Portuguese journal of cardiac thoracic and vascular surgery最新文献

{"title":"PERCUTANEOUS MECHANICAL THROMBECTOMY: A NEW TOOL IN THE TREATMENT OF ACUTE MESENTERIC ISCHEMIA.","authors":"Vânia Fernandes, João Vasconcelos, José Vidoedo, Miguel Maia, João Almeida Pinto","doi":"10.48729/pjctvs.659","DOIUrl":"https://doi.org/10.48729/pjctvs.659","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of acute mesenteric ischemia (AMI) remains challenging due to nonspecific symptoms and signs that lead to a high mortality rate. Common causes include cardiac emboli and thrombosis of a mesenteric plaque.</p><p><strong>Objective: </strong>To present a clinical case of acute mesenteric ischemia that underwent successful endovascular revascularization.</p><p><strong>Case report: </strong>82-year-old female patient with a history of atrioventricular block, hypertension, and dementia. She was admitted to the emergency department for acute abdominal pain with onset 3 days before. Diagnosis of ischemic colitis secondary to acute superior mesenteric artery occlusion was confirmed by angioCT scan. Endovascular treatment was performed: percutaneous mechanical thrombectomy through left brachial access using the Rotarex® system (Straub Medical). She improved from her previous symptoms and was discharged at day 6, with no need of exploratory laparotomy.</p><p><strong>Discussion/conclusion: </strong>AMI is a vascular emergency that requires rapid identification and treatment. There are two courses of action for mesenteric revascularization: open or endovascular. Some authors have demonstrated an advantage in the endovascular approach, with reduced morbidity and mortality, especially in an often aging and frail group of patients. The Rotarex® (Straub Medical) system fragments the thrombus and aspirates it at the same time, thus avoiding embolic phenomena at distance. Despite being a new technology, it has shown to be a very promising tool for AMI treatment due to its fast restoration of blood flow with minimal invasiveness.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"28 3","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198370","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":"Shifting the learning curve in robotic cardiac surgery.","authors":"Adnan Abibe-Goia, Klaudiusz Stoklosa, Javier Gallego Poveda, Nelson Paulo, Frank Van Praet, Markus Gesla, Rodrigo Ribeiro de Souza, Ravindra Singh Bundela, Miguel Angel Valera, David Varghese","doi":"10.48729/pjctvs.637","DOIUrl":"https://doi.org/10.48729/pjctvs.637","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802812","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":"Cognitive And Balance Improvement After Carotid Endarterectomy In Asymptomatic Patients: A Prospective Study.","authors":"Joana Cruz Silva, Eduardo Silva, Manuel Fonseca","doi":"10.48729/pjctvs.643","DOIUrl":"https://doi.org/10.48729/pjctvs.643","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies proved impaired cognition, mobility and balance in patients with significant asymptomatic carotid stenosis (ACAS) in comparison to general adult population. In our study, we tested the hypothesis that patients with severe ACAS ( ≥70%≥70% diameter- reducing stenosis) would have long- term cognitive, mobility and balance improvement after carotid revascularization.</p><p><strong>Methods: </strong>All asymptomatic patients who underwent carotid endarterectomy from a 20- month period in our institution were prospectively enrolled. Cognitive, mobility and balance tests were performed the week before surgery and had postoperative re- evaluation at 6- 8 months. Executed tests were Mini- Mental State Exam (MMSE), Timed Up and Go test (TUG), 2 Minute Walk Test (2MWT), Berg Balance Scale (BBS) and Activities- specific Balance Confidence (ABC) Scale.</p><p><strong>Results: </strong>18 patients were recruited. The mean age was 70.11±7.2970.11±7.29 years, 72.22%72.22% were man, 44.44%44.44% had severe unilateral stenosis and the remaining bilateral stenosis. Patients had impaired scores at baseline, ranging from 11.11%11.11%to 44.44%44.44% . Post- operative upgrading in absolute score was noted in all tests (p<.021)(p<.021) except TUG, and greatest improvement in the percentage of compromised scores was noted in BBS (relative risk 6.6, p=.025p=.025 ). A strong negative correlation was verified between several baseline absolute scores and the level of postoperative variation (r=-0.87(r=-0.87 for MMSE, r=0.80r=0.80 for TUG and r=0.82r=0.82 for BBS with p<.001p<.001 , and r=0.52r=0.52 for ABC with p=.032p=.032 .</p><p><strong>Conclusion: </strong>Carotid endarterectomy improved balance and cognition in a group of asymptomatic patients with severe carotid stenosis. Greatest improvements were noted in dynamic movement tests with most reduced scores at baseline.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"17-23"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802792","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":"Presternal Subcutaneous Bronchogenic Cyst: An Unusual Ectopic Presentation Of A Congenital Lesion.","authors":"Amal Lahssini, Hiba El Hajjouli, Wafae El Aamadi, Rachid Taoufiq, Mohammed Bouchikh, Abdellah Achir","doi":"10.48729/pjctvs.639","DOIUrl":"10.48729/pjctvs.639","url":null,"abstract":"<p><p>Bronchogenic cysts are rare benign congenital lesions, most commonly located within the thoracic cavity, particularly in the mediastinum or pulmonary parenchyma. Subcutaneous presternal bronchogenic cysts are exceedingly uncommon, with fewer than 80 cases reported in the literature since their first description in 1945. We report a rare case of a 14- year- old girl presenting with a progressive presternal midline swelling since childhood, previously managed by needle aspiration with subsequent recurrence. Thoracic computed tomography suggested a thyroglossal duct cyst. Complete surgical excision through a cervical incision was performed, and histopathological examination confirmed the diagnosis of a bronchogenic cyst. This case highlights the diagnostic challenges of presternal cystic masses and underscores that complete surgical excision is the only curative treatment, as needle aspiration invariably leads to recurrence.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"39-42"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802759","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":"An Unusual Cause of Hematuria and Flank Pain.","authors":"George Koudounas, Dimitrios Karkos, Thomas Kalogirou, Aphrodite Maria Mitka, Konstantinos Papazoglou, Christos Karkos","doi":"10.48729/pjctvs.622","DOIUrl":"https://doi.org/10.48729/pjctvs.622","url":null,"abstract":"<p><p>Hematuria and flank pain are a typical urology emergency, often presented as the primary complaint. However, in patients with previous aortolia surgery, these symptoms may rarely indicate external compression of the urinary tract by an anastomotic pseudoaneurysm. We herein describe an unusual case of a 50-year-old man who presented to the urologist with hematuria and right flank pain due to ureteric compression by an aortic anastomotic pseudoaneurysm. He had undergone an open aortolia revascularization procedure with a bifurcated graft 9 years earlier and the pseudoaneurysm was found at the proximal anastomosis pressurizing the right ureter. The patient was successfully treated with a pigtail placement and an endograft implantation resulting in resolution of his symptoms. Urological symptoms in patients with a history of previous aortolia surgery should raise the suspicion of an anastomotic pseudoaneurysm.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"35-38"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802819","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":"From local success to national standard: the case for Patient Blood Management guidelines in Portuguese cardiac surgery.","authors":"Diana Castro Paupério, Filipe Leite","doi":"10.48729/pjctvs.641","DOIUrl":"https://doi.org/10.48729/pjctvs.641","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802737","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":"Endovenous Treatment Of Superficial Chronic Venous Disease In A Strict Ambulatory Setting: A Single-Center Experience.","authors":"Luís Loureiro, Paulo Almeida","doi":"10.48729/pjctvs.624","DOIUrl":"10.48729/pjctvs.624","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive endovenous techniques have become central to the treatment of superficial chronic venous disease (CVD) of the lower limbs. Their ability to avoid general or locoregional anaesthesia allows treatment to be performed in an outpatient setting.</p><p><strong>Objective: </strong>To evaluate clinical and duplex ultrasound outcomes of endovenous treatment of superficial CVD performed exclusively in a strict ambulatory setting.</p><p><strong>Methods: </strong>A retrospective observational study was conducted, including patients treated for superficial CVD between January 2017 and March 2019. Treatments modalities included radiofrequency ablation, catheter-directed foam sclerotherapy, and ultrasound-guided foam sclerotherapy by direct puncture. Clinical status was assessed using the CEAP classification. Duplex ultrasound follow-up was performed according to the institutional follow-up protocol.</p><p><strong>Results: </strong>Ninety-seven patients were included, with a mean age of 67 years and predominance of CEAP C2-C3 disease (86%). Axial reflux was treated by radiofrequency ablation in 78% of patients and catheter-directed foam sclerotherapy in 22%. At 12 months, 95% of treated saphenous segments were completely occluded, with a recanalization rate of 2.5%. CEAP reassessment at 12 months was available for 84 patients, of whom 87% were classified as CEAP C0-C1. All patients initially classified as CEAP C5 or C6 were lost to follow-up before the 12-month assessment. All procedures were performed on an outpatient basis, with same-day discharge.</p><p><strong>Conclusions: </strong>Endovenous treatment of superficial chronic venous disease in a strict ambulatory setting was feasible and associated with high anatomical success at 12 months. Clinical follow-up findings were favorable among the assessed patients, but should be interpreted in light of the loss to follow-up among patients with more advanced baseline CEAP classes.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802734","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":"Regression Of Primary Tumor In Lung Adenocarcinoma: A Rare Case With Persistent Nodal Metastasis.","authors":"Tatiana Moreira Marques, Pedro Veiga, Ana Margarida Silva, Gonçalo Paupério, Filipe Leite","doi":"10.48729/pjctvs.578","DOIUrl":"https://doi.org/10.48729/pjctvs.578","url":null,"abstract":"<p><p>Spontaneous regression (SR) of pulmonary adenocarcinoma is an exceedingly rare event, characterized by the unexplained disappearance or reduction of a tumor without adequate medical intervention. We report a case of a 60-year-old male with a history of heavy smoking and previous gastric adenocarcinoma. A surveillance CT scan identified a suspicious nodule in the right upper lung. PET/CT and biopsy confirmed adenocarcinoma. The patient underwent right upper lobectomy, and histology showed no residual cancer, consistent with SR. Lymph node metastasis was detected, leading to a staging of pTxN2R1M0. The patient is currently with no signs of recurrence. SR in pulmonary adenocarcinoma is extremely rare, and its mechanisms are not well understood. Ongoing research and careful follow-up are essential for better understanding and management.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802756","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":"Multifocal Pulmonary Epithelioid Hemangioendothelioma: A Metastatic Disease Mimicker.","authors":"Vânia Almeida, João Pereira, Rita Pancas, Lina Carvalho","doi":"10.48729/pjctvs.588","DOIUrl":"https://doi.org/10.48729/pjctvs.588","url":null,"abstract":"<p><p>We present the case of a 79-year-old woman with multiple bilateral pulmonary nodules identified during an investigation for abdominal pain, initially suspected to represent metastatic disease. Extensive clinical, laboratory, and imaging workup failed to reveal a primary origin. After two non-diagnostic transthoracic biopsies, the patient underwent single-port video-assisted thoracoscopic surgery (VATS) with excision of two nodules from the upper and lower lobes of the right lung. Histopathological examination revealed an epithelioid hemangioendothelioma (EHE), a rare vascular neoplasm. This case illustrates the diagnostic process and pathological features of pulmonary EHE, with a brief clinical overview.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 2","pages":"31-33"},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802800","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":"Traumatic Great Vessel Injuries In Children: A 10-Year Experience Of A Pediatric Intensive Care Unit In A Tertiary Hospital Center.","authors":"Inês Teixeira, Marta Grilo, Maria José Oliveira, Augusto Ribeiro","doi":"10.48729/pjctvs.519","DOIUrl":"10.48729/pjctvs.519","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries of the great vessels are rare but life-threatening in most cases. Road traffic crashes are the main cause of preventable traumatic injuries in Europe, namely great vessel injuries. Management of this condition in the pediatric population is poorly established and documented. We present our experience in assisting traumatic patients with traumatic great vessel injuries at a tertiary center Pediatric Intensive Care Unit. We also reviewed the approaches and clinical outcomes reported in the literature on behalf of this case series.</p><p><strong>Methods: </strong>We conducted a retrospective review of traumatic injuries reported from 2012 to 2021 at our Pediatric Intensive Care Unit. Patients under 18 years old who were victims of traumatic great vessel injuries were selected. Demographic and clinical data from these patients were collected until September of 2025 and analyzed.</p><p><strong>Results: </strong>Of the 260 trauma patients admitted to the Pediatric Intensive Care Unit, there were 4 (1.5%) cases of traumatic great vessel injuries associated with trauma. Three patients (75%) were male, and the mean age was 15.5 ± 1.7 years (range 13-17). The mechanism of trauma was blunt thoracoabdominal trauma from road traffic crashes in 3 patients and an abdominal stab wound due to aggression in 1 patient. The mean Modified Injury Severity Score and standard deviation were 15.5 ± 0.9. All patients required emergent surgery at hospital admission. The mean PICU stay and standard deviation were 24.7 ± 7.8 days. The median follow-up period was 71 (51-158) months. No major vessel complications or deaths were identified.</p><p><strong>Conclusion: </strong>Traumatic great vessel injuries are rare, severe, and difficult to diagnose in children; however, early recognition and treatment are essential to improve survival. Prevention of trauma resulting from high-speed accidents and domestic violence among adolescents must be promoted by healthcare services, as well as by authorities and social and political entities.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"33 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2026-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977637","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}