JTCVS open最新文献

{"title":"Reoperation Following Aortic Root Replacement and its Impact on Long-term Survival","authors":"Elizabeth L. Norton, Parth M. Patel, D. Levine, Sameer Singh, Shreya Chodisetty, Ore Olakunle, Bradley Leshnower, Hiroo Takayama, Edward P. Chen","doi":"10.1016/j.xjon.2024.05.003","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.05.003","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131395","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":"Percutaneous decannulation reduces procedure length and rates of groin wound infection in patients on venoarterial extracorporeal membrane oxygenation","authors":"Sophia H. Roberts MD ,&nbsp;Erin M. Schumer MD ,&nbsp;Mary Sullivan AGACNP-BC ,&nbsp;John Grotberg MD ,&nbsp;Bianca Jenkins BSN ,&nbsp;Irene Fischer MPH ,&nbsp;Marci Damiano BSN ,&nbsp;Matthew R. Schill MD ,&nbsp;Muhammad F. Masood MD ,&nbsp;Kunal Kotkar MD ,&nbsp;Amit Pawale MD","doi":"10.1016/j.xjon.2024.01.012","DOIUrl":"10.1016/j.xjon.2024.01.012","url":null,"abstract":"<div><h3>Objective</h3><p>Open decannulation from femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) carries high risk of morbidity, including groin wound infection. This study evaluated the impact of percutaneous decannulation on rates of groin wound infection in patients decannulated from femoral VA-ECMO.</p></div><div><h3>Methods</h3><p>Between January 1, 2022, and April 30, 2023, 47 consecutive patients received percutaneous femoral VA-ECMO and survived to decannulation. A percutaneous suture-mediated closure device was used for decannulation in patients with relatively smaller arterial cannulas. Patients with larger arterial cannulas or unsuccessful percutaneous closures underwent surgical cutdown and repair of the femoral artery. The primary outcome was arterial site wound infection following decannulation.</p></div><div><h3>Results</h3><p>Among the 47 patients who survived to decannulation from VA-ECMO, 21 underwent percutaneous decannulation and 27 underwent surgical cutdown. One patient underwent 2 VA-ECMO runs, one with percutaneous decannulation and one with surgical cutdown. Percutaneous decannulation was attempted in 22 patients, with 21 of 22 (95.5%) success rate. Decannulation procedure length was significantly shorter in the percutaneous group (79 minutes vs 148 minutes, <em>P</em> = .0001). The percutaneous group had significantly reduced rates of groin wound complications (0% vs 40.7%, <em>P</em> = .001) and groin wound infections (0% vs 22.2%, <em>P</em> = .03) when compared with the surgical cutdown group. Three patients (14.3%) in the percutaneous group experienced vascular complications, including pseudoaneurysm at the distal perfusion catheter site and nonocclusive thrombus of the common femoral artery.</p></div><div><h3>Conclusions</h3><p>Percutaneous decannulation may reduce decannulation procedure length and rate of groin wound infection in patients who survive to decannulation from VA-ECMO.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000135/pdfft?md5=46da8225ef91cf133c8d2e66c06ccf5b&pid=1-s2.0-S2666273624000135-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640057","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":"Are There Etiology-Specific Risk Factors for Adverse Outcomes in Patients on Impella 5.5 Support?","authors":"Jean-Luc A. Maigrot, Lucy Thuita, Michael Tong, E. Soltesz, Nicholas G. Smedira, Shinya Unai, Randall C. Starling, Andrew Higgins, David Moros, Eugene H Blackstone, Aaron J. Weiss","doi":"10.1016/j.xjon.2024.04.014","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.04.014","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768468","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":"Subclinical hypothyroidism and clinical outcomes after cardiac surgery: A systematic review and meta-analysis","authors":"Michele Dell’Aquila BS ,&nbsp;Camilla S. Rossi MD ,&nbsp;Tulio Caldonazo MD ,&nbsp;Gianmarco Cancelli MD ,&nbsp;Lamia Harik MD ,&nbsp;Giovanni J. Soletti MD ,&nbsp;Kevin R. An MD ,&nbsp;Jordan Leith BS ,&nbsp;Hristo Kirov MD ,&nbsp;Mudathir Ibrahim MD ,&nbsp;Michelle Demetres MLIS ,&nbsp;Arnaldo Dimagli MD ,&nbsp;Mohamed Rahouma MD, PhD ,&nbsp;Mario Gaudino MD","doi":"10.1016/j.xjon.2024.02.009","DOIUrl":"10.1016/j.xjon.2024.02.009","url":null,"abstract":"<div><h3>Background</h3><p>Subclinical hypothyroidism (SCH) is associated with major adverse cardiovascular events. Despite the recognized negative impact of SCH on cardiovascular health, research on cardiac postoperative outcomes with SCH has yielded conflicting results, and patients are not currently treated for SCH before cardiac surgery procedures.</p></div><div><h3>Methods</h3><p>We performed a study-level meta-analysis on the impact of SCH on patients undergoing nonurgent cardiac surgery, including coronary artery bypass grafting and valve and aortic surgery. The primary outcome was operative mortality. Secondary outcomes were hospital length of stay (LOS), intensive care unit (ICU) stay, postoperative atrial fibrillation (POAF), intra-aortic balloon pump (IABP) use, renal complications, and long-term all-cause mortality.</p></div><div><h3>Results</h3><p>Seven observational studies, with a total of 3445 patients, including 851 [24.7%] diagnosed with SCH and 2594 [75.3%] euthyroid patients) were identified. Compared to euthyroid patients, the patients with SCH had higher rates of operative mortality (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.09-6.04; <em>P</em> = .03), prolonged hospital LOS (standardized mean difference, 0.32; 95% CI, 0.02-0.62; <em>P</em> = .04), a higher rate of renal complications (OR, 2.53; 95% CI, 1.74-3.69; <em>P</em> &lt; .0001), but no significant differences in ICU stay, POAF, or IABP use. At mean follow-up of 49.3 months, the presence of SCH was associated with a higher rate of all-cause mortality (incidence rate ratio, 1.82; 95% CI, 1.18-2.83; <em>P</em> = .02).</p></div><div><h3>Conclusions</h3><p>Patients with SCH have higher operative mortality, prolonged hospital LOS, and increased renal complications after cardiac surgery. Achieving and maintaining a euthyroid state prior to and after cardiac surgery procedures might improve outcomes in these patients.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000445/pdfft?md5=3b18d9024bf9a93aa28a6acd31e1a7bc&pid=1-s2.0-S2666273624000445-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139967049","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":"Use of a novel microbiome modulator improves anticancer immunity in a murine model of malignant pleural mesothelioma","authors":"Christophe Gattlen PhD ,&nbsp;Kirby R. Frank MSc ,&nbsp;Damien N. Marie MSc ,&nbsp;Aurélien Trompette MSc ,&nbsp;Louis-Emmanuel Chriqui MD, PhD ,&nbsp;Yameng Hao PhD ,&nbsp;Etienne Abdelnour MD ,&nbsp;Michel Gonzalez MD ,&nbsp;Thorsten Krueger MD ,&nbsp;Paul J. Dyson PhD ,&nbsp;Sviatlana Siankevich PhD ,&nbsp;Christophe von Garnier MD ,&nbsp;Niki D.J. Ubags PhD ,&nbsp;Sabrina Cavin PhD ,&nbsp;Jean Y. Perentes MD, PhD","doi":"10.1016/j.xjon.2024.02.007","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.02.007","url":null,"abstract":"<div><h3>Objective</h3><p>Malignant pleural mesothelioma is a fatal disease and a clinical challenge, as few effective treatment modalities are available. Previous evidence links the gut microbiome to the host immunoreactivity to tumors. We thus evaluated the impact of a novel microbiome modulator compound (MMC) on the gut microbiota composition, tumor immune microenvironment, and cancer control in a model of malignant pleural mesothelioma.</p></div><div><h3>Methods</h3><p>Age- and weight-matched immunocompetent (n = 23) or athymic BALB/c mice (n = 15) were randomly assigned to MMC or no treatment (control) groups. MMC (31 ppm) was administered through the drinking water 14 days before AB12 malignant mesothelioma cell inoculation into the pleural cavity. The impact of MMC on tumor growth, animal survival, tumor-infiltrating leucocytes, gut microbiome, and fecal metabolome was evaluated and compared with those of control animals.</p></div><div><h3>Results</h3><p>The MMC delayed tumor growth and significantly prolonged the survival of immunocompetent animals (<em>P</em> = .0015) but not that of athymic mice. The improved tumor control in immunocompetent mice correlated with increased infiltration of CD3⁺CD8⁺GRZB⁺ cytotoxic T lymphocytes in tumors. Gut microbiota analyses indicated an enrichment in producers of short chain fatty acids in MMC-treated animals. Finally, we observed a positive correlation between the level of fecal short chain fatty acids and abundance of tumor-infiltrating cytotoxic T cells in malignant pleural mesothelioma.</p></div><div><h3>Conclusions</h3><p>MMC administration boosts antitumor immunity, which correlates with a change in gut microbiome and metabolome. MMC may represent a valuable treatment option to combine with immunotherapy in patients with cancer.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000421/pdfft?md5=86d39f4f9c8e6670614463fdfb630149&pid=1-s2.0-S2666273624000421-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140555603","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 pulmonary arterioplasty at bidirectional cavopulmonary anastomosis leads to favorable pulmonary hemodynamics at final stage palliation","authors":"Anna Olds MD ,&nbsp;W. Hampton Gray MD ,&nbsp;Markian Bojko MD ,&nbsp;Carly Weaver BA ,&nbsp;John D. Cleveland MD ,&nbsp;Michael E. Bowdish MD, MS ,&nbsp;Winfield J. Wells MD ,&nbsp;Vaughn A. Starnes MD ,&nbsp;S. Ram Kumar MD, PhD, FACS","doi":"10.1016/j.xjon.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.xjon.2024.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>Pulmonary arterioplasty (PA plasty) at bidirectional cavopulmonary anastomosis (BDCA) is associated with increased morbidity, but outcomes to final stage palliation are unknown. We sought to determine the influence of PA plasty on pulmonary artery growth and hemodyamics at Fontan.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed clinical data and outcomes for BDCA patients from 2006 to 2018. PA plasty was categorized by extent (type 1-4), as previously described. Outcomes included pulmonary artery reintervention and mortality before final palliation.</p></div><div><h3>Results</h3><p>Five hundred eighty-eight patients underwent BDCA. One hundred seventy-nine patients (30.0%) underwent concomitant PA plasty. Five hundred seventy (97%) patients (169 [94%] PA plasty) survived to BDCA discharge. One hundred forty out of 570 survivors (25%) required PA/Glenn reintervention before final stage palliation (59 out of 169 [35%]) PA plasty; 81 out of 401 (20%) non-PA plasty; <em>P</em> &lt; .001). Twelve-, 24-, and 36-month freedom from reintervention after BDCA was 80% (95% CI, 74-86%), 75% (95% CI, 69-82%), and 64% (95% CI, 57-73%) for PA plasty, and 95% (95% CI, 93-97%), 91% (95% CI, 88-94%), and 81% (95% CI, 76-85%) for non-PA plasty (<em>P</em> &lt; .001). Prefinal stage mortality was 37 (6.3%) (14 out of 169 PA plasty; 23 out of 401 non-PA plasty; <em>P</em> = .4). Five hundred four (144 PA plasty and 360 non-PA plasty) patients reached final stage palliation (471 Fontan, 26 1.5-ventricle, and 7 2-ventricular repair). Pre-Fontan PA pressure and pulmonary vascular resistance were 10 mm Hg (range, 9-12 mm Hg) and 1.6 mm Hg (range, 1.3-1.9 mm Hg) in PA plasty and 10 mm Hg (range, 8-12 mm Hg) and 1.5 mm Hg (range, 1.3-1.9 mm Hg) in non-PA plasty patients, respectively (<em>P</em> = .29, .6). Fontan hospital mortality, length of stay, and morbidity were similar.</p></div><div><h3>Conclusions</h3><p>PA plasty at BDCA does not confer additional mortality risk leading to final palliation. Despite increased pulmonary artery reintervention, there was reliable pulmonary artery growth and favorable pulmonary hemodynamics at final stage palliation.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266627362400041X/pdfft?md5=f028be2da1002b423527a6138272e2a1&pid=1-s2.0-S266627362400041X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140554986","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":"Discussion to: En bloc chest wall resection in locally advanced cT3N2 (stage IIIB) lung cancer involving the chest wall: Revisiting guidelines","authors":"","doi":"10.1016/j.xjon.2024.01.013","DOIUrl":"10.1016/j.xjon.2024.01.013","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000147/pdfft?md5=5e7c90776eff229683a05bec22b414d2&pid=1-s2.0-S2666273624000147-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640075","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":"Death by a thousand delays","authors":"John K. Sadeghi MD ,&nbsp;Joseph A. Reza MD ,&nbsp;Claire Miller MD ,&nbsp;David T. Cooke MD ,&nbsp;Cherie Erkmen MD","doi":"10.1016/j.xjon.2024.01.005","DOIUrl":"10.1016/j.xjon.2024.01.005","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000068/pdfft?md5=00bcc2aeeff8d07c098534f82590c963&pid=1-s2.0-S2666273624000068-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457193","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":"Long-term follow-up of posterior mitral leaflet extension for Type IIIb ischemic mitral regurgitation","authors":"Sharifa Alsheebani MD ,&nbsp;Carole Albert RN ,&nbsp;Benoit de Varennes MD, MSc, FRCS","doi":"10.1016/j.xjon.2024.01.007","DOIUrl":"10.1016/j.xjon.2024.01.007","url":null,"abstract":"<div><h3>Objective</h3><p>Ischemic mitral regurgitation (MR) is generally associated with very poor outcomes and disappointing results, despite a seemingly perfect initial repair and optimal revascularization. We previously published our intermediate-term results of posterior leaflet augmentation without follow-up extending beyond 4 years. Our objective is to assess long-term durability of the repair, survival, and the causes of late mortality.</p></div><div><h3>Methods</h3><p>Ninety-one patients with severe (4+) Carpentier Type IIIb ischemic MR underwent repair in a single center between 2003 and 2022 by method of posterior leaflet extension using a patch of bovine pericardium and a true-sized remodeling annuloplasty ring, with or without surgical revascularization. Serial echocardiography was performed over the years to ascertain valve competence and degree of ventricular remodeling, in addition to telephone follow-up and chart reviews.</p></div><div><h3>Results</h3><p>The average age of patients was 67 ± 9.6 years. Mean follow-up was 8 ± 5 years with some extending to almost 20 years. One-, 5-, and 10-year freedom from recurrent significant MR, characterized as moderate or severe MR, was 98.6%, 85.5%, and 71.3%, respectively. Thirty-day mortality was 6.5%. One-, 5-, and 10-year survival was 85.5%, 64.4%, and 43.3%, respectively. Of all the mortalities, only 17.5% were proven to be directly cardiac related.</p></div><div><h3>Conclusions</h3><p>The suggested repair technique offers satisfactory long-term outcomes with minimal residual regurgitation in surviving patients when used in context of ischemic MR. Despite durable repair, we have discovered that poor long-term survival is not directly related to cardiovascular causes.</p></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000081/pdfft?md5=416c25d7193b84c2fd3a2b14d606146a&pid=1-s2.0-S2666273624000081-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631822","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":"Reply from authors: Shouldn’t we start gathering evidence for improved hemodynamic support in patients with postcardiotomy cardiogenic shock?","authors":"Wiebke Sommer MD ,&nbsp;Rawa Arif MD ,&nbsp;Gregor Warnecke MD","doi":"10.1016/j.xjon.2024.01.011","DOIUrl":"10.1016/j.xjon.2024.01.011","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666273624000123/pdfft?md5=9e23294789716f09ba0ab0700fb3f7d8&pid=1-s2.0-S2666273624000123-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636724","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}