Portuguese journal of cardiac thoracic and vascular surgery最新文献

{"title":"Surgical Aortic Valve Replacement For Bicuspid And Tricuspid Valve Disease: 7-Year Outcomes In >1100 Patients.","authors":"Louis Labrousse, Michael G Moront, Francois Dagenais, Michael J Reardon, G Michael Deeb, Ralf Günzinger, Marc Ruel, Tianhua Wu, Robert J M Klautz, Joseph F Sabik","doi":"10.48729/pjctvs.531","DOIUrl":"https://doi.org/10.48729/pjctvs.531","url":null,"abstract":"<p><strong>Introduction: </strong>Bicuspid aortic valve affects 0.5-2% of the population in developed countries. Given uncertainties about the best aortic valve replacement (AVR) option in this often younger, low-risk, population, it is important to understand how newer bioprostheses perform in these patients. The primary objective of this analysis was to compare 7-year outcomes of surgical AVR (SAVR) with the Avalus bioprosthesis between patients with a congenital bicuspid or tricuspid valve.</p><p><strong>Methods: </strong>This prospective, non-randomized study included 1132 patients with aortic valve stenosis or chronic severe aortic regurgitation who underwent successful SAVR with the Avalus bioprosthesis. Patients were categorized into bicuspid (n=339) and tricuspid (n=775) groups; 18 patients had unknown etiology. Kaplan-Meier analyses estimated valve-related adverse events over 7 years. Multivariable Cox proportional hazard models with propensity score adjustments evaluated the association of valve etiology with clinical outcomes, and a multivariable analysis identified risk factors for all-cause mortality.</p><p><strong>Results: </strong>Patients with a tricuspid valve were older with more advanced heart failure symptoms and a higher mean Society of Thoracic Surgeons risk score (P<0.01). At 7 years postimplant, mortality was lower [8.9% (95% CI: 5.9%-13.4%) versus 21.3% (95% CI: 18.1%-24.9%), P<0.01] and non-structural valve dysfunction was higher in the bicuspid cohort [2.9% (95% CI: 1.5%-5.5%) versus 0.6% (95% CI: 0.2%-1.6%), P<0.01]. Other safety parameters were not significantly different. In the bicuspid and tricuspid cohorts, the respective mean effective orifice area was 2.0±0.5 and 2.0±0.5 at 7 years, and the respective mean aortic gradient was 13.6±6.4 and 14.1±5.7. Reintervention rates were low [6.8% (95% CI: 4.1%-10.9%) versus 5.4% (95% CI: 3.7%-7.8%), P=0.54] in both cohorts.</p><p><strong>Conclusions: </strong>SAVR with the Avalus bioprosthesis yielded excellent 7-year outcomes for patients with either a congenital bicuspid or tricuspid valve. Hemodynamic performance and reintervention rates were similar between cohorts with low rates of other valve-related adverse events.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"25-33"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045238","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":"Concerning the TNM 9th edition - Go forth and validate.","authors":"Filipe Leite","doi":"10.48729/pjctvs.559","DOIUrl":"https://doi.org/10.48729/pjctvs.559","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"9-11"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065360","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":"\"Deviceless\" Video-Assisted Thoracoscopic Lobectomy: Is It Feasible?","authors":"Victor Hugo R Motoki Teixeira, Rafael Spessirits Barbosa, Fábio De Oliveira Sousa, Marco António Franco Tavares, Geraldo Roger Normando Junior","doi":"10.48729/pjctvs.441","DOIUrl":"10.48729/pjctvs.441","url":null,"abstract":"<p><p>We demonstrate that performing anatomical pulmonary resection by video-assisted thoracoscopic surgery without staplers or energy devices is feasible. This technique is an alternative for surgeons with limited access to expensive technologies.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043714","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":"Catheter-Based Aspiration of A Large Superior Vena Cava Mass In A Patient With Endocarditis.","authors":"Alexandra Kats, Matthew Bocchese, Sabrina Islam, Vladimir Lakhter, Suyog Mokashi","doi":"10.48729/pjctvs.492","DOIUrl":"10.48729/pjctvs.492","url":null,"abstract":"<p><p>Infective endocarditis carries a high risk of morbidity and mortality with recurrent infections and non-compliance. In the case of right-sided endocarditis, the indications for intervention are less clear. The Angiovac procedure provides a treatment for right-sided endocarditis that is a less-invasive and ideal for a complicated patient population.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043763","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":"Abstracts of the SPCCTV 4D VISIONS 2024 - Thoracic Surgery.","authors":"Pjctvs Journal","doi":"10.48729/pjctvs.553","DOIUrl":"https://doi.org/10.48729/pjctvs.553","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"107-162"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043739","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":"Successful Radical Resection Of Masaoka Iii Squamous Cell Thymic Carcinoma Invading Superior Vena Cava And Right Atrium - Case Report.","authors":"Ágata Nawojowska, Daniel Cabral, José Neves, Francisco Félix","doi":"10.48729/pjctvs.456","DOIUrl":"10.48729/pjctvs.456","url":null,"abstract":"<p><strong>Introduction: </strong>Complete radical resection is crucial for successfully treating thymic carcinomas. However, when the invasion of the great vessels or the heart in Masaoka III and IV stages occurs, the management poses more challenges. The R0 resection often requires neoadjuvant treatment. We present an example of a debatable case in which a treatment decision was guided by an imminent risk to the patient's life.</p><p><strong>Case description: </strong>We report the case of a 74-year-old female with a mediastinal mass invading the superior vena cava (SVC) and the right atrium (RA), which was successfully treated with radical resection. The procedure under the femoro-femoral CardioPulmonary Bypass (CPB) included resection of the right intra-auricular mass and the SVC followed by the interposition of a Gore-Tex conduit between the left innominate vein and RA and also wedge resection of the upper left (LUL) and right lobes (RUL). A final histopathological examination confirmed the diagnosis of squamous cell carcinoma.</p><p><strong>Conclusions: </strong>Complete radical resection is essential for successful treatment and represents the most significant prognostic factor.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"33-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043772","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":"Surgical Challenges In Managing Haemodialysis Arteriovenous Fistula Complications In Tertiary Care Centre: Our Approach.","authors":"Kritikalpa Behera, Ajit Kumar Padhy, Manju Gupta, Subrata Pramanik, Poorna Chandhar, Anubhav Gupta","doi":"10.48729/pjctvs.503","DOIUrl":"10.48729/pjctvs.503","url":null,"abstract":"<p><strong>Introduction: </strong>Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture. While some patients undergo elective AV fistula takedown post renal transplantation or for cosmesis, majority of patients presenting with life-threatening rupture require emergency surgery for AV fistula takedown with or without maintaining arterial continuity. This study aims to compile our experience with surgical management of various AV fistula complications.</p><p><strong>Methods: </strong>This is a retrospective study of 29 patients who underwent Arteriovenous Fistula takedown in our institute over a period of 3years from May 2021 to May 2024.</p><p><strong>Results: </strong>The most common cause of fistula takedown in our setup was rupture (n=25, 86.21%). AV fistula takedown was done in all cases (n=29, 100%). Arterial ligation was done in all infected cases (n=22, 75.86%) whereas in non-infected cases arterial continuity was maintained by repair or interposition venous graft. There was no aneurysm or psedoaneurysm formation or limb ischaemia in a follow up period ranging from 1month to 3 years.</p><p><strong>Conclusion: </strong>Erroneous ways of cannulation and lack of awareness of fistula care were the prime cause of AV fistula complications. Early detection and presentation to healthcare setup could offer a better prognosis for limb salvage in the long term and decrease the incidence of morbidity and mortality.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043796","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":"Symptomatic Carotid Web: a Rare Cause of Stroke.","authors":"Henrique Guedes da Rocha, Pedro Sá Pinto","doi":"10.48729/pjctvs.505","DOIUrl":"https://doi.org/10.48729/pjctvs.505","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043783","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":"Aortic Valve-Sparing operations.","authors":"Márcio Madeira, Jose Neves","doi":"10.48729/pjctvs.541","DOIUrl":"https://doi.org/10.48729/pjctvs.541","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"11-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043761","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":"Advances in Diagnosis, Treatment and Prognostic in Aortoiliac Occlusive Disease - A Narrative Review.","authors":"Maria Azevedo, Leandro Nóbrega, João Rocha-Neves","doi":"10.48729/pjctvs.469","DOIUrl":"10.48729/pjctvs.469","url":null,"abstract":"<p><strong>Background: </strong>Aortoiliac disease (AID) is a variant of peripheral artery disease involving the infrarenal aorta and iliac arteries. Similar to other arterial diseases, aortoiliac disease obstructs blood flow through narrowed lumens or by embolization of plaques. AID, when symptomatic, may present with a triad of claudication, impotence, and absence of femoral pulses, a triad also referred as Leriche Syndrome (LS).</p><p><strong>Objective: </strong>The authors aim to review the available evidence on the management of the aortoiliac occlusive disease and describe its clinical characteristics, diagnosis and treatment management.</p><p><strong>Methods: </strong>A comprehensive review of the literature was carried out to collect data from relevant studies concerning patients with moderate to severe symptomatic aortic occlusive disease. The data was identified by a search using PubMed and Google Scholar with the keywords / MESH terms \"aortoiliac occlusive disease\". For this study, the authors included papers published in the past two decades, written in English.</p><p><strong>Results: </strong>The diagnosis and evaluation of extensive aortoiliac disease involves several important considerations: vascular imaging plays a fundamental role in confirming the diagnosis of peripheral artery disease (PAD), evaluating the severity and extent of the disease and directing the planning of revascularization procedures. It provides essential information to select the most appropriate treatment modality.</p><p><strong>Conclusion: </strong>Despite successful revascularization, patients are at high risk of mortality and numerous life-threatening complications. Clinical and imagiologic factors may be used for risk stratification in order to select appropriate patients for revascularization and to better counsel patients about expected postoperative outcomes.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"31 4","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043759","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}