Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Local Recurrence After Sublobar Resection for Primary Lung Cancer: Does the Type of Stapling Device Matter?","authors":"Go Kamimura, Masaya Aoki, Satomi Imamura, Shoichiro Morizono, Takuya Tokunaga, Tadashi Umehara, Aya Harada-Takeda, Koki Maeda, Toshiyuki Nagata, Kazuhiro Ueda","doi":"10.1093/icvts/ivaf171","DOIUrl":"10.1093/icvts/ivaf171","url":null,"abstract":"<p><strong>Objectives: </strong>Two major types of stapling devices exist: those with disposable built-in knives and those with nondisposable built-in knives. This study investigated whether the stapler type influences the incidence of local recurrence, including margin recurrence and pleural dissemination, after curative sublobar resection for lung cancer.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent sublobar resection at our institution between 2010 and 2021. We compared disease-free survival, overall survival, and local recurrence between procedures using a stapler with a disposable knife and those using a stapler with a nondisposable knife.</p><p><strong>Results: </strong>A total of 269 patients were included: 84 were treated with the disposable-knife stapler and 185 with the nondisposable-knife stapler. Local recurrence occurred in 22 of 269 patients (8.2%), including 9 of 84 (10.7%) in the disposable group and 13 of 185 (7.0%) in the nondisposable group (P = .72). Patients who developed local recurrence tended to be older, male, have a smoking history, squamous cell carcinoma, absence of a ground-glass component, positive stapling cartridge cytology, partial resection, right lower lobe tumours, elevated carcinoembryonic antigen, and higher maximum standardized uptake values. In a propensity score-matched study (78 patients per group), no significant differences in disease-free survival, overall survival, or local recurrence were detected between the stapler types.</p><p><strong>Conclusions: </strong>No statistically significant differences in oncological outcomes were observed between stapler types in this retrospective study; however, the absence of a significant difference does not rule out a real effect. Further large-scale 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/PMC12342734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715234","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":"Role of Computational Modelling in Enhancing Thermal Safety During Cardiac Ablation.","authors":"Leila Seidabadi, Indra Vandenbussche, Rowan Carter Fink, MacKenzie Moore, Bailey McCorkendale, Fateme Esmailie","doi":"10.1093/icvts/ivaf184","DOIUrl":"10.1093/icvts/ivaf184","url":null,"abstract":"<p><strong>Objectives: </strong>In this narrative review, we aim to provide an analysis of current cardiac ablation techniques, such as radiofrequency ablation, cryoablation, and pulsed-field ablation, with a focus on the role of computational modelling in enhancing the precision, safety, and effectiveness of these treatments. Particular attention is given to thermal management, exploring how computational approaches contribute to understanding and controlling energy delivery, heat distribution, and tissue response during ablation procedures.</p><p><strong>Methods: </strong>We conducted this narrative review based on our expertise and a targeted search using over 50 keywords across major databases. We selected studies for their relevance, impact, and methodological rigor, and included additional references suggested during peer review. While we did not follow a systematic protocol, our approach ensured broad coverage of key developments and emerging trends in the field. We then presented the mechanisms, applications, and limitations of radiofrequency ablation, cryoablation, and pulsed-field ablation. Additionally, we discussed the use of computational approaches, including numerical methods and artificial intelligence based models, for evaluating energy distribution, lesion size, and tissue response during ablation procedures.</p><p><strong>Results: </strong>Computational methods can be used to predict ablation treatment outcomes and help optimize lesion size, ablation parameters, and procedural safety. However, these models are only reliable when properly validated and verified.</p><p><strong>Conclusions: </strong>Further research is essential to collect reliable in vivo data for validating computational models and integrating them into clinical practice to improve patient outcomes.</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/PMC12360848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755276","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":"Rescue Therapy With Factor VII for Refractory Cardiac Surgical Bleeding: A Propensity-Score-Matched Study.","authors":"Victor M Neira, Christian D Neira, Kara Matheson, Matthias Scheffler, Renata Morton, Heather E Mingo, Edgar G Chedrawy, Hashem Aliter","doi":"10.1093/icvts/ivaf185","DOIUrl":"10.1093/icvts/ivaf185","url":null,"abstract":"<p><strong>Objectives: </strong>To compare effectiveness and safety of rescue therapy approach with recombinant Factor VII activated (rFVIIa) for refractory bleeding in cardiac surgery compared with a propensity-score-matched control group at a single academic institution.</p><p><strong>Methods: </strong>In total, 8860 adult patients had cardiac surgery with cardiopulmonary bypass between 2009 and 2019. Ninety-seven patients (1.1%) received rFVIIa; 81 (83.5%) of rFVIIa cases were propensity score matched 1:1 with controls using pre- and intraoperative variables. Effectiveness was assessed with coagulation tests, chest tube drainage, and reoperation for bleeding. Safety was assessed with morbi-mortality.</p><p><strong>Results: </strong>The median dose of rFVIIa was 55.6 μg/kg (IQR, 37.4-80.0 μg/kg). The first dose after CPB was given at a Median time of 176 min (IQR, 131-232 min). Postoperative INR was lower in the rFVIIa group (Median, 0.8; IQR, 0.7-0.9) versus control (Median, 1.4; IQR 1.3-1.6; P <.0001). Other coagulation tests, chest tube drainage, and reoperation for bleeding were no different. Mortality and thrombo-embolism were higher in the rFVIIa-OR, 3.17 (95% CI, 1.41-7.14; P = .0054) and OR, 10.50 (95% CI, 1.64-117.5; P = .0196). Stroke (OR, 1.82; 95% CI, 0.51-6.48; P = .35) and renal failure (OR, 1.31, 95% CI, 0.69-2.48, P = .41) were not statistically different. RFVIIa group received 4.4 (95% CI, 3.28-5.91, P = .0001) and 1.97 (95% CI, 1.18-3.30; P = .02) times more blood products volume intra- and postoperatively.</p><p><strong>Conclusions: </strong>Rescue therapy with rFVIIa seems to effectively control bleeding. However, we observed an association with increased mortality, thromboembolism, and transfusion. We did not find rFVIIa association with risk of stroke or renal failure.</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/PMC12377900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839255","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":"Last-minute cancellation of elective lung cancer surgery is associated with poorer survival.","authors":"Marco Nardini, Nilanjan Chaudhuri, Joshil Lodhia, Richard Milton, Peter Tcherveniakov, Elaine Teh, Alessandro Brunelli","doi":"10.1093/icvts/ivae172","DOIUrl":"10.1093/icvts/ivae172","url":null,"abstract":"<p><strong>Objectives: </strong>Our objective was to assess the incidence and reason of last-minute cancellations before surgery for lung cancer and their association with outcomes.</p><p><strong>Methods: </strong>Retrospective analysis on all consecutive patients booked for elective lung cancer surgery from January 2017 through December 2022 in a single centre. Last-minute cancellation: a cancellation occurring within the last 24 h from the planned operation. Cancellation categories: process-related and patient-related. The short-term and long-term outcomes of patients who experienced a last-minute cancellation were analysed.</p><p><strong>Results: </strong>197 patients of 1587 (12%) had a last-minute cancellation: 156 (79%) were process-related and 41 (21%) were patient-related. Three percent (5/156) of patients cancelled for process reasons did not receive surgery versus 39% (16/41) of those cancelled for patient-related reasons, P < 0.0001. The 90-day mortality rates of cancelled and non-cancelled patients were similar (4.6% vs 4.7%, P = 1). Five-year overall survival of patients with cancellation was 58% (95% confidence interval 49-66) vs 69% (95% confidence interval 66-71) of those without cancellations, P = 0.022. Among those who had a cancellation, the 5-year overall survival of those with process-related cancellations was 61% (52-60) vs 35% (14-58) of those with patient-related cancellations (adjusted P value for multiple comparisons = 0.14). Cox regression analysis showed that surgery cancellations within the last 24 h for patient-related (hazard ratio 1.87, 95% confidence interval 1.02-3.42, P = 0.043) reasons remained a factor associated with poorer overall survival after adjusting for clinical stage, type of operation and patient-related variables.</p><p><strong>Conclusions: </strong>Implementing the patient's preoperative clinical evaluation to reduce the occurrence of related last-minute cancellations might mitigate its negative impact on survival.</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/PMC12342984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395739","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":"Early and Late Outcomes of Redo Procedure for Total Arch Replacement After Previous Cardiovascular Surgery: 10-Year Experience.","authors":"Ruojin Zhao, Weijing Wang, Yanxiang Liu, Yaojun Dun, Bowen Zhang, Luchen Wang, Sangyu Zhou, Xiaogang Sun","doi":"10.1093/icvts/ivaf179","DOIUrl":"10.1093/icvts/ivaf179","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the early and late outcomes of the redo procedure for total arch replacement following previous cardiovascular surgery.</p><p><strong>Methods: </strong>Between January 2013 and November 2023, 117 patients underwent total aortic arch replacement after previous cardiovascular surgery in our centre. Surgical indication, perioperative data, postoperative complications, and late outcomes were retrospectively analysed.</p><p><strong>Results: </strong>The mean age of patients was 46.8 ± 13.0 years, and 32 were female (27.4%). Indications for redo procedure included aortic arch aneurysm (11, 9.4%), aneurysmal expansion of a chronic dissection (35, 29.9%), staged surgery in plan (3, 2.6%), aortitis (2, 1.7%), and iatrogenic reasons (16, 13.7%). In-hospital mortality was 6.8% with 13.7% major adverse events. Patients who received bilateral cerebral perfusion had significantly higher intraoperative temperatures [nasopharyngeal: 23.4°C (20.4°C-25.0°C) vs 26.8°C (25.0°C-27.5°C), P < .001; bladder: 25.5 ± 3.2°C vs 28.8 ± 1.8°C, P < .001] and required fewer platelet transfusions [median units: 1.0 (1.0-2.0) vs 1.00 (1.0-1.0), P = .003], with no significant differences in postoperative neurological deficits. Overall survival of the patients was 90.1% [95% confidence interval (CI): 84.2%-96.5%], 86.9% (95% CI: 79.8%-94.6%), and 80.0% (95% CI: 70.5%-90.8%) at 1, 3, and 5 years, respectively. During follow-up, 14 patients received aortic-related reintervention. The cumulative incidence of reintervention was 17.20% (95% CI: 7.22%-26.11%) at 5 years.</p><p><strong>Conclusions: </strong>Although redo total arch replacement is technically challenging, acceptable early and late results can be obtained through tailored surgical planning and end-organ protection.</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/PMC12342358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735891","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 Outlet Orifice Diameter of Surgical Bioprosthetic Aortic Stented Valves Is Predominantly Much Smaller Than the Inlet Orifice Diameter.","authors":"Astrid Gerritje Maria van Boxtel, Tjark Ebels","doi":"10.1093/icvts/ivaf163","DOIUrl":"10.1093/icvts/ivaf163","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical prosthetic valve labelling is misleading, as labelled diameters (LDs) are currently always larger than inlet orifice diameter (IOD), while the outlet orifice diameter (OOD) is unknown. The IOD, OOD, and height of the flow channel determine its conical shape. The instructions for use (IFUs) do not list all essential metrics. This study reports a comprehensive overview of all relevant aortic stented tissue prosthetic valve metrics.</p><p><strong>Methods: </strong>We measured the OOD of these valves with an optical method. Height was measured using a calliper. The conicity angle of the flow channel was calculated. We hunted for IFU on the internet and in packaging boxes.</p><p><strong>Results: </strong>Eight valve models of 4 manufacturers were included. In all but 2 models, the OODs were smaller (89%, range 83%-95%) than their IODs, which depicts a converging shape of the flow channel. In 1 model (Avalus) OOD equals IOD, implicating a cylindrical flow channel; and 1 model (Crown) has a diverging shape. The proportion of OOD in relation to IOD seemed to be consistent among the different sizes within the same model type.</p><p><strong>Conclusions: </strong>Information on metrics for surgical aortic tissue valves is incomplete, scarce, and confusing. This article shows a comprehensive overview of valve metrics, which makes it possible to compare different aortic valve models and sizes. Flow channel shape turned out to be different amongst models. The smallest flow channel diameter is most often the OOD. Since LD should reflect the IOD, one must be aware of all relevant metrics.</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/PMC12349921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602444","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":"Objective Assessment of Ergonomics and Performance of Thoracic Surgeons During Real-Life Anatomical Robotic Pulmonary Resections.","authors":"Ahmed G Elkhouly, Gowthanan Santhirakumaran, Ben Shanahan, Tim Batchelor, Henrietta Wilson, David Waller, Steven Stamenkovic, Kelvin Lau","doi":"10.1093/icvts/ivaf180","DOIUrl":"10.1093/icvts/ivaf180","url":null,"abstract":"<p><strong>Objectives: </strong>Motion tracking tools have been used in the analysis of surgeons' technical expertise and posture in simulated endoscopic surgery. But its use in humans in real-life robotic surgery is limited. We analysed the effect of surgeons' ergonomics and posture on skill metrics for vascular dissection during anatomical pulmonary resection.</p><p><strong>Methods: </strong>In this observational study of vascular dissection/division during segmentectomy or lobectomy, we analysed the inter-group differences of those with more than (group 1) and less than (group 2) 100 robotic resections. The rapid upper limb assessment (RULA) scale was used to estimate ergonomic risk. Operative performance and posture for RULA were measured using the Kinovea-0.9.5 system. Path length of moving instruments, instrument speed, time for task completion, and duration of instruments out of vision were calculated to objectively assess operator performance.</p><p><strong>Results: </strong>Group 1 (expert) comprised 2 males and 1 female, aged 42-61 years. Group 2 (novice) comprised 4 males, aged 31-52 years. Sixty-seven patients underwent robotic anatomical resection using the da Vinci Xi robotic platform, with 180 pulmonary vessels isolations/divisions (Group 1 = 95 vs Group 2 = 85). Group 1 had significantly better RULA ergonomic scores (4.3 vs 4.7, P < .001) which was associated with higher speed (2.8 ± 0.8 vs 2.1 ± 0.2 cm/s, P < .001), shorter task completion time (388 ± 278 vs 520 ± 322 s, P = .001), and shorter duration of instruments out of vision (P < .001). There was no difference in path length (P = .8) and no significant correlation between RULA score and different parameters that assessed surgical performance.</p><p><strong>Conclusions: </strong>Video motion tracking software is an effective and unobtrusive method to evaluate surgical ergonomics and performance in robotic surgery. Better ergonomics were associated with increased surgical experience and improved surgical performance.</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/PMC12342787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746302","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":"Electrosurgical Laceration and Stabilization of Clip Followed by Transapical Mitral Valve Replacement after Failed Transcatheter Edge-to-Edge Mitral Valve Repair: A Promising Alternative to Surgery.","authors":"Fabio Pregaldini, Mevlüt Çelik, Maria Nucera, Selim Mosbahi, Kai Alexander Münker, Paul Potratz, Fabien Praz, David Reineke, Matthias Siepe, Clarence Pingpoh","doi":"10.1093/icvts/ivaf183","DOIUrl":"10.1093/icvts/ivaf183","url":null,"abstract":"<p><strong>Objectives: </strong>The study analyses perioperative outcomes in patients who underwent transcatheter electrosurgical laceration and stabilization of the clip (ELASTA-clip), followed by transapical mitral valve replacement or conventional mitral valve surgery (MVS) after failed transcatheter edge-to-edge mitral valve repair.</p><p><strong>Methods: </strong>Consecutive patients who experienced failure of a transcatheter edge-to-edge mitral valve repair and subsequently underwent either the ELASTA-clip procedure followed by transapical mitral valve replacement or conventional open MVS were retrospectively analysed. Perioperative and mid-term outcomes including mortality, stroke, bleeding, pacemaker implantation, and the need for mechanical circulatory support were assessed descriptively.</p><p><strong>Results: </strong>A total of 5 patients were enrolled in the ELASTA group and 31 in the open surgery group, with median follow-up periods of 2 years [IQR: 1.2-2.1] and 1.4 years [IQR: 0.3-3.7], respectively. Procedural success was achieved in all ELASTA cases (100%) compared to 96% in the open surgery group. No in-hospital deaths occurred in the ELASTA group, whereas the surgical group had a mortality rate of 6.5% (n = 2). During follow-up, adverse events occurred in 20% (n = 1) of ELASTA patients and 54.8% (n = 17) of those who underwent surgery.</p><p><strong>Conclusions: </strong>Surgical intervention in patients with failed edge-to-edge mitral valve repair carries a high risk of complications. The ELASTA-clip technique, combined with transapical mitral valve replacement, offers a minimally invasive and safe alternative to conventional surgery, highlighting the need for further prospective studies with longer-term follow-up.</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/PMC12342810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right vertical infra-axillary thoracotomy for surgical repair of paediatric ventricular septal defect: a propensity score matched cohort study.","authors":"Hongbo Luo, Qin Zhou, Honggen Wu, Jingjing Zhu, Jin Shentu, Guocheng Shi, Wenxuan Dai, Huiwen Chen","doi":"10.1093/icvts/ivaf153","DOIUrl":"10.1093/icvts/ivaf153","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to evaluate the feasibility and learning curve of a right vertical infra-axillary thoracotomy (RVIAT) in the surgical closure of a ventricular septal defect (VSD).</p><p><strong>Methods: </strong>Clinical outcomes in paediatric patients (<18 years) undergoing VSD operations between 2018 and 2021 in 2 tertiary hospitals were reviewed retrospectively. After 1:1 propensity score matching, patients undergoing an RVIAT were compared with those undergoing a median sternotomy (MS). The learning curve that reflected the number of cases needed to achieve technical proficiency was measured using total operating time as a metric and was evaluated using a risk-adjusted cumulative sum analysis.</p><p><strong>Results: </strong>Of the 3515 eligible patients, 2183 (62%) underwent an MS and 1332 (38%) underwent an RVIAT. After matching, 797 cases in the RVIAT and MS groups were recorded, respectively. Propensity weighting produced an excellent balance in patient baseline characteristics including age, weight, and VSD subtypes. There was no between-group difference in postoperative rhythm disturbances (0.6% vs 1.1%; P = 0.83), significant residual VSD (0.1% vs 0.4%, P = 0.62), and reoperation within 60 days postoperatively (0.1% vs 0.9%, P = 0.07). The RVIAT provided better cosmesis (satisfactory score: 9.21 ± 0.06 points vs 6.98 ± 1.17 points; P < 0.001), shorter median length of hospital stay (5.5 days vs 8.0 days, P < 0.001), and lower cost (8513.3 ± 3193.2 USD vs 9222.3 ± 2504.9 USD; P < 0.001). The surgeons could conquer the early learning phase of the RVIAT after performing a mean of 41 operations.</p><p><strong>Conclusions: </strong>A RVIAT can combine good outcomes with favourable cosmesis in VSD repair, and sufficient exposure to RVIAT procedures is crucial for proficiency.</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/PMC12451698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509821","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":"Recurrent Nonbacterial Thrombotic Endocarditis after Vegetectomy of Bioprosthetic Mitral Valve.","authors":"Taro Nakazato, Matsuda Yasuhiro, Tatsuya Ozaki, Mutsunori Kitahara","doi":"10.1093/icvts/ivaf192","DOIUrl":"10.1093/icvts/ivaf192","url":null,"abstract":"<p><p>We report a case of recurrent nonbacterial thrombotic endocarditis (NBTE) following vegetectomy of bioprosthesis without malignancy or autoimmune disorders. A 76-year-old woman underwent mitral valve replacement with a bioprosthesis for mitral regurgitation. Six years later, an outpatient echocardiography revealed a mobile vegetation incidentally. No signs of infection were observed, and various tests ruled out malignancy or autoimmune disorders. Pathological findings after an urgent vegetectomy also showed no signs of infection, and the diagnosis was NBTE. Anticoagulation therapy with warfarin was continued, but 1 year after surgery, an outpatient echocardiography revealed NBTE recurrence. After the patient underwent anticoagulation therapy with heparin and resection of the papilloma of the maxillary sinus, the vegetation disappeared, and there has been no recurrence. Since NBTE can recur, strict lifelong follow-up with anticoagulation therapy might be required.</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/PMC12451686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884443","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}