JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.05.008
Nafiye Busra Celik MD , Mara B. Antonoff MD
{"title":"Unspoken challenges facing international medical graduates in training","authors":"Nafiye Busra Celik MD , Mara B. Antonoff MD","doi":"10.1016/j.xjon.2025.05.008","DOIUrl":"10.1016/j.xjon.2025.05.008","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Page 336"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912817","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.013
Albert J. Pedroza MD, Alex R. Dalal MD, Jennifer Kim MD, Matthew Duda MD, Emily Tognozzi PA-C, Casey Gilles BS, D. Craig Miller MD, Michael P. Fischbein MD, PhD
{"title":"Loeys-Dietz syndrome subtypes exhibit distinct clinical behavior and aortic cellular transcriptomic profiles","authors":"Albert J. Pedroza MD, Alex R. Dalal MD, Jennifer Kim MD, Matthew Duda MD, Emily Tognozzi PA-C, Casey Gilles BS, D. Craig Miller MD, Michael P. Fischbein MD, PhD","doi":"10.1016/j.xjon.2025.06.013","DOIUrl":"10.1016/j.xjon.2025.06.013","url":null,"abstract":"<div><h3>Objectives</h3><div>Loeys-Dietz syndrome comprises genetically discrete subtypes of varying clinical severity. This study integrates longitudinal Loeys-Dietz syndrome clinical outcomes after aortic root replacement with transcriptomic analysis of aortic smooth muscle cell dysregulation to investigate mechanisms governing this subtype-specific aortic vulnerability.</div></div><div><h3>Methods</h3><div>Single institutional experience with aortic root replacement for nondissected aneurysm in patients with Loeys-Dietz syndrome was reviewed for midterm survival and distal aortic events (subsequent aortic intervention, aneurysm, or dissection). Single-cell RNA sequencing was performed using fresh aortic aneurysm tissue to compare smooth muscle cell phenotypes between patients with <em>TGFBR1/2</em> and <em>SMAD3</em> variants.</div></div><div><h3>Results</h3><div>A total of 62 patients with Loeys-Dietz syndrome were identified, including 59 genetically confirmed (n = 36 <em>TGFBR1/2,</em> n = 16 <em>SMAD3,</em> and n = 7 <em>TGFB2/TGFB3</em>). Valve-sparing operations were performed in 54 patients, 8 patients underwent composite root replacement operations, and 19 patients underwent concomitant arch replacement. Median follow-up was 6.16 years (interquartile range, 2.88-10.82). Estimated 5- and 10-year survivals for <em>TGFBR1/2</em> patients were 97% (99%-82%) and 86% (96%-61%), respectively, and estimated incidence of aortic events at 5- and 10-year follow-up was 17% (7%-36%) and 28% (14%-51%), respectively. For <em>SMAD3</em> patients, estimated survival was 94% (99%-63%) at both 5 and 10 years, and estimated incidence of aortic events at both 5- and 10-year follow-ups was 0%. Single-cell RNA sequencing analysis (n = 3 <em>TGFBR1/2,</em> n = 5 <em>SMAD3</em>) demonstrated altered smooth muscle cell phenotype modulation patterns, with greater retention of contractile gene expression, enriched collagen, and integrin receptor expression in <em>TGFBR1/2</em> smooth muscle cells, whereas <em>SMAD3</em> patients showed activation of osteochondrogenic matrix components (<em>TNFRSF11B, CYTL1</em>) and inflammatory pathways.</div></div><div><h3>Conclusions</h3><div>Loeys-Dietz syndrome subtypes may demonstrate variable clinical outcomes after aortic root replacement. Distinct gene dysregulation patterns suggest varying smooth muscle cell–extracellular matrix interactions may participate in clinical variation.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913305","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.003
Zohaib R. Khawaja BS , Akalya Villenthi MS , Charles E. Bardawil MD , Simran P. Patwa BS , Aaron S. Gilani MD, MBA , Benjamin I. Schachner MD , Ulysis H. Baal MD , Gabriel E. Cambronero MD , Joseph C. Sweeney MD , Nidhi N. Desai MD , Timothy E. Craven MSPH , Bartlomiej R. Imielski MD
{"title":"Social media use among cardiothoracic surgeons: The online landscape and comparisons between subgroups","authors":"Zohaib R. Khawaja BS , Akalya Villenthi MS , Charles E. Bardawil MD , Simran P. Patwa BS , Aaron S. Gilani MD, MBA , Benjamin I. Schachner MD , Ulysis H. Baal MD , Gabriel E. Cambronero MD , Joseph C. Sweeney MD , Nidhi N. Desai MD , Timothy E. Craven MSPH , Bartlomiej R. Imielski MD","doi":"10.1016/j.xjon.2025.06.003","DOIUrl":"10.1016/j.xjon.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Social media use among cardiothoracic surgeons has yet to be analyzed. This study aimed to explore how online media utilization by cardiothoracic surgeons differs by subspecialty, sex, geographic region, practice type, level of experience, and training pathway.</div></div><div><h3>Methods</h3><div>A list of 223 cardiothoracic surgeons was generated by querying the 1066 members of the American Association for Thoracic Surgery and randomly selecting 223 actively practicing surgeons. For each surgeon, demographic information and online platform information was searched for in a standardized manner. Platforms assessed included practice websites, personal websites, CTSNet, LinkedIn, ResearchGate, Wikipedia, X/Twitter, Facebook, Instagram, practice YouTube, personal YouTube, and TikTok. A cumulative online presence score was then calculated for each surgeon.</div></div><div><h3>Results</h3><div>CTSNet (98.2%), LinkedIn (78.9%), and ResearchGate (57.4%) were the most frequently used online platforms. X/Twitter (32.7%) was the most popular social media platform. There were no differences in online platform utilization by subspecialty, practice type, or training pathway; however, differences did exist by sex, geographic region, and level of experience. Females more frequently used Facebook and Instagram. Surgeons in the Southwest were more likely to use Facebook and Instagram, as well as to have a personal website. Early-career surgeons had a higher median cumulative online presence score and were more active on X/Twitter, while mid-career surgeons were more likely to use LinkedIn.</div></div><div><h3>Conclusions</h3><div>Virtually all (99.6%) of cardiothoracic surgeons use professional networking platforms; however, social media use remains relatively low overall at 42.6%. These findings provide foundational data on how cardiothoracic surgeons engage with the online landscape to supplement their practice.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 306-312"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912812","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.002
Andrea Amabile MD , Daniela Molena MD
{"title":"Empowering international medical graduates in cardiothoracic surgery: Breaking barriers, building bridges","authors":"Andrea Amabile MD , Daniela Molena MD","doi":"10.1016/j.xjon.2025.06.002","DOIUrl":"10.1016/j.xjon.2025.06.002","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 334-335"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912816","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.005
J. Asher Jenkins MD , Pedro Augusto Reck Dos Santos MD, MS, PhD , Zhong Gu MS , Matthew Buras MS , Juan M. Farina MD , Nathan Y. Yu MD , Yanmei Peng MD, PhD , Jason Wampfler BS , Cecilia Benz MD , Vinicius Ernani MD , Jonathan D'Cunha MD, PhD , Stephen D. Cassivi MD, MS , Ping Yang MD, PhD
{"title":"Surgical management of both stage III and stage IV pulmonary carcinoid tumors confers survival benefit","authors":"J. Asher Jenkins MD , Pedro Augusto Reck Dos Santos MD, MS, PhD , Zhong Gu MS , Matthew Buras MS , Juan M. Farina MD , Nathan Y. Yu MD , Yanmei Peng MD, PhD , Jason Wampfler BS , Cecilia Benz MD , Vinicius Ernani MD , Jonathan D'Cunha MD, PhD , Stephen D. Cassivi MD, MS , Ping Yang MD, PhD","doi":"10.1016/j.xjon.2025.06.005","DOIUrl":"10.1016/j.xjon.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Pulmonary carcinoid tumors are an uncommon entity, with an incidence of 1.35 cases per 100,000 individuals. Although decisions about surgical resection are commonly made similarly to those for non–small cell lung cancer, data surrounding the optimal treatment and prognostication for patients with advanced disease are limited. Thus, we sought to examine patterns of treatment, risk factors, and outcomes for advanced-stage pulmonary carcinoid tumors.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed healthcare system-wide data from an ongoing, prospectively followed primary lung cancer cohort to identify patients with stage III and IV pulmonary carcinoid tumors from 1997 to 2016, followed through 2023, and analyzed using multivariable Cox modeling and Kaplan–Meier estimates.</div></div><div><h3>Results</h3><div>We identified 155 patients diagnosed with advanced-stage pulmonary carcinoid tumors (73 with stage III, 82 with stage IV). In patients with stage III, atypical histology (hazard ratio [HR], 2.91; 95% CI, 1.55-5.47; <em>P = .</em>001) was associated with higher mortality risk. For patients with stage IV, atypical histology (HR, 2.82; 95% CI, 1.38-5.76; <em>P = .</em>004) was associated with a higher mortality risk. Receipt of surgery was associated with significantly decreased mortality risk in both stage III (HR, 0.42; 95% CI, 0.19-0.94; <em>P = .</em>036) and stage IV (HR, 0.36; 95% CI, 0.17-0.80; <em>P = .</em>010).</div></div><div><h3>Conclusions</h3><div>Advanced-stage pulmonary carcinoid tumors are a rare entity, infrequently described in the literature. Through a large retrospective analysis spanning 26 years, we have identified risk factors associated with mortality for advanced-stage pulmonary carcinoid tumors and demonstrated a potential role for surgical therapy in stage IV disease.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 218-233"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912820","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}
{"title":"Comparison of a novel mechanical valve versus stented bioprosthetic valves for isolated mitral valve replacement in patients older than 65 years","authors":"Antonio Piperata MD, PhD , Carlo Mariani MD, PhD , Giacomo Murana MD, PhD , Elio Fabbri PhD , Paola Rucci PhD , Maria Francesca Scuppa MD , Filippo Londi MD , Edoardo Bianco MD , Benedetta Guerrini MD , Ivan Tammaro MD , Ludovica Fabiani MD , Margherita Careddu MD , Marta Bellomare MD , Silvia Snaidero MD , Riccardo Nania MD , Sabrina Castagnini MD , Marta Di Carlo MD , Valentina Orioli MD , Gianluca Folesani MD , Davide Pacini MD, PhD","doi":"10.1016/j.xjon.2025.06.015","DOIUrl":"10.1016/j.xjon.2025.06.015","url":null,"abstract":"<div><h3>Objective</h3><div>To compare early and long-term clinical outcomes of bioprosthetic versus mechanical (On-X) mitral valve replacement (MVR) in patients aged 65 years and older.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included consecutive patients equal to or older than 65 years underwent isolated MVR from 2005 to 2023. A propensity score-matched analysis was performed to compare early- and long-term clinical outcomes between patients with bioprostheses and mechanical On-X valve.</div></div><div><h3>Results</h3><div>A total of 330 patients were included, of whom 232 (70.3%) experienced bioprosthetic mitral valve replacement (BMVR group) and 98 (29.7%) mechanical mitral valve replacement (MMVR group) with On-X prosthesis. Propensity score analysis allowed to match 98 patients from each group. In the matched cohorts, the overall survival at 1, 5, and 10 years was 97.7%, 86.5%, and 69.5% for the MMVR group and 89.6%, 80.8%, and 62.5% for the BMVR (log-rank test: 1.88, <em>P</em> = .170). The 1-, 5-, and 10-year freedom from reoperation, endocarditis, pacemaker implantation, and hemorrhagic events were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>In patients older than 65 years requiring isolated MVR, the use of On-X mechanical prosthesis showed comparable long-term outcomes over bioprostheses.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 85-93"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913181","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.010
Chijioke Chukwudi MD , Ruby Singh MD, MPH , Thais Faggion Vinholo MD, MS , Ben Grobman BS , Patrick Udeh BS , Ashraf Sabe MD , Borami Shin MD , David A. D'Alessandro MD , Thoralf M. Sundt III MD , Asishana A. Osho MD, MPH
{"title":"Surgical outcomes following telehealth preoperative evaluation in elective cardiac surgery","authors":"Chijioke Chukwudi MD , Ruby Singh MD, MPH , Thais Faggion Vinholo MD, MS , Ben Grobman BS , Patrick Udeh BS , Ashraf Sabe MD , Borami Shin MD , David A. D'Alessandro MD , Thoralf M. Sundt III MD , Asishana A. Osho MD, MPH","doi":"10.1016/j.xjon.2025.06.010","DOIUrl":"10.1016/j.xjon.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>Telehealth preoperative evaluations have been shown to improve access to care, reduce appointment cancellations, and support efficient procedural planning across multiple surgical subspecialties. However, few studies have assessed the safety and efficacy in patients undergoing elective cardiac surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multi-institutional cohort study comparing procedural and postoperative outcomes for patients who had telehealth versus in-person preoperative evaluations for elective cardiac surgery between March 1, 2020, and March 1, 2021. Primary outcome was 1-year mortality assessed using Kaplan-Meier curves and multivariable Cox regression. Secondary outcomes of procedural duration, reoperations, readmission, deep vein thrombosis, postoperative rebleeding, sepsis, prolonged ventilation, intensive care unit length of stay, and hospital length of stay were assessed using multivariable linear or logistic regression.</div></div><div><h3>Results</h3><div>Five hundred fifty-nine patients who were evaluated through telehealth and 554 patients who were evaluated in person were included. The telehealth group had fewer women, smokers, dialysis-dependent patients, and patients on Medicare/Medicaid (all <em>P</em> values < .05); they underwent more isolated mitral (27% vs 20%; <em>P</em> = .006), and fewer isolated aortic procedures (3% vs 5%; <em>P</em> = .005). Adjusted 1-year mortality was similar between both groups (adjusted hazard ratio, .8; 95% CI, 04-1.4; <em>P</em> = .371). There was no difference in secondary outcomes between the 2 groups (all <em>P</em> values > .05). We found no difference in the proportion of patients with high Social Vulnerability Index between groups (12% vs 14%; <em>P</em> = .28). More telehealth patients resided further than 67 miles from the hospital (23% vs 17%; <em>P</em> = .03) and had median savings of 2.4 gas-gallons (range, 1.0-4.6 gas-gallons and 91.8 minutes (range, 39.6-182 minutes) of travel time.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that telehealth may be efficiently and safely used for preoperative evaluation of patients undergoing elective cardiac surgery.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 138-146"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913303","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}
{"title":"Thrombotic complications after aortic arch replacement with frozen elephant trunk stent-graft: A 10-year United Kingdom institutional experience","authors":"Ravi de Silva BSc, MBBS, MRCS, FRCS , Morgan Quinn MBChB, MSc, FANZCA , Ciprian Nita MD , Rushmi Purmessur BSc, MBChB, MRCS , Ismail Vokshi MBBS, FRCS , Shakil Farid MBBS, MBA, FCPS, FRCS , Florian Falter MD, PhD, FRCA, FFICM","doi":"10.1016/j.xjon.2025.05.003","DOIUrl":"10.1016/j.xjon.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Postoperative intraluminal thrombosis after frozen elephant trunk replacement has been reported to occur with a frequency of 6% to 17% and is associated with poor outcomes. The purpose of this institutional review is to analyze thrombosis rate, predisposing patient and operative factors, and assess different anticoagulation regimens.</div></div><div><h3>Methods</h3><div>This retrospective cohort study includes 174 patients operated on over 10 years. one hundred forty-five of these underwent elective aortic arch replacement; 29 had the procedure for Type A aortic dissection repair.</div></div><div><h3>Results</h3><div>Sixteen elective (11%) and 3 dissection patients (10%) had radiographic evidence of intraluminal thrombus. There were no statistical differences in demographic or intraoperative characteristics between the 2 groups. Of the 16 elective patients with thrombus, 12 (75%) had aneurysmal disease. Central graft position is associated with a higher incidence of intraluminal thrombus formation than eccentric position in both cohorts, 17% versus 7% in elective patients and 15% versus 0% in the dissection group. Patients with intraluminal thrombosis had significantly lower 6-month survival in both cohorts (69% vs 92% and 66% vs 88%; <em>P</em> = .0037) and this was also true for the elective group (69% vs 96%; <em>P</em> = .0001). Of several anticoagulation regimens employed over the study period, early introduction of warfarin proved superior.</div></div><div><h3>Conclusions</h3><div>The incidence of thrombus formation is higher in patients with aneurysmal disease and when the graft is positioned centrally. Early anticoagulation with warfarin appears to be protective. We advocate the creation of a registry to help improve outcomes after this complex surgery.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 132-137"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913304","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}
JTCVS openPub Date : 2025-08-01DOI: 10.1016/j.xjon.2025.06.012
Shuyi Feng MD , Hongping Wang PhD , Xinyi He PhD , Pengxu Kong MD , Fan Wu PhD , Shizhao Wang PhD , Xiangbin Pan MD , Guowei He PhD
{"title":"Impact of mitral valve interventions on left ventricular hemodynamics: Insights into energy loss and flow dynamics","authors":"Shuyi Feng MD , Hongping Wang PhD , Xinyi He PhD , Pengxu Kong MD , Fan Wu PhD , Shizhao Wang PhD , Xiangbin Pan MD , Guowei He PhD","doi":"10.1016/j.xjon.2025.06.012","DOIUrl":"10.1016/j.xjon.2025.06.012","url":null,"abstract":"<div><h3>Objectives</h3><div>Left ventricular vortex dynamics play a crucial role in cardiac function but are significantly altered by mitral valve diseases or surgical interventions. Such hemodynamic changes may lead to maladaptive intracardiac vortices, potentially triggering pathways associated with progressive left ventricular remodeling and thrombosis. This study assessed left ventricular hemodynamics under both physiological and pathological conditions using a biohybrid in vitro platform, aiming to analyze the impact of these conditions on cardiac function.</div></div><div><h3>Methods</h3><div>An in vitro platform was established to simulate 6 mitral valve conditions: healthy, mitral regurgitation, bioprosthetic valve replacement, mechanical valve replacement (in 2 orientations), and transcatheter mitral valve edge-to-edge repair. Flow fields within the left ventricle were captured using 4-dimensional particle image velocimetry, including mean flow fields, vortex depth, vortex transversal position, viscous shear stress, and energy dissipation.</div></div><div><h3>Results</h3><div>Mitral regurgitation preserved vortex structure compared with healthy conditions. Mechanical valves altered vortex direction and reduced vortex transversal position (0.66-0.47, <em>P</em> < .001), potentially impairing pump efficiency and increasing cardiac workload. Bioprosthetic valves displaced the vortex away from the apex, decreasing vortex depth (0.64-0.32, <em>P</em> < .001), which may elevate apical thrombosis risk. Transcatheter mitral valve edge-to-edge repair reduced mitral regurgitation but significantly increased energy dissipation and viscous shear stress, indicating higher cardiac energy expenditure and disturbed flow.</div></div><div><h3>Conclusions</h3><div>Preserving native valve function optimizes left ventricular hemodynamics, whereas valve replacements and transcatheter mitral valve edge-to-edge repair alter flow patterns, increasing cardiac workload and thrombotic risks. These findings underscore the importance of assessing left ventricular flow dynamics in the treatment of mitral regurgitation.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 104-114"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913308","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}
JTCVS openPub Date : 2025-06-01DOI: 10.1016/j.xjon.2025.03.001
Karthik Vaidyanathan Ramakrishnan MD, FRCS
{"title":"Commentary: Is it a long run for a short slide? Probability [sic] not!","authors":"Karthik Vaidyanathan Ramakrishnan MD, FRCS","doi":"10.1016/j.xjon.2025.03.001","DOIUrl":"10.1016/j.xjon.2025.03.001","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Page 364"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320934","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}