Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Endovascular vs. open surgical repair in retrograde type a dissection & intramural hematoma: A study-level meta-analysis.","authors":"Kelvin Jeason Yang, Nai-Hsin Chi, Hsi-Yu Yu, Yih-Sharng Chen, Chih-Hsien Wang, I-Hui Wu","doi":"10.1093/icvts/ivaf224","DOIUrl":"10.1093/icvts/ivaf224","url":null,"abstract":"<p><strong>Objectives: </strong>Retrograde type A intramural haematoma (IMH) and aortic dissection are serious conditions requiring prompt surgical intervention. While open surgery is the traditional treatment, Thoracic Endovascular Aortic Repair (TEVAR) has emerged as a less invasive alternative. This meta-analysis compares the clinical outcomes of TEVAR versus open surgery for these conditions.</p><p><strong>Methods: </strong>A systematic review and study-level meta-analysis were conducted using study-level data extracted from published reports and analyzed using DerSimonian-Laird random-effects model, in line with the PRISMA guidelines. The study was prospectively registered with PROSPERO (registration ID: CRD42024594305). Databases including PubMed, Ovid MEDLINE, and EMBASE were searched for studies reporting outcomes on either open aortic repair or TEVAR for retrograde type A IMH/dissection that were published between 1st January 2000 and 31st March 2025. We included literatures that did not directly compare the two modalities and then pooled the event rates for comparison.</p><p><strong>Results: </strong>The meta-analysis included 24 studies-one comparative and 23 single-arm studies-with a total of 709 patients, comprising 259 who underwent open surgery and 450 who received TEVAR. The pooled in-hospital mortality was 3.9% (95% CI: 2.2-6.7; I  2 = 0.0%) for TEVAR and 12.5% (95% CI: 8.7-17.7; I  2 = 20.6%) for open surgery, showing a significant difference (logit event rate difference: -1.27; 95% CI: -1.94 to -0.60). TEVAR also showed fewer neurological complications, such as stroke and paraplegia (TEVAR: 4.1% [95% CI: 2.2 to 7.4]; I2 = 0.0% vs Open: 11.6% [95% CI: 7.6 to 17.2]; I2 = 30.9%), compared to open surgery. TEVAR also had a higher rate of false lumen thrombosis and IMH regression in the descending aorta (TEVAR: 97.4% [95% CI: 88.3 to 99.5]; I2 = 0% vs Open: 72.0% [95% CI: 51.5 to 86.2]; I2 = 50.8%). However, no significant differences were found in long-term mortality or the need for reintervention between the two groups.</p><p><strong>Conclusions: </strong>This meta-analysis synthesizes current evidence for the use of TEVAR in retrograde type A IMH/dissection and use available information on open surgery as a reference. Our results suggested that TEVAR may be a safe and feasible alternative, with satisfactory short-term and long-term outcomes. Further large-scale studies are needed to clarify TEVAR's role and its efficacy against open surgery.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132982","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":"Early Haemodynamic Performance and Clinical Outcomes of a Novel Bioprosthetic Mitral Valve.","authors":"Yuki Wada, Akira Marui, Atsushi Nagasawa, Shinichi Tsumaru, Keisuke Hakamada, Kazuya Terazono, Yuta Kitagata, Hironori Mihara, Nobuhisa Ohno","doi":"10.1093/icvts/ivaf186","DOIUrl":"10.1093/icvts/ivaf186","url":null,"abstract":"<p><strong>Objectives: </strong>The MITRIS RESILIA mitral bioprosthesis is a novel pericardial valve developed to improve durability and haemodynamic performance. However, clinical data on its use in mitral valve replacement are limited. This single-center retrospective study aimed to evaluate the early haemodynamic performance and clinical outcomes of the MITRIS RESILIA valve in patients requiring mitral valve replacement.</p><p><strong>Methods: </strong>We retrospectively reviewed data from 66 patients who underwent mitral valve replacement using MITRIS RESILIA between May 2021 and May 2024. Transthoracic echocardiography was used to assess valve haemodynamic performance at discharge, 1 year, and 2 years postoperatively. The primary end-point was early valve haemodynamics, and the secondary end-points were overall survival and structural valve deterioration.</p><p><strong>Results: </strong>The mean age of the cohort was 75.0 ± 5.8 years, and 48.5% of the patients were male. The mean pressure gradient was 3.9 ± 1.4 mmHg at discharge, 4.0 ± 2.0 mmHg at 1 year, and 3.9 ± 1.3 mmHg at 2 years. The effective orifice area was 1.52 ± 0.50 cm2 after surgery. None of the patients experienced structural valve deterioration or significant paravalvular leak. The rate of freedom from all-cause mortality at 2 years was 93.3%.</p><p><strong>Conclusions: </strong>MITRIS RESILIA demonstrated stable early haemodynamic performance across all valve sizes, including the 23 mm prosthesis. No cases of structural valve deterioration or paravalvular leak were observed, supporting its feasibility for mitral valve replacement. Further studies with extended follow-up are required to confirm the long-term durability and clinical benefits of the valve.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839252","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":"Development, Validation, and Testing of a Simple Risk Score System Incorporating Routine Clinical and Laboratory Variables to Predict Moderate-to-Severe Acute Kidney Injury After Cardiac Surgery.","authors":"Xiaoting Su, Juntong Zeng, Shen Lin, Zhongchen Li, Xiaohong Huang, Yan Zhao, Sheng Liu, Zhe Zheng","doi":"10.1093/icvts/ivaf205","DOIUrl":"10.1093/icvts/ivaf205","url":null,"abstract":"<p><strong>Objectives: </strong>Early prediction is crucial for cardiac surgery-associated acute kidney injury (CSA-AKI). We aimed to develop and validate a simple, clinical- and laboratory-based risk score system for better CSA-AKI prediction.</p><p><strong>Methods: </strong>We developed a new pre-operative risk score system for moderate-to-severe CSA-AKI in a 10-year cohort of patients undergoing coronary artery bypass grafting at one tertiary centre. Most predictive laboratory and clinical variables were identified and constituted a simple and a full model. External testing was performed in patients at another centre. The risk score system was compared with 2 established clinical models.</p><p><strong>Results: </strong>The overall cohort comprised 27 534, 6403, and 1733 patients with moderate-to-severe CSA-AKI rates of 3.3%, 2.8%, and 8.4% for training, validation, and external testing, respectively. A simple 6-variable AB2C-S2 score (Age, Biomarkers of N-terminal pro-B-type natriuretic peptide and haemoglobin, Clinical history of preoperative critical state, Surgical factors of isolated surgery and on-pump surgery) and a full 9-variable AB2C2-S4 score (AB2C-S2 score plus hypertension, urgent surgery, and previous surgery) were developed. The simple model achieved similar performance as the full model in validation (area under the receiver-operating characteristic curve [AUC] 0.78 vs 0.79, P = .37) and external testing (AUC 0.74 vs 0.75, P = .17), and both significantly outperformed than 2 established clinical models: Cleveland Clinic model (validation: AUC 0.71, external testing: AUC 0.65, all P < .001) and Ng model (validation: AUC 0.64, external testing: AUC 0.65, all P < .001).</p><p><strong>Conclusions: </strong>A simple preoperative risk score system for moderate-to-severe CSA-AKI was developed and outperformed established complex clinical models.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994444","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":"Ultrasound and Three-Dimensional Image Reconstruction Angio-Computed Tomography Scan for Hybrid Surgical Tracheostomy in Patient with Abnormal Neck Vascularization.","authors":"Duilio Divisi, Luca Procaccini, Stefania De Sanctis, Chiara Angeletti","doi":"10.1093/icvts/ivaf193","DOIUrl":"10.1093/icvts/ivaf193","url":null,"abstract":"<p><p>Percutaneous dilatational tracheostomy is a common and safe ICU procedure. However, neck anatomy variations can cause bleeding. Pre-procedural ultrasound should be carried out to detect abnormalities in neck structures. A 3D image reconstruction angio-computed tomography scan of the epiaortic vessels should be performed for precise planning of actions. We describe a hybrid tracheostomy technique required following an anomalous vascularization of the neck discovered preoperatively by echography and imaging method.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981423","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":"Reply to Narayan P.","authors":"Andreas Schaefer","doi":"10.1093/icvts/ivaf201","DOIUrl":"10.1093/icvts/ivaf201","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994522","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":"Transapical Beating-Heart Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy With Anomalous Papillary Muscle Insertion.","authors":"Yue Chen, Eduard Quintana, Jing Fang, Yani Liu, Xiang Wei","doi":"10.1093/icvts/ivaf195","DOIUrl":"10.1093/icvts/ivaf195","url":null,"abstract":"<p><strong>Objectives: </strong>Anomalous papillary muscles (PMs) directly inserted into the anterior mitral valve (MV) constitute an infrequent anomaly in obstructive hypertrophic cardiomyopathy (HCM). This study sought to evaluate the efficacy and safety of a novel approach with transapical beating-heart septal myectomy to relieve obstruction while avoiding abnormal PM manipulation.</p><p><strong>Methods: </strong>Among 439 patients with obstructive HCM from March 2023 to February 2024, 27 patients (6.2%) were diagnosed with anomalous PM directly inserted into the anterior mitral leaflet. Isolated myectomy without PMs intervention was performed in these patients with a transapical beating-heart septal myectomy approach.</p><p><strong>Results: </strong>The median age of patients was 54 (47-60) years. The abnormal PMs insertion into the body (type I/II) and only the free edge (type III) of anterior MV leaflet were 21 and 6 patients, respectively. There was no operative death, septal perforation, conversion to sternotomy, blood transfusion, and no patients with preoperative normal conduction required a pacemaker. The resting left ventricular outflow tract gradient decreased from 110 (70-121) mm Hg at baseline to 10 (8-21) mm Hg at 12 months. Reduction to a mitral regurgitation (MR) grade ≤ 1+ was achieved in 25 (92.6%) patients at 12 months. At follow-up, 25 (92.6%) patients returned to New York Heart Association (NYHA) class I.</p><p><strong>Conclusions: </strong>In selected patients with sufficient septal thickness and no intrinsic MV pathology, transapical beating-heart septal myectomy may provide obstruction and MR relief without direct PMs intervention. This new approach without sternotomy or cardiopulmonary bypass increases the options for this infrequent condition.</p><p><strong>Clinical registration number: </strong>NCT05332691.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981440","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 Ignazio Condello et al.","authors":"Manel Tauron-Ferrer","doi":"10.1093/icvts/ivaf202","DOIUrl":"10.1093/icvts/ivaf202","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994383","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":"Resident-Performed Coronary Artery Bypass Grafting Using Bilateral Internal Mammary Arteries: Clarifying Methodological Gaps.","authors":"Pradeep Narayan","doi":"10.1093/icvts/ivaf199","DOIUrl":"10.1093/icvts/ivaf199","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Analysis of Coronary to Pulmonary Artery Fistula and Its Associated Aneurysm in Adults.","authors":"Chaoneng Wu, Shayne Joseph, Rakesh Devireddy, Marco Kaldas, Maxim Zlatopolsky, Omar Qaqish, Yunguo C Gong, Sonela Blaceri, Chadi Saad, William E Harder, Fadi A Saab, Sujata Kambhatla, Ashok Kondur","doi":"10.1093/icvts/ivaf206","DOIUrl":"10.1093/icvts/ivaf206","url":null,"abstract":"<p><strong>Objectives: </strong>We conducted a systematic review to evaluate the clinical features, diagnosis, and treatment of coronary artery to pulmonary artery fistula (CPAF) and its associated aneurysms.</p><p><strong>Methods: </strong>Our search encompassed MEDLINE/PubMed, Scopus, Google Scholar, and the Cochrane Collaboration Database from 1970 to 2025.</p><p><strong>Results: </strong>A total of 461 cases were analysed. The volume of publications steadily increased after 2010. The left anterior descending coronary artery was the most common site of origin for CPAF. A total of 457 cases underwent coronary angiography confirming CPAF, with computed tomography coronary angiography being the most frequently used non-invasive imaging modality (190 cases, 41.2%). Stress tests were conducted in 78 cases (16.9%), revealing a coronary steal phenomenon associated with CPAF. Particularly, when comparing aneurysm CPAF to non-aneurysm CPAF, we found that older age is an independent risk factor for developing an aneurysm. For interventions, the symptomatic patients were more likely to close the fistula. We identified that 218 cases (49.7%) underwent surgical treatment, while 121 cases (27.6%) received percutaneous embolization. There were 8 reported deaths, resulting in a mortality rate of 1.8%.</p><p><strong>Conclusions: </strong>The clinical presentations of CPAF are often non-diagnostic. Computed tomography coronary angiography is the preferred method for visualizing the fistulas and their surrounding structures. Surgical treatment is beneficial in cases of aneurysm CPAF or with other surgical indications. Transcatheter closure of CPAF may be considered for selected individuals with favourable anatomy (PROSPERO Number CRD42025643603).</p><p><strong>Clinical registration number: </strong>PROSPERO Number CRD42025643603.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"40 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132774","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":"CABG at a Crossroads: Reinventing the Distal Anastomosis.","authors":"Willem J L Suyker, John D Puskas","doi":"10.1093/icvts/ivaf210","DOIUrl":"10.1093/icvts/ivaf210","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"40 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187728","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}