Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Impact of treatment-related complications on long-term outcomes in recurrence-free survivors with locally advanced non-small cell lung cancer after Trimodality therapy.","authors":"Kazuhiro Okada, Ken Suzawa, Hideki Aoyama, Tsuyoshi Ryuko, Kumi Nakajima, Haruchika Yamamoto, Shin Tanaka, Hidejiro Torigoe, Kazuhiko Shien, Kentaroh Miyoshi, Kotaro Yoshio, Mikio Okazaki, Seiichiro Sugimoto, Takao Hiraki, Junichi Soh, Shinichi Toyooka","doi":"10.1093/icvts/ivag247","DOIUrl":"https://doi.org/10.1093/icvts/ivag247","url":null,"abstract":"<p><strong>Objectives: </strong>Trimodality therapy, consisting of induction chemoradiotherapy followed by surgery, remains a viable treatment option for locally advanced non-small cell lung cancer (LA-NSCLC). However, because this approach constitutes highly intensive local therapy, late adverse events may contribute to long-term, non-cancer-related outcomes. This study sought to clarify the prognostic impact of these events in recurrence-free patients treated with trimodality therapy.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who underwent trimodality therapy from January 1999 to December 2021 and remained recurrence-free during the follow-up.</p><p><strong>Results: </strong>Of the 199 patients who received trimodality therapy, 112 (56.3%) remained recurrence-free and were included in this analysis. Their median age at surgery was 62.5 years. The clinical stages were stage II (n = 27), stage III (n = 85). The median follow-up was 11.5 years, and the overall survival rates among patients without recurrence at 3, 5, and 10 years were 90.0%, 84.4%, and 71.5%, respectively. Multivariable analysis showed chronic lung injury extending beyond the anatomical segment (P = 0.04) was independent prognostic factors.</p><p><strong>Conclusions: </strong>We observed an association between treatment-related pulmonary morbidity and long-term survival among recurrence-free patients after trimodality therapy. These findings suggest that minimizing treatment-related complications may be important for long-term outcomes.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914583","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":"Fibrillar haemostatic agents mimicking nodal recurrence after thoracic surgery: a cohort study.","authors":"Thomas Roberts, Giulia Raffaele, Kunal Bhakhri, Thomas Fraccalini, Oleg Aleksandrov, Alessandro Maraschi","doi":"10.1093/icvts/ivag245","DOIUrl":"https://doi.org/10.1093/icvts/ivag245","url":null,"abstract":"<p><strong>Objectives: </strong>Fibrillar haemostatic agents are widely used to control bleeding. However, they may persist post-operatively and induce a foreign body reaction or mimic lymph-node recurrence on different imaging modalities.</p><p><strong>Methods: </strong>This retrospective cohort study included 11 patients who underwent thoracic surgery for lung or mediastinal malignancy with intraoperative fibrillar haemostatic material and subsequently developed imaging findings suspicious for malignancy recurrence. Patient demographics, tumour characteristics, surgical details, and fibrillar usage were recorded. Imaging findings across CT and PET-CT were analysed. Clinical outcomes, including follow-up interventions and histopathological results, were reviewed.</p><p><strong>Results: </strong>The mean time from surgery to detection of a suspicious lesion was 9.7 months (range 2-24). PET-CT was the follow-up modality in 81.9% of cases, demonstrating increased FDG uptake in 7/9 cases, with SUVmax ranging from 2.0-14.4. FDG uptake and SUVmax values overlapped substantially between benign and malignant lesions, with no threshold reliably distinguishing the two. In all cases, lesions were located at or adjacent to prior surgical sites corresponding to fibrillar placement. 10/11 patients (90.9%) required active intervention beyond imaging surveillance. Histopathology showed benign foreign-body reaction in 7/11, malignant recurrence in 2/11, and both in 2/11 (malignancy present in 4/11 overall).</p><p><strong>Conclusions: </strong>Fibrillar residues are a recognised and clinically significant mimic of nodal recurrence across imaging modalities, particularly on PET-CT. Recognition of characteristic imaging features and correlation with surgical history are essential to avoid unnecessary invasive procedures. Where tissue diagnosis is required, endobronchial ultrasound (EBUS)-guided biopsy is recommended as the preferred first-line approach before surgical re-intervention.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914598","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":"Extracorporeal Membrane Oxygenation Outside the Operating Room in Neonates and Infants.","authors":"Keisuke Shibagaki, Yuji Tominaga, Masashi Takeshita, Takuji Watanabe, Masaya Nakamizo, Hiroyuki Kamiya, Shigemitsu Iwai","doi":"10.1093/icvts/ivag235","DOIUrl":"10.1093/icvts/ivag235","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term outcomes of emergent extracorporeal membrane oxygenation (ECMO) initiated outside the operating room remain poorly defined. We evaluated long-term outcomes after emergent ECMO support outside the operating room in neonates and infants.</p><p><strong>Methods: </strong>We retrospectively evaluated 59 neonates and infants requiring emergent ECMO support outside the operating room at our institution (2010-2024). The primary outcome was overall survival after ECMO support. Secondary outcomes included in-hospital outcomes, mortality risk factors, and the impact of manual cardiopulmonary resuscitation (CPR) duration at ECMO cannulation.</p><p><strong>Results: </strong>Median age and body weight at emergent ECMO were 1.6 months and 3.2 kg, respectively. Indications for ECMO were extracorporeal CPR in 40 (68%) patients, cardiogenic shock in 12 (20%), septic shock in 1 (2%), and respiratory failure in 6 (10%). The median manual CPR duration was 36 min. A CPR duration exceeding 36 min was associated with cervical ECMO cannulation (P = .001) and hypoxic encephalopathy (P = .008). The median ECMO duration was 4 days. Forty-two (71%) patients were weaned from ECMO, and 32 (54%) survived to discharge. At a median follow-up of 3.7 years, overall survival after ECMO support was 57%, 47%, and 44% at 1, 3, and 5 years, respectively. Multivariable analysis detected non-cerebral bleeding (P = .049) and lack of catheter/surgical intervention (P = .004) as mortality risk factors.</p><p><strong>Conclusions: </strong>Long-term survival after emergent ECMO outside the operating room was acceptable in neonates and infants. Strategies to reduce bleeding complications and minimize resuscitation time may further improve outcomes.</p><p><strong>Clinical trial registration number: </strong>R19092; December 20, 2020.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819641","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":"Erratum: Evaluation of a Novel Multielectrode Surgical Pulsed Field Ablation Clamp: An Ex-Vivo Vegetal Study.","authors":"","doi":"10.1093/icvts/ivag243","DOIUrl":"10.1093/icvts/ivag243","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957418","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":"Outcomes of Complex Sleeve Resections by Video-Assisted Thoracic Surgery: Single-Centre Study.","authors":"Volkan Erdoğu, Melike Ülker, Ayşegül Çiftçi, Merve Ekinci Fidan, Nisa Yıldız, Çiğdem Obuz, Salih Bilen, Esra Gözügül, Tuğçe Barça Şeker, Muzaffer Metin","doi":"10.1093/icvts/ivag225","DOIUrl":"10.1093/icvts/ivag225","url":null,"abstract":"<p><p>Complex sleeve resections performed by video-assisted thoracic surgery (VATS) are technically demanding procedures requiring advanced surgical experience. We retrospectively evaluated 21 complex sleeve resections performed by VATS between January 2018 and October 2024. Complex sleeve resections included carinal sleeve pneumonectomy, isolated carinal reconstruction, bronchovascular sleeve lobectomy, vascular sleeve resections, sleeve lingulectomy, distal tracheal reconstruction, and segmental bronchial sleeve resections. Patient selection was based on tumour location, vascular and airway invasion, radiologic resectability, and the feasibility of achieving R0 resection through a minimally invasive approach. The mean operative time was 195 ± 70.2 min, and the average blood loss was 340 ± 135.2 mL. Mean postoperative hospital stay was 5.5 ± 1.74 days. Early postoperative morbidity occurred in 4 patients (19%), and postoperative mortality occurred in 1 patient (4.7%). R0 resection was achieved in all malignant cases. In experienced centres with advanced minimally invasive thoracic surgery expertise, complex sleeve resections can be safely performed by VATS with acceptable perioperative morbidity and mortality.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802576","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":"Multiple Authors in a Scientific Article: Friends and Foes.","authors":"Carlos A Mestres, Andres Obeso, Laszlo Göbölös","doi":"10.1093/icvts/ivag224","DOIUrl":"10.1093/icvts/ivag224","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802582","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":"Surviving or Thriving? Tenets of Shared Decision-Making in Communicating Perioperative Risk Prior to High-Risk Cardiac Surgery.","authors":"Ali Hage, Fadi Hage, Caroline A Magro, Aubrey Galloway","doi":"10.1093/icvts/ivag234","DOIUrl":"10.1093/icvts/ivag234","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 9","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893084","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":"Outcomes of Delayed Norwood Operation in High-Risk Patients-Time to Reconsider the Dogma of a Primary Norwood Operation?","authors":"Mahmut Ozturk, Arif Selcuk, Aybala Tongut, Elizabeth M Moynihan, Manan Desai, Alejandro Jose Lopez Magallon, Mary T Donofrio, Heather Gordish-Dressman, Kathleen Kalinger Reid, Ricardo Alfonso Munoz, Yves d'Udekem, Gil Wernovsky, Can Yerebakan","doi":"10.1093/icvts/ivag218","DOIUrl":"10.1093/icvts/ivag218","url":null,"abstract":"<p><strong>Objectives: </strong>The delayed Norwood (DN) approach, preceded by bilateral pulmonary artery banding (bPAB), has emerged as a strategy to improve outcomes in high-risk infants by addressing neonatal haemodynamic instability and organ immaturity.</p><p><strong>Methods: </strong>This single-centre, retrospective study analysed 20 consecutive patients with hypoplastic left heart syndrome/variants and multiple risk factors who underwent a DN operation following bPAB between 2019 and 2024.</p><p><strong>Results: </strong>Bilateral pulmonary artery banding was performed at a median age of 2.5 days (interquartile range [IQR]: 2-4). Preoperative risk factors included prematurity (35%), low birth weight <2.5 kg (25%), non-cardiac comorbidities (25%), genetic syndromes (50%), preoperative cardiogenic shock (35%), and restrictive atrial septum (25%). The median age at DN was 36 days (IQR: 29-79), with an operative survival rate of 75%. Patients who underwent the DN within 4 weeks of bPAB did not require any pulmonary artery (PA) reinterventions. Median lactate clearance time was 8 hours (IQR: 5-18), and the median vasoactive inotropic score decreased by 47% within 48 hours postoperatively. Cerebral near-infrared spectroscopy values improved in patients without postoperative extracorporeal membrane oxygenation (ECMO) support from 53% to 58% and 63% at 0, 12, and 36 hours, respectively.</p><p><strong>Conclusions: </strong>The DN approach, preceded by initial bPAB in a high-risk patient cohort, achieved surgical outcomes comparable to those of lower-risk patients undergoing primary Norwood operation. A DN procedure around 4-6 weeks of following bPAB may improve survival rates in high-risk patients with a reduction in surgical or catheter-based reinterventions.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842280","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":"Safety and Efficacy of Transaortic Transcatheter Aortic Valve Implantation Via Right Mini-Thoracotomy.","authors":"Naonori Kawamoto, Kizuku Yamashita, Kota Suzuki, Takashi Kakuta, Ayumi Ikuta, Rieko Kutuzawa, Satsuki Fukushima","doi":"10.1093/icvts/ivag226","DOIUrl":"10.1093/icvts/ivag226","url":null,"abstract":"<p><strong>Objectives: </strong>Transcatheter aortic valve implantation (TAVI) via the transfemoral (TF) approach is widely used. However, patients with unsuitable peripheral arterial anatomy require alternative transthoracic access. In such patients, the transaortic TAVR via right mini-thoracotomy (Rt-TAo) approach offers a less invasive option than conventional sternotomy. Therefore, this study aimed to evaluate the procedural and 2-year clinical outcomes of TF TAVI versus Rt-TAo TAVI.</p><p><strong>Methods: </strong>Patients who underwent TAVI via the TF approach or the Rt-TAo approach between January 2012 and November 2023 were retrospectively reviewed. Baseline characteristics and clinical outcomes were compared, and propensity score matching was performed to adjust for baseline differences. The primary end-points were in-hospital mortality, stroke, other periprocedural morbidities, and postprocedural length of hospitalization. Secondary end-points included overall survival, freedom from cardiac-related death, and major adverse cardiac and cerebrovascular events (MACCE) at 2 years.</p><p><strong>Results: </strong>A total of 767 consecutive patients were included in the analysis, of whom 694 underwent TF TAVI and 73 underwent Rt-TAo TAVI. Before matching, the Rt-TAo group had higher baseline prevalences of comorbidities and Society of Thoracic Surgeon risk scores. After matching, the Rt-TAo group had a longer procedural time, higher transfusion requirements, and longer lengths of intensive care unit and total hospital stays. However, the 2 groups had similar rates of periprocedural stroke, coronary obstruction, annular rupture, access-related complications, and in-hospital mortality. The 2 groups had similar 2-year rates of survival and freedom from MACCE.</p><p><strong>Conclusions: </strong>The Rt-TAo TAVI is a safe and feasible alternative for patients with unsuitable peripheral arterial access, demonstrating comparable 2-year outcomes to TF TAVI.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762919","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":"Surgical Outcomes of in situ Internal Thoracic Artery Grafting in Patients with Ipsilateral Upper-Extremity Arteriovenous Fistulas.","authors":"Chijioke Chukwudi, Ruby Singh, Arian Mansur, Benjamin Grobman, Patrick Udeh, Jordan Bloom, George Tolis, David A D'Alessandro, Thoralf M Sundt, Asishana A Osho","doi":"10.1093/icvts/ivag231","DOIUrl":"10.1093/icvts/ivag231","url":null,"abstract":"<p><strong>Objectives: </strong>The use of in situ internal thoracic artery (ITA) grafts ipsilateral to upper extremity arterio-venous fistulas (UE-AVFs) during coronary artery bypass grafting (CABG) in dialysis-dependent patients raises concerns of coronary steal and compromised graft perfusion. However, the clinical significance of ITA-AVF laterality remains uncertain.</p><p><strong>Methods: </strong>We retrospectively analysed dialysis-dependent patients who underwent CABG between February 2015 and December 2023 at 2 institutions. Patients with non-UE-AVF access, total vein grafting, or composite vein-artery configurations were excluded. The final cohort (N = 122) was divided into 2 groups: ipsilateral in situ ITA grafts (N = 66) and contralateral in situ or free ITA grafts (N = 56). The primary outcome was the incidence of major adverse cardiovascular and cerebrovascular events (MACCE); secondary outcomes included perioperative complications, haemodialysis-induced ischaemia, and 3-year survival.</p><p><strong>Results: </strong>Baseline and operative characteristics were largely comparable between groups. Perioperative outcomes, including surgical site infection, 30-day mortality, and prolonged ventilation, showed no significant differences. Over a median follow-up of 2.4 years, MACCE occurred in 44% of patients (39% ipsilateral vs 50% contralateral/free ITA; P = .24), with no significant differences in 3-year mortality (29% vs 21%; P = .352). Multivariable analyses showed no association between ITA-AVF laterality and MACCE (adjusted odds ratio 0.68, P = .31) or 3-year mortality (adjusted hazard ratio 1.56, P = .291).</p><p><strong>Conclusions: </strong>In this modestly sized retrospective cohort, ipsilateral in situ ITA grafting was not associated with significantly worse perioperative or long-term outcomes. Our findings should be interpreted as hypothesis-generating, and larger multicentre studies are needed to more definitively evaluate the safety of this grafting strategy in dialysis-dependent patients with UE-AVFs.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820483","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}