Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Impact of aetiology on short- and long-term outcomes in open descending and thoracoabdominal aneurysm repair.","authors":"Joshua R Chen, Christopher Pritting, Vishal N Shah, Colin King, Jacqueline McGee, Konstadinos A Plestis","doi":"10.1093/icvts/ivae203","DOIUrl":"10.1093/icvts/ivae203","url":null,"abstract":"<p><strong>Objectives: </strong>We analysed the impact of chronic type B aortic dissection (cTBAD) and degenerative aneurysm (DA) on the short- and long-term outcomes of patients undergoing open descending thoracic aortic aneurysm and thoracoabdominal aortic aneurysm repair.</p><p><strong>Methods: </strong>We performed a retrospective analysis of a prospectively maintained aortic database. From 1999 to 2023, 245 patients underwent open descending thoracic aortic aneurysm or thoracoabdominal aortic aneurysm repair. We compared preoperative comorbidities, postoperative complications and operative and long-term mortality for patients with cTBAD (120 patients, 49%) and DA (125 patients, 51%).</p><p><strong>Results: </strong>Patients with cTBAD were significantly younger, more likely to be male and less likely to have comorbidities including diabetes, chronic obstructive pulmonary disease and coronary artery disease. There were no statistically significant differences in the incidence of operative mortality between cTBAD (7.5%) and DA patients (11.2%) (P = 0.44). Survival at 1, 5, 10 and 15 years for cTBAD versus DA patients was 90% versus 76%, 79% versus 59%, 59% versus 42% and 50% versus 29%, respectively (P < 0.01); however, this lost statistical significance in the Cox regression (P = 0.86). Following multivariable analysis, older age, female gender, coronary artery disease, urgent or emergent procedure and descending thoracic aortic aneurysm were independent predictors of long-term outcomes.</p><p><strong>Conclusions: </strong>There were no statistically significant differences in the incidence of postoperative complications, operative deaths and long-term survival between cTBAD and DA patients.</p><p><strong>Irb number: </strong>(#20D.802), Obtained: 1/31/23.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831036","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 to: Closed-incision negative pressure therapy as a strategy to reduce sternal wound infection in identified high-risk patients: a multicentre propensity matched study.","authors":"","doi":"10.1093/icvts/ivae209","DOIUrl":"10.1093/icvts/ivae209","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"39 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873600","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":"Association between preoperative D-dimer with morphologic features and surgical outcomes of acute type A aortic dissection.","authors":"Shuanglei Zhao, Zhou Liu, Mingxiu Wen, Hongkai Zhang, Longfei Wang, Nan Zhang, Lei Li, Wei Luo, WenJian Jiang, Hongjia Zhang, Ming Gong","doi":"10.1093/icvts/ivae193","DOIUrl":"10.1093/icvts/ivae193","url":null,"abstract":"<p><strong>Objectives: </strong>The association between preoperative D-dimer with morphologic features and surgical outcomes of acute type A aortic dissection is still unclear.</p><p><strong>Methods: </strong>430 acute type A aortic dissection patients who underwent total arch replacement and frozen elephant trunk in Beijing Anzhen Hospital of Capital Medical University between January 2016 and December 2020 were enrolled in the present study. Patients were divided into higher D-dimer (>2307 ng/ml) group and lower D-dimer (≤2307 ng/ml) group. We compared the extent of dissection and branch artery perfusion patterns between the 2 groups. The restricted cubic spline was performed to assess the association between D-dimer with the extent of dissection and major adverse events after surgery.</p><p><strong>Results: </strong>Among 430 patients, there were 45 (10.47%) in-hospital mortality and 156 (36.28%) major adverse events. Patients with higher D-dimer had bigger dissection extension length and false lumen perimeter in ascending aorta, thoracic descending aorta, diaphragmatic, coeliac trunk and renal artery level. For the branch artery perfusion patterns, patients with higher D-dimer had a higher proportion of malperfusion among the innominate artery, right renal artery and both side iliac arteries, a higher proportion of dissected intercostal artery/all intercostal arteries >0.5 (43.46% vs 29.63%, P = 0.003). The restricted cubic spline linear regression model revealed a nonlinear association between lnD-dimer with extension length and false lumen perimeter (all P for overall and P for nonlinearity <0.001 except false lumen perimeter in ascending aorta level). The restricted cubic spline logistic regression model revealed a linear association between lnD-dimer with major adverse events (P for overall <0.001, P for nonlinearity = 0.637). The association between lnD-dimer and major adverse events was still significant in the fully adjusted logistic regression model with computed tomography angiography characteristics [odds ratio (95% confidence interval) =1.388 (1.137, 1.695), P = 0.001].</p><p><strong>Conclusions: </strong>Preoperative D-dimer strongly and positively correlates with the extent of dissection and major adverse events of acute type A aortic dissection after total arch replacement and frozen elephant trunk. D-dimer seems to be a supplement that indicates the severity of aortic dissection to aortic computed tomography angiography.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683521","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":"Right ventricular outlet tract reconstruction for tetralogy of Fallot: systematic review and network meta-analysis.","authors":"Akira Yamaguchi, Tomonari Shimoda, Hiroo Kinami, Jun Yasuhara, Hisato Takagi, Shinichi Fukuhara, Toshiki Kuno","doi":"10.1093/icvts/ivae180","DOIUrl":"10.1093/icvts/ivae180","url":null,"abstract":"<p><strong>Objectives: </strong>Concerns persist regarding pulmonary regurgitation after transannular patch repair (TAP) for tetralogy of Fallot. Despite the introduction of various architectural preservation techniques, the optimal strategy remains controversial. Our goal was to compare different right ventricular outlet tract reconstruction techniques.</p><p><strong>Methods: </strong>PubMed, EMBASE and Cochrane Central were searched through March 2024 to identify comparative studies on right ventricular outlet tract reconstruction techniques (PROSPERO ID: CRD42024519404). The primary outcome was mid-term pulmonary regurgitation, with secondary outcomes including postoperative mortality, postoperative pulmonary regurgitation, length of intensive care unit stays, postoperative right ventricular outlet tract pressure gradient and mid-term mortality. We performed a network meta-analysis to compare outcomes among TAP, valve-repairing (VR), TAP with neo-valve creation (TAPN) and valve-sparing (VS).</p><p><strong>Results: </strong>Two randomized controlled studies and 32 observational studies were identified with 8890 patients. TAP carried a higher risk of mid-term pulmonary regurgitation compared to TAPN [hazard ratio, 0.53; 95% confidence interval (CI) (0.33; 0.85)] and VS [hazard ratio, 0.27; 95% CI (0.19; 0.39)], with no significant difference compared to VR. VS was also associated with reduced postoperative mortality compared to TAP [risk ratio, 0.31; 95% CI (0.18; 0.56)], in addition to reduced ventilation time. TAP also carried an increased risk of postoperative pulmonary regurgitation compared to the other groups. The groups were comparable in terms of length of intensive care unit stay, right ventricular outlet tract pressure gradient and mid-term mortality.</p><p><strong>Conclusions: </strong>VR was associated with a reduced risk of postoperative pulmonary regurgitation, whereas TAPN was associated with reduced risks of both postoperative and mid-term pulmonary regurgitation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585170","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 3-dimensional imaging and printing on septal myectomy results.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/icvts/ivae199","DOIUrl":"10.1093/icvts/ivae199","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775350","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":"Return to work after parenting in thoracic surgery: a call to action.","authors":"Cecilia Pompili, Rita Costa, Isabelle Opitz, Maria Teresa Tsukazan, Niek Hugen, Nuria Novoa, Shanda Blackmon, Agathe Seguin-Givelet, Mara Antonoff","doi":"10.1093/icvts/ivae196","DOIUrl":"10.1093/icvts/ivae196","url":null,"abstract":"<p><strong>Objectives: </strong>Women in our modern era are facing considerable challenges in the workplace, particularly in Cardiothoracic Surgery where women are under-represented in leadership and academic roles. Returning to work after parental leave may potentially uncover or exacerbate existing gender biases within the workplace, with important consequences on professional and personal lives. Our goal was to characterize the experiences and the impact of return-to-work after parenting on Thoracic Surgery careers across Europe.</p><p><strong>Methods: </strong>All the participants of the European Society of Thoracic Surgeons Annual Meeting in 2023 were invited to complete this 32-item questionnaire. The survey was subsequently distributed through the European Society of Thoracic Surgeons social media platform from November to January 2024. A descriptive and specific group analysis was performed according to the distribution.</p><p><strong>Results: </strong>There were 152 participants, 92 of whom were female (61.0%) and 66 (43%) were between 31 and 40 years, constituting the most heavily represented age group. More women parents reported their role as the primary care provider of their child (89% vs 34%; P < 0.00001). Moreover, presence of in-hospital childcare facilities was evaluated as more important by women. Approximately half of the parent-respondents reported breastfeeding (42, 52%), but only 26% (11) of this group indicated having any type of flexible hours for breast-feeding. Compared to men, women more often agreed that parenting might affect their career (81% vs 53%; P = 0.040) and felt less supported by their employers when having children (45% vs 68%; P = 0.37).</p><p><strong>Conclusions: </strong>This survey study identified main challenges to return to surgical work after parental leaves. Lack of structural or system-level support and limited resources for childcare and breastfeeding were considerably affecting women surgeons. Institutional initiatives for new parents and breast-feeding colleagues are crucial for supporting a diverse workforce, and any kind of discrimination derived from parental leaves should not be tolerated.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752491","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":"Insidious pericardial journey of an orthodontic metallic retainer wire.","authors":"Daniel Grandmougin, Pan Dan, Francesco Ferraro, Juan-Pablo Maureira","doi":"10.1093/icvts/ivae201","DOIUrl":"10.1093/icvts/ivae201","url":null,"abstract":"<p><p>Ingestion of foreign bodies may be a frequent cause of painful dysphagia. We report the case of a metallic wire impacted in the oesophagus with potentially devastating consequences.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775353","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":"Prosthesis selection for reconstruction of superior vena cava: comparison of midterm patency rates.","authors":"Han Cho, Suk Ho Sohn, Jae Woong Choi, Ho Young Hwang, Kyung Hwan Kim, Kwon Joong Na, Chang Hyun Kang","doi":"10.1093/icvts/ivae194","DOIUrl":"10.1093/icvts/ivae194","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared the mid-term patency of expanded polytetrafluoroethylene grafts without rings versus that of bovine pericardial conduits used for superior vena cava reconstruction for various thoracic diseases.</p><p><strong>Methods: </strong>Among 80 patients who underwent superior vena cava resection and reconstruction between 2009 and 2023 at our institution, 31 patients who received polytetrafluoroethylene grafts without rings (Polytetrafluoroethylene group) and 28 patients who received bovine pericardial conduits (Bovine group) were enrolled. Median follow-up durations were 19.5 and 64.6 months in the Polytetrafluoroethylene and Bovine groups, respectively. Primary outcome was midterm graft patency rate, and secondary outcomes were early and midterm clinical outcomes, including all-cause mortality and superior vena cava reintervention.</p><p><strong>Results: </strong>Operative mortality was 1.7%. Cumulative incidence of all-cause mortality was not significantly different between the groups. Graft occlusion was detected in 22 patients. Cumulative incidence of graft occlusion was 24.2%, 36.4%, 42.4%, 48.5% and 60.6% at 1 month, 3 months, 6 months, 1 year and 2 years, respectively, in the Bovine group, whereas no graft occlusion was observed in the Polytetrafluoroethylene group (P = 0.007). Although the incidence of graft occlusion was higher in the Bovine group, cumulative incidence of reintervention was not significantly different between the groups (0.0% vs 3.0% in Polytetrafluoroethylene vs Bovine groups at 1 year, P = 0.406). Multivariate analysis demonstrated that bovine pericardial conduit (polytetrafluoroethylene graft as reference) and left brachiocephalic vein reconstruction (right brachiocephalic vein reconstruction as reference) were significant risk factors for graft occlusion.</p><p><strong>Conclusions: </strong>In superior vena cava reconstruction, polytetrafluoroethylene grafts without rings were superior to bovine pericardial conduits in terms of midterm graft patency.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735195","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":"A case of superior trunk brachial plexus injury after right mini-thoracotomy mitral valve repair.","authors":"Tatsuya Ozaki, Masashi Kawamura, Toru Iwahashi, Shigeru Miyagawa","doi":"10.1093/icvts/ivae190","DOIUrl":"10.1093/icvts/ivae190","url":null,"abstract":"<p><p>We report a case of superior trunk brachial plexus injury following a right mini-thoracotomy mitral valve repair. A 45-year-old woman with systemic lupus erythematosus, who was on steroids and immunosuppressive drugs, underwent mitral valve repair via right mini-thoracotomy. The patient was positioned in the left semisagittal position with the right upper arm elevated. Postoperatively, she exhibited focal motor and sensory deficits in the right upper extremity, and a superior trunk brachial plexus injury on the right side was diagnosed through brachial plexus MRI and electrophysiological examination. The nerve injury was likely due to excessive left lateral flexion of the head during the procedure. Sensation returned to normal 4 weeks postoperatively, and muscle strength fully recovered 3 months postoperatively. Careful attention to positioning during minimally invasive cardiac surgery is crucial to prevent nerve compression in superficial areas and excessive lateral flexion of the head.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683518","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":"Comparison of pulmonary and aortic root and cusp dimensions in normal adults using computed tomography: potential implications for Ross procedure planning.","authors":"Matija Jelenc, Blaž Jelenc, Sara Habjan, Karen B Abeln, Peter Fries, Hector I Michelena, Hans Joachim Schäfers","doi":"10.1093/icvts/ivae206","DOIUrl":"10.1093/icvts/ivae206","url":null,"abstract":"<p><strong>Objectives: </strong>The Ross procedure is currently receiving renewed interest. Its function and durability depend on preservation of pulmonary valve anatomy; limited data exist on normal pulmonary valve geometry. The objective was to compare aortic and pulmonary root and cusp dimensions in adults with normal tricuspid aortic and pulmonary valves.</p><p><strong>Methods: </strong>We reviewed 507 coronary computed tomography studies, selecting those with adequate visibility of both pulmonary and aortic roots for further analysis. Diastolic aortic and pulmonary root and cusp dimensions were measured. Root dimensions at different phases of the cardiac cycle were measured in 3 patients.</p><p><strong>Results: </strong>We analysed studies of 50 patients with the mean age of 54 years [standard deviation (SD): 16]. In end-diastole, pulmonary root had a smaller sinutubular to basal ring ratio than the aortic root [0.82 (SD: 0.09) vs 1.14 (SD: 0.12), P < 0.001]. Aortic and pulmonary cusps had similar dimensions; however, pulmonary cusp effective height was lower [5.9 mm (SD: 1.6) vs 8.4 mm (SD: 1.2), P < 0.001]. Pulmonary basal ring perimeter was largest at end-diastole and smallest at end-systole, with the relative difference of 23.5% (SD: 2.7).</p><p><strong>Conclusions: </strong>The pulmonary root has a similar cusp size compared to the aortic root, but a different shape, resulting in a lower pulmonary cusp effective height. The perimeter of the pulmonary basal ring changes during the cardiac cycle. These findings suggest that stabilizing the autograft to normal aortic, rather than pulmonary, root dimensions should result in normal autograft cusp configuration. Computed tomography angiography could become a tool for personalized planning of the Ross procedure.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808508","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}