Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Validation of the German registry of acute aortic dissection type A score for predicting 30-day mortality after acute type A aortic dissection surgery in a single Japanese aortic centre.","authors":"Shinsuke Kotani, Genichi Sakaguchi","doi":"10.1093/icvts/ivaf037","DOIUrl":"10.1093/icvts/ivaf037","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the applicability of the German Registry of Acute Aortic Dissection Type A (GERAADA) score in predicting 30-day mortality in Japanese patients undergoing surgery for acute type A aortic dissection (ATAAD) and compared its predictive performance with that of the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II).</p><p><strong>Methods: </strong>This single-centre retrospective study involved 154 patients who underwent emergency surgery for ATAAD between January 2019 and April 2024. The GERAADA and EuroSCORE II were calculated for each patient. Predictive accuracy for 30-day mortality was assessed using the area under the receiver operating characteristic curve (AUC). A multivariate logistic regression identified independent predictors of mortality, and long-term outcomes were evaluated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>The 30-day mortality rate was 11.0%. The GERAADA score showed an AUC of 0.80, indicating good discriminatory ability, while the EuroSCORE II demonstrated moderate performance with an AUC of 0.67 (P = 0.07). The GERAADA score significantly overestimated mortality in this cohort, whereas the EuroSCORE II underestimated it. Independent predictors of mortality included the use of catecholamines at referral. Kaplan-Meier analysis revealed a 1-year survival rate of 79.4% with an AUC of 0.72, demonstrating the GERAADA score's utility as a predictor of long-term survival.</p><p><strong>Conclusions: </strong>The GERAADA score provides accurate predictions of 30-day mortality in Japanese patients undergoing ATAAD surgery, comparable to the EuroSCORE II. This score demonstrates robust predictive ability for short- and long-term outcomes and may serve as a practical tool for risk stratification in ATAAD surgery.</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/PMC11882300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484653","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":"Neonatal enlargement of the aortic arch roof without cardiopulmonary bypass using ductal patency for lower body perfusion: impact on long-term growth, function and shape of the aortic arch†.","authors":"Luigi Di Pasquale, Barbara Burkhardt, Julia Selena Beck, Martin Schweiger, Robert Cesnjevar, Hitendu Dave","doi":"10.1093/icvts/ivaf042","DOIUrl":"10.1093/icvts/ivaf042","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the long-term outcome of neonatal aortic arch roof enlargement using ductal patency in the context of coarctation associated with aortic arch hypoplasia.</p><p><strong>Methods: </strong>Retrospective single-centre analysis of children undergoing roof enlargement of the distal arch (left common carotid artery-left subclavian artery) without cardiopulmonary bypass (utilizing ductal patency for lower body perfusion); followed by resection and extended end-to-end anastomosis, through a left posterior thoracotomy. This study evaluates the long-term outcome with emphasis on arch growth and shape.</p><p><strong>Results: </strong>Thirty consecutive patients were included (2006-24). Median age and weight were 6.0 [interquartile range: 4.0-7.8)] days and 3.1 (2.7-3.5) kg, respectively. Simple congenital heart disease with simple intracardiac shunts (n = 17) and complex congenital heart disease (Complete Atrioventricular Septal Defect (AVSD), interrupted aortic arch and univentricular hearts) (n = 13) constituted the cohort. Non-ischaemic clamp time for roof enlargement was 43 (36-50) min. Ischaemic clamp time for coarctation resection was 23 (21-25) min. Pulmonary artery banding was performed in 19 (63.3%) patients. Twenty-seven (90%) successfully underwent staged repair at 6.1 (4.5-8.2) months age. Follow-up was complete at a median duration of 46.9 (21.7-159.9) months. All patients survived the operation and are in good health at follow-up. Median ventilation time, ICU and hospital stay were 1 (1-2), 3 (2-5) and 23.5 (14-40) days, respectively. No patient developed any neurological complication. Three developed left subclavian artery thrombosis, one requiring surgical revision. With one unrelated late accidental death 14 years after neonatal repair, Kaplan-Meier survival was 90.9 [50.8-98.7]% at 15 years. Two patients underwent arch re-enlargement at the inner curvature to accommodate the DKS during stage 2, resulting in freedom from reoperation of 93.3[75.9-98.3]% at 10 years. All survivors enjoy subjective normal exercise tolerance with no relevant gradient. No patient is on anti-hypertensive medication. Median Z value of the proximal, transverse and distal arch was normalized to -0.88 (-2.19 to -0.12), -0.66(-1.33 to 0.08) and 0.34 (-0.10 to 1.33), respectively, at the last follow-up. Twenty-three (76.7%) arches achieved Romanesque shape at follow-up.</p><p><strong>Conclusions: </strong>Long-term results of this minimally invasive approach show proportional growth without relevant gradient, freedom from hypertension and a Roman arch form, thus making it the preferred approach.</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":"143560276","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":"Initial single-institutional experience with salvage surgery for stage IV non-small-cell lung cancer.","authors":"Tomoyuki Hishida, Naoyuki Oka, Kaito Yano, Seiji Omura, Yu Okubo, Kyohei Masai, Kaoru Kaseda, Keiko Ohgino, Hideki Terai, Hiroyuki Yasuda, Keisuke Asakura","doi":"10.1093/icvts/ivaf029","DOIUrl":"10.1093/icvts/ivaf029","url":null,"abstract":"<p><p>The purpose of this study was to assess surgical outcomes of salvage surgery for clinical stage IV non-small-cell lung cancer. A total of 14 patients who underwent lung resection following systemic therapy between 2010 and 2022 were included in this study. Systemic therapy prior to surgery included agents including epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in eight patients and non-TKI agents in six (chemotherapy alone: four, chemotherapy plus immune checkpoint inhibitors: two). During a median follow-up of 5.2 years, the EGFR-TKI group showed a favourable 5-year overall survival of 83%; however, it was due to treatment after relapse, and there were no 4-year relapse-free survivors. The non-EGFR-TKI group showed a 5-year relapse-free survival of 33%, and 2 patients have survived more than 3 years without any relapse and further treatment. When considering the role of surgery in multimodal treatment for initial c-stage IV non-small-cell lung cancer, salvage surgery following non-TKI therapy (chemotherapy with or without immune checkpoint inhibitor) can be regarded as genuine salvage surgery.</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/PMC11906397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416420","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":"Full-root aortic valve replacement using Medtronic Freestyle bioroots for infective endocarditis.","authors":"Emilien Philippe Ruchonnet, Laura Didisheim, Matthaios Papadimitriou-Olivgeris, Pierre Monney, Lars Niclauss, René Prêtre, Matthias Kirsch, Ziyad Gunga","doi":"10.1093/icvts/ivaf034","DOIUrl":"10.1093/icvts/ivaf034","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the potential efficacy of the Freestyle Medtronic bioroot in the treatment of aortic endocarditis, based on our single-centre experience.</p><p><strong>Methods: </strong>In this retrospective study conducted between 2015 and 2023, adult patients who underwent aortic root replacement with coronary arteries reimplantation using the modified Bentall technique with a Medtronic Freestyle bioroot in our centre for infective endocarditis were included.</p><p><strong>Results: </strong>Thirty patients, with five deaths, no cases of relapse and two cases of reinfection, were included, and prosthetic valve endocarditis represented 73.3% of cases. The median age was 66 years (IQR 14.5 years), and 24/30 (80%) were male. Median EuroSCORE II was 12.2% (IQR 13.9%). The most commonly identified pathogen was Staphylococcus aureus (eight cases; 23.3%). Fourteen additional procedures were performed on 12 patients. Annular abscess was present in 73.3% of cases and required annulus patch repair in 13/22 (59%). Early reoperation rate was 20%, mostly for surgical bleeding. One- and 5-year actuarial survival rates were 90.0 and 82.2%, respectively. There were no cases of relapse, and reinfection-free survival was 86.7% at 1 year and 75.5% at 5 years. Postoperative mean and maximal transvalvular gradients were 7 (IQR 3.3 mmHg) and 14.6 mmHg (IQR 4.6 mmHg), respectively.</p><p><strong>Conclusions: </strong>The Medtronic Freestyle bioroot could be a valid alternative to homografts for the treatment of infective endocarditis, particularly in cases necessitating aortic root reconstruction after extensive debridement of annular abscesses, with comparable outcomes and potential advantages in terms of durability and availability.</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/PMC11913326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560253","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":"Subclinical leaflet thrombosis in Ozaki procedure.","authors":"Mathieu van Steenberghe, Francois Perret, Patrick O Myers, Gregory Khatchatourov","doi":"10.1093/icvts/ivaf051","DOIUrl":"10.1093/icvts/ivaf051","url":null,"abstract":"<p><p>Aortic valve reconstruction with autologous glutaraldehyde-fixed pericardium (Ozaki procedure) represents an alternative to conventional prosthetic valve replacement, allowing excellent haemodynamic outcomes. We report two cases of subclinical leaflet thrombosis (SLT) at 12 and 23 months of follow-up. Anticoagulation was initiated, and later echocardiography showed haemodynamic and mobility improvement. SLT is well documented for bioprosthetic valve. To our knowledge, this is the first report for Ozaki procedure in an adult population. Glutaraldehyde is known for cytotoxicity, and partial endothelialization can be responsible for thrombosis, creating favourable conditions for later endocarditis and degeneration. Anticoagulation should be recommended postoperatively for the first 3 months with control at 6 months. Finally, alternative treatment to glutaraldehyde should be investigated.</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/PMC11913325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560287","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":"Buckberg versus Del Nido in isolated aortic valve replacement: a prospective, two-centre, randomized trial.","authors":"Manel Tauron-Ferrer, Elena Roselló-Díez, Christian Muñoz-Guijosa, Constanza Fernández-DeVinzenzi, José Montiel, Sandra Casellas, Ángela Irabien-Ortiz, Laura Corominas-García, César Piedra, Ignasi Julià, Claudio Fernández, Virginia Cegarra, Nerea Guadalupe, Marta Molina, Juan F Tabilo, Carla Gotsens-Asenjo, Cristina Sobre, Víctor Gomez, Elisabet Berastegui, Antonino J Ginel","doi":"10.1093/icvts/ivaf054","DOIUrl":"10.1093/icvts/ivaf054","url":null,"abstract":"<p><strong>Objectives: </strong>Interest in Del Nido solution is increasing in adult cardiac surgery. This study compared Del Nido with Buckberg cardioplegia in patients undergoing isolated aortic valve replacement.</p><p><strong>Methods: </strong>A prospective, two-centre, randomized trial was conducted from July 2019 to August 2023, with adult patients undergoing first-time isolated aortic valve replacement, and were randomized to receive Buckberg (n = 159) or Del Nido (n = 152) solution. Primary end-point was Creatine Kinase and ultrasensitive Troponin T postoperative peak level.</p><p><strong>Results: </strong>A total of 311 patients were recruited. Total cardioplegia volume was higher in Del Nido group (1000 ml vs 374.5 ml, P < 0.001). No differences were observed in peak Creatine Kinase or Troponin T levels (422 vs 407 U/L and 282 vs 258 ng/L for Buckberg and Del Nido, respectively) or during postoperative days 1-5. After cross-clamp removal, patients in Del Nido group showed higher rates of spontaneous rhythm (66.7% vs 43.1%, P < 0.001) and less ventricular fibrillation requiring defibrillation (23.6% vs 49.7%, P < 0.001). Peak intraoperative glucose levels (128 mg/dl vs 198 mg/dl, P < 0.001) and insulin administration (18.1% vs 51.0%, P < 0.001) were lower in the Del Nido group. No other differences were found.</p><p><strong>Conclusions: </strong>No differences between Del Nido and Buckberg solutions were detected. Del Nido presents better intraoperative glycaemic control, higher spontaneous rhythm, less ventricular fibrillation requiring defibrillation after cross-clamp removal, and more comfortable surgical workflow due to less re-dose interruptions.</p><p><strong>Clinical registration number: </strong>EU-CTR number: 2018-002701-59.</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":"143598420","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 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":"https://doi.org/10.1093/icvts/ivaf047","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic root rotation is a significant factor influencing the structures around the aortic valve and the atrioventricular conduction system. However, its relationship with mitral valve remains unexplored. This study aimed to investigate the impact of aortic root 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, using electrocardiography-gated computed tomography angiography scans to identify rotation variants of aortic root. Aortic root 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 aortic root rotation (clockwise vs central vs counterclockwise: 63.2% vs 4.1% vs 21.9%, P < 0.001).</p><p><strong>Conclusions: </strong>Aortic root 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 aortic root rotation and mitral annulus morphology.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","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":"Assessment of short- and long-term outcomes of aortic valve sparing operation at concomitant aortic root and arch repair.","authors":"Yu Hohri, Megan M Chung, Kavya Rajesh, Dov Levine, Christopher He, Elizabeth L Norton, Bradley Leshnower, Yanling Zhao, Paul Kurlansky, Edward P Chen, Hiroo Takayama","doi":"10.1093/icvts/ivaf045","DOIUrl":"https://doi.org/10.1093/icvts/ivaf045","url":null,"abstract":"<p><strong>Objectives: </strong>Concomitant aortic root and arch replacement is a complex procedure. Although valve-sparing root replacement may offer advantages over valve prostheses, the decision to spare the valve may increase the risk profile of this procedure. This study examines the safety of aortic valve-sparing operation in such settings.</p><p><strong>Methods: </strong>All patients who underwent concomitant aortic root and arch replacement between 2004 and 2021 at two aortic centers were reviewed. Patients with aortic stenosis, endocarditis, or a history of previous cardiac surgery were excluded. Inverse probability treatment weighting yielded well-balanced cohorts. The primary end-points were mortality and complications during the index hospital stay, and secondary end-points were long-term survival and aortic valve reintervention rate.</p><p><strong>Results: </strong>A total of 764 patients who underwent concomitant aortic root and arch replacement, including valve-sparing root replacement (n = 311) or composite valve graft root replacement (n = 453), were analyzed. Surgical indication was dissection in 155 (20.2%), and distal extension was total arch replacement in 50 (6.5%). Cardiopulmonary bypass and cross-clamp times were longer in valve-sparing root replacement (P = 0.006, and P < 0.001, respectively). Valve-sparing root replacement demonstrated comparable in-hospital mortality rates (2.5% vs 4.9%, P = 0.195), and showed higher long-term survival rates (P = 0.04) (12-year survival rate; 78.5% [71.7%-86.1%] vs 64.2% [57.4%-71.6%]), which was reconfirmed on multivariable Cox regression analysis (Hazard ratio: 0.505 [0.348-0.734], P < 0.001). The cumulative incidence of reintervention was similar in both groups (P = 0.62).</p><p><strong>Conclusions: </strong>In appropriately selected patients requiring aortic root and arch replacement, a valve-sparing operation may be performed safely without increased operative risk.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560270","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":"Impact of non-significant right coronary ostial involvement on coronary events in type A aortic dissection surgery.","authors":"Ling-Chen Huang, Xiang-Min Hu, Ai-Kai Zhang, Ze-Hua Shao, Yang-Xue Sun, Dong Zhao, Yi Chang, Xiang-Yang Qian, Hong-Wei Guo","doi":"10.1093/icvts/ivaf035","DOIUrl":"https://doi.org/10.1093/icvts/ivaf035","url":null,"abstract":"<p><strong>Objectives: </strong>Coronary-related technical complications constantly occur during type A aortic dissection surgical repair and are potentially fatal, yet their risk factors require further investigation. The intricate morphology of coronary ostial involvement may have a substantial impact.</p><p><strong>Methods: </strong>From June 2019 to January 2024, consecutive type A aortic dissection patients who underwent open surgery were included. Patients were divided into the coronary involvement group (non-significant involvement: Neri A-dissected intima involving the margin of the coronary ostium; significant involvement: Neri B and Neri C) and the non-involvement group. Coronary events were defined as coronary-related technical complications necessitating bailout coronary revascularization or coronary ostial repair. Logistic regression analysis identified risk factors associated with coronary events. Overall survival was estimated using Kaplan-Meier method and Cox regression analysis.</p><p><strong>Results: </strong>Of 1,168 patients, 660 patients had coronary involvement, while 508 did not. Coronary events occurred in 58 patients (4.97%), including 53(4.54%) who required bailout coronary revascularization. Patients with coronary involvement had a higher incidence of coronary events (8.18% vs 0.79%, p < 0.001). Logistic regression analysis revealed that significant right coronary involvement was associated with coronary events (odds ratio : 20.58, 95%confidence interval : 7.37-57.50, p < 0.001). Notably, non-significant right coronary involvement, accounting for 44.61% of patients, was also associated with coronary events compared to those without involvement (odds ratio : 7.05, 95%confidence interval : 2.69-18.50, p < 0.001).</p><p><strong>Conclusions: </strong>Coronary events occurred in 4.97% patients. Significant right coronary involvement is strongly associated with coronary events; non-significant right coronary involvement, which is relatively common in surgical patients, also poses a substantial risk for coronary events and warrants attention.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484641","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":"Identifying the intersegmental line using a concave portion during upper lobe apical segmentectomies.","authors":"Hirohisa Kato, Masami Abiko, Kaito Sato","doi":"10.1093/icvts/ivaf022","DOIUrl":"https://doi.org/10.1093/icvts/ivaf022","url":null,"abstract":"<p><strong>Objectives: </strong>The hilum approach of intersegmental division along the intersegmental vein is difficult in the case with central vein type during upper lobe apical segmentectomy. We aimed to explore the possibilities of the simple intersegmental division used the concave portion of the apical pleura with computed tomography images.</p><p><strong>Methods: </strong>We evaluated computed tomography images of patients who underwent anatomical lung resection between June 2020 and April 2024. The upper pulmonary vein branching pattern was categorised into apical, apico-central, and central vein types. We evaluated whether the peripheral points of intersegmental veins (left V1 + 2a or right V1b) could be identified on which portions (anterior-convex, concave, and apical-convex) within the apical pleura in each branching pattern, using three-dimensional computed tomography images.</p><p><strong>Results: </strong>The peripheral points of the intersegmental veins of 175 subjected patients were concentrated in the anterior-convex, concave, and apical-convex portions. In the left lung, the peripheral points were significantly concentrated in the concave (n = 106, 60.9%) and the anterior-convex portion of the right lung (n = 115, 67.2%). By contrast, the peripheral points were significantly identified in the concave portion of the central vein type (n = 9, 100%) in the left lung for each branching pattern of the upper pulmonary vein. There was no similar tendency in the right lung.</p><p><strong>Conclusions: </strong>Peripheral intersegmental points obtained from the intersegmental veins were concentrated in the three portions constituting the concave portion of the apical pleura and especially in the concave portion of the left lung, suggesting that they can serve as convenient intersegmental line markers during upper segmentectomy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470075","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}