigate associations between prior PCI, reintervention, mortality, and intraoperative graft flow.</p><p><strong>Results: </strong>Prior PCI was not associated with increased mortality after adjustment for clinical and procedural variables (HR 1.00, 95%CI 0.861-1.160, p > 0.99), but independently predicted higher rates of repeat coronary reintervention (HR 1.553, 95%CI 1.225-1.969, p < 0.001), especially for recent and urgent PCI (HR 2.304, 95%CI 1.141-4.651, p = 0.020). The prognostic effect of prior PCI was heterogeneous, with adverse outcomes more closely associated in unfavourable coronary anatomy. Importantly, intraoperative graft flow to the right coronary artery was predictive for adverse events only in patients with prior PCI (Interaction p = 0.002; HR 0.424, 95%CI 0.244-0.738 per log2-increment in RCA graft flow within the prior-PCI stratum).</p><p><strong>Conclusion: </strong>Prior PCI was not independently associated with increased mortality after CABG but is a predictor of repeat revascularization. The effect is heterogeneous and most pronounced among patients with additional risk factors and reduced right coronary graft flow. These findings underscore the need for individualized risk assessment and tailored perioperative management in CABG patients with a history of PCI.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013386","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":"Long-term outcome of patients with positive lavage cytology of staplers used during surgery for non-small cell lung cancer.","authors":"Shota Mitsuboshi, Motoka Omata, Hiroaki Shidei, Akira Ogihara, Tamami Isaka, Masato Kanzaki","doi":"10.1093/icvts/ivag268","DOIUrl":"https://doi.org/10.1093/icvts/ivag268","url":null,"abstract":"<p><p>Stapler lavage cytology (SLC) is an intraoperative method used to detect malignant cells by cytologic examination of saline used to rinse the stapling device. This study evaluated the prognostic significance of positive SLC after lung cancer surgery. Of 674 patients who underwent lung cancer surgery between January 2013 and July 2019, 589 were included after excluding biopsy-only cases, clinical stage IIIB-IV disease, small-cell lung cancer, and cases with unavailable SLC results, and were classified according to SLC status. Overall survival (OS) and recurrence-free survival (RFS) comparisons showed a significantly lower 5-year survival rate in the SLC[+] group. Univariable analysis showed that older age, pleural invasion, higher pathological T and N classifications, non-adenocarcinoma histology, and SLC positivity were associated with poorer OS. Similarly, pleural invasion, higher pathological T and N classifications, non-adenocarcinoma histology, and SLC positivity were associated with poorer RFS. Notably, all five recurrences in the SLC[+] group were local recurrences. SLC positivity was associated with poor OS and RFS. These findings suggest that SLC may have prognostic value and warrant validation in larger prospective studies.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018964","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":"Multidisciplinary single stage surgical management of advanced breast carcinoma with concomitant left atrial myxoma.","authors":"Shriya Haval, Anurag Garg, Ranjit Pawar, Manoj Dongare","doi":"10.1093/icvts/ivag252","DOIUrl":"https://doi.org/10.1093/icvts/ivag252","url":null,"abstract":"<p><strong>Background: </strong>Primary cardiac tumors are rare, with atrial myxomas accounting for approximately 50% of benign cardiac tumors. In patients with malignancy, intracardiac masses pose a diagnostic challenge because distinguishing primary tumors from metastases directly influences management.</p><p><strong>Case presentation: </strong>A 58-year-old woman with locally advanced invasive mucinous breast carcinoma developed a progressive fungating breast mass despite neoadjuvant chemotherapy and radiotherapy.Routine echocardiography incidentally revealed a large left atrial mass attached to the interatrial septum. Cardiac MRI and FDG PET-CT suggested a cardiac neoplasm but could not exclude metastasis.Given the embolic risk and urgent need for oncologic surgery,a multidisciplinary team performed single-stage toilet mastectomy,atrial mass excision with interatrial septal reconstruction and split-thickness skin grafting under one anaesthetic. Histopathology confirmed glandular atrial myxoma.</p><p><strong>Conclusion: </strong>Single-stage multidisciplinary surgery may safely reduce treatment delay, embolic risk, repeated anaesthesia, and hospitalization in carefully selected patients.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019020","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":"Alpha-Amino Oleic Acid as Anticalcification Agent for Porcine Bioprosthetic Heart Valves: A Narrative Review.","authors":"Lennart Vanglabeke, Marie Van den Bosch, Kenny Anseele, Tom Verbelen, Bart Meuris","doi":"10.1093/icvts/ivag246","DOIUrl":"https://doi.org/10.1093/icvts/ivag246","url":null,"abstract":"<p><strong>Objective: </strong>Calcification remains the principal mechanism limiting the durability of bioprosthetic heart valves. Alpha-amino oleic acid (AOA) was developed as an anticalcification treatment to preserve tissue integrity. This review synthesizes preclinical and clinical evidence on the efficacy of AOA-treated bioprosthetic valves.</p><p><strong>Methods: </strong>A narrative review was conducted using major biomedical databases to assess experimental and clinical studies evaluating AOA-treated tissues and valve platforms. Evidence from in vitro experiments, small/large animal models, and long-term clinical cohorts was qualitatively synthesized, with emphasis on calcification, structural valve degeneration, and durability outcomes.</p><p><strong>Results: </strong>Preclinical studies consistently demonstrated significant reductions in leaflet calcification in AOA-treated tissues compared with glutaraldehyde-fixed controls, across multiple models. These effects were most pronounced in leaflet tissue, whereas protection of the aortic wall or conduit tissue was less consistent. Large-animal models confirmed delayed mineralization and preservation of leaflet flexibility, but revealed susceptibility of non-leaflet components to calcific degeneration. Clinically, long-term follow-up of several surgical valve platforms incorporating AOA showed acceptable freedom from structural valve degeneration extending beyond ten years in selected patient populations. Durability remains strongly age-dependent, and late valve failures can still be associated with progressive calcification. Evidence from newer valve platforms is becoming available through various long-term follow-up studies.</p><p><strong>Conclusion: </strong>AOA provides effective anticalcification protection of bioprosthetic valve leaflets, supporting durable clinical performance in surgical platforms.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992772","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":"Preoperative PET-CT SUVmax and predominant histological pattern in resected lung adenocarcinoma: a retrospective cohort study of 166 patients.","authors":"Murat Kiliç, Merve Biyikli, Ayşenur Akatli","doi":"10.1093/icvts/ivag264","DOIUrl":"https://doi.org/10.1093/icvts/ivag264","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated whether preoperative maximum standardized uptake value (SUVmax) on PET-CT tracks the predominant histological pattern of resected lung adenocarcinoma and lymphovascular invasion (LVI).</p><p><strong>Methods: </strong>We retrospectively reviewed 166 consecutive patients resected between 2014 and 2026. Tumours were classified by predominant pattern (IASLC/ATS/ERS 2011) using descriptive labels, not grade terms: lepidic-predominant (n = 49), acinar/papillary-predominant (n = 59), solid/micropapillary/cribriform-predominant (n = 47) and invasive mucinous adenocarcinoma (n = 8). PET-CT was available in 94 (56.6%), who were compared with the 72 without. Pairwise comparisons were Holm-corrected and logistic models included age, sex and pleural invasion.</p><p><strong>Results: </strong>Imaged and non-imaged patients did not differ in any recorded variable (p ≥ 0.10). Median SUVmax rose stepwise across the three non-mucinous groups (8.80, 12.60, 15.40; Kruskal-Wallis p = 0.034, ε²=0.080); after Holm correction only the lepidic- versus solid/micropapillary/cribriform-predominant contrast remained significant (p = 0.042). Mucinous tumours showed low uptake (median 2.70; five imaged cases, descriptive only) and SUVmax was higher when LVI was present (13.10 vs 7.35; p = 0.001). Discrimination was modest: area under the curve 0.648 (95% CI 0.513-0.783) for an aggressive pattern and 0.698 (0.593-0.803) for LVI, with specificity below 50%. Adjusted for tumour size, age, sex and pleural invasion, SUVmax remained associated with LVI (odds ratio 1.12; 95% CI 1.05-1.21; p = 0.002).</p><p><strong>Conclusions: </strong>SUVmax shows a graded association with the predominant histological pattern and with LVI, but discrimination is modest. Our thresholds are two to three times higher than those from screen-detected series, indicating that published cut-offs are not transferable across populations, and SUVmax complements rather than replaces clinical and radiological assessment.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992796","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 between stent graft landing zone angle and aneurysm remodelling after total arch replacement with frozen elephant trunk for distal aortic arch aneurysm.","authors":"Shinji Kanemitsu, Satoshi Maruyama, Takato Yamasaki, Koh Kajiyama","doi":"10.1093/icvts/ivag259","DOIUrl":"https://doi.org/10.1093/icvts/ivag259","url":null,"abstract":"<p><strong>Objectives: </strong>Total arch replacement combined with the frozen elephant trunk (TARFET) technique using the FROZENIX prosthesis is widely adopted for distal aortic arch aneurysms; however, factors influencing postoperative aneurysm remodelling in true degenerative aneurysms remain unclear. We aimed to identify computed tomography (CT)-derived stent-graft parameters associated with aneurysm shrinkage.</p><p><strong>Methods: </strong>Between July 2014 and June 2024, 113 patients underwent total arch replacement (TAR) for true distal arch aneurysm. Of 57 who underwent TARFET using FROZENIX, 9 were excluded (3 scheduled secondary thoracic endovascular aortic repair; 6 lost to CT follow-up), leaving 48 patients. The following CT parameters were measured at discharge and at 6 months, 1 year, and 2 years: distal landing zone level, stent migration, landing zone angle, and stent-to-aorta diameter ratio. Patients were classified as the shrinkage group (>10% diameter decrease) or the no-change group (≤10% change or expansion).</p><p><strong>Results: </strong>Mean age was 75.6 years and mean aneurysm diameter was 58.1 mm. In-hospital mortality was 0%; stroke and spinal cord injury (paraparesis) each occurred in 2 patients (4.2%). Type Ib endoleak occurred in 1 patient (2.1%). Aneurysm shrinkage was achieved in 31 patients (64.6%). The initial landing zone angle was clinically and statistically smaller in the shrinkage group than in the no-change group (15.1 ± 11.5° vs 26.8 ± 21.1°, a difference of approximately 12°; P = 0.046). No significant differences were observed in angle change (P = 0.63), landing length (P = 0.95), diameter ratio (P = 0.91), or migration (P = 0.44).</p><p><strong>Conclusions: </strong>In this exploratory subgroup analysis, a larger initial stent graft landing zone angle was associated with failure of aneurysm shrinkage after TARFET for true degenerative distal arch aneurysms. Preoperative three-dimensional CT assessment of the predicted landing angle may be a useful adjunct to surgical planning.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984308","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":"Readmission after coronary artery bypass surgery in women and men.","authors":"Melanie Arnreiter, Alexandra Kaider, Philipp Angleitner, Marija Pljakova, Selma Rizvanovic, Kira Osipenko, Nicole Klaus, Julia Riebandt, Thomas Bergmair, Andreas Zuckermann, Mario Gaudino, Sigrid Sandner","doi":"10.1093/icvts/ivag260","DOIUrl":"https://doi.org/10.1093/icvts/ivag260","url":null,"abstract":"<p><strong>Objectives: </strong>Readmissions after coronary artery bypass grafting (CABG) are common and contribute substantially to long-term morbidity, yet extended follow-up data remain limited. Women experience higher perioperative morbidity, mortality, and short-term readmission rates than men, but long-term sex-specific patterns of readmission after CABG are poorly defined.</p><p><strong>Methods: </strong>Nationwide data for patients undergoing CABG between 2015 and 2021 from the Austrian Cardiac Surgery Registry were linked to the federal social insurance claims database to assess long-term cardiovascular (CV) and all-cause readmission. Cumulative incidence functions accounting for the competing risk of death and cause-specific Cox proportional hazards models were used.</p><p><strong>Results: </strong>A total of 12,169 patients (2,192 [18%] women) were included. Cumulative incidences of CV readmission were higher in women than in men at 1 year (19.1% vs. 17.3%), 4 years (37.8% vs. 34.9%), and 6 years (46.9% vs 43.4%) (p = 0.003). All-cause readmission showed a similar pattern at 1 year (42.2% vs. 37.6%), 4 years (69.6% vs. 66.7%), and 6 years (79.1% vs 75.9%) (p = 0.0004). Female sex was not independently associated with CV (HR 1.01, 95% CI 0.94-1.10, p = 0.73) or all-cause readmission (HR 0.99, 95% CI 0.94-1.05, p = 0.74). Earlier readmission correlated with earlier CV (ρ = 0.36, 95% CI 0.28-0.44) and all-cause death (ρ = 0.39, 95% CI 0.34-0.43).</p><p><strong>Conclusions: </strong>Women experienced higher unadjusted cumulative incidences of readmission. Long-term readmission after CABG is driven primarily by clinical risk rather than biological sex, underscoring the need for targeted management of high-risk comorbidities.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984373","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":"Does the type of aortic valve substitute affect patients' survival?","authors":"Tirone E David","doi":"10.1093/icvts/ivag256","DOIUrl":"https://doi.org/10.1093/icvts/ivag256","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992853","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":"Stroke risk after on-pump minimally invasive multivessel coronary artery bypass grafting with right axillary artery cannulation and preoperative computed tomography angiography.","authors":"Christian Sellin, Hilmar Dörge, Marius Grossmann, Alexandru Durutya, Ardawan Rastan, Niki Tabesh, Volodymyr Demianenko","doi":"10.1093/icvts/ivag257","DOIUrl":"https://doi.org/10.1093/icvts/ivag257","url":null,"abstract":"<p><strong>Objectives: </strong>Stroke remains a major concern in on-pump minimally invasive coronary artery bypass grafting, particularly when peripheral arterial cannulation and aortic manipulation are required in patients with systemic atherosclerosis. This study evaluated stroke outcomes after total coronary revascularization via left anterior thoracotomy with preoperative computed tomography angiography and right axillary artery cannulation.</p><p><strong>Methods: </strong>A total of 800 consecutive patients undergoing isolated non-emergent multivessel minimally invasive coronary artery bypass grafting were analysed. All procedures were performed on cardiopulmonary bypass with right axillary artery cannulation, transthoracic aortic cross-clamping, cardioplegic arrest, cardiac slinging manoeuvres and side-bite clamping for proximal anastomoses. Of these, 85.4% were male; median age was 67.0 years (IQR 13.0) and median EuroSCORE II was 2.0 (IQR 2.1). All patients underwent preoperative computed tomography angiography. Stroke events were analysed by timing, distribution and presumed mechanism.</p><p><strong>Results: </strong>The overall in-hospital rate of major adverse cardiac and cerebrovascular events was 1.9%. In-hospital mortality was 1.0%, myocardial infarction 0.4%, repeat revascularization 0.6% and stroke 0.6%. All strokes were ischaemic. Two strokes (0.25%) occurred within 72 hours and were considered procedure-related, whereas three (0.37%) occurred after 72 hours and were associated with postoperative atrial fibrillation or advanced intracranial atherosclerosis.</p><p><strong>Conclusions: </strong>In patients undergoing minimally invasive on-pump multivessel CABG after preoperative CTA confirmed suitable anatomy for transthoracic clamping and planned aortic manipulation, a standardized TCRAT strategy with right axillary artery cannulation was associated with a low rate of clinically apparent in-hospital stroke. These findings support the feasibility and clinical rationale of this approach in routine practice, while comparative studies are required to define its independent effect on stroke prevention.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978667","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":"The aortic valve: integrated gross, microstructural, and cellular anatomy.","authors":"Steve W F R Waqanivavalagi","doi":"10.1093/icvts/ivag228","DOIUrl":"https://doi.org/10.1093/icvts/ivag228","url":null,"abstract":"<p><strong>Objectives: </strong>To synthesise current knowledge of the normal human aortic valve by integrating its gross anatomy, microarchitecture, and cellular biology within a unified anatomical framework. This review aims to bridge traditionally separate descriptions of macroscopic, histological, and biological structure and highlight their relevance to valve function and contemporary clinical practice.</p><p><strong>Methods: </strong>A narrative review of the literature was undertaken, examining the macrostructural anatomy of the aortic valve and root, leaflet microarchitecture, extracellular matrix organisation, and the cellular biology of valvular endothelial and interstitial cells. Emphasis was placed on anatomical terminology, three-dimensional geometry, and the functional relationships between structure across multiple spatial scales.</p><p><strong>Results: </strong>The competence and durability of the aortic valve depend on coordinated interactions between root geometry, leaflet architecture, extracellular matrix composition, and cellular regulation. The functional interplay between the leaflets, interleaflet triangles, annulus, and sinuses of Valsalva maintains valve competence, while the conserved trilaminar leaflet structure provides region-specific mechanical properties. Valvular endothelial and interstitial cells regulate matrix homeostasis and adaptive remodelling, linking normal physiology with mechanisms underlying valve degeneration and disease.</p><p><strong>Conclusions: </strong>Viewing the aortic valve as an integrated, multiscale biological system provides a more comprehensive understanding than isolated anatomical or histological descriptions. This framework has direct relevance to valve-sparing surgery, transcatheter interventions, and the development of tissue-engineered valve substitutes, providing an anatomical basis for understanding normal valve function, pathological change, and future therapeutic innovation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972673","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}