Interdisciplinary cardiovascular and thoracic surgery最新文献

{"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}

{"title":"Clinical significance of positron emission tomography-computed tomography in the classification of thymic tumors.","authors":"Jian Gao, Si-Yang Wang, Yong-Qiang Ao, Jia-Hao Jiang, Miao Lin, Shuai Wang, Hong-Cheng Shi, Jian-Yong Ding","doi":"10.1093/icvts/ivaf065","DOIUrl":"10.1093/icvts/ivaf065","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the possibility of positron emission tomography/computed tomography (PET-CT) in identifying histological classification of thymic tumours.</p><p><strong>Methods: </strong>Patients diagnosed as thymic tumours and accepted PET-CT scans were included. Thymic tumours were classified into three subgroups: low-risk thymoma (A, AB and B1), high-risk thymoma (B2, B3) and thymic carcinoma (TC). Logistic regression analysis was performed to identify potential factors differentiating the classification of thymic tumours. The receiver operating characteristic curve was applied to assess the diagnosis efficiency and the cut-off value.</p><p><strong>Results: </strong>From 2015 to 2023, a total of 176 patients, including 75 cases of low-risk thymoma, 60 cases of high-risk thymoma and 41 cases of TC, were included. The logistic regression models suggested maximum standardized uptake value (SUVmax) as a potential factor differentiating the three subgroups. Moreover, the receiver operating characteristic curve identified the SUVmax in differentiating low-risk thymoma vs high-risk thymoma (area under the curve [AUC]: 0.845, 95% CI: 0.776-0.913, specificity: 0.907, sensitivity: 0.716), low-risk thymoma vs TC (AUC: 0.976, 95% CI: 0.953-0.999, specificity: 0.933, sensitivity: 0.951) and high-risk thymoma vs TC (AUC: 0.84, 95% CI: 0.761-0.92, specificity: 0.865, sensitivity: 0.703), respectively. SUVmax was also an independent factor identifying thymic tumours with or without lymph node metastasis. The cut-off of 10 in SUVmax could well identify lymph node metastasis with the positive predict value of 0.684 and negative predict value of 0.981.</p><p><strong>Conclusions: </strong>SUVmax is a reliable factor in distinguishing different histological subgroups and identifying lymph node metastasis in thymic tumours.</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/PMC11928932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617937","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":"Patient-centered supportive roadmap: patients and caregivers need to drive their care.","authors":"Cecilia Pompili, Jill Feldman, Shani Shilo, Jonathan Koffman","doi":"10.1093/icvts/ivaf033","DOIUrl":"10.1093/icvts/ivaf033","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"40 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607342","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":"Are there any limits to perform segmentectomy for non-peripheral early-stage non-small-cell lung cancer?","authors":"Apostolos C Agrafiotis, Paul E Van Schil","doi":"10.1093/icvts/ivaf059","DOIUrl":"10.1093/icvts/ivaf059","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/PMC11922550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635010","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":"Minimally invasive mitral valve surgery for mitral valve prolapse: a comparison between fibro-elastic deficiency and Barlow's disease.","authors":"Simon Huyghe, Bodine Colpaert, Jens Czapla, Tine Philipsen, Frank Timmermans, Thierry Bové","doi":"10.1093/icvts/ivaf041","DOIUrl":"10.1093/icvts/ivaf041","url":null,"abstract":"<p><strong>Objectives: </strong>Within the spectrum of degenerative mitral valve (MV) prolapse, Barlow's disease remains a risk factor for suboptimal long-term outcomes after MV repair (MVr). This study reports on the results of MVr through minimally invasive surgery benchmarking patients with Barlow's disease to fibro-elastic deficiency (FED).</p><p><strong>Methods: </strong>Between July 2008 and December 2021, 246 patients underwent MVr for degenerative MV prolapse via minimally invasive surgery, including 180 FED and 66 Barlow patients. Study end-points focused on 10-year survival, MV reoperation and recurrence of MV regurgitation ≥grade 2.</p><p><strong>Results: </strong>Barlow patients were significantly younger (Barlow: 58 years (IQR 47-67); FED: 68 years (IQR 60-76), P < 0.001), showing more complex MV prolapse than FED patients. The overall 30 day-mortality was 0.4%. Survival at 10 years was 78.8 ± 11.3% and 64.5 ± 7.4% (P = 0.161) in Barlow and FED patients, respectively. The cumulative incidence of MV reoperation at 10 years was comparable between Barlow and FED patients (FED: 9.7 ± 3.1%; Barlow: 8.0 ± 4.7%, P = 0.645). The cumulative incidence of mitral regurgitation recurrence ≥grade 2 was 3.0 ± 1.4% and 6.8 ± 3.1% at 5 and 10 years overall. Mitral regurgitation recurrence rate at 10 years was higher in Barlow patients, but the difference was not significant (FED: 3.3 ± 1.7% at 10 years; Barlow: 11.1 ± 8.7% at 10 years, P = 0.765).</p><p><strong>Conclusions: </strong>Despite more extensive MV prolapse in Barlow patients, MVr through minimally surgical access can be achieved with a mid-term outcome comparable to patients with FED. Concentrating the expertise to increase the individual surgeon's experience for surgical approach as the MV procedure itself allowed to achieve outcome results concurrent with those reported by high-volume centres.</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/PMC11886819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506539","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":"Impact of the establishment of a multidisciplinary national chronic thromboembolic pulmonary hypertension board on a monocentric surgical endarterectomy program.","authors":"Bianca Battilana, Kathrin Chiffi, Mona Lichtblau, Laura Mayer, Thomas Frauenfelder, Sabine Franckenberg, Gilbert Puippe, John-David Aubert, Benoît Lechartier, Andrei M Darie, Sabina Anna Guler, Jean-François Deux, Jean-Marc Fellrath, Patrick Yerly, Stephane Noble, Frédéric Lador, Silvia Ulrich, Isabelle Opitz","doi":"10.1093/icvts/ivaf040","DOIUrl":"10.1093/icvts/ivaf040","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic thromboembolic pulmonary hypertension is a rare disease, characterized by delays in diagnosis and curative surgical treatment. After establishing a surgical pulmonary endarterectomy centre in Switzerland and due to a historically low resection rate of 14%, a national multidisciplinary evaluation board was established in January 2018. Herein, we summarize the impact of the board on our programme.</p><p><strong>Methods: </strong>Patients discussed in the national chronic thromboembolic pulmonary hypertension board from January 2018 to December 2023 were included. Clinical characteristics, treatment allocation and survival were compared between patients undergoing surgery, patients refusing surgery and non-operable patients. Fisher's exact test or three-way ANOVA and Kaplan-Meier analyses were used.</p><p><strong>Results: </strong>188 patients were discussed at our national chronic thromboembolic pulmonary hypertension board; 131 (70%) presented with operable disease, 77 (41%) were referred for pulmonary endarterectomy and 34 (18%) of operable patients declined surgery. There is a significant difference in survival between these groups (P = 0.048). One- and 2-year survival in the subgroup undergoing pulmonary endarterectomy was 97% and 79%, respectively, while 1- and 2-year survival in the subgroup refusing pulmonary endarterectomy was 91% and 76%, respectively. The pulmonary endarterectomy rate has increased from a historical low of 14-41% since establishing the board.</p><p><strong>Conclusions: </strong>Establishing an interdisciplinary board is essential to address diagnostic and management challenges in chronic thromboembolic pulmonary hypertension patients. The Swiss national chronic thromboembolic pulmonary hypertension board played an important role in substantially increasing the rate of curative 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/PMC11897790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560273","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":"Global cardiothoracic surgery: outcomes from a survey on current worldwide training programmes.","authors":"Rebekah Boyd, Justin Robinson, Rajika Jindani, Miia Lehtinen, Fabian Dorr, Alvaro Perazzo, Nqobile Manzini, Maroua Eid, Agneta Odera, Irbaz Hameed, Ahmed Youssef, Sharmil Kanna, Charles Jenkinson, Joseph Turek","doi":"10.1093/icvts/ivaf049","DOIUrl":"10.1093/icvts/ivaf049","url":null,"abstract":"<p><strong>Objectives: </strong>There are significant disparities in global access to cardiothoracic surgery. Training a diverse cohort of global cardiothoracic surgeons is a critical step. However, little is known about training pathways globally, and there is a lack of standardization in training.</p><p><strong>Methods: </strong>The Global Thoracic Surgery Residents' Association developed a 25-item survey covering the five domains of country of origin, access to cardiothoracic surgical training, variations in training, barriers and facilitators to training, and future plans of cardiothoracic surgery trainees. The survey was disseminated electronically and over social media platforms.</p><p><strong>Results: </strong>A total of 73 responses from trainees in 21 countries were received. Wide variations were found in training programmes, including length of training, operative autonomy, reliance on simulation, trainee supervision and minimum case requirements. Common barriers included discrimination, separation from family and inadequate supervision and volume. Facilitators included participation in global rotations and mentorship. The majority (78%) of trainees plan on additional training.</p><p><strong>Conclusions: </strong>There is a lack of standardization of trainee experience with extreme variations in global cardiothoracic training programmes in terms of length of training, reliance on simulation, supervision, research opportunities and minimum case requirements. These variations are opportunities to think forward in terms of collectively working on standardization of trainee experience, developing innovative modalities to increase supervision of trainees and recognizing trainee interest in research. There is a clear demand for increased global collaboration and the transfer of knowledge and techniques in addition to trainee recognition of need for further training.</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/PMC11928929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665589","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 arterial switch operation for transposition of the great arteries with left ventricular outflow tract obstruction and ventricular septal defect: clinical outcomes and specimen study.","authors":"Roel L F van der Palen, Abe den Ouden, Ingmar Knobbe, Berto J Bouma, David R Koolbergen, Monique R M Jongbloed, Mark G Hazekamp","doi":"10.1093/icvts/ivaf071","DOIUrl":"10.1093/icvts/ivaf071","url":null,"abstract":"<p><strong>Objectives: </strong>In selected patients with transposition of the great arteries (TGA), ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO), the arterial switch operation (ASO) may be the procedure of choice. This study reviews the clinical outcomes of TGA-VSD-LVOTO patients after ASO and compares mechanisms of LVOTO in this patient group to a historical series of cardiac specimens.</p><p><strong>Methods: </strong>This retrospective analysis included all cases with TGA-VSD-LVOTO who underwent ASO between January 1977 and December 2023. Additionally, a series of non-operated cardiac specimens with TGA-VSD-LVOTO was selected and examined for morphological comparison.</p><p><strong>Results: </strong>Eleven patients with TGA-VSD-LVOTO underwent ASO. Eight of them had TGA-VSD, and three had Taussig-Bing anomaly. LVOTO mechanisms were multifactorial, including posteriorly deviated infundibular septum and fibrous tissue masses. Median age at ASO was 0.4 (0.07-1.8) years. Ten patients underwent primary LVOTO relief during ASO; no in-hospital mortality occurred. Two patients died >30 days post-ASO at 3.1 months and 6.0 years. Median follow-up was 19.0 (11.1-26.8) years, all survivors in NYHA class I. The patient without initial LVOTO relief did require reoperation during follow-up for progressive LVOTO at 3.5 months post-ASO. Two patients had moderate residual LVOTO at latest follow-up (gradient 30-50 mmHg). No significant neoaortic valve regurgitation was observed. From the anatomical specimen series, 10 of 33 TGA-VSD-LVOTO specimen were deemed eligible for ASO, revealing similar LVOTO mechanisms as the clinical cases.</p><p><strong>Conclusions: </strong>ASO is feasible in selected patients with TGA-VSD-LVOTO showing good long-term outcomes with preserved neoaortic valve function and no reoperations for LVOTO after initial relief.</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/PMC11947414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652460","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":"Survival outcomes after surgery for type A aortic dissection: a contemporary Dutch nationwide registry study.","authors":"Patrick T Timmermans, Bart J J Velders, Rolf H H Groenwold, Roemer J Vos, Maaike M Roefs, Jerry Braun, Robert J M Klautz, Gianclaudio Mecozzi, Jesper Hjortnaes","doi":"10.1093/icvts/ivaf009","DOIUrl":"10.1093/icvts/ivaf009","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the nationwide survival outcomes after surgery for type A aortic dissection.</p><p><strong>Methods: </strong>All patients who underwent surgery for type A aortic dissection in the Netherlands between 2018 and 2021 were identified in the Netherlands Heart Registration (NHR) database. The NHR data were linked to lifelong survival data from Statistics Netherlands (98% match). Time trends for in-hospital and mid-term mortality were described, and age- and sex-adjusted regression analysis was performed. The cause and location of death were reported and stratified according to survival time intervals.</p><p><strong>Results: </strong>The study population consisted of 1317 patients with a mean age of 63.1 years (11.8). The number of surgeries increased from 284 in 2018 to 375 in 2021. The surgery included the ascending aorta in 99%, aortic arch in 73%, aortic root in 32.5% and the descending aorta in 5% of cases. In-hospital mortality decreased from 20.4% in 2018 to 13.9% (95% CI: [10.4%, 17.4%]) in 2021. A total of 318 deaths were recorded, and the majority (70%) of patients died from the consequences of their dissection. However, among 365-day survivors, only 14% died related to their dissection, while 37% of deaths were related to cardiovascular disease and 17% to cancer. The majority (84%) of patients died in the hospital, but deaths after 365 days occurred most frequently (37%) at home.</p><p><strong>Conclusions: </strong>Over the recent years, the number of surgeries for type A dissections in the Netherlands has increased, and in-hospital mortality has decreased. For patients surviving 1 year after surgery, the main cause of death was not dissection, but other causes such as cardiovascular disease or cancer.</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/PMC11893151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366889","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}