Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Major Bleeding and Thromboembolic Events with the On-X Mechanical Aortic Valve Prosthesis: A SWEDEHEART Study.","authors":"Ruixin Lu, Michael Dismorr, Magnus Dalén, Natalie Glaser, Ulrik Sartipy","doi":"10.1093/icvts/ivaf182","DOIUrl":"10.1093/icvts/ivaf182","url":null,"abstract":"<p><strong>Objectives: </strong>Lifelong anticoagulation therapy is mandatory in patients with mechanical heart valves. The On-X aortic valve is currently the only mechanical heart valve approved for a lower (1.5-2.0) target international normalized ratio (INR) compared to the standard INR target 2.0-3.0. There is limited evidence demonstrating clinical benefits of the On-X valve over other mechanical aortic valves. We therefore investigated the risk of bleeding and thromboembolic events in patients with the On-X aortic valve.</p><p><strong>Methods: </strong>This nationwide, population-based cohort study, using the target trial emulation framework, included all adults who underwent primary mechanical aortic valve replacement in Sweden 2014-2022 from the SWEDEHEART register. The rates of major bleeding and thromboembolic events were obtained from national registers. Confounding was addressed by weighting.</p><p><strong>Results: </strong>Of the 3047 patients, 656 patients (22%) received an On-X aortic valve and 2391 patients (78%) received other mechanical aortic valves. The mean age was 54 years and 23% were women. After 8 years, the weighted major bleeding cumulative incidence was 7.2% (95% CI: 4.8%-10.7%) in the On-X valve group vs 7.0% (95% CI: 5.5%-8.8%) in the other mechanical valves group, and the weighted cumulative incidence of thromboembolic events was 7.3% (95% CI: 5.3%-10.2%) in the On-X valve group vs 6.4% (95% CI: 5.0%-7.9%) in the other mechanical valves group.</p><p><strong>Conclusions: </strong>We found no clinically relevant difference in major bleeding or thromboembolic events in patients with the On-X aortic valve compared to patients with other mechanical aortic valves.</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/PMC12342359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746301","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":"Free Margin Running Suture Repair for Bileaflet Mitral Valve Prolapse in Patients with Left Ventricular Dysfunction: A Mid-term Follow-up Study.","authors":"Alfonso Agnino, Antonio D'Errico Ramirez, Matteo Parrinello, Salvatore Muccio, Amedeo Anselmi, Vito Giovanni Ruggieri","doi":"10.1093/icvts/ivaf187","DOIUrl":"10.1093/icvts/ivaf187","url":null,"abstract":"<p><strong>Objectives: </strong>Repairing severe mitral regurgitation (MR) in patients with degenerative bileaflet prolapse and reduced left ventricular ejection fraction (LVrEF) is challenging. The Free Margin Running Suture (FMRS) technique offers a non-resectional approach, but mid-term data are limited.</p><p><strong>Methods: </strong>We analysed 28 patients with bileaflet degenerative MR and LVrEF (≤40%) undergoing FMRS. Primary outcomes were mid-term survival and MR recurrence; secondary outcomes included LVEF, in-hospital complications, transmitral gradient, coaptation length, and mitral valve orifice area.</p><p><strong>Results: </strong>Mean age was 59.3 ± 12.8 years; 69.4% were male. No perioperative deaths; 1 patient required ECMO. Mean aortic cross-clamp time was 47 ± 18.6 min. Over 4.7 years, survival was 100%, with 1 case of moderate MR recurrence. At follow-up, LVEF improved to 43.04 ± 2.26 (P < 0.001), and all patients were NYHA I-II.</p><p><strong>Conclusions: </strong>FMRS is a minimally invasive, reproducible technique providing durable repair, symptomatic improvement, and excellent mid-term 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/PMC12371330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839253","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":"Thoracoscopic pneumonectomy for massive haemoptysis secondary to chronic pulmonary vein stenosis post-atrial fibrillation ablation.","authors":"Fumie Osuga, Kentaro Minegishi, Shunsuke Endo, Hiroyoshi Tsubochi","doi":"10.1093/icvts/ivaf166","DOIUrl":"10.1093/icvts/ivaf166","url":null,"abstract":"<p><p>Pulmonary vein (PV) stenosis is a rare but serious complication after transcatheter ablation for atrial fibrillation, potentially leading to massive haemoptysis. We present a case of severe PV stenosis resulting in haemoptysis. A 57-year-old man presented with haemoptysis 18 months after catheter ablation. His left PV was almost completely occluded and required the left pneumonectomy. Pathological examination revealed irreversible fibrosis of the PV intima, which led to pulmonary congestion. Surgical intervention resolved the haemoptysis. Anatomical pulmonary resection is required for massive haemoptysis caused by PV stenosis that occurs long after transcatheter ablation.</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/PMC12341673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692623","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":"Short- and Long-Term Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Patients With Chronic Lung Disease: An Analysis From the German Aortic Valve Registry.","authors":"Andreas Böning, Umniye Balaban, Eva Herrmann, Andreas Beckmann, Raffi Bekeredjian, Sabine Bleiziffer, Stephan Ensminger, Christian Frerker, Helge Möllmann, Thomas Walther, Timm Bauer","doi":"10.1093/icvts/ivaf189","DOIUrl":"10.1093/icvts/ivaf189","url":null,"abstract":"<p><strong>Objectives: </strong>Data from the German Aortic Valve Registry (GARY) were analysed to determine whether there are differences between patients with and without chronic lung disease (CLD) undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) and whether TAVI or SAVR is more beneficial in patients with preexisting CLD.</p><p><strong>Methods: </strong>Follow-up data from GARY registry patients treated from 2014 to 2015 and from 2018 to 2019 were incorporated in the analysis. Demographic results for each of the 2 treatment modalities were evaluated, and patients with and without CLD were compared. In a second step, variables that would have influenced the treatment decision in CLD patients in direction of either SAVR or TAVI were accounted for in the adjusted analysis. This led to a subgroup of 1385 patients with CLD that was subjected to propensity score weighted analysis to compare outcomes of TAVI and SAVR.</p><p><strong>Results: </strong>After exclusion, 11 457 SAVR patients and 2378 TAVI patients were analysed. CLD patients were sicker than patients without CLD, although the observed 30-day mortality was lower than expected by 3 risk scores. Accordingly, long-term survival in CLD patients was lower in both treatment groups than in patients without CLD. Thirty-day mortality was similar in the 2 treatment groups (SAVR 2.3%, TAVI 3.8%, P = .964) in spite of a possible selection bias in favour of SAVR. During a 5-year follow-up, survival after TAVI (44.6%) was significantly lower than after SAVR (56.7%), P = .029.</p><p><strong>Conclusions: </strong>Patients with CLD undergoing SAVR or TAVI are generally at higher risk for complications or death after the procedure than patients without CLD. After 5 years, patient-reported outcomes were similar in TAVI and in SAVR patients.</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/PMC12396625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877031","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":"Promising early outcomes in surgical aortic valve replacement utilizing the rapid deployment approach for isolated aortic valve regurgitation.","authors":"Julia von der Linden, Polyxeni Vlachea, Olesya Kolos, Florian Herrmann, Sergey Belyaev, Gerd Juchem, Sven Peterss, Christian Hagl, Alexey Dashkevich","doi":"10.1093/icvts/ivaf147","DOIUrl":"10.1093/icvts/ivaf147","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical aortic valve implantation remains the therapeutic gold standard for aortic valve regurgitation. Due to annular dilatation and lack of calcification, transcatheter aortic valve replacement is not recommended. Although rapid deployment valves allow faster implantation and excellent haemodynamics, they are currently not recommended for patients with aortic valve regurgitation. This study retrospectively analysed the use of rapid deployment prostheses in patients with pure aortic valve regurgitation.</p><p><strong>Methods: </strong>From 2014 to 2022, 444 rapid deployment valves were implanted. Since 2017 until 2022, 22 were used for patients with pure aortic valve regurgitation. This cohort was compared to 77 patients who had undergone rapid deployment valve implantation for pure aortic stenosis during the same time period. Both cohorts were analysed for major clinical outcomes, including pacemaker implantation, mortality, major adverse cardiovascular and cerebrovascular events (MACCE), and the need for redo surgery.</p><p><strong>Results: </strong>In both groups, no valve intraoperative and postoperative valve revisions were required. Transvalvular gradients were comparable between the groups (ΔPmean/max 7.1/13.3 mmHg in the aortic valve regurgitation and 7.9/14.7 mmHg in the AS cohort), and there were no paravalvular leaks. The postoperative pacemaker implantation rate was 0% for the rapid deployment group and 1.3% for the conventional valve replacement group.</p><p><strong>Conclusions: </strong>These results suggest that rapid deployment valves can be safely applied for the treatment of patients with aortic valve regurgitation, even in the absence of calcification. This expands the surgeon's armamentarium and can be especially useful in patients requiring extensive surgery where saving aortic cross-clamp time may be especially beneficial.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531445","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":"Surgical management of complex mediastinitis: an 8-year single-centre experience reinforcing the role of open thoracotomy.","authors":"Nabih Berjaoui, Felix Santos, Fabiana Curti, Puiyee Sophia Chan, Savvas Lampridis, Akshay Patel, Andrea Bille","doi":"10.1093/icvts/ivaf154","DOIUrl":"10.1093/icvts/ivaf154","url":null,"abstract":"<p><strong>Objectives: </strong>Mediastinitis is an infection affecting the mediastinum, often caused by cardiovascular or thoracic surgery procedures. Management entails antibiotic therapy, surgical debridement, drainage of infected sites and immediate or delayed closure. Negative pressure wound therapy is useful in cases of delayed sternal closure. Several approaches for mediastinal drainage have been proposed, but there is no consensus on the thoracic intervention approach.</p><p><strong>Methods: </strong>A single-centre, retrospective analysis from the UK analysed data from 19 patients who underwent surgical management for mediastinitis between September 2015 and April 2023. Our primary aim was to describe the outcomes from our series where we predominantly employed an open surgical approach.</p><p><strong>Results: </strong>The mean age of our cohort was 49 ± 17.12 years old; the mean performance status (PS ECOG) was 2 ± 0.77. Two people were known smokers (10.53%), while five were non-smokers (26.31%). Fifteen patients underwent an open operation (78.85%), with rest undergoing a minimally invasive approach. The majority of procedures were undertaken from the right-hand side. The overall intensive care unit admission rate was 68.42% (n = 13) with an in-hospital complication rate of 5.26% (n = 1). This was a respiratory arrest secondary to mucous plugging. There were no in-hospital deaths, and median follow-up was 41 months (22-50). Overall survival at 3 years was 85%.</p><p><strong>Conclusions: </strong>Open thoracotomy remains an important surgical strategy in the management of complex mediastinitis, but further validation is required through larger, prospective studies.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509823","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":"Single-Port Robotic-Assisted Approach in Thoracic Surgery: A Prospective Real-World Study.","authors":"Chengqiang Li, Xiang Chen, Xipeng Wang, Wei Guo, Yajie Zhang, Fengxia Chen, Hecheng Li","doi":"10.1093/icvts/ivaf161","DOIUrl":"10.1093/icvts/ivaf161","url":null,"abstract":"<p><strong>Objective: </strong>Robotic systems have enhanced thoracic surgery through 3D visualization, manoeuvrability, and tremor filtration. This study evaluated the effectiveness and safety of the da Vinci single-port surgical system for thoracic surgery in a Chinese population (ClinicalTrials.gov; NCT06246617).</p><p><strong>Design: </strong>Patients with highly malignant pulmonary nodules suitable for minimally invasive lung resection underwent anatomical lung resection using a single-port robotic system between December 2023 and May 2024. Perioperative and short-term follow-up outcomes were also assessed. Clinical data from another clinical trial (RVlob Trial: NCT03134534) were also obtained for comparison.</p><p><strong>Results: </strong>The procedure was successful in all 15 patients without intraoperative conversion, although 3 required an additional auxiliary port owing to a high body mass index and complex anatomy. Additionally, the median intraoperative blood loss and operative time were 15 (interquartile range [IQR], 10-37.5) mL and 100 (IQR, 86-119) minutes, respectively. The median length of hospital stay and duration of thoracic catheter retention were 8 (IQR, 7-9) and 2 (IQR, 2-2) days, respectively. No rehospitalizations or readmissions occurred. In comparison to the traditional robotic-assisted and video-assisted surgery groups, the single-port robotic surgery group showed a shorter operative time and less blood loss.</p><p><strong>Conclusions: </strong>Single-port robotic thoracic surgery using the da Vinci single-port surgical system is safe and feasible for anatomical lung resection. Moreover, larger controlled studies are required to validate its effectiveness and compare its advantages with those of other surgical platforms.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov; NCT06246617.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627926","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":"Management of the aortic arch in patients with syndromic heritable thoracic aortic disease.","authors":"Maria Nucera, Murat Yildiz, Selim Mosbahi, Marina Rieder, Silvan Jungi, Vladimir Makaloski, Matthias Siepe, Florian S Schoenhoff","doi":"10.1093/icvts/ivaf143","DOIUrl":"10.1093/icvts/ivaf143","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to examine the evolution of the aortic arch over time in patients with HTAD.</p><p><strong>Methods: </strong>We screened all patients with Marfan syndrome (MFS) or Loeys-Dietz syndrome (LDS) who were seen at our HTAD clinic since 1995. Patients who had undergone aortic surgery were included in the present study. Patients were analysed based on (1) extent of aortic arch replacement, (2) history of aortic dissection and (3) outcome after secondary total aortic arch replacement (TAR).</p><p><strong>Results: </strong>A cohort of 260 patients was identified of whom 165 patients with MFS (n = 138) and LDS (n = 27) had already undergone aortic surgery and were included in this study. LDS: initial presentation was acute aortic dissection (AAD) in five (19%) patients, while 22 (81%) patients presented with aneurysmal disease. Only two patients required secondary TAR during follow-up. MFS: initial presentation was AAD in 41 (30%) patients, while 97 (70%) presented with aneurysmal disease. Only 3% (n = 3) of the MFS patients without primary aortic arch replacement required a secondary TAR. There was significantly more secondary TAR in MFS patients with history of aortic dissection compared to those without (P = 0.019). However, there was no significant differences in rate of downstream aortic events in MFS patients with secondary TAR compared to those without (P = 0.089). There was no significant difference in mortality in MFS patients with secondary TAR compared to those without (P = 0.366).</p><p><strong>Conclusions: </strong>Concomitant prophylactic TAR in MFS patients undergoing elective root repair is not justified. One out of four MFS patients with history of AAD will have to undergo secondary TAR during follow-up. MFS patients undergoing secondary TAR do not have worse survival compared to those without. Current data do not provide enough evidence for strong recommendations regarding the need for prophylactic aortic arch replacement in LDS patients.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531444","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":"Outcomes following extended thoracic endovascular aortic repair for Type B aortic dissection from the global registry for endovascular aortic treatment.","authors":"Sara Allievi, Tim J Mandigers, Fred A Weaver, Ali Azizzadeh, Gabriele Piffaretti, Marc L Schermerhorn, Gregory A Magee, Dennis R Gable, Chiara Lomazzi, Santi Trimarchi","doi":"10.1093/icvts/ivaf156","DOIUrl":"10.1093/icvts/ivaf156","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the short- to longer-term safety and efficacy of extended thoracic endovascular aortic repair for Type B aortic dissection.</p><p><strong>Methods: </strong>We identified acute and subacute Type B dissection between 2010 and 2016 in the Global Registry for Endovascular Aortic Treatment. We stratified the population based on treatment extent: 'non-extended' (1 stent graft deployed), 'extended' (>1 stent graft deployed). Our primary outcomes were in-hospital spinal cord ischaemia and mortality. Secondarily, we evaluated procedure-related complications (endoleak, migration, fracture, compression, reinterventions), sac dynamics, rupture, and all-cause mortality at 1 and 5 years. Sensitivity analysis was performed in patients without prior aortic procedures.</p><p><strong>Results: </strong>Of 170 procedures, 78 (46%) were extended (median 2 [range 2-5] stent-grafts). Extended and non-extended treatment had similar rates of complicated presentations (53% vs 64%; P = 0.13). Compared with non-extended treatment, extended treatment had similar in-hospital rates of spinal cord ischaemia (2.6% vs 2.2%; P = 1) and mortality (2.6% vs 2.2%, P = 1). Additionally, extended treatment had not statistically different sac expansion rates, (1 year: 14% vs 23%, P =0.80; 5 years: 16% vs 32%, P=0.29) and rupture risk (1 year: 1.3% vs 3.3%, P = 0.63), similar procedure-related complications (endoleak, migration, fracture, compression, reinterventions; all P > 0.05) and all-cause mortality (1 year: 10% vs 7.6%, P=0.54; 5 years: 19% vs 21%, P=0.82). All outcomes remained similar on sensitivity analysis.</p><p><strong>Conclusions: </strong>Our findings suggest that extended treatment for Type B aortic dissection may be associated with similar procedure-related risks and complications. Future larger studies are needed to define who might benefit from an extended treatment and further optimize patient-specific treatment for aortic dissection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661167","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":"Hybrid treatment of multifocal lung malignancy by concomitant transbronchial microwave ablation with same-session lung resection and post-lung resection ablation.","authors":"Aliss T C Chang, Joyce W Y Chan, Ivan C H Siu, Rainbow W H Lau, Cheuk Man Chu, Tony S K Mok, Calvin S H Ng","doi":"10.1093/icvts/ivaf152","DOIUrl":"10.1093/icvts/ivaf152","url":null,"abstract":"<p><strong>Objectives: </strong>Transbronchial microwave ablation may have additional value when performed with the same-session lung resection or in patients with a history of lung resection(s). We present our institutional cohort to assess the feasibility and safety of transbronchial microwave ablation with the presence of lung resection.</p><p><strong>Methods: </strong>From March 2019 to February 2024, 92 patients who underwent transbronchial microwave ablation with either a history of major lung resection(s) or same-session ablation with concomitant video-assisted thoracoscopic lung resection(s) were included in this study. Procedural details, safety outcomes and length of stay were retrospectively analysed.</p><p><strong>Results: </strong>There were 103 episodes of transbronchial microwave ablation performed, and 142 lung lesions were ablated. The average size of nodules was 11.80 mm. Technical success was 100% with a mean minimum margin of 6 mm. Complications occurred in 23 procedures; the majority were CTCAE grade 1 complications (74%), which resolved shortly with observation, and the rest were grade 2 and 3 complications (13%), including one case of bronchopleural fistula and two cases of pneumothorax that required drainage. The average length of stay was 1.46 days. A total of 11 cases of same-session ablation with lung resection were performed. The average procedural time was 226 min, which is significantly shorter than the 27 cases of separate surgery and ablation during the same period (P = 0.012).</p><p><strong>Conclusions: </strong>Performing transbronchial microwave ablation utilizing electromagnetic navigation bronchoscopic guidance is feasible and safe in the background of lung resection. This technique can also be incorporated into a one-stop treatment with concomitant lung resection.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509820","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}