Michael Salna, Joseph E Bavaria, David Heimansohn, Thomas Beaver, Bartley Griffith, Lars G Svensson, Philippe Pibarot, Michael A Borger, Vinod H Thourani, Eugene H Blackstone, Lorraine D Cornwell, John D Puskas, Hiroo Takayama
{"title":"Seven-Year Results for RESILIA Tissue in Bicuspid Aortic Valve Replacement Patients: Age and Valve Size Considerations.","authors":"Michael Salna, Joseph E Bavaria, David Heimansohn, Thomas Beaver, Bartley Griffith, Lars G Svensson, Philippe Pibarot, Michael A Borger, Vinod H Thourani, Eugene H Blackstone, Lorraine D Cornwell, John D Puskas, Hiroo Takayama","doi":"10.1093/icvts/ivaf176","DOIUrl":"10.1093/icvts/ivaf176","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with bicuspid aortic valve disease requiring surgical aortic valve replacement are often younger and want to avoid lifelong anticoagulation. A multicentre single-arm non-randomized study, the COMMENCE trial, studied outcomes of RESILIA tissue aortic valves in bicuspid aortic valve patients through 7 years of follow-up.</p><p><strong>Methods: </strong>Of 672 patients who underwent surgical replacement of native aortic valves, 214 had bicuspid and 458 had tricuspid aortic valves. Propensity score analyses with inverse probability of treatment weighting were utilized to minimize bias due to measured confounders. Linear mixed-effect models compared longitudinal changes in haemodynamic parameters.</p><p><strong>Results: </strong>Patients with bicuspid were significantly younger than those with tricuspid aortic valves-mean age of bicuspid: 59.8 (12.4) vs tricuspid: 70.2 (9.5) years; P < .001; 39/214 (18%) bicuspid aortic valve patients were <50 years old. There was no evidence of structural valve deterioration in any bicuspid aortic valve patients over 7 years of follow-up. At 7 years, there was no significant difference between bicuspid and tricuspid aortic valve patients in propensity score- and age-adjusted survival (91.9% vs 88.1%, respectively; P = .35), stroke, or reoperation. Among bicuspid aortic valve patients <65 years of age, there was no significant difference in prosthetic valve effective orifice areas and mean gradients between 3 months and 7 years postoperatively.</p><p><strong>Conclusions: </strong>Patients with bicuspid aortic valves had excellent outcomes with RESILIA tissue valves at 7 years with no evidence of structural valve deterioration. These results suggest a durable alternative for carefully selected younger patients wishing to avoid anticoagulation.</p><p><strong>Clinical trial registration number: </strong>NCT01757665.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765862","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":"In vivo aortic elasticity measurement using electrocardiogram-gated computed tomography: validation with ex vivo loading test.","authors":"Junki Yokota, Takashi Shirakawa, Kazuo Shimamura, Takayuki Shijo, Koichi Maeda, Takuji Kawamura, Kizuku Yamashita, Toru Ide, Ryota Matsumoto, Ryoto Sakaniwa, Daisuke Yoshioka, Shigeru Miyagawa","doi":"10.1093/icvts/ivaf148","DOIUrl":"10.1093/icvts/ivaf148","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic aneurysm size is a key determinant for surgical intervention, but aortic catastrophes can occur before reaching the size criteria, indicating size alone is insufficient for risk assessment. Aortic mechanical properties could be another factor for predicting such catastrophes. However, its estimation in daily clinical settings remains impractical. This study aimed to validate a noninvasive electrocardiogram-gated computed tomography (EGCT)-based method for assessing aortic mechanical properties by comparing its measurements with ex vivo tensile testing of resected specimens.</p><p><strong>Methods: </strong>We analysed 49 patients who underwent surgical repair of the ascending aorta. The mechanical properties of the aortic wall were assessed using two parameters: elastic modulus (E), representing stiffness and strain energy (SE), reflecting stored deformation energy. Ex vivo loading test was performed on resected specimens, while in vivo measurements were obtained from preoperative EGCT scans using a custom analysis plugin. Correlation and agreement between methods were evaluated using Spearman's correlation (r), Bland-Altman analysis and intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>EGCT-based measurements of E and SE showed strong correlations with ex vivo loading test (r = 0.733 and r = 0.773, respectively). Bland-Altman analysis demonstrated good agreement, with minimal bias for E and a negative proportional bias for SE. ICC values indicated good-to-excellent reliability for E (0.86) and moderate reliability for SE (0.63).</p><p><strong>Conclusions: </strong>EGCT-based measurement is a feasible, reliable method for assessing aortic mechanical properties noninvasively. Although further studies are needed to refine predictive accuracy, this approach may enhance risk stratification for aortic catastrophes in future clinical practice.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884442","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}
XiaoJuan Yang, Qian Zhang, Cuiling Ye, Yalan Cheng, Jianwei Wu, Yi Liang, Jianwei Su
{"title":"Factors Influencing Symptom Severity at Discharge after Lobectomy and Sublobar Resection Through Video-assisted Thoracoscopic Surgery.","authors":"XiaoJuan Yang, Qian Zhang, Cuiling Ye, Yalan Cheng, Jianwei Wu, Yi Liang, Jianwei Su","doi":"10.1093/icvts/ivaf170","DOIUrl":"10.1093/icvts/ivaf170","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates factors affecting symptom severity at discharge in patients who have undergone lobectomy and sublobar resection via video-assisted thoracoscopic surgery for pulmonary nodules, including both benign and malignant cases.</p><p><strong>Methods: </strong>This retrospective analysis utilized data from a patient cohort in a randomized controlled trial at Zhongshan City People's Hospital. Symptom severity was assessed using the validated Perioperative Symptom Assessment for Lung Surgery questionnaire at 4 time points. Patients were grouped by discharge-day symptoms: Alert (scores >3) and No Alert. Symptom scores were further compared between pathology subgroups: lung cancer and benign/others. Mann-Whitney tests and repeated measures analysis of variance were used to compare symptom trajectories between groups. Univariate and multivariate logistic regression analyses were employed to identify factors associated with symptom severity at discharge.</p><p><strong>Results: </strong>Two hundred and forty-three patients were included in the analysis. The Alert group showed slower postoperative symptom improvement compared to the No Alert group (P < .05). Logistic regression analysis identified several key factors associated with symptom severity at discharge, including age, gender, smoking history, FEV1% (Forced Expiratory Volume in 1 second as a percentage of the predicted value), right upper lobe involvement, tumour stage, in-hospital complications, and length of stay after operation. In-hospital complications were significantly associated with increased severity of symptoms at discharge, including disturbed sleep, fatigue, drowsiness, and sadness.</p><p><strong>Conclusions: </strong>Multiple patient-specific and surgical factors influence postoperative symptom severity at discharge. These findings identify key factors associated with symptom severity and may inform future personalized management strategies following lung surgery.</p><p><strong>Clinical registration number: </strong>ClinicalTrials.gov; NCT05990946; https://clinicaltrials.gov/study/NCT05990946.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857200","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}
Leo Consoli, Francisco Javier Nino Gonzalez, Henri Bartolozzi, Namira Mohammed Ali, Oluwaseun Fagbamila, Massimo Baudo
{"title":"Surgical Ablation by a Right Mini-thoracotomy Versus a Median Sternotomy: A Systematic Review and Meta-analysis of Observational Studies.","authors":"Leo Consoli, Francisco Javier Nino Gonzalez, Henri Bartolozzi, Namira Mohammed Ali, Oluwaseun Fagbamila, Massimo Baudo","doi":"10.1093/icvts/ivaf178","DOIUrl":"10.1093/icvts/ivaf178","url":null,"abstract":"<p><strong>Objectives: </strong>A minimally invasive approach by a right mini-thoracotomy has been developed for surgical ablation of atrial fibrillation. However, the efficacy and safety compared to a median sternotomy remains unclear.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Library for eligible studies. Meta-analysis was performed for primary (recurrence of atrial tachyarrhythmias at 1 and 2 years) and secondary (hospital and ICU stay, adverse events, 30-day mortality, cardiopulmonary bypass, and aortic cross-clamp time) end-points. We compared end-points using risk ratio (RR) for binary outcomes and mean difference (MD) for continuous ones. We calculated 95% confidence intervals (CI) and used the random-effects model for all outcomes. We performed subgroup analysis for the main outcome based on lesion set, energy source, type of surgery, and propensity score matching.</p><p><strong>Results: </strong>We included 12 observational studies (n = 3122). No difference was found for the primary outcome at 1 (RR 0.8; [95% CI]: 0.62-1.03; P = 0.08) and 2 years (RR 0.9; [95% CI]: 0.74-1.13; P = 0.4). The thoracotomy group had lower complications (RR 0.72; [95% CI]: 0.55-0.97; P = 0.016), 30-day mortality (OR 0.26; [95% CI]: 0.10-0.70; P = 0.007), hospital stay (MD -5.35; [95% CI]: -7.94 to 2.77; P < 0.001), and ICU stay (MD -2.21; [95% CI]: -3.02 to 1.40; P < 0.001). Cardiopulmonary bypass and aortic clamping time were significantly higher in the thoracotomy group.</p><p><strong>Conclusions: </strong>This meta-analysis found that surgical ablation by a mini-thoracotomy might achieve similar rhythm control to a median sternotomy while possibly improving safety and promoting faster recovery. However, conclusions are limited by the observational nature of the evidence and randomized trials are warranted.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719248","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":"Polyglycolic Acid-Reinforced Sutures for Alveolar-Bronchiole Level Fistula Closure During Acute Empyema Surgery.","authors":"Junichi Murakami, Toshiki Tanaka, Mototsugu Shimokawa, Sota Yoshimine, Naohiro Yamamoto, Hiroshi Kurazumi, Kimikazu Hamano","doi":"10.1093/icvts/ivaf188","DOIUrl":"10.1093/icvts/ivaf188","url":null,"abstract":"<p><strong>Objectives: </strong>Closure of alveolar-bronchiole level fistulas encountered during surgery for acute empyema is challenging due to compromised lung tissue, increasing the risk of persistent air leaks and infection. The use of polyglycolic acid (PGA)-reinforced sutures offers potential, but their application in infected fields is debated. This study evaluates the safety and efficacy of this technique for managing such intraoperative fistulas during video-assisted thoracoscopic (VATS) decortication.</p><p><strong>Methods: </strong>This single-centre retrospective study between 2017 and 2023 compared outcomes in patients undergoing VATS decortication for acute empyema. Patients requiring intraoperative closure of alveolar-bronchiole fistulas using PGA-reinforced sutures (Suture group, N = 7) were compared to those without identified fistulas (Control group, N = 14). Patients with post-resection empyema were excluded. The primary end-point was postoperative complications.</p><p><strong>Results: </strong>The Suture group had longer surgical durations (mean 139.3 vs 103.5 min, P < 0.01) and greater intraoperative blood loss (mean 192.0 vs 58.1 g, P = 0.04) compared to Controls. All identified air leaks in the Suture group were successfully sealed intraoperatively, confirmed by water-seal test and intraoperative confirmation test. Crucially, the Suture group experienced significantly fewer postoperative complications (Clavien-Dindo ≥ Grade 2) (0/7 [0%] vs 8/14 [57.1%], P = 0.01). No re-exacerbations or re-operations occurred in the Suture group, compared to 4 each in controls. Postoperative inflammatory markers decreased similarly in both groups (P > 0.05).</p><p><strong>Conclusions: </strong>PGA-reinforced suturing for alveolar-bronchiole fistulas during acute empyema surgery appears feasible and safe. While fewer complications were noted in the Suture group, this small, non-randomized study precludes definitive conclusions on efficacy. Larger prospective studies are warranted.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839254","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}
Krishna Bhandari, Khaled Shorbaji, Akinwale Victor Famotire, Brett Welch, Lucas Witer, Nicolas Pope, Arman Kilic
{"title":"Evolving Changes in Centre-Level Utilization of Longer Distance Donors in Heart Transplantation.","authors":"Krishna Bhandari, Khaled Shorbaji, Akinwale Victor Famotire, Brett Welch, Lucas Witer, Nicolas Pope, Arman Kilic","doi":"10.1093/icvts/ivaf190","DOIUrl":"10.1093/icvts/ivaf190","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates changes in centre-level utilization of longer distance donors (LDD) in heart transplantation (HT) before and after the allocation policy change in 2018.</p><p><strong>Methods: </strong>Adult HT recipients from 2010 to 2023 were identified from the United Network for Organ Sharing registry. Patients were categorized based on donor centre distance and policy change. The Mann-Kendall trend test was utilized for trend analysis. A propensity-matched analysis was performed. Survival analyses were performed using Kaplan-Meier, restricted mean survival time, and multivariable Cox proportional models. Interaction analysis with Bonferroni correction and sensitivity analysis to test the robustness of primary findings were performed.</p><p><strong>Results: </strong>Among 32 036 recipients from 152 centres, 29 410 from ≤500 miles and 2626 from >500 miles. The mean distance increased from 171 miles to 288 (P < .001) and mean cold ischaemia time from 3.20 to 3.60 h (P < .001) after allocation change. The proportion of recipients with LDD increased from 5.50% in 2010 to 14.00% in 2022, P = .021. In the unmatched cohort, unadjusted 30-day, 1-year, and 5-year survival was comparable between LDD and non-LDD recipients (P > .05). However, risk-adjusted survival in the matched cohort was significantly better with LDD: 30-day (0.60, 0.43-0.82, P = .002), 1-year (0.67, 0.55-0.82, P < .001), and 5-y (0.75, 0.65-0.86, P < .001). Similar findings persisted even after restricted mean survival time analysis. There was a weak correlation between distance and ischaemia time in the matched cohort (r = 0.19).</p><p><strong>Conclusions: </strong>There has been a substantial increase in the use of LDD following the allocation change. Distance is not a surrogate for ischaemia time. Survival after HT with LDD use is significantly better compared to non-LDD, but further research is warranted.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877029","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":"The Overlooked Factors: How Cardioplegia Delivery and Deairing May Shape Clinical Results.","authors":"Ignazio Condello","doi":"10.1093/icvts/ivaf203","DOIUrl":"10.1093/icvts/ivaf203","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884465","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}
Torbjörn Ivert, Aninda Omar, Andreas Rück, Magnus Dalén
{"title":"Endocarditis and other indications for open-heart surgery after a transcatheter aortic valve implant.","authors":"Torbjörn Ivert, Aninda Omar, Andreas Rück, Magnus Dalén","doi":"10.1093/icvts/ivaf173","DOIUrl":"10.1093/icvts/ivaf173","url":null,"abstract":"<p><p>This retrospective observational single-centre analysis included 31 patients who underwent transcatheter aortic valve implantation (TAVI) between 2016 and 2024 and subsequent open-heart surgery between 2019 and 2024. They were admitted from infectious disease departments or cardiology clinics and accounted for 0.7% of heart operations performed in 2024. The incidence of definite endocarditis was 0.5% (17/3226) of all TAVI procedures performed during this period. Of the 17 patients, 9 (53%) with definite endocarditis underwent aortic valve replacement, with 1 early death (11%) from bowel ischaemia and liver failure. The 2-year postoperative survival for definite endocarditis was 76%. Open-heart surgery was contraindicated in all 8 patients with definite endocarditis due to severe comorbidities and frailty. These patients died within 2 years of the infection or due to heart failure. Furthermore, 10 patients classified as having endocarditis after TAVI were medically treated and had a 2-year survival rate of 72%. The survival rate was 87% at 2 years after open-heart surgery for non-infectious indications performed up to 5 years after TAVI in 22 patients. In conclusion, heart surgery can be curative in selected patients with definite endocarditis after TAVI and lifesaving after rare TAVI complications.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719247","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}
Gianluca Brancaccio, Marin Verrengia, Matteo Trezzi, Veronica Bordonaro, Ileana Croci, Enrico Piccinelli, Fabio Miraldi, Marcello Chinali, Aurelio Secinaro, Victoria D'Inzeo, Roberta Iacobelli, Lorenzo Galletti
{"title":"Investigating the Long-term Durability of Prosthetic Valves in Patients Who Have Undergone Tetralogy of Fallot Surgery with Transannular Patch.","authors":"Gianluca Brancaccio, Marin Verrengia, Matteo Trezzi, Veronica Bordonaro, Ileana Croci, Enrico Piccinelli, Fabio Miraldi, Marcello Chinali, Aurelio Secinaro, Victoria D'Inzeo, Roberta Iacobelli, Lorenzo Galletti","doi":"10.1093/icvts/ivaf159","DOIUrl":"10.1093/icvts/ivaf159","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the longevity of bioprosthetic valves (BPVs) or valved conduits in the pulmonary position and the factors associated with prosthetic valve longevity in patients who underwent surgical repair of tetralogy of Fallot (TOF).</p><p><strong>Methods: </strong>We performed a single-centre retrospective study in patients undergoing placement of a bioprosthesis or valved conduit in patients operated for TOF with a transannular patch. The primary end-point was freedom from pulmonary valve replacement (PVR) reintervention. The composite secondary end-point was freedom from PVR reintervention and structural valve degeneration.</p><p><strong>Results: </strong>A total of 211 patients undergoing 255 operations were identified. The median age at first PVR was 15.4 years (IQR 12.3-20.7 years). The freedom from reintervention at 5, 10, and 15 years was 94%, 77%, and 64%, respectively. Multivariable analysis shows that factors that are independently associated with a more significant hazard of reintervention are younger age, smaller valve size, and male sex. Of the implanted prosthetic valves, 122 were bioprosthesis; 38 (18%) were homografts; 37 (17%) percutaneous valve, and 14 (7%) were other prosthetic valves or conduits. The freedom from reintervention was not different between homografts and all other heterografts (P = 0.938). Percutaneous valves showed an average longevity of 9.4 years, significantly lower than other prosthetic valves (P = 0.007).</p><p><strong>Conclusions: </strong>Younger patient age and a smaller valve size were associated with reduced BPV durability. There is a concern about an early PVR to preserve right ventricle function overall during adolescent age.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562174","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}
Gabriel Saiydoun, Elie Nassar, Saadé Saadé, Chadi Aludaat, Sylvain Rubin, Ibrahim Alqdeimat, Vito Giovanni Ruggieri
{"title":"Mid-Term Outcomes After Aortic Valve Replacement in Patients Under 70: A Comparative Study of INSPIRIS RESILIA Versus PERIMOUNT MAGNA EASE Bioprostheses.","authors":"Gabriel Saiydoun, Elie Nassar, Saadé Saadé, Chadi Aludaat, Sylvain Rubin, Ibrahim Alqdeimat, Vito Giovanni Ruggieri","doi":"10.1093/icvts/ivaf169","DOIUrl":"10.1093/icvts/ivaf169","url":null,"abstract":"<p><strong>Objectives: </strong>INSPIRIS RESILIA, launched in 2017, is a bioprosthetic aortic valve developed to improve durability and facilitate future valve-in-valve procedures. Despite its advanced design, many surgeons continue to use the PERIMOUNT MAGNA EASE valve, which has long-standing clinical validation. This study aimed to compare mid-term clinical and echocardiographic outcomes in patients under 70 undergoing aortic valve replacement with either prosthesis.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients who underwent surgical aortic valve replacement between January 2018 and May 2023 at the University Hospital of Reims. The primary outcome was all-cause mortality at 1 year following surgical aortic valve replacement. Secondary outcomes included haemodynamic parameters, left ventricular ejection fraction, and major postoperative complications such as reintervention, stroke, pacemaker implantation, mediastinitis, transfusion, and new-onset atrial fibrillation.</p><p><strong>Results: </strong>A total of 300 patients were included: 52 received the INSPIRIS RESILIA valve and 248 received the PERIMOUNT MAGNA EASE valve. After matching, 52 patients from each group were compared. All-cause mortality at 3 years was 0% in the INSPIRIS group and 1.9% in the PERIMOUNT group. Mean transvalvular gradients were similar at 1 year (11.3 vs 11.2 mmHg) and 3 years (12.9 mmHg for both). Two cases of endocarditis-related reoperation occurred in the INSPIRIS group. No structural valve degeneration requiring surgery was observed. Postoperative aortic regurgitation was trivial or absent. Transfusion rates were lower in the INSPIRIS group (46.1% vs 69.2%, P = .017).</p><p><strong>Conclusions: </strong>INSPIRIS RESILIA and MAGNA EASE valves offer similar mid-term safety and performance in patients under 70 years of age.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715235","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}