Portuguese journal of cardiac thoracic and vascular surgery最新文献

{"title":"Surgical Repair Of Severe Mitral And Tricuspid Valve Regurgitation In Patient With Left Ventricle Noncompaction - A Case Report.","authors":"Aayushi Donariya, Herin Patel, Fagun Gajjar, Shobhit Mathur, Archit Patel, Kartik Patel","doi":"10.48729/pjctvs.524","DOIUrl":"10.48729/pjctvs.524","url":null,"abstract":"<p><p>Left ventricular non-compaction (LVNC) cardiomyopathy is a rare congenital cardiomyopathy which is characterized by prominent and extensive trabeculation and deep intertrabecular recesses communicating with left ventricular cavity. Here we present a rare case report of patient with severe secondary Mitral regurgitation (MR) and severe tricuspid regurgitation (TR) in LVNC cardiomyopathy who underwent MV Repair using ring annuloplasty with #28 CG future ring and kay's suture annuloplasty for severe TR and its postoperative management. Patient recovered well after surgery and was discharged with improved hemodynamics. The valve surgery in patients with such cardiomyopathy is very rare. This case will add to the small growing literature of surgery in severe secondary Mitral regurgitation in LVNC and the problems we faced while coming off bypass and its postoperative management.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981841","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":"Long-Term Impact Of Permanent Pacing After Mitral Valve Surgery: A Scoping Review Of Current Literature.","authors":"Adham H. El Sherbini, Hasheminia Amin, Nazanin Soghrati, Aparna Kuchibhatla, Salah Elsherif, Mohamed Abdel-Halim, Yasir Abu-Omar, Marc Pelletier, Mohammad El-Diasty","doi":"10.48729/pjctvs.479","DOIUrl":"10.48729/pjctvs.479","url":null,"abstract":"<p><strong>Background: </strong>Conduction disorders after mitral valve surgery (MVS) are frequent with a considerable percentage of patients requiring the implantation of a permanent pacemaker (PPM). This has been associated with prolonged hospital length of stay and increased resource utilization. In this scoping review, we consolidate the current evidence on the impact of PPM on late outcomes after MVS in terms of heart failure and mortality.</p><p><strong>Methods: </strong>A comprehensive electronic literature search was conducted on Medline, EMBASE, Cochrane, ClinicalTrials.gov, and Google Scholar using the keywords ('mitral valve repair', 'mitral valve replacement', 'pacemaker implantation'). The search was performed in November 2023. Studies were included if they involved adults ≥18 years old who underwent MVS, reported the long-term outcomes of PPM implantation, and were observational or randomized control trials. Exclusion criteria included case series, case reports, conference abstracts, and non-English studies.</p><p><strong>Results: </strong>Literature search identified 2263 citations, of which, four studies, with a total of 49,006 patients (of which, 38,063 underwent mitral valve procedures) were ultimately included in this review. The incidence of PPM after MVS ranged between 4.2-11.8%. Factors associated with higher PPM risk, including advanced age, concomitant surgical procedures, pre-existing atrial fibrillation, conduction disorders, and ischemic heart disease, were chosen for their consistent identification across multiple studies. Data was not conclusive on whether there was a correlation between PPM implantation and an increased risk of late congestive heart failure or mortality.</p><p><strong>Conclusions: </strong>We did not find enough evidence to suggest that permanent pacing may have negative impact on late outcomes after mitral valve surgery. This may be explained by the heterogeneity of the included studies and the complex nature and multi-factorial etiology of post-surgical electric conduction disorders.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"51-58"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981598","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":"Hot Topic In Thoracic Surgery: Can Sublobar Anatomical Resections Be Non-Inferior To Lobectomies For Small, Peripheral Non-Small-Cell Lung Cancer (NSCLC)? 9 Year Experience In A Single Center.","authors":"Agata Nawojowska, Samuel Mendes, Daniel Cabral, Marion Emma Gaspar, Cristina Rodrigues, Mariana Antunes, Magda Alvoeiro, Telma Calado, Francisco Félix","doi":"10.48729/pjctvs.405","DOIUrl":"https://doi.org/10.48729/pjctvs.405","url":null,"abstract":"<p><strong>Background: </strong>Technological advances and widely spread screening programs enabled the discovery of ever smaller lesions. As such, in the last years, the tendency has shifted towards lung-sparing procedures. The role of limited surgical excision for small peripheral nodules is currently a topic of heated debate.</p><p><strong>Aim: </strong>In our work, we try to answer whether the segmentectomy could adequately treat the peripheral NSCLC staged as Tis/1a-bN0M0.</p><p><strong>Materials and methods: </strong>Our analysis is a single-center retrospective study based on the 8-year experience of our department. We identified 73 lobectomy patients and 16 segmentectomy patients. However, the lack of similarity between the two groups made it inadequate to draw satisfactory conclusions, therefore we reduced the lobectomy group and selected only those patients who could be paired with corresponding patients in the segmentectomy group. The established parameters of similarity were age (weighted at 15%), size of the lesion (50%), and follow-up (35%), and the input values were normalized. With this method, we could compare two samples of the most similar patients. 32 cases were included in the final analysis. The inclusion criteria were: NSCLC histology, size up to 2 cm, no visceral pleura invasion, N0 disease, and performed segmentectomy or lobectomy between Jan/2015 and Dec/2022. We analyzed the disease-free time and relapse rate.</p><p><strong>Results: </strong>Data refers to a total of 32 patients distributed in two groups: group A with 16 segmentectomies (S6, S1+2 or S1) and group B with 16 lobectomies. The mean time of follow-up was 30 months (1-85) for group A and 32 months (1-91) for group B. The disease-free survival was 27 months for group A and 31 months for group B. The relapse rate was 19% for segmentectomies and 12.5% for lobectomies.</p><p><strong>Conclusions: </strong>In conclusion, while this article presents our center's experience with segmentectomy, we believe further studies with larger sample sizes are needed to establish its non-inferiority. Nevertheless, our experience indicates that segmentectomy offers significant benefits, including lung preservation and the potential for future resections.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981623","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":"Using Pedal Acceleration Time To Predict Ischemic Wound Healing In Diabetic Patients.","authors":"Eduardo Silva, Joana Iglésias, Pedro Lima, Luís F Antunes, Manuel Fonseca","doi":"10.48729/pjctvs.530","DOIUrl":"https://doi.org/10.48729/pjctvs.530","url":null,"abstract":"<p><strong>Aim: </strong>Diabetes Mellitus is one of the main factors for peripheral arterial disease (PAD), while also being associated with medial arterial calcification, thus limiting the use of the ankle-brachial index. Pedal acceleration time (PAT), has emerged as a diagnostic alternative, by measuring the systolic acceleration in the arteries of the foot, with higher PAT values corresponding to a worse prognosis and with the literature suggesting a cut-off of 180 ms as a predictor of wound healing. We aimed to confirm whether we could use PAT to predict wound healing, need for revascularization and amputation in diabetic patients and whether this cut-off was valid in our population.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was carried on diabetic patients referred to our department with PAD and lower limb wounds. Each limb was assessed individually in case of bilateral wounds. Limbs with unmeasurable PAT were excluded. Limbs were assessed on follow-up and classified as: healed wounds (HW), non-healed wounds (NHW), revascularized or amputated. PAT cut-off for wound healing was measured with ROC curve. Significance was defined at p≤0.05.</p><p><strong>Results: </strong>A total of 88 patients and 100 limbs were included, mostly males (80.68%) with a median age of 75 years. Cut-off for wound healing was validated at 180.5 ms. Among the assessed limbs, 26% HW, 31% NHW, 33% revascularized limbs and 7% amputations. Mean PAT in each group was 159.81 ms (HW), 199.32 ms (NHW), 239.18 ms (revascularized), 279.14 ms (amputated). When comparing the HW and NHW groups, 61.3% of NHW had PAT >180ms versus 19.2% HW, p<0.001 (OR=6.65; 95%CI [1.98-22.39]). In the sub-set of NHW we further analysed whether the wound was clinically better or worse: wounds with a positive healing process had a mean PAT of 189.96 ms vs 231.43 ms (p=0.14) in wounds with worse evolution.</p><p><strong>Conclusion: </strong>The results of our study validate the cut-off of 180 ms and reinforce using PAT as a predictor for wound healing, even among diabetic patients. In our analysis, only patients with HW had mean PAT ≤180 ms, with higher values of PAT being associated with worse outcomes (need for revascularization/amputation). Furthermore, in NHW patients, those with a PAT closer to 180 ms were associated with more favourable wound healing outcomes.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"47-50"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981815","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":"Prosthetic Graft Infection in Femoropopliteal Bypass.","authors":"Maria Catarina-Ferreira, Lourenço Thierstein, António Pereira-Neves, João Rocha-Neves, Leonardo Araújo-Andrade","doi":"10.48729/pjctvs.538","DOIUrl":"https://doi.org/10.48729/pjctvs.538","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral artery disease, a manifestation of systemic atherosclerosis, often necessitates surgical revascularization in advanced stages, with femoropopliteal bypass serving as a primary intervention to restore adequate lower limb perfusion. When autologous vein grafts are not available, prosthetic conduits are commonly used. However, these heterologous materials carry an increased risk of infectious complications, which, although rare, are associated with substantial morbidity and mortality. This study aims to review the current literature on prosthetic graft infections in femoropopliteal bypass surgeries, focusing on epidemiology, risk factors, microbiology, diagnostic methods, treatment strategies, and preventive measures.</p><p><strong>Materials and methods: </strong>A narrative review of the literature was conducted using databases such as PubMed to identify relevant studies on vascular prosthetic infections, particularly in femoropopliteal bypass surgeries.</p><p><strong>Results: </strong>Prosthetic graft infections occur in approximately 2.6% of femoropopliteal bypass surgeries. Staphylococcus epidermidis is the most commonly isolated pathogen. Other relevant Gram-positive bacteria include Staphylococcus aureus, and Gram-negative bacteria such as Pseudomonas aeruginosa. Accurate identification of the etiological agent through microbiological and diagnostic methods is essential for improving clinical outcomes. Early diagnosis is crucial to enable timely and effective treatment, which generally combines antibiotic therapy with surgical intervention, often necessitating graft removal. Furthermore, adopting preventive measures, such as perioperative antibiotic prophylaxis, is fundamental to reducing the incidence of these complications and minimizing the morbidity and mortality associated with prosthetic graft infections.</p><p><strong>Conclusion: </strong>Prosthetic graft infections in femoropopliteal bypass surgeries remain a challenging complication. A multidisciplinary approach encompassing early detection, evidence-based treatment, and targeted prevention strategies is essential to improve outcomes, preserve limb function, and mitigate long-term morbidity.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"59-68"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981820","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":"Orogastric Tube Use in Patients Undergoing Cardiac Surgery, A Pilot Study.","authors":"Sarah Paleczny, William Khoury, Adriyan Hrycyshyn, Yannis Amador-Godoy, Tarit Saha, Mohammad El-Diasty","doi":"10.48729/pjctvs.545","DOIUrl":"10.48729/pjctvs.545","url":null,"abstract":"<p><strong>Objectives: </strong>This pilot study investigated the potential impact of using orogastric tube (OGT) on the immediate post- operative outcomes in adult patients undergoing coronary artery bypass graft procedures.</p><p><strong>Design: </strong>A prospective non-blinded randomised study.</p><p><strong>Setting: </strong>At a single University Hospital.</p><p><strong>Participants: </strong>Seventy-eight consecutive adult patients that underwent coronary artery bypass graft surgery were included.</p><p><strong>Interventions: </strong>Thirty-nine patients received an OGT, and thirty-nine patients did not (control group).</p><p><strong>Measurements: </strong>Primary outcomes included: the incidence of postoperative nausea and vomiting, opiate use for pain, prolonged ventilation, and gastric dilatation on x-ray. Secondary outcomes included: the incidence of major adverse cardiac and cerebral events, major respiratory, gastrointestinal, and renal complications, and total hospital length of stay.</p><p><strong>Main results: </strong>There were non-significant trends towards higher incidence of post-operative nausea (n=2/39; 5.1%; p=0.156) and vomiting (n=1/39; 2.6%, p=0.314) in the OGT group compared to the non-OGT group (n = 0). There was a significant increase in opiates use for pain in the OGT group (n = 13/39; 33.3%) compared to the non-OGT group (n = 3/39, 7.7%) (p=0.0054), indicating that OGT may contribute to the development of postoperative pain or discomfort. There was no difference in the incidence of major postoperative outcomes.</p><p><strong>Conclusions: </strong>In this pilot study, the use of OGT did not impact the immediate postoperative outcomes after coronary artery bypass surgery. However, it was significantly associated with higher use of opiates in these patients.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 2","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981560","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":"Two-Staged Treatment of Symptomatic Complex Type 2 Thoracoabdominal Aneurysm with Unconventional EVAR, TEVAR, and iBEVAR.","authors":"Henrique Guedes da Rocha, Paulo Almeida, Carolina Vaz, Rui Machado","doi":"10.48729/pjctvs.513","DOIUrl":"https://doi.org/10.48729/pjctvs.513","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001906","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":"Unseen Impact: A Bullet Lodged in an Unexpected Location.","authors":"Patricia M Castro, Cátia Silva, Paulo Ponce, Daniel Martins","doi":"10.48729/pjctvs.501","DOIUrl":"https://doi.org/10.48729/pjctvs.501","url":null,"abstract":"","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"65-66"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000207","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":"Chest Wall Intramuscular Myxoma : A Rare Tumor.","authors":"Hamid El Kouatli, Mohamed Bhairis, Aymar Kassa Boukat, Mustapha Azekhmam, Massine El Hammoumi, El Hassane Kabiri","doi":"10.48729/pjctvs.527","DOIUrl":"10.48729/pjctvs.527","url":null,"abstract":"<p><p>Intramuscular myxomas are rare benign soft-tissue tumors. The myocardium is the most common site for myxomas, while extracardiac myxomas are commonly localized in the musculature (broad muscle), upper extremities (shoulder and arm), thighs and gluteal muscles. We report the case of a 68-year-old with an extremely rare intramuscular myxoma localized in the chest wall. Difficulties include differentiation from sarcomas, intramuscular lipomas, hematomas and desmoid tumors.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"51-53"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045614","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":"Endobronchic Follicular Dendritic Cell Sarcoma: An Exceptionnal Endobronchic Tumour.","authors":"Nabil Tiress, Massine El Hammoumi, Mohammed Bhairis, Hamid Kouatli, Reda El Ochi, Ismail El Rhorfi, El Hassane Kabiri","doi":"10.48729/pjctvs.473","DOIUrl":"10.48729/pjctvs.473","url":null,"abstract":"<p><p>Follicular dendritic cell sarcoma is a very rare entity subject of few studies, we report a case of endobronchial site manifested by a total atelectasis of the right lung managed by initial endobronchic desobstruction and surgical excision with successful results.</p>","PeriodicalId":74480,"journal":{"name":"Portuguese journal of cardiac thoracic and vascular surgery","volume":"32 1","pages":"59-61"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037824","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}