Interdisciplinary cardiovascular and thoracic surgery最新文献_第8页

Moderate hypothermia circulatory arrest as a brain-protective strategy for type A aortic dissection. 将中度低体温循环停止作为主动脉夹层的脑保护策略。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae166

Hodaka Wakisaka, Shunta Miwa, Yuji Matsubayashi, Yotaro Mori, Junghun Lee, Kenichi Kamiya, Noriyuki Takashima, Tomoaki Suzuki

{"title":"Moderate hypothermia circulatory arrest as a brain-protective strategy for type A aortic dissection.","authors":"Hodaka Wakisaka, Shunta Miwa, Yuji Matsubayashi, Yotaro Mori, Junghun Lee, Kenichi Kamiya, Noriyuki Takashima, Tomoaki Suzuki","doi":"10.1093/icvts/ivae166","DOIUrl":"10.1093/icvts/ivae166","url":null,"abstract":"Objectives: Brain-protective strategies for acute type A aortic dissection (TAAD) remain controversial. Moderate hypothermia circulatory arrest (MHCA) without cerebral perfusion is not commonly used. However, we aimed to assess its safety and efficacy in 358 patients who underwent hemiarch replacement with MHCA for acute type A aortic dissection at our institution from August 2012 to August 2022.Methods: Clinical outcomes were compared according to circulatory arrest time [≤15 min (S group, n = 52) vs ≥16 min (L group, n = 306)]. The primary outcome was postoperative stroke.Results: The S group had more older patients (72.5 vs 68.8 years; P = 0.04), a greater incidence of carotid artery malperfusion (21% vs 11%; P = 0.043) and a lower body mass index (21.7 vs 23.6 kg/m2; P < 0.01) and hemodynamic instability (3.8% vs 16%; P = 0.02) than the L group. The incidence of postoperative stroke (7.7% vs 12%; P = 0.33) and the rate of 30-day mortality (5.8% vs 6.5%; P = 0.83) did not significantly differ between groups. After adjusting for all potential confounding factors pre- and intraoperatively, there was no significant difference in postoperative outcomes between groups.Conclusions: MHCA alone for TAAD had comparable postoperative outcomes with circulatory arrest times under and over 15 min. However, longer arrest times were associated with a higher risk of stroke.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367740","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

Treatment of degenerated mitral bioprosthesis using inovare alpha rapid deployment balloon-expandable prosthesis-a minimally invasive approach. 使用 Inovare alpha 快速展开球囊扩张假体治疗退化的二尖瓣生物前列腺--一种微创方法。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae160

Ricardo Barros Corso, Marcus Vinicius Nascimento Dos Santos, Glauco Kalil da Silva Pina, João Carlos Ferreira Leal

引用次数: 0

Last minute cancellation of elective lung cancer surgery is associated with poorer survival. 最后一刻取消肺癌择期手术与生存率较低有关。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae172

Marco Nardini, Nilanjan Chaudhuri, Joshil Lodhia, Richard Milton, Peter Tcherveniakov, Elaine Teh, Alessandro Brunelli

{"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":"https://doi.org/10.1093/icvts/ivae172","url":null,"abstract":"Objectives: Our objective was to assess the incidence and reason of last-minute cancellations before surgery for lung cancer and their association with outcomes.Methods: 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 hours 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.Results: 197 patients of 1587 (12%) had a last-minute cancellation: 156 (79%) were process-related and 41 (21%) were patient-related.3% (5/156) of patients cancelled for process reasons did not receive surgery vs 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% CI 49-66) vs 69% (95% CI 66-71) of those without cancellations, p = 0.022.Among those who had a cancellation, the 5-year OS 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 hours for patient-related (HR 1.87, 95% CI 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.Conclusions: Implementing the patient's preoperative clinical evaluation to reduce the occurrence of related last-minute cancellations might mitigate its negative impact on survival.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395739","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

Venous obstruction of the upper extremity caused by subclavian vein valve hypertrophy. 锁骨下静脉瓣膜肥大导致上肢静脉阻塞。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae165

Jianyu Liao, Zhoupeng Wu

引用次数: 0

Repair of mitral paravalvular leak using left atrial appendage tissue. 利用左心房阑尾组织修复二尖瓣口旁漏。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae161

Ryohei Otsuka, Shunei Saito, Tsukasa Ohno, Ken Miyahara

引用次数: 0

Clinical impact of multiple pectus bars on surgical outcomes following pectus excavatum repair. 多条褶皱条对切除褶皱修复术后手术效果的临床影响。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-10-08 DOI: 10.1093/icvts/ivae168

Naoyuki Oka, Kyohei Masai, Yu Okubo, Kaoru Kaseda, Tomoyuki Hishida, Keisuke Asakura

{"title":"Clinical impact of multiple pectus bars on surgical outcomes following pectus excavatum repair.","authors":"Naoyuki Oka, Kyohei Masai, Yu Okubo, Kaoru Kaseda, Tomoyuki Hishida, Keisuke Asakura","doi":"10.1093/icvts/ivae168","DOIUrl":"10.1093/icvts/ivae168","url":null,"abstract":"Objectives: The Nuss procedure, a minimally invasive surgery for pectus excavatum, has undergone various improvements. However, the impact of using multiple bars on thoracic shape changes and surgical outcomes remains unclear.Methods: We retrospectively evaluated patients who underwent the Nuss procedure for pectus excavatum between August 2014 and September 2021. We divided the patients into 2 groups based on the number of bars placed and identified differences in surgical outcomes and morphological characteristics.Results: A total of 225 patients were evaluated, of whom 132 were classified into the ≤2 bar group (using 1 or 2 bars) and 93 into the ≥3 bar group (using 3 or more bars). There was no difference in the preoperative Haller index [median (interquartile range), 4.59 (3.67-6.16) vs 4.67 (4.12-6.14), P = 0.227], and asymmetric excavatum was more frequently observed in the ≥3 bar group (81% vs 51%, P < 0.001). The preoperative sternal torsion angle was larger in the ≥3 bar group, but no difference was found between the 2 groups postoperatively. The incidence of postoperative complications (≥grade 3) was comparable between groups (10% vs 17%, P = 0.105); however, postoperative pleurisy was more frequently observed in the ≥3 bar group (12% vs 4%, P = 0.021). In univariable and multivariable analyses, ≥3 bar placement was the only risk factor for postoperative pleurisy.Conclusions: The placement of multiple bars (≥3 bars) is useful for the correction of asymmetric pectus excavatum, but attention should be paid to the potential risk of postoperative pleurisy.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367738","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

A novel miniaturized roller pump circuit for simulation of extracorporeal circulation. 用于模拟体外循环的新型微型滚轴泵电路。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-09-18 DOI: 10.1093/icvts/ivae156

Anders Karl Hjärpe,Anders Jeppsson,Lukas Lannemyr,Fredrik Pernbro,Camilla Hesse,Birgitta Romlin

{"title":"A novel miniaturized roller pump circuit for simulation of extracorporeal circulation.","authors":"Anders Karl Hjärpe,Anders Jeppsson,Lukas Lannemyr,Fredrik Pernbro,Camilla Hesse,Birgitta Romlin","doi":"10.1093/icvts/ivae156","DOIUrl":"https://doi.org/10.1093/icvts/ivae156","url":null,"abstract":"OBJECTIVESExtracorporeal circulation induces pronounced effects on haemostasis and rheology. To study these, an ex vivo simulation model is an attractive alternative but often requires large amounts of blood. We sought to create a miniaturized roller pump circuit requiring minimal amounts of blood and to test if the circuit could be used to compare coagulation, platelet function and blood rheology between a dextran-based and a crystalloid-based priming solution.METHODSA miniaturized roller pump circuit requiring only 27 ml of blood was created. Blood samples from eight cardiac surgery patients were mixed with either a dextran-based or a crystalloid-based solution and circulated for 60 min. Coagulation was assessed by rotational thromboelastometry (ROTEM), and platelet function by impedance aggregometry and flow cytometry, before and at 5 and 60 min of circulation.RESULTSA time-dependent impairment of coagulation was observed in both groups. Maximum clot firmness was lower with dextran-based than with crystalloid-based priming at 5 min (HEPTEM 37 ± 4 vs 43 ± 4 mm, p < 0.001; EXTEM 37 ± 4 vs 43 ± 4 mm, p < 0.001; FIBTEM 3 ± 2 vs 9 ± 2 mm, p < 0.001) and at 60 min (HEPTEM 29 ± 9 vs 38 ± 5 mm, p < 0.001; EXTEM 30 ± 7 vs 39 ± 5 mm, p < 0.001; FIBTEM 3 ± 2 vs 8 ± 3 mm, p = 0.002). The EXTEM clotting time was longer with dextran-based solution at 5 (109 ± 19 vs 63 ± 7 sec, p < 0.001) and at 60 min (176 ± 72 vs 73 ± 7 sec, p = 0.004).CONCLUSIONSThe novel miniaturized roller pump circuit can be used to mimic extracorporeal circulation for selected research questions. Dextran-based priming caused a significant impairment in haemostasis compared with a standard crystalloid solution.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262530","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

Tracheobronchoplasty for severe tracheobronchomalacia: a case-series of patients with acute and chronic critical comorbidities. 气管支气管成形术治疗严重气管支气管畸形：急慢性危重合并症患者病例系列。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-09-18 DOI: 10.1093/icvts/ivae155

Robert Herron,Ankit Dhamija,Jenna Shumar Pa-C,Jahnavi Kakuturu,J W Awori Hayanga,Jason Lamb,Alper Toker

{"title":"Tracheobronchoplasty for severe tracheobronchomalacia: a case-series of patients with acute and chronic critical comorbidities.","authors":"Robert Herron,Ankit Dhamija,Jenna Shumar Pa-C,Jahnavi Kakuturu,J W Awori Hayanga,Jason Lamb,Alper Toker","doi":"10.1093/icvts/ivae155","DOIUrl":"https://doi.org/10.1093/icvts/ivae155","url":null,"abstract":"OBJECTIVESThere is little data within the literature regarding tracheobronchoplasty (TBP) in the setting of the acute and chronically ill, morbidly obese, or ventilator dependent patients with Tracheobronchomalacia (TBM). Short- and long-term outcomes are studied.METHODSThe series represents 12 TBM patients with American Society of Anesthesiologists (ASA) physical status scores of 3 to 5. Candidacy was based on bronchoscopic findings during spontaneous respirations with >90% collapse of the trachea and both mainstem bronchi. We used dynamic CT scan as an adjunct in those not mechanically ventilated. Our operative approach was a complete portal robotic approach for those outpatients (wheelchair dependent) and right thoracotomy for those who were already mechanically ventilated with 100% fraction of inspired oxygen (FiO2) with high pressure. Extracorporeal support was used in 2 patients.RESULTSPatients who underwent robotic repair, were discharged without complications. Two patients who were critically ill and required extracorporeal support for their surgeries, were separated from extracorporeal membrane oxygenation (ECMO) on postoperative day 2. Three patients died at the follow-up. In 1 patient, the prolene mesh migrated into trachea and caused obstruction of the trachea and required removal with endobronchial techniques.CONCLUSIONSThe repair of TBM in patients with multiple comorbidities and with severe life-threatening problems in or outside the ICU, may have improvement due to the ability to wean from positive pressure ventilation. Surgical technique and the utilization of mesh support in TBP operations may need to be debated due to duration of the surgery in patients with severe comorbidities.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262404","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

Totally endoscopic coronary artery bypass grafting: experience in 1500 patients. 完全内窥镜冠状动脉旁路移植术：1500 例患者的经验。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-09-16 DOI: 10.1093/icvts/ivae159

Jade Claessens,Loren Packlé,Hanne Oosterbos,Elke Smeets,Jelena Geens,Jens Gielen,Silke Van Genechten,Samuel Heuts,Jos G Maessen,Alaaddin Yilmaz

{"title":"Totally endoscopic coronary artery bypass grafting: experience in 1500 patients.","authors":"Jade Claessens,Loren Packlé,Hanne Oosterbos,Elke Smeets,Jelena Geens,Jens Gielen,Silke Van Genechten,Samuel Heuts,Jos G Maessen,Alaaddin Yilmaz","doi":"10.1093/icvts/ivae159","DOIUrl":"https://doi.org/10.1093/icvts/ivae159","url":null,"abstract":"OBJECTIVESTotally endoscopic coronary artery bypass grafting (TECAB) is a minimally invasive approach to achieve surgical revascularisation through a minimally invasive approach. Still, data regarding non-robotic TECAB is limited. This report presents the results of a TECAB technique using long-shafted instruments, defined as Endo-CABG, from a single-centre experience in 1500 consecutive patients.METHODS1500 patients underwent Endo-CABG between January 2016 and February 2023. Data were collected retrospectively, and patients were followed up for one year. The primary outcome of this study was major adverse cardiac and cerebrovascular events (MACCE)-free survival. Secondary efficacy outcomes were graft failure and mortality. Furthermore, we analysed factors influencing long-term freedom from MACCE and all-cause mortality.RESULTSThe mean age was 68[61-75] years, of which 193 (12.87%) were octogenarians. Multivessel disease was present in 1409 (93.93%) patients, and the mean Euroscore II was 1.64[1.09-2.92] %. All patients underwent full arterial revascularisation with bilateral internal mammary grafting in 88.47%. Graft failure occurred in 1.80% of cases after one year (n = 27). Thirty-day mortality was 1.73% (n = 26), one-year survival was 94.7% (95% CI : 93.5-95.9%; n = 26), and 1-year MACCE-free survival was 91.7% (95% CI : 90.2-93.2%). Age, left ventricular ejection fraction, arterial hypertension, and urgency were significantly associated with 1-year MACCE-free survival.CONCLUSIONSEndo-CABG appears to be a safe procedure, achieves surgical revascularisation, and provides good outcomes regarding graft failure and major adverse cardiac and cerebrovascular events at one year, while age, left ventricular ejection fraction, arterial hypertension, and urgency were associated with one-year outcomes.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262531","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

Density of fresh wall of acute aortic dissection with synchrotron-based x-ray phase tomography. 基于同步加速器的 X 射线相位断层扫描显示急性主动脉夹层新鲜壁的密度。

Interdisciplinary cardiovascular and thoracic surgery Pub Date : 2024-09-13 DOI: 10.1093/icvts/ivae157

Koki Yokawa,Masato Hoshino,Naoto Yagi,Yutaka Nakashima,Kazunori Nakagawa,Yutaka Okita,Kenji Okada,Takuro Tsukube

{"title":"Density of fresh wall of acute aortic dissection with synchrotron-based x-ray phase tomography.","authors":"Koki Yokawa,Masato Hoshino,Naoto Yagi,Yutaka Nakashima,Kazunori Nakagawa,Yutaka Okita,Kenji Okada,Takuro Tsukube","doi":"10.1093/icvts/ivae157","DOIUrl":"https://doi.org/10.1093/icvts/ivae157","url":null,"abstract":"OBJECTIVESThe mechanisms behind the onset of acute aortic dissection have not been fully elucidated. We developed dynamic Synchrotron-based X-ray phase tomography to quantitatively study the dynamics of biological samples and applied it to the fresh aortic wall in acute type-A aortic dissection.METHODSFresh, ring-shaped aortas undergoing aortic repair in acute type-A aortic dissection were measured in a container filled with normal cold saline within 24 hours of surgery. As a control, we obtained five formalin-fixed normal ascending aortas from autopsies (female : 2, 59.7 (SD : 5.5) years). To evaluate the quantitative morphological change, we estimated the density at five each step stretched by 2 mm per step. The fresh specimens were analyzed pathologically about the area ratio of elastic fibre.RESULTSSamples were obtained from five patients (1 man and 4 women, 59.4 (SD: 8.7) years) The overall density of the tunica media in the fresh aorta was 1.062(SD : 0.006) g/cm3 and differed significantly between the dissected and non-dissected portion (1.05(SD : 0.004) vs 1.066(SD : 0.004) g/cm3, respectively; p = 0.0122). When the fresh aortic wall was stretched and became thinner, the density of the tunica media remained unchanged. Compared with pathological findings, area ratio of the elastic fibre of the tunica media were lower in non-dissected portion than normal (48.6 (SD : 7.1) % v.s 60.5 (SD : 5.7) %, p < 0.001).CONCLUSIONSDynamic-XPCT can trace the deformation process that occurs in situ in fresh aorta in acute type-A aortic dissection. We confirmed that densitometric property of the aortic wall in acute type-A aortic dissection was unchanged during the stretching process.","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269784","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