Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"A case of Lemierre-like syndrome with mediastinal-pulmonary communication managed without lung resection.","authors":"Sotaro Takemura, Tomoki Keiya, Hirofumi Uehara, Masahiro Miyajima","doi":"10.1093/icvts/ivag242","DOIUrl":"https://doi.org/10.1093/icvts/ivag242","url":null,"abstract":"<p><p>Lemierre-like syndrome, an atypical variant of Lemierre's syndrome, is characterised by septic thrombophlebitis without classical features and may be complicated by descending necrotising mediastinitis (DNM). Contrast-enhanced computed tomography revealed extensive thrombosis of the right internal jugular, external jugular, and subclavian veins, along with multiple cervical and mediastinal abscesses, consistent with DNM. A cystic lesion in the right upper lobe suggested a lung abscess. Emergency cervical drainage was performed, followed by thoracoscopic mediastinal drainage. Communication between the mediastinal and pulmonary abscess cavities was identified intraoperatively. As no air leak was detected during a 20 cmH₂O leak test, pulmonary resection was avoided. Methicillin-susceptible Staphylococcus aureus was isolated, and the patient recovered with antibiotics and anticoagulants. The patient remained recurrence-free for 7 months. Careful intraoperative assessment may allow successful management without resection in selected cases of mediastinal-pulmonary communication.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868178","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":"Transapical transcatheter mitral valve replacement with apical tethering system. Single-center mid-term results.","authors":"Laura Besola, Cristina Di Franco, Federico Giorgi, Danilo Ruggiero, Giosuè Salvatore Falcetta, Michele Celiento, Giacomo Ravenni, Cristina Giannini, Andrea Colli","doi":"10.1093/icvts/ivag194","DOIUrl":"https://doi.org/10.1093/icvts/ivag194","url":null,"abstract":"<p><strong>Objectives: </strong>In high-risk patients, transcatheter mitral valve replacement (TMVR) is an alternative to surgery and transcatheter edge-to-edge repair (TEER). This study aims to evaluate the mid-term results of TMVR with the Tendyne System in a real-world population at a single center.</p><p><strong>Methods: </strong>Between November 2018 and December 2023, all consecutive patients undergoing TMVR with the Tendyne System were included. The primary outcomes were overall and cardiovascular death. Secondary outcomes included the absence of mitral regurgitation (MR) >mild, improved functional status and device success, as defined by the Mitral Valve Academic Research Consortium criteria.</p><p><strong>Results: </strong>Thirty patients were included. Mean age was 74.6±7.1 years, with a mean EuroScore 2 of 7.7±3.8%. MR was severe in 90% of cases and moderate with concomitant stenosis in 10%; 57% of patients were in NYHA class III-IV, and left ventricular ejection fraction was 42±13%. Technical success was 100%; 30-day mortality was 3.3%; there was no MR > mild; 4 (13%) patients had mild MR; and the mean transvalvular gradient was 3.7±1.1 mmHg. At a median follow-up of 2.8 (IQR 2) years, overall mortality was 50% and cardiovascular mortality was 27%, and we had no device-related complications, apart from one case of bacterial endocarditis that was medically treated. None of the patients presented MR >mild; the mean transvalvular gradient was 2.9±1.7 mmHg. At the latest follow-up, the device success rate was 100%, and NYHA class II was observed in 94% of patients, compared with 43% at baseline (p < 0.001); however, 30% have had a rehospitalization for acute heart failure during FU.</p><p><strong>Conclusions: </strong>In high-risk patients, TMVR with the Tendyne device is associated with acceptable procedure-related morbidity and mortality and leads to mid-term improvement in functional class; however, mid-term survival remains poor.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868246","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":"Ten-year reintervention-free survival after surgical aortic valve replacement for different prosthetic aortic valve models: comparison using real-world data from the Netherlands Heart Registration.","authors":"Hector W L de Beaufort, Maaike M Roefs, Edgar J Daeter, Wilson W L Li, Wim Jan P van Boven, Niels P van der Kaaij, Dennis van Veghel","doi":"10.1093/icvts/ivag240","DOIUrl":"https://doi.org/10.1093/icvts/ivag240","url":null,"abstract":"<p><strong>Objectives: </strong>To compare long-term outcomes across different models of mechanical and biological aortic valve prostheses after surgical aortic valve replacement (SAVR) in the Netherlands.</p><p><strong>Methods: </strong>Data from the Netherlands Heart Registration on isolated, primary SAVR procedures performed from 2007 to 2018 in adult patients were used, excluding active endocarditis. Ten-year survival and freedom from valve-related reintervention were estimated for models that were implanted >200 times, using Cox proportional hazards models for survival and Fine and Gray's models with death as the competing-event for freedom of reintervention.</p><p><strong>Results: </strong>For 11,139 patients treated with a biological prosthetic aortic valve, ten-year survival was highest for the Perimount Magna Ease (72.6%) and Epic (70.0%), and significantly lower for the Perimount Magna (65.1%), Trifecta (63.1%), Perimount (61.4%), Freedom Solo (51.5%), and Mitroflow (50.7%). Ten-year freedom from reintervention was highest for the Perimount Magna (99.3%), and significantly lower for the Perimount Magna Ease (98.2%), Perimount (98.2%), Epic (97.3%), Trifecta (96.8%), Freedom Solo (93.2%) and Mitroflow (90.5%). For 2,123 patients treated with a mechanical prosthetic aortic valve, ten-year survival was highest for the Regent (91.2%) and not significantly different for the Open Pivot (89.2%), Slimline (87.5%), HP (87.3%) and significantly lower for the Carbomedics Reduced (87.0%). Ten-year freedom from reintervention was highest for the Carbomedics Reduced (97.1%), not significantly different for the Open Pivot (96.1%), Slimline (96.5%), Regent (95.9%), and significantly lower for the HP (94.9%).</p><p><strong>Conclusions: </strong>Differences in ten-year outcomes after SAVR were observed for the different prosthetic aortic valve models that were used in the Netherlands Heart Registration, especially for biological prosthetic aortic valve models, with survival varying from 50.7% to 72.6% and freedom from reintervention from 90.5% to 99.3%.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868252","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":"Surveillance after thoracic aortic surgery yields to low number of reinterventions: A Retrospective Cohort Study.","authors":"Henri-Jussi Kurvinen, Ari Mennander, Mikko Uimonen","doi":"10.1093/icvts/ivag239","DOIUrl":"https://doi.org/10.1093/icvts/ivag239","url":null,"abstract":"<p><strong>Aim: </strong>Postoperative imaging surveillance after thoracic aortic surgery is widely recommended, but its clinical yield, efficiency, and optimal targeting remain poorly defined. We aimed to quantify imaging intensity, determine the procedural yield of surveillance imaging, and assess whether follow-up strategies could be better individualized.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre cohort study of patients undergoing thoracic aortic surgery between 2010 and 2024. Postoperative imaging examinations were reviewed and linked with subsequent treatment decisions. Imaging findings, reinterventions, timing of events, detection context, and follow-up patterns were analysed.</p><p><strong>Results: </strong>The cohort included 380 patients with 1,757 postoperative imaging examinations, of which 1,074 were classified as surveillance aortic imaging performed ≥30 days after surgery. Overall, 42 examinations led to reintervention in 29 patients (7.6%), including 13 examinations leading to aortic reoperation in 12 patients. Among surveillance aortic examinations, 41 (3.8%) led to reintervention and 16 (1.5%) met treatment thresholds without immediate intervention, yielding a combined directly or potentially actionable finding rate of 5.3%. This corresponded to 26.2 surveillance examinations per reintervention and 82.6 per aortic reoperation. Cumulative incidences of first reintervention were 2.8% at 1 year, 5.9% at 3 years, and 8.3% at 5 years. Most reinterventions were identified during elective surveillance imaging (71.4%). Despite more frequent imaging among emergency patients, reintervention risk and imaging yield were similar to those of non-emergency patients.</p><p><strong>Conclusion: </strong>Postoperative imaging surveillance after thoracic aortic surgery was associated with substantial imaging burden but low immediate procedural yield, with clinically relevant findings concentrated in a minority of patients. These findings support the need to better define patient-specific risk and imaging efficiency, but do not establish that less intensive surveillance would be safe without prospective validation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835385","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":"Multivessel versus single-vessel coronary endarterectomy as an adjunct to coronary artery bypass grafting: A meta-analysis of short-term outcomes and implications for target-vessel selection.","authors":"Joshua J Hon, Arian Arjomandi Rad, Abdullah Tahir, Elisa Salagean, Marco Moscarelli, Dimitrios E Magouliotis, Roberto Casula, Thanos Athanasiou","doi":"10.1093/icvts/ivag238","DOIUrl":"https://doi.org/10.1093/icvts/ivag238","url":null,"abstract":"<p><strong>Objectives: </strong>Coronary endarterectomy (CE) extends complete revascularisation to patients with diffuse coronary disease unsuitable for conventional bypass but adds perioperative risk to coronary artery bypass grafting (CABG). Whether the number of vessels endarterectomised influences early outcomes has not been formally synthesised. We compared short-term outcomes of single-vessel and multivessel CE-CABG.</p><p><strong>Methods: </strong>MEDLINE, Embase, and CENTRAL were searched for studies of CE-CABG reporting outcomes stratified by single-vessel versus multivessel CE within the same cohort. The primary outcome was 30-day or in-hospital mortality. Risk ratios (RR) were pooled using DerSimonian-Laird random-effects models. Sensitivity analyses included leave-one-out analysis, Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment, and univariate meta-regression on study-level covariates. Risk of bias was assessed with ROBINS-I.</p><p><strong>Results: </strong>Nine studies (1988-2022; 7,302 patients; 4,731 single-vessel CE, 2,571 multivessel CE) met inclusion criteria. Multivessel CE was associated with higher mortality (RR, 2.59; 95% CI, 1.78-3.77), higher perioperative myocardial infarction (RR, 2.09; 95% CI, 1.67-2.62), and higher stroke (RR, 1.62; 95% CI, 1.01-2.61). Intra-aortic balloon pump use did not differ. Findings were stable on leave-one-out, HKSJ adjustment, and exclusion of pre-2000 studies. No single covariate accounted for the multivessel effect on meta-regression.</p><p><strong>Conclusions: </strong>Multivessel CE substantially increases early mortality and infarction relative to single-vessel CE. The signal is consistent across analyses but the evidence is largely retrospective and unadjusted. These data support a selective approach to CE in which the prognostic value of each target vessel is weighed against the cumulative operative cost, rather than routine extension of endarterectomy to multiple territories.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835392","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":"Association between one-lung ventilation parameters and postoperative pulmonary infection after radical lung cancer surgery: A retrospective cohort study.","authors":"Qianming Chen, Zhuangwen Hu, Yu Sheng, Zhenlin Jiang","doi":"10.1093/icvts/ivag237","DOIUrl":"https://doi.org/10.1093/icvts/ivag237","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between lung-protective parameters during one-lung ventilation (OLV) and the risk of postoperative pulmonary infection (PPI) after radical lung cancer (LC) surgery.</p><p><strong>Methods: </strong>This retrospective study included 319 patients with non-small cell lung cancer who underwent radical LC surgery with OLV during January 1, 2022-December 31, 2025. Patients were divided into PPI (n = 35) and non-PPI (n = 284) groups based on whether PPI occurred during postoperative hospitalization. Baseline data, preoperative pulmonary function, and intraoperative OLV parameters were collected. Logistic regression analyses were performed to identify relevant factors. The discriminatory ability of the multivariate model was evaluated using the ROC curve.</p><p><strong>Results: </strong>The incidence of PPI was 11.0%. Compared with the non-PPI group, the PPI group had older age, a higher proportion of hypertension, lower forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF), a higher proportion of open thoracic surgery, higher tidal volume (VT), higher inspiratory pressure, higher ventilation frequency, and higher fraction of inspired oxygen (FiO₂), but lower positive end-expiratory pressure (PEEP) (all P < 0.05). Multivariate logistic regression analysis showed that hypertension, lower FEV1, open thoracic surgery, higher inspiratory pressure, and higher FiO₂ were independently associated with PPI (all P < 0.05). The AUC of the model constructed based on these independent factors was 0.856 (95% CI: 0.782-0.906).</p><p><strong>Conclusion: </strong>Lung-protective parameters during OLV are associated with PPI after radical LC surgery. Notably, higher inspiratory pressure and higher FiO₂ remain independently associated with PPI after adjusting for confounding factors.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820578","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":"Angiosarcoma in the setting of vascular procedures: A systematic review and our experiences.","authors":"Phil Yi Jun Lu, Joel Ding, Casey Hiu Ching Fung, Michelle Davis, Mark Westcott, Justin Jedynak, Yahya Lahham","doi":"10.1093/icvts/ivag236","DOIUrl":"https://doi.org/10.1093/icvts/ivag236","url":null,"abstract":"<p><strong>Objectives: </strong>Angiosarcoma is a rare, aggressive endothelial malignancy with a poor prognosis; diagnosis is often delayed by vague symptoms, nonspecific imaging and challenging histopathology. Case reports have suggested an association with prior vascular procedures, with or without prosthetic material, but no causal link is established. We reviewed angiosarcoma across the full spectrum of vascular reconstruction.</p><p><strong>Methods: </strong>We systematically reviewed English-language human studies in PubMed, Embase and the Cochrane Library for histologically confirmed angiosarcomas diagnosed after and anatomically related to vascular procedures. The review was registered on PROSPERO (CRD42024602643).</p><p><strong>Results: </strong>We describe three patients with metastatic angiosarcoma contiguous with vascular prostheses: a 75-year-old male with left inguinal angiosarcoma seven years after PTFE bypass grafting; a 69-year-old male with angiosarcoma within the aneurysm sac seven years after endovascular aneurysm repair (EVAR); and an 80-year-old male with intraluminal angiosarcoma within an EVAR limb presenting as distal embolisation. Systematic review identified 44 studies comprising 46 additional cases. Including these, 49 patients were analysed: 27 associated with endovascular prostheses, 14 with open prosthetic or mixed grafts, and 8 with autologous-vein bypass. Mean diagnostic latency was 7 years (range 5 months to 18 years); mean age 70.5 years; 12.2% were female.</p><p><strong>Conclusions: </strong>Angiosarcoma is difficult to diagnose given its nonspecific presentation but should be considered in atypical or refractory post-procedural presentations. This is the largest synthesis to date and the first to describe intraluminal EVAR-limb angiosarcoma with distal embolisation. Inclusion of autologous-vein reconstructions argues against a purely prosthetic-material explanation; further investigation is needed to clarify causality.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809440","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":"Determinants of effective height in morphologically normal tricuspid aortic valves: A computed tomography-based anatomical study.","authors":"Keiichi Ishida, Takashi Igarashi, Hitoshi Yokoyama, Kenichi Imasaka","doi":"10.1093/icvts/ivag233","DOIUrl":"https://doi.org/10.1093/icvts/ivag233","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the relationship between effective height and other morphological parameters of the aortic valve complex when the aortic valve is closed.</p><p><strong>Methods: </strong>We retrospectively analysed 105 patients (mean age 70.7±10.1 years) with morphologically normal aortic valves, roots, or ascending aortas who had undergone electrocardiography-gated cardiac computed tomography as a screening test of the coronary artery, from August 2014 to December 2018. Parameters of the aortic valve complex configuration (effective height, geometric height, aortic annular diameter, sinus of Valsalva diameter, sinotubular junction diameter, commissure height, and Valsalva height) in diastole were measured using Ziostation2 software. Pearson's correlation was used to evaluate the associations between the effective height and other parameters. Multiple regression analysis was performed to evaluate the variables independently associated with effective height.</p><p><strong>Results: </strong>Significant associations were observed between the effective height and geometric height, sinus of Valsalva diameter, sinotubular junction diameter, commissure height, and Valsalva height (all p < 0.001) but not between effective height and aortic annular diameter (p = 0.227). Multivariable analysis showed that geometric height, aortic annular diameter, and sinotubular junction diameter were independently associated with effective height (all p < 0.001; overall model fit: R2=0.739).</p><p><strong>Conclusions: </strong>Our findings demonstrate that effective height is strongly associated with geometric height, which remained independently associated after adjustment, along with aortic annular and sinotubular junction diameters. These results provide quantitative in vivo evidence regarding the anatomical determinants of effective height in morphologically normal tricuspid aortic valves and may serve as anatomical reference data for future research on individualised approaches to aortic valve repair.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802615","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":"Long-term outcomes after supravalvar aortic stenosis repair: Impact of residual haemodynamics on reintervention.","authors":"Nabil Hussein, Branko Mimic, Mats Synnergren, Nagarajan Muthialu, Victor Tsang, Martin Kostolny","doi":"10.1093/icvts/ivag230","DOIUrl":"https://doi.org/10.1093/icvts/ivag230","url":null,"abstract":"<p><strong>Objective: </strong>Surgical repair of supravalvar aortic stenosis (SVAS) provides excellent early outcomes; however, late reintervention remains common. The determinants of left ventricular outflow tract (LVOT) failure, particularly the role of residual haemodynamics, remain incompletely defined. We sought to identify predictors of LVOT reintervention in a contemporary cohort.</p><p><strong>Methods: </strong>A retrospective study of consecutive patients aged <18 years undergoing SVAS repair between 2005 and 2024 was performed. Primary endpoints were overall survival and freedom from LVOT reintervention. Survival and freedom from reintervention were assessed using Kaplan-Meier analysis. Multivariable Cox regression was used to identify independent predictors of LVOT reintervention.</p><p><strong>Results: </strong>Seventy-seven patients underwent repair at a median age of 3 (1-8) years, with median follow-up of 9.3 (6-14) years. There was no early or late mortality, nineteen patients (25%) required reintervention, including 16 (21%) LVOT-related procedures. Freedom from LVOT reintervention was 74% at 10 years and 71% at 15-20 years. Discharge LVOT velocity >3 m/s was independently associated with LVOT reintervention (HR 11.66, 95% CI 3.56-38.18; p < 0.001). Younger age was also independently associated with increased risk (HR per year 0.74, 95% CI 0.59-0.94; p = 0.013) for LVOT re-intervention. Coronary abnormalities were documented in 17% of patients, with one early coronary reintervention.</p><p><strong>Conclusion: </strong>SVAS repair is associated with excellent long-term survival. Residual discharge velocity emerged as an independent predictor of late LVOT reintervention supporting the importance of achieving optimal haemodynamic relief at the index operation and structured lifelong surveillance.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802599","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":"Association between blood pressure variability and acute kidney injury following transcatheter aortic valve replacement: a study based on the MIMIC-IV database.","authors":"Ruowen Li, Zhao Li, Bo Zhang","doi":"10.1093/icvts/ivag227","DOIUrl":"https://doi.org/10.1093/icvts/ivag227","url":null,"abstract":"<p><strong>Objectives: </strong>Acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR) is a prevalent complication that impacts patient prognosis. While blood pressure variability (BPV) has been implicated in AKI among patients undergoing other surgical procedures, its association with AKI following TAVR remains uncharted. This study aimed to investigate the association between BPV and post-TAVR AKI.</p><p><strong>Methods: </strong>Based on the Medical Information Mart for Intensive Care database, logistic regression models were employed to investigate the associations of average real variability of systolic blood pressure (ARV-SBP) and average real variability of diastolic blood pressure (ARV-DBP) with AKI following TAVR. Multiple sensitivity analyses evaluated the robustness of the results. The marginal standardization analysis estimated the odds of AKI after ARV-SBP adjustment.</p><p><strong>Results: </strong>A total of 340 patients undergoing TAVR were enrolled, among whom 107 (31.5%) developed AKI. Logistic regression analysis demonstrated a positive correlation between ARV-SBP and the odds of post-TAVR AKI (OR = 1.34, 95%CI: 1.03-1.74, P=0.029) in the fully adjusted model. In contrast, no significant correlation was observed between ARV-DBP and AKI (P=0.559). In covariate and blood pressure measurement sensitivity analyses, the direction of the ARV-SBP effect was generally consistent with that in the primary analysis. Marginal standardization analysis demonstrated that higher ARV-SBP levels were associated with elevated odds of AKI.</p><p><strong>Conclusions: </strong>Elevated ARV-SBP was associated with increased odds of post-TAVR AKI. ARV-SBP may serve as an auxiliary indicator for early risk identification of post-TAVR AKI, yet its clinical value remains to be validated in prospective studies.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764207","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}