Interdisciplinary cardiovascular and thoracic surgery最新文献

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Association between blood pressure variability and acute kidney injury following transcatheter aortic valve replacement: a study based on the MIMIC-IV database. 经导管主动脉瓣置换术后血压变异性与急性肾损伤的关系:一项基于MIMIC-IV数据库的研究
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-14 DOI: 10.1093/icvts/ivag227
Ruowen Li, Zhao Li, Bo Zhang
{"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}
引用次数: 0
Strategy and clinical outcomes of open surgical repair for adult Kommerell's diverticulum: a retrospective cohort study and our 10-year experience. 开放式手术修复成人Kommerell憩室的策略和临床结果:一项回顾性队列研究和我们10年的经验。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-11 DOI: 10.1093/icvts/ivag210
Bowen Zhang, Mingxin Xie, Yanxiang Liu, Han Li, Ruojin Zhao, Xiangyang Qian, Cuntao Yu, Yaojun Dun, Xiaogang Sun
{"title":"Strategy and clinical outcomes of open surgical repair for adult Kommerell's diverticulum: a retrospective cohort study and our 10-year experience.","authors":"Bowen Zhang, Mingxin Xie, Yanxiang Liu, Han Li, Ruojin Zhao, Xiangyang Qian, Cuntao Yu, Yaojun Dun, Xiaogang Sun","doi":"10.1093/icvts/ivag210","DOIUrl":"https://doi.org/10.1093/icvts/ivag210","url":null,"abstract":"<p><strong>Objectives: </strong>To report our strategy and outcomes in open surgically treating adult Kommerell's diverticulum (KD) over the past decade.</p><p><strong>Methods: </strong>44 patiens who underwent open surgical repair for KD at our institution between 2015 and 2024 were enrolled. Patients were classified as aneurysm group (n = 25, 56.8%) or dissection (n = 19, 43.2%) group. Depending on the position and pathology, 1 of 4 procedures was performed: (1) descending aorta replacement and aberrant subclavian artery reconstruction; (2) total arch and partial descending aorta replacement; (3) thoracoabdominal aortic replacement; or (4) total arch replacement with frozen elephant trunk. Long-term prognosis and perioperative safety were analyzed.</p><p><strong>Results: </strong>Early mortality and composite adverse events for the overall cohort were 13.6% and 20.5%, respectively, without significant differences between the aneurysm and dissection groups (8.0% vs 21.1%, P = 0.42; 16.0% vs 26.3%, P = 0.32). However, the dissection group had a higher rate of acute kidney injury (52.6% vs 20.0%, P = 0.02), longer mechanical ventilation (33.4 [13.2∼122.1] vs 14.2 [6.8∼22.7] h, P = 0.005), longer intensive care unit stay (5 [3∼10] vs 2 [1∼5] d, P = 0.001), and longer postoperative hospitalization (15 [14∼21] vs 10 [7∼18] d, P = 0.007). For the entire cohort, 5-year overall survival and freedom from aortic-related reintervention were 77.8% and 88.9%. Patients in the dissection group had significantly lower 5-year overall survival (61.2% vs 92.0%, P=0.022) and freedom from aortic-related reintervention rates (77.3% vs 100%, P=0.036).</p><p><strong>Conclusions: </strong>Open surgical strategy was selected arrording to the position and pathology of KD. Open surgery achieved acceptable early and long-term outcomes. Once KD progressed to dissection, the difficulty and risk of open surgery increased and the long-term prognosis was impaired.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707682","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}
引用次数: 0
Haematocrit During Cardiopulmonary Bypass and Risk for Acute Kidney Injury: An Observational Single-Centre Study. 体外循环期间的红细胞压积与急性肾损伤的风险:一项观察性单中心研究。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag207
Anders Karl Hjärpe, Anders Jeppsson, Lukas Lannemyr, Birgitta Romlin
{"title":"Haematocrit During Cardiopulmonary Bypass and Risk for Acute Kidney Injury: An Observational Single-Centre Study.","authors":"Anders Karl Hjärpe, Anders Jeppsson, Lukas Lannemyr, Birgitta Romlin","doi":"10.1093/icvts/ivag207","DOIUrl":"10.1093/icvts/ivag207","url":null,"abstract":"<p><strong>Objectives: </strong>Low haematocrit during cardiopulmonary bypass is a known risk factor for acute kidney injury, but it is unclear whether high haematocrit also increases acute kidney injury risk. We examined if a haematocrit range associated with a reduced risk for acute kidney injury could be identified.</p><p><strong>Methods: </strong>This observational study included cardiac surgery patients operated on between 2016 and 2020, using prospectively collected data from the SWEDEHEART registry and a local cardiopulmonary bypass database. Acute kidney injury was defined by registry-available data as a postoperative serum‑creatinine increase >1.5 times baseline or postoperative initiation of renal replacement therapy. For each predefined haematocrit threshold, weighted exposure was calculated as the accumulated time‑and‑magnitude by which haematocrit rose above or fell below the thresholds. Associations between weighted exposure and acute kidney injury were analysed using multivariable logistic regression adjusted for established acute kidney injury risk factors.</p><p><strong>Results: </strong>A total of 3798 patients were included. Postoperative acute kidney injury occurred in 598 of 3798 patients (15.7%). After adjustment, a non‑linear association between haematocrit weighted exposure during aortic cross‑clamp and acute kidney injury was observed. AKI risk increased with haematocrit below 25% (adjusted odds ratio [aOR] 1.006 per 1 [%×min]; 95% CI 1.002-1.009; P < .001) and above 38% (aOR 1.006 per 1 [%×min]; 95% CI 1.001-1.011; P = .019).</p><p><strong>Conclusions: </strong>In this cohort, haematocrit exposure below 25% and above 38% during aortic cross-clamp was associated with higher postoperative acute kidney injury risk. Further studies are needed to confirm these findings.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594836","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}
引用次数: 0
An Unusual Pulmonary Vascular Connection Encountered During Right Upper Lobectomy. 右上肺叶切除术时发现不寻常的肺血管连接。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag205
Temmuz Baran Şencan, Mariam Arafa, Fikri Tarık Arıcı, Cansel Atinkaya Baytemir
{"title":"An Unusual Pulmonary Vascular Connection Encountered During Right Upper Lobectomy.","authors":"Temmuz Baran Şencan, Mariam Arafa, Fikri Tarık Arıcı, Cansel Atinkaya Baytemir","doi":"10.1093/icvts/ivag205","DOIUrl":"10.1093/icvts/ivag205","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary vascular variations may complicate thoracic surgery, particularly video-assisted procedures, where such anomalies increase the risk of bleeding.</p><p><strong>Case presentation: </strong>We report a 77-year-old female undergoing right upper lobectomy for invasive mucinous adenocarcinoma. Imaging revealed a 2 cm posterior right upper lobe nodule with low FDG uptake. Histology showed mixed adenocarcinoma and large-cell neuroendocrine carcinoma (stage IA). Intraoperatively, a vascular connection consistent with an arteriovenous fistula between the superior pulmonary vein and the interlobar pulmonary artery was identified and ligated.</p><p><strong>Conclusions: </strong>Recognition of rare pulmonary vascular anomalies through careful preoperative imaging and intraoperative assessment is essential to minimize surgical complications and ensure safe thoracic resection..</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13467007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563890","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}
引用次数: 0
Optimizing Heparin and Protamine Dosing During Cardiopulmonary Bypass Using Activated Clotting Time-Guided Protocols: A Single-Centre Prospective Randomized Controlled Trial. 利用活化凝血时间指导方案优化体外循环期间肝素和鱼精蛋白剂量:一项单中心前瞻性随机对照试验。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag197
Youssef El Dsouki, Ignazio Condello, Orhan Eren Gunertem, Abducelil Yildirim, Serdar Gunaydin, Roberto Lorusso
{"title":"Optimizing Heparin and Protamine Dosing During Cardiopulmonary Bypass Using Activated Clotting Time-Guided Protocols: A Single-Centre Prospective Randomized Controlled Trial.","authors":"Youssef El Dsouki, Ignazio Condello, Orhan Eren Gunertem, Abducelil Yildirim, Serdar Gunaydin, Roberto Lorusso","doi":"10.1093/icvts/ivag197","DOIUrl":"10.1093/icvts/ivag197","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether an activated clotting time (ACT)-guided, formula-based anticoagulation strategy supported by viscoelastic coagulation monitoring (ROTEM) improves perioperative coagulation management and reduces bleeding compared with standard weight-based heparin dosing in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>In this single-centre prospective, randomized controlled trial, 100 adults undergoing isolated CABG with CPB were allocated to ACT-guided management (n = 50) or standard care (n = 50). The ACT-guided group received individualized heparin and protamine dosing calculated using predefined ACT-based formulas targeting ACT ≥400 seconds. The control group received a fixed heparin bolus (300 IU/kg) with empirical protamine reversal. ROTEM was performed preoperatively, intraoperatively, and postoperatively. The primary end-point was total chest drain output at 24 hours. Secondary end-points included transfusion requirements, thrombotic events, platelet count variation, oxygenator performance, additional heparin or protamine use, ROTEM-derived parameters, and perioperative clinical outcomes.</p><p><strong>Results: </strong>The ACT-guided group had lower 24-hour chest drain bleeding and reduced total exposure to heparin and protamine. Intraoperative ACT values were more consistently within target range, with fewer supplemental heparin doses required. ROTEM demonstrated shorter clotting times and improved clot firmness, indicating reduced postoperative hypocoagulability. Platelet decline during CPB was attenuated. Transfusion rates (28% vs 52%, P = .01) and total allogeneic units transfused (0.6 ± 1.0 vs 1.4 ± 1.6, P = .003) were significantly lower, with no observed increase in thrombotic events.</p><p><strong>Conclusions: </strong>Activated clotting time-guided, formula-based anticoagulation supported by ROTEM was associated with more favourable coagulation parameters and reduced bleeding without evidence of increased thrombotic complications within the limitations of the study sample size. Larger prospective studies are warranted to confirm these findings.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414085","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}
引用次数: 0
Blood-Based Versus Crystalloid Cardiopulmonary Bypass Priming in Left Ventricular Assist Device Surgery: Impact on End-Organ Function and Survival. 左心室辅助装置手术中血液与晶体体外循环启动:对终末器官功能和生存的影响。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag216
Sophie Bonni, Rashad Zayat, Natasja W M Ramnath, Nima Hatam, Lachmandath Tewarie, Ajay Moza, Marjolijn C Sales
{"title":"Blood-Based Versus Crystalloid Cardiopulmonary Bypass Priming in Left Ventricular Assist Device Surgery: Impact on End-Organ Function and Survival.","authors":"Sophie Bonni, Rashad Zayat, Natasja W M Ramnath, Nima Hatam, Lachmandath Tewarie, Ajay Moza, Marjolijn C Sales","doi":"10.1093/icvts/ivag216","DOIUrl":"10.1093/icvts/ivag216","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiopulmonary bypass (CPB) priming may influence haemodilution, bleeding, and end-organ injury during HeartMate 3 (HM3) implantation, but evidence in contemporary left ventricular assist device (LVAD) surgery is limited.</p><p><strong>Methods: </strong>We retrospectively analysed 92 HM3 implantations (2015-2025) by priming strategy (blood-based [FFP + RBC], n = 36; crystalloid, n = 56). The primary end-point was postoperative right heart failure (RHF; Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS]). Multivariable regression and propensity score-based inverse probability of treatment weighting (IPTW) sensitivity analyses were performed.</p><p><strong>Results: </strong>Baseline characteristics were balanced between groups, with comparable age (blood-based: 58 [49.5-66.0]; crystalloid: 62 [55.8-68.2]; P = .069) and female sex (blood-based: n = 3/36 [8.3%]; crystalloid: n = 8/56 [14.3%]; P = .518). Right heart failure was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 17/56 [30.4%]; P = .012; adjusted OR 0.23 [95% confidence interval (CI) 0.06-0.86]; P = .030). Dialysis was lower unadjusted (blood-based: n = 4/36 [11.1%]; crystalloid: n = 18/56 [32.1%]; P = .021), with a directionally lower adjusted estimate (OR 0.30 [95% CI, 0.09-1.01]; P = .053). Delirium was lower with blood-based priming (blood-based: n = 3/36 [8.3%]; crystalloid: n = 16/56 [28.6%]; P = .019; adjusted OR 0.22 [95% CI, 0.06-0.84]; P = .027). Survival did not differ significantly (log-rank P = .055; adjusted HR 0.59 [95% CI, 0.27-1.32]; P = .201). IPTW analyses showed lower delirium (OR 0.23 [95% CI, 0.06-0.84]) and an attenuated RHF association (OR 0.35 [95% CI, 0.10-1.23]).</p><p><strong>Conclusions: </strong>Blood-based CPB priming was associated with lower RHF and delirium, and directionally lower dialysis rates, after HM3 implantation. Survival estimates were not statistically significant. Findings require prospective validation.</p><p><strong>Clinical registration number: </strong>Ethics Committee of the Medical Faculty of RWTH Aachen (EK 25-154).</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632934","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}
引用次数: 0
Clinical Outcomes of Ascending Aortic Replacement for Aneurysm and the Impact of Centre Volume: A Nationwide Population-Based Study. 升主动脉置换术治疗动脉瘤的临床结果和中心容积的影响:一项基于全国人群的研究。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag184
Sue Hyun Kim, Jinhee Kim, Yoonjin Kang, Suk Ho Sohn, Yeiwon Lee, Ho Young Hwang, Kyung Hwan Kim, Mi-Sook Kim, Jae Woong Choi
{"title":"Clinical Outcomes of Ascending Aortic Replacement for Aneurysm and the Impact of Centre Volume: A Nationwide Population-Based Study.","authors":"Sue Hyun Kim, Jinhee Kim, Yoonjin Kang, Suk Ho Sohn, Yeiwon Lee, Ho Young Hwang, Kyung Hwan Kim, Mi-Sook Kim, Jae Woong Choi","doi":"10.1093/icvts/ivag184","DOIUrl":"10.1093/icvts/ivag184","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate contemporary outcomes of elective ascending aortic replacement (AAR) and the impact of centre volume using a nationwide database.</p><p><strong>Methods: </strong>Adults undergoing elective AAR for aneurysms (2003-2021) were identified from the Korean National Health Insurance Service database. Acute dissections, ruptures, and arch involvements were excluded. Restricted cubic splines (RCS) and multivariable regression evaluated the impact of institutional volume and concomitant procedures.</p><p><strong>Results: </strong>Among 5209 patients, operative mortality and stroke rates were 2.9% and 2.2%. Over a 5.9-year median follow-up, RCS revealed a significant non-linear inverse relationship between annual institutional volume and mortality. Treatment at high-volume centres (≥10 cases/year) independently lowered operative mortality (odds ratio, 0.26; 95% CI, 0.18-0.37) and long-term mortality (hazard ratio, 0.64; 95% CI, 0.57-0.73). Distinct clinical phenotypes, including bicuspid aortic valves and concomitant aortic valve surgery, were associated with favourable survival.</p><p><strong>Conclusions: </strong>Elective AAR demonstrates low perioperative risk and stable long-term survival, significantly influenced by annual institutional volume and clinical phenotypes. These findings support dedicated aortic centres and individualized risk stratification.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610898","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}
引用次数: 0
Arch and Frozen Elephant Trunk Repair for Aortic Dissection in Pregnancy With Situs Inversus Totalis. 弓形和冷冻象鼻修复妊娠完全性倒位主动脉夹层。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag223
Yi Yang, Yipeng Ge, Chengnan Li, Junming Zhu
{"title":"Arch and Frozen Elephant Trunk Repair for Aortic Dissection in Pregnancy With Situs Inversus Totalis.","authors":"Yi Yang, Yipeng Ge, Chengnan Li, Junming Zhu","doi":"10.1093/icvts/ivag223","DOIUrl":"10.1093/icvts/ivag223","url":null,"abstract":"<p><strong>Objective: </strong>Acute type A aortic dissection during pregnancy with situs inversus totalis is exceptionally rare.</p><p><strong>Methods: </strong>We report a 27-year-old woman at 24 weeks of gestation who underwent emergency ascending aortic and total arch replacement with frozen elephant trunk implantation.</p><p><strong>Results: </strong>Fetal demise occurred on postoperative day 1, but the mother recovered without neurological deficit and remained well at 10-year follow-up.</p><p><strong>Conclusions: </strong>This case demonstrates the feasibility of complex arch repair in mirror-image anatomy and highlights the importance of individualized operative planning and multidisciplinary maternal-fetal management in experienced aortic centres.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 8","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802589","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}
引用次数: 0
Impact of Donation After Circulatory Death on Waitlist Duration and Early Outcomes in Heart Transplantation for Patients With Durable Mechanical Circulatory Support. 循环死亡后捐赠对持久机械循环支持心脏移植患者等候时间和早期结局的影响。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag214
Takeshi Wada, Joyce Ho, Andrew Belec, Jessica Dominic, Devon Kelly, Shinji Miyamoto, Pavan Atluri
{"title":"Impact of Donation After Circulatory Death on Waitlist Duration and Early Outcomes in Heart Transplantation for Patients With Durable Mechanical Circulatory Support.","authors":"Takeshi Wada, Joyce Ho, Andrew Belec, Jessica Dominic, Devon Kelly, Shinji Miyamoto, Pavan Atluri","doi":"10.1093/icvts/ivag214","DOIUrl":"10.1093/icvts/ivag214","url":null,"abstract":"<p><strong>Objective: </strong>While heart transplantation primarily relies on donors after brain death, the use of donors after circulatory death is increasing to address donor shortages. Although favourable outcomes with donation after circulatory death (DCD) have been reported, its safety in patients bridged with durable mechanical circulatory support (MCS) remains uncertain.</p><p><strong>Design: </strong>Using the United Network for Organ Sharing database, we identified adult recipients supported with durable MCS who underwent isolated primary heart transplantation between 2019 and 2023. Outcomes were compared between recipients of hearts from donors after brain death and donors after circulatory death.</p><p><strong>Results: </strong>Among 14 881 heart transplants, 3681 patients were supported with durable MCS, comprising 3374 (91.7%) recipients from donors after brain death and 307 (8.3%) from donors after circulatory death. Compared with recipients of hearts from donors after brain death, those receiving hearts from donors after circulatory death were more often male, had higher body mass index, lower ABO blood group compatibility, fewer pretransplant infections, less extracorporeal membrane oxygenation use, longer ischaemic times (3.5 vs 5.5 hours, P < .05), and shorter waitlist times (404.4 vs 336.9, P < .05). Survival was similar between groups (90.9% vs 93.2% at 6 months, 89.0% vs 90.2% at 1 year; P = .946). Cause of death and other adverse events were also comparable.</p><p><strong>Conclusions: </strong>Utilizing DCD donors significantly reduces waitlist duration for patients with durable MCS. Although early post-transplant survival was statistically stable, definitive conclusions regarding survival equivalence involve several limitations. Further larger comparative studies with comprehensive donor characteristics are strictly required to evaluate the safety profile of DCD hearts in this high-risk recipient population.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623011","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}
引用次数: 0
Corrigendum to: Repair of aortic coarctation in neonates less than two kilograms. 对小于2公斤新生儿主动脉缩窄修复的更正。
IF 1.4
Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2026-08-03 DOI: 10.1093/icvts/ivag220
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