Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Aneurysm Shape and Sac Shrinkage After Total Arch Replacement With Frozen Elephant Trunk for True Aortic Arch Aneurysm.","authors":"Shinji Abe, Yasushige Shingu, Taro Minamida, Nobuyasu Kato, Hiroshi Sugiki, Satoru Wakasa","doi":"10.1093/icvts/ivaf200","DOIUrl":"10.1093/icvts/ivaf200","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate midterm outcomes and identify predictors of sac shrinkage following total arch replacement with a frozen elephant trunk (TAR-FET) for true aortic arch aneurysms.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 28 patients who underwent elective TAR-FET for true arch aneurysms between July 2014 and March 2022. Postoperative sac changes on CT were categorized as shrinkage (≥5 mm reduction), enlargement (≥5 mm increase), or no change (<5 mm change). The sphericity index, a novel morphological parameter, was calculated by dividing the average axial and sagittal sac diameters by sac length.</p><p><strong>Results: </strong>The median age was 74 years, and 23 were male. No operative deaths or recurrent laryngeal nerve palsy occurred. Among 28 patients, 12 experienced sac shrinkage attributable to the initial TAR-FET. Over a median follow-up of 3.6 years, 12 cases showed shrinkage, 2 enlargement, and 14 no change. Cumulative shrinkage rates at 1, 2, and 3 years were 42%, 47%, and 47%, respectively. Additional thoracic endovascular aortic repair (TEVAR) was required in 5 patients (22% at 3 years). Multivariable analysis showed that shorter preoperative sac length (subdistribution hazard ratio [SHR] 0.96; 95% CI, 0.93-0.99) and a higher sphericity index (per 0.1 increment: SHR 1.38; 95% CI, 1.21-1.57) were independently associated with sac shrinkage.</p><p><strong>Conclusions: </strong>TAR-FET resulted in sac shrinkage in a substantial proportion of patients. Aneurysms that were shorter and more protruding, as indicated by a higher sphericity index, may be more likely to exhibit postoperative sac shrinkage.</p><p><strong>Clinical registration number: </strong>022-0242; 16 November 2022 (Ethics Committee of Hokkaido University Hospital).</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/PMC12448843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981437","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":"Transfemoral Bridging Stent-Graft Delivery in Zone 0 Endovascular Arch Repair With Triple-Fenestrated Endograft.","authors":"Hiroaki Kaneyama, Kenichi Hashizume, Toshiaki Yagami, Kiyoshi Koizumi, Koki Ikebata, Takashi Hashimoto, Masayoshi Waga, Hideyuki Shimizu","doi":"10.1093/icvts/ivaf209","DOIUrl":"10.1093/icvts/ivaf209","url":null,"abstract":"<p><p>Zone 0 thoracic endovascular aortic repair (TEVAR) remains technically demanding because of limited proximal landing zones and the need to preserve all supra-aortic branches. Conventional strategies-including branched endografts, chimney or snorkel techniques, and hybrid repairs-have been associated with increased risks of stroke, retrograde type A dissection, and perioperative mortality. We describe a technique using a physician-modified triple-fenestrated endograft with transfemoral delivery of all bridging covered stents (BCSs) to the brachiocephalic, left common carotid, and left subclavian arteries. Cervical and brachial access was used solely for angiography and minimal catheter manipulation, thereby aiming to reduce cerebral embolization risk. A 71-year-old man with a history of coronary artery bypass surgery and reduced left ventricular ejection fraction (31%) presented with fever. Imaging revealed a dissecting aortic aneurysm confined to the arch. Blood cultures were positive for methicillin-susceptible Staphylococcus aureus. After intravenous antibiotic therapy, cultures became negative; however, the aneurysm enlarged. Given the high surgical risk, TEVAR was selected. All BCSs were delivered transfemorally without complications. Postoperative and 1-year follow-up imaging showed no endoleak and a reduction in aneurysm size. This approach may offer a less invasive and embolic risk-reducing option for managing arch pathology in high-risk patients.</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":"145093099","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":"An Expert Panel Review of Endoscopic Vein Harvesting Devices: Benefits, Limitations, and Clinical Insights.","authors":"Bhuvaneswari Krishnamoorthy, Sam Raaj, Andjela Susanj, Gianluca Adinolfi, Donna Croft, Asher G Joseph, Michael L Sullivan, Thuy Le, Matthew Petrides, Chris Darst, Richard M Vitali, Igor Zivkovic, James B Barnard","doi":"10.1093/icvts/ivaf204","DOIUrl":"10.1093/icvts/ivaf204","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic vessel harvesting (EVH) devices are technically complex and the learning curve for novice practitioners can be steep, due to the need for refined hand-eye coordination and device familiarity. Training and mentoring approaches vary widely, as does the experience level of practitioners entering EVH practice.</p><p><strong>Methods: </strong>This expert review was conducted by 10 international EVH specialists from the United Kingdom, United States, and Serbia, each with 18 to 28 years of experience. Comprehensive searches of EMBASE, Cochrane, PubMed, CINAHL, and Google Scholar revealed no head-to-head comparative studies of EVH devices. As a result, the group evaluated EVH device industry specifications and white papers to analyse the evolution, component features, and limitations of current systems. Expert consensus was also sought to outline ideal device attributes and training enhancements.</p><p><strong>Results: </strong>Studies suggest the EVH learning curve ranges from 5 to 30 cases; however, studies have reported that even after 100 cases, learning may be incomplete, particularly when assessed using optical coherence tomography for conduit injury. A lack of high-quality comparative studies and wide variability in device design, institutional practices, and user experience hinder conclusions about the superiority of any specific EVH system. Device choice is often based more on training background and availability than on clinical evidence.</p><p><strong>Conclusions: </strong>No existing studies link specific device-related learning curves to clinical outcomes or conduit quality. There is an apparent need for independent device evaluation, standardized training programmes, and robust comparative outcome data to support evidence-based device selection that prioritizes patient safety and conduit long-term patency.</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":"144981429","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":"Utility of GERAADA Score for Predicting Long-term Survival Following Surgical Repair of Aortic Dissection.","authors":"Francesco Pollari, Paolo Nardi, Elisa Mikus, Francesco Ferraro, Marco Gemelli, Ilaria Franzese, Ilaria Chirichilli, Claudia Romagnoni, Giuseppe Santarpino, Salvatore Nicolardi, Roberto Scrofani, Federico Ranocchi, Enzo Mazzaro, Gino Gerosa, Massimo Massetti, Carlo Savini, Giovanni Ruvolo, Luca Di Marco, Oriana D'Ecclesiis, Emma Guagneli, Giorgia Duranti, Alessandro Parolari, Fabio Barili","doi":"10.1093/icvts/ivaf160","DOIUrl":"10.1093/icvts/ivaf160","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to assess the long-term survival following surgical repair because of acute type A aortic dissection (ATAAD) and the correlation with the preoperative GERAADA (German Registry for Acute Type A Aortic Dissection)-score value.</p><p><strong>Methods: </strong>We enrolled patients who underwent emergent aortic surgery because of ATAAD from 2010 to 2022 from 9 hospitals. Follow-up information was obtained by matching the clinical patient data with a national administrative database. Discrimination and calibration of GERAADA were tested at 1, 2, 5, and 10 years. The relationship between long-term outcome and score was also tested through time-to-event methods.</p><p><strong>Results: </strong>A total of 1110 patients were analysed: Median age was 67 years [IQR 57-75], and 30.8% of subjects were female. Median GERAADA score was 14.3% [10.2-22]. Mean length of follow-up was 4.19 years. The Kaplan-Meier estimates of survival at 5 and 10 years were, respectively, 62.5% ± 1.5%, and 48.5% ± 2.1%. Discrimination was poor but remained stable over the time (area under the curve [AUC] at 1-year follow-up: 0.66; 95% CI 0.63-0.70. AUC at 10-year follow-up: 0.64; 95% CI 0.61-0.68). Calibration plots showed underprediction until 50%-predicted probability and progressive overprediction afterward. There is a steep mortality in the first couple of months after surgery while afterward the mortality rate is constantly lower. GERAADA score was found to be a predictor of long-term mortality with a nonlinear association.</p><p><strong>Conclusions: </strong>GERAADA score showed a poor performance in predicting long-term survival.</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/PMC12448939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034812","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":"Electrocardiographic Imaging as Preoperative Tool in Persistent and Long-Standing Persistent Atrial Fibrillation: A Prospective Observational Study.","authors":"Emilio Osorio-Jaramillo, Luca Conci, Thomas Schlöglhofer, Iuliana Coti, Andreas Strassl, Christoph Schukro, Daniel Zimpfer, Marek P Ehrlich, Niv Ad","doi":"10.1093/icvts/ivaf198","DOIUrl":"10.1093/icvts/ivaf198","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical ablation for treating atrial fibrillation (AF) is currently performed mostly without preoperative electrophysiological imaging. This study aimed to investigate the use of non-invasive surface mapping as a preoperative tool to explore potential mechanisms and patterns involved in the electrophysiology of persistent and long-standing persistent AF.</p><p><strong>Methods: </strong>This prospective, observational study included cardiac surgery candidates without previous ablation. Bi-atrial epicardial activation sequences were obtained with electrocardiographic imaging and analysed in an independent core lab. Statistical analyses included hierarchical clustering, which quantified 3 clusters based on the number of drivers to identify specific characteristics.</p><p><strong>Results: </strong>All 51 patients [14 (27%) persistent; 37 (73%) long-standing persistent; AF, duration 42 months (interquartile range 14-120)] had bi-atrial electrophysiological abnormalities. Most rotors were harbored in the upper half of the right atrium, involved in almost all patients (50/51, 98%), followed by the pulmonary vein areas and left-atrial backwall (48/51, 94%). Longer AF duration showed no association towards fewer rotor and focal activity (r = -0.08, P = 0.42; r = -0.06, P = 0.56, respectively). A significant correlation existed between larger left atrial (LA) size and fewer rotors (r = -0.33, P < 0.001), but not focal activity (r = 0.01, P = 0.92). The clusters differed in AF duration and LA size, and in their number of rotor and focal activities (P = 0.005, P < 0.001, respectively).</p><p><strong>Conclusions: </strong>The underlying electrophysiological mechanism was identified in all patients and consistently showed bi-atrial involvement irrespective of AF duration, LA size, or concomitant heart disease. In larger left atria and longer AF duration, the observed lower number of rotors might be related to atrial tissue fibrosis and lower amplitudes. The results demonstrate the potential role of preoperative mapping to improve procedural planning and our understanding of patients' electrophysiology.</p><p><strong>Clinical registration: </strong>ClicalTrials.gov NCT06803615.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884440","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":"Secondary Asphyxiating Thoracic Dysplasia Due to Multiple Chondromas: A Novel Surgical Report.","authors":"Wenlin Wang, Rajkamal Vishnu, Weiguang Long, Yang Liu","doi":"10.1093/icvts/ivaf191","DOIUrl":"10.1093/icvts/ivaf191","url":null,"abstract":"<p><p>Asphyxiating thoracic dysplasia (ATD), also known as Jeune syndrome, is a rare and serious genetic condition; its incidence in adult populations is even rarer. A 25-year-old male had a 10-year history of chest wall deformity and progressive dyspnoea. A complex chest wall reconstruction, along with the excision of bone tumours, was performed in view of critical hypoxia. Mechanical ventilation was persistently required postoperatively. However, the patient did improve, and eventually proper chest configuration was restored with a special surgical technique. Histopathological analysis demonstrated the presence of multiple osteochondromas of the ribs. To the best of our knowledge, this is the first reported case of secondary ATD caused by osteochondromas of the ribs.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877030","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":"Hybrid Atrial Fibrillation Ablation: Association of Clinical Characteristics, Biomarkers, and Blanking Period with Recurrence.","authors":"Marieke J H Velt, Federico T Magni, Yuri Blaauw, Massimo A Mariani, Theo J Klinkenberg, Michiel Rienstra, Bart A Mulder","doi":"10.1093/icvts/ivaf197","DOIUrl":"10.1093/icvts/ivaf197","url":null,"abstract":"<p><strong>Objectives: </strong>Hybrid atrial fibrillation (AF) ablation is a treatment for therapy-resistant, symptomatic AF. Limited data exist on the risk factors for failure of the procedure. Therefore, this study aimed to identify clinical factors and blood biomarkers associated with atrial arrhythmia recurrence within 2 years following hybrid ablation.</p><p><strong>Methods: </strong>The hybrid AF ablation study is a single-centre, prospective, observational study including consecutive AF patients who underwent hybrid ablation between January 2015 and September 2021. Blood samples were collected pre-ablation, and 7 biomarkers were assessed based on their possible association with recurrence. The blanking period was defined as the first 3 months after ablation. Clinical follow-up visits combined with 12-lead electrocardiogram (ECG) and 72-hour Holter monitoring were scheduled at 3, 6, 12, and 24 months post-procedure. Cox proportional hazard regression analyses were performed to assess the association with recurrence.</p><p><strong>Results: </strong>Of the 91 patients included (mean age 57.1 years [standard deviation: 8.1]; 16% women), 31 (34%) experienced atrial arrhythmia recurrence within 2 years following hybrid ablation, with a median time to recurrence of 254 days (interquartile range 147-428). Multivariable Cox proportional hazard regression, adjusted for age and sex, showed that recurrence in the blanking period was associated with atrial arrhythmia recurrence within 2 years post-ablation (hazard ratio 4.05, 95% confidence interval 1.85-8.91); however, no association was detected between other clinical factors or blood biomarkers and atrial arrhythmia recurrence.</p><p><strong>Conclusions: </strong>In AF patients undergoing hybrid ablation, recurrence in the blanking period was associated with atrial arrhythmia recurrence within 2 years post-ablation.</p><p><strong>Clinical registration: </strong>ClinicalTrials.gov, NCT02516033, https://clinicaltrials.gov/ct2/show/NCT02516033.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884441","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":"Effects of Ulinastatin on Inflammation Response and Lung Tissue Injury in Deep Hypothermic Circulatory Arrest.","authors":"Qiang Hu, Yuan Teng, Yuan Yuan, Guodong Gao, Bingyang Ji","doi":"10.1093/icvts/ivaf177","DOIUrl":"10.1093/icvts/ivaf177","url":null,"abstract":"<p><strong>Objectives: </strong>Deep hypothermic circulatory arrest (DHCA) is known to trigger a systemic inflammatory response and ischaemia-reperfusion injury, leading to exacerbated lung dysfunction. Ulinastatin (UTI) is a commonly used anti-inflammatory drug in clinical settings, but its protective effects may vary depending on the timing and dosage.</p><p><strong>Methods: </strong>A rat model of DHCA was established, and 2 different doses of UTI (5/10 × 104 U/kg; low/high dose) were administered. We measured the levels of inflammatory factors using enzyme-linked immunosorbent assay kits and assessed the functional indicators of lung tissue injury. All rats (n = 18) underwent the standard cardiopulmonary bypass (CPB) procedure with DHCA.</p><p><strong>Results: </strong>Following rewarming, the levels of interleukin-6 (IL-6), IL-10, tumour necrosis factor (TNF)-α, and neutrophil elastase 2 (ELA-2) gradually increased in rats exposed to DHCA. Compared to the DHCA group, both the UTI groups exhibited significant reductions in IL-6 (DHCA vs DHCA+UTI-H, 8931.68 ± 650.31 vs 2498.05 ± 552.16), TNF-α (DHCA vs DHCA+UTI-H, 633.74 ± 74.53 vs 221.19 ± 31.63), and ELA-2 (DHCA vs DHCA+UTI-H, 4.94 ± 0.49 vs 3.29 ± 0.34), while remarkably increased the IL-10 (DHCA vs DHCA+UTI-H, 975.04 ± 110.33 vs 3081.27 ± 554.10) levels 4 hours after weaning from CPB (all P < 0.05). Interestingly, the high dose of UTI demonstrated a dose-dependent inhibition of inflammation. Meanwhile, we found that UTI contributed to maintain haemodynamic stability, improve tissue perfusion, and reduce hypoxia, as evidenced by elevated heart rate, blood pressure, haematocrit and oxygenation index, and decreased glucose and lactate. Reduced pathological changes in lung histopathology were also observed after UTI intervention, especially in 10 × 104 U/kg group.</p><p><strong>Conclusions: </strong>This study revealed that administration of low to high doses of UTI during DHCA could reduce the release of inflammatory factors, exert anti-inflammatory effects, and alleviate lung injury.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746300","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":"Durability Testing With Calcification of Surgical Aortic Valves and Transcatheter Heart Valves: An In Vitro Study.","authors":"Najla Sadat, Antonia Osterloh, Michael Scharfschwerdt, Matthias Klinger, Buntaro Fujita, Stephan Ensminger","doi":"10.1093/icvts/ivaf196","DOIUrl":"10.1093/icvts/ivaf196","url":null,"abstract":"<p><strong>Objectives: </strong>Structural valve deterioration, mainly caused by calcification, is the Achilles heel of the bioprosthetic heart valves. While clinical long-term experience of surgical aortic valve (SAV) bioprostheses exists, transcatheter heart valve (THV) requires further investigations into biological degeneration. Therefore, this in vitro study aimed to analyse the calcification pattern of different SAV and THV models under standardized conditions.</p><p><strong>Methods: </strong>SAVs (Perimount Magna Ease, Perimount, Mosaic Ultra and Hancock II) and THVs (Evolut PRO and SAPIEN XT) models were calcified with a calcification buffer (pH = 7.4 and CaCl2 = 1.5 mM) circulating at 37°C over 157.684 million cycles in a Hi-Cycle-tester to simulate 5 patient-years. Hydrodynamic performance (mean pressure gradient [MPG] and effective orifice area [EOA]) of the valves were compared in a pulse duplicator before and after calcification. The calcified group and one untreated prosthesis (control group) were analysed by macroscopic evaluation, tissue thickness measurement, calcium titration, scanning electron microscopy, and histological examination (n = 12).</p><p><strong>Results: </strong>After durability testing, the MPG and EOA of all valves changed significantly, except for Evolut PRO. The valve leaflets of the calcified group presented hydroxyapatite crystals and a distinct calcification along regions with high mechanical stress-the commissures, nadirs, and ventricle side. Durability testing with calcification buffer resulted in significantly higher calcium content within all valve models' leaflets than in their control group. The THVs showed superiority vs surgical valves regarding the susceptibility to calcification, with a degree of calcification differing significantly depending on the valve model.</p><p><strong>Conclusions: </strong>The Evolut PRO THV's functional performance was not significantly impaired after durability testing. Further clinical evaluation of this aspect is essential to confirm the susceptibility to calcification of bioprosthetic heart valves.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884439","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":"Interdisciplinary periprocedural management of patients undergoing transapical tmvi with the tendyne™ system: A narrative review and institutional experience.","authors":"Cyril D Ferro, Fabien Praz, Nicolas Brugger, David Reineke, Terbeck Sandra, Florian Setzer, Stephan Windecker, Gabor Erdoes","doi":"10.1093/icvts/ivaf181","DOIUrl":"https://doi.org/10.1093/icvts/ivaf181","url":null,"abstract":"<p><strong>Objectives: </strong>Mitral regurgitation (MR) represents the most common valvular heart disease (VHD) in the Western world. While transcatheter mitral valve repair (M-TEER) is the leading interventional treatment for surgically high-risk patients, transcatheter mitral valve implantation (TMVI) is reserved for selected patients with unsuitable anatomy for M-TEER. This review aims to summarize our institutional experience with TMVI using the Tendyne™ valve (Abbott Vascular, CA, USA), focusing on interdisciplinary preoperative, intraoperative, and postoperative management strategies.</p><p><strong>Methods: </strong>We conducted a narrative review of current literature on TMVI with the Tendyne™ system and integrated it with a comprehensive analysis of our interdisciplinary clinical experience. Data were collected regarding patient selection, imaging protocols, procedural techniques, and postoperative care.</p><p><strong>Results: </strong>Utilizing the Tendyne™ valve, TMVI addresses symptomatic moderate-to-severe or severe MR in patients unsuitable for conventional surgery or transcatheter mitral valve repair (M-TEER). Successful outcomes require thorough patient selection, including assessment for minimal mitral annular calcification, absence of intracardiac thrombus, low left ventricular outflow tract (LVOT) obstruction risk, and optimal annular sizing. Multimodal imaging, particularly transoesophageal echocardiography and cardiac computed tomography, is essential for procedural planning and execution. TMVI is performed under general anaesthesia with intraoperative transoesophageal guidance and haemodynamic monitoring to minimize complications such as LVOT obstruction, bleeding, and valve malposition. Postoperative management emphasizes haemodynamic stabilization, bleeding control, and surveillance for paravalvular leaks or device dysfunction.</p><p><strong>Conclusions: </strong>TMVI with the Tendyne™ valve provides a viable and effective treatment for selected patients with symptomatic moderate to severe MR. Optimal outcomes are dependent on meticulous interdisciplinary collaboration, advanced imaging protocols, and comprehensive perioperative management.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857168","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}