Annals of Thoracic and Cardiovascular Surgery最新文献_第2页

A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass. 心肺搭桥术后重症监护引起的虚弱的预测提名图。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2024-01-25 Epub Date: 2023-07-15 DOI: 10.5761/atcs.oa.23-00029

Fuxiu Zhong, Haoruo Zhang, Yanchun Peng, Xueying Lin, Liangwan Chen, Yanjuan Lin

{"title":"A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass.","authors":"Fuxiu Zhong, Haoruo Zhang, Yanchun Peng, Xueying Lin, Liangwan Chen, Yanjuan Lin","doi":"10.5761/atcs.oa.23-00029","DOIUrl":"10.5761/atcs.oa.23-00029","url":null,"abstract":"Purpose: Intensive care unit-acquired weakness (ICUAW) affects patient prognosis after cardiopulmonary bypass (CPB) surgery, but its risk factors remain unclear. We investigated these risk factors and developed a nomogram for predicting ICUAW after CPB.Methods: Baseline characteristics, preoperative laboratory data, and intra- and postoperative variables of 473 patients after CPB were determined in this prospective cohort study. Lower limb muscles on bedside ultrasound images were compared 1 day before and 7 days after CPB. Risk factors were assessed using logistic regression models.Results: Approximately 50.95% of the patients developed ICUAW after CPB. The body mass index (BMI), New York Heart Association (NYHA) class, lactate, albumin, aortic clamping time, operation time, and acute physiological and chronic health evaluation II were determined as independent risk factors. The average absolute error of coincidence was 0.019; the area under the curve, sensitivity, and specificity were 0.811, 0.727, and 0.733, respectively, for the predictive nomogram.Conclusion: A high BMI, poor NYHA class, preoperative high serum lactate, low serum albumin, long surgical duration, aortic clamping, and high acute physiological and chronic health evaluation II score are risk factors for ICUAW after CPB. This robust and easy-to-use nomogram was developed for clinical decision-making.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and In-Hospital Outcomes of Patients Who Underwent Coronary Artery Bypass Grafting during Hospitalization for ST-Segment Elevation or Non-ST-Segment Elevation Myocardial Infarction. 因 ST 段抬高或非 ST 段抬高心肌梗死住院期间接受冠状动脉旁路移植术的患者的特征和院内疗效。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2024-01-25 Epub Date: 2023-07-07 DOI: 10.5761/atcs.oa.23-00016

Nobunari Tomura, Satoshi Honda, Misa Takegami, Kensaku Nishihira, Sunao Kojima, Morimasa Takayama, Satoshi Yasuda

{"title":"Characteristics and In-Hospital Outcomes of Patients Who Underwent Coronary Artery Bypass Grafting during Hospitalization for ST-Segment Elevation or Non-ST-Segment Elevation Myocardial Infarction.","authors":"Nobunari Tomura, Satoshi Honda, Misa Takegami, Kensaku Nishihira, Sunao Kojima, Morimasa Takayama, Satoshi Yasuda","doi":"10.5761/atcs.oa.23-00016","DOIUrl":"10.5761/atcs.oa.23-00016","url":null,"abstract":"Purpose: Little is known about the outcomes of patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) who undergo coronary artery bypass grafting (CABG) in the current percutaneous coronary intervention (PCI) era.Methods: We analyzed 25120 acute myocardial infarction (AMI) patients hospitalized between January 2011 and December 2016. In-hospital outcomes were compared between patients who underwent CABG during hospitalization and those who did not undergo CABG in the STEMI group (n = 19428) and NSTEMI group (n = 5692).Results: Overall, CABG was performed in 2.3% of patients, while 90.0% of registered patients underwent primary PCI. In both the STEMI and NSTEMI groups, patients who underwent CABG were more likely to have heart failure, cardiogenic shock, diabetes, left main trunk lesion, and multivessel disease than those who did not undergo CABG. In multivariable analysis, CABG was associated with lower all-cause mortality in both the STEMI group (adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] 0.26-0.72) and NSTEMI group (adjusted OR = 0.34, 95% CI 0.14-0.84).Conclusion: AMI patients undergoing CABG were more likely to have high-risk characteristics than those who did not undergo CABG. However, after adjusting for baseline differences, CABG was associated with lower in-hospital mortality in both the STEMI and NSTEMI groups.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9764565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-Term Outcomes of Bioprosthetic and Mechanical Tricuspid Valve Replacement after Left-Sided Valves Surgery. 左侧瓣膜手术后生物人工三尖瓣和机械三尖瓣置换术的长期疗效。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-06-29 DOI: 10.5761/atcs.oa.23-00041

Ye Yuan, Yangyong Sun, Ning Li, Lin Han, Fanglin Lu, Bailing Li, Zhiyun Xu

{"title":"Long-Term Outcomes of Bioprosthetic and Mechanical Tricuspid Valve Replacement after Left-Sided Valves Surgery.","authors":"Ye Yuan, Yangyong Sun, Ning Li, Lin Han, Fanglin Lu, Bailing Li, Zhiyun Xu","doi":"10.5761/atcs.oa.23-00041","DOIUrl":"10.5761/atcs.oa.23-00041","url":null,"abstract":"Purpose: This study aimed to show the outcomes of isolated tricuspid valve replacement (ITVR) after left-sided valve surgery (LSVS).Methods: Patients who underwent ITVR after LSVS were divided into bioprosthetic tricuspid valve (BTV) and mechanical tricuspid valve (MTV) groups. Clinical data were collected and analyzed between groups.Results: 101 patients were divided into BTV (n = 46) and MTV (n = 55) groups. The mean ages of the BTV and MTV groups were 63.4 ± 8.9 and 52.4 ± 7.6 years, respectively (P <0.01). There was no significant difference in 30-day mortality (BTV 10.9% vs. MTV 5.5%), early postoperative complications, and long-term tricuspid valve (TV)-related adverse events between these two groups. New-onset renal insufficiency was an independent risk factor for early mortality. Survival rates in the BTV group were 94.8% ± 3.6%, 86.5% ± 6.5%, and 54.2% ± 17.6% and in the MTV group were 96.0% ± 2.8%, 79.0% ± 7.4%, and 59.4% ± 14.8% at 1, 5, and 10 years, respectively (P = 0.826).Conclusion: The TV prosthesis selection in ITVR after LSVS seems to not affect 30-day mortality and early postoperative complications. Long-term survival and the occurrence of TV-related events were also comparable between these two groups.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"307-314"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of Orexin Receptor Antagonist for Postoperative Atrial Fibrillation in Patients Who Underwent Off-Pump Coronary Artery Bypass Grafting. 奥列克辛受体拮抗剂对接受体外循环冠状动脉旁路移植术患者术后房颤的疗效。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-06-02 DOI: 10.5761/atcs.oa.23-00008

Kiyoshi Tamura, Shogo Sakurai

{"title":"Efficacy of Orexin Receptor Antagonist for Postoperative Atrial Fibrillation in Patients Who Underwent Off-Pump Coronary Artery Bypass Grafting.","authors":"Kiyoshi Tamura, Shogo Sakurai","doi":"10.5761/atcs.oa.23-00008","DOIUrl":"10.5761/atcs.oa.23-00008","url":null,"abstract":"Purpose: We retrospectively evaluated the postoperative efficacy of an orexin receptor antagonist for patients who underwent off-pump coronary artery bypass grafting (OPCAB).Materials and methods: We invested 108 patients who underwent cardiovascular surgery at our hospital. Patients were categorized as those received orexin receptor antagonist after surgery (S group, n = 64) or without orexin receptor antagonist (N group, n = 44), and the following data were analyzed between both groups.Results: The incidence of postoperative delirium (POD) was significantly less in the S group than in the N group (N vs. S = 36.4 vs. 6.3%, p <0.001). Postoperative new atrial fibrillation (POAF) was significantly less in the S group compared with the N group (N vs. S = 36.4% vs. 12.5%, p = 0.003). Intensive care unit stay (N vs. S = 5.0 ± 1.5 vs. 3.8 ± 0.9 days, p <0.001) and hospitalization (N vs. S = 20.5 ± 9.2 vs. 17.1 ± 7.2 days, p = 0.037) were significantly shorter in the S group compared with the N group.Conclusion: Orexin receptor antagonists might reduce POD and POAF, and this effect could introduce the shortness of intensive care unit stay and hospitalization. Orexin receptor antagonist could be useful for patients who undergo OPCAB.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"294-298"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early and Late Surgical Outcomes after Geometrical Infarct Exclusion for Post-Infarct Ventricular Septal Perforation. 脑梗塞后室间隔穿孔的几何梗塞排除术后的早期和晚期手术效果。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-06-17 DOI: 10.5761/atcs.oa.23-00058

Hiroshi Kurazumi, Ryo Suzuki, Shigeru Ikenaga, Hiroshi Ito, Akihito Mikamo, Hidenori Gohra, Kimikazu Hamano

{"title":"Early and Late Surgical Outcomes after Geometrical Infarct Exclusion for Post-Infarct Ventricular Septal Perforation.","authors":"Hiroshi Kurazumi, Ryo Suzuki, Shigeru Ikenaga, Hiroshi Ito, Akihito Mikamo, Hidenori Gohra, Kimikazu Hamano","doi":"10.5761/atcs.oa.23-00058","DOIUrl":"10.5761/atcs.oa.23-00058","url":null,"abstract":"Purpose: Ventricular septal perforation (VSP) is a critical complication of acute myocardial infarction. Various surgical procedures for it have been developed; however, surgical outcomes remain unsatisfactory. In 2010, we introduced geometrical infarct exclusion (GIE) as a modification of the Komeda-David technique. This retrospective study compared the surgical outcomes of our geometric infarct exclusion technique to those of other surgical procedures.Methods: This study included 38 patients who underwent surgery for VSP. They were divided into patients who underwent GIE (GIE group; n = 17) and those who underwent other procedures (non-GIE group; n = 21). The clinical outcomes of the two groups were compared.Results: Operation, cardiopulmonary bypass, and cardiac arrest times in the GIE group were significantly longer than those in the non-GIE group (p <0.001). A residual shunt was observed in one patient (5.8%) in the GIE group and eight (38.0%) in the non-GIE group (p = 0.026). No patients in the GIE group required a reoperation for the residual shut, while two patients required it in the non-GIE group (p = 0.492). Operative mortality was insignificantly different between the two groups.Conclusion: Geometric infarct exclusion has a longer procedural time than does other surgical procedures but can reduce the rates of residual shunts and reoperations.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"299-306"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9636155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extent of Lymph Node Dissection in Patients with Small-Sized Peripheral Non-Small Cell Lung Cancer during Intentional Segmentectomy. 小面积周围型非小细胞肺癌患者在有意分段切除术中的淋巴结切除范围

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-04-25 DOI: 10.5761/atcs.oa.22-00216

Tomohiro Maniwa, Masayuki Ohue, Yasushi Shintani, Jiro Okami

{"title":"Extent of Lymph Node Dissection in Patients with Small-Sized Peripheral Non-Small Cell Lung Cancer during Intentional Segmentectomy.","authors":"Tomohiro Maniwa, Masayuki Ohue, Yasushi Shintani, Jiro Okami","doi":"10.5761/atcs.oa.22-00216","DOIUrl":"10.5761/atcs.oa.22-00216","url":null,"abstract":"Purpose: Segmentectomy and mediastinal lymph node dissection (MLND) are becoming standard procedures for small-sized (<2 cm) peripheral non-small cell lung cancer (NSCLC). Although the benefits of the less resected lung are proven, the extent of lymph node dissection remains unchanged.Methods: We studied 422 patients who underwent lobectomy with MLND (lobe specific or systemic) for small peripheral NSCLC with clinical N0 disease. Patients with middle lobectomy (n = 39) and a consolidation-to-tumor (C/T) ratio ≤0.50 (n = 33) were excluded. We investigated the clinical factors, lymph node metastasis distributions, and lymph node recurrence patterns of 350 patients.Results: Thirty-five (10.0%) patients had lymph node metastasis; none with C/T ratio <0.75 had lymph node metastasis and lymph node recurrence. None had solitary lymph node metastasis in the outside lobe-specific MLND. Six patients had mediastinal lymph node metastasis at the initial site of recurrence; none had mediastinal lymph node recurrence outside the lobe-specific MLND, except for two patients with S6 primary disease.Conclusion: NSCLC patients with small peripheral tumors and a C/T ratio <0.75 during segmentectomy may not require MLND. The optimal MLND for patients with a C/T ratio ≥0.75, except for those with S6 primary, may be lobe-specific MLND.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"271-278"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9706935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

New-Onset Sleep Disorders before Cardiac Surgery May Indicate an Increased Risk of Postoperative Atrial Fibrillation. 心脏手术前新发睡眠障碍可能预示着术后心房颤动风险增加

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-06-23 DOI: 10.5761/atcs.oa.23-00074

Xiaokang Xu, Weitao Liang, Juan Tang, Zhong Wu

{"title":"New-Onset Sleep Disorders before Cardiac Surgery May Indicate an Increased Risk of Postoperative Atrial Fibrillation.","authors":"Xiaokang Xu, Weitao Liang, Juan Tang, Zhong Wu","doi":"10.5761/atcs.oa.23-00074","DOIUrl":"10.5761/atcs.oa.23-00074","url":null,"abstract":"Purpose: We aimed to determine if sleep disorders before cardiac surgery indicate an increased risk of postoperative atrial fibrillation (POAF).Methods: In this study, 238 patients undergoing coronary artery bypass grafting in our center were included. Patients were separated into the preoperative sleep disorder group and the control group. The primary endpoint was the incidence of POAF, and the secondary endpoints were the incidence of postoperative stroke, duration of invasive ventilation, length of intensive care unit, and hospitalization stay. Propensity score matching and multivariable logistic regression were used for adjusting potential confounders.Results: A total of 165 (69.3%) patients had sleep disorders before surgery, and 73 well-matched pairs were generated. A higher incidence of POAF was found in the preoperative sleep disorder group (16.4% versus 5.5%, p = 0.034). In multivariable logistic regression, preoperative sleep disorders were correlated to a higher risk of POAF (odds ratio = 4.627, 95% confidence interval: 1.181-18.123, p = 0.028). In the subgroup of patients without long-term sleep disorders, those who experienced preoperative sleep disorders had a higher incidence of POAF (16.1% versus 4.3%, p = 0.024), meanwhile, no difference was found in the subgroup of long-term sleep disorders.Conclusion: New-onset sleep disorders before cardiac surgery may indicate a higher incidence of POAF.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"287-293"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prognostic Impact of Visceral Pleural Invasion in Resected Solitary Lung Metastases from Gastric Cancer. 胃癌单发肺转移灶切除后内脏胸膜侵犯的预后影响

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-12-20 Epub Date: 2023-06-13 DOI: 10.5761/atcs.oa.23-00032

Takao Shigenobu, Takashi Ohtsuka, Ryutaro Hanawa, Hiroyuki Sakamaki, Akira Yoshizu, Atsushi Tajima

{"title":"Prognostic Impact of Visceral Pleural Invasion in Resected Solitary Lung Metastases from Gastric Cancer.","authors":"Takao Shigenobu, Takashi Ohtsuka, Ryutaro Hanawa, Hiroyuki Sakamaki, Akira Yoshizu, Atsushi Tajima","doi":"10.5761/atcs.oa.23-00032","DOIUrl":"10.5761/atcs.oa.23-00032","url":null,"abstract":"Purpose: Pulmonary resection of metastases from gastric cancer is extremely rare because gastric cancer metastasis to the lungs or thoracic cavity occurs as multiple pulmonary metastases, carcinomatous lymphangitis, or carcinomatous pleurisy. Therefore, the significance of surgery for pulmonary metastasis of gastric cancer remains unclear. This study aimed to investigate the surgical outcomes and prognostic factors for survival after the resection of pulmonary metastases from gastric cancer.Methods: From 2007 to 2019, 13 patients with pulmonary metastasis of gastric cancer underwent metastasectomy. Surgical outcomes were analyzed to determine the prognostic factors for recurrence and overall survival (OS).Results: All the patients underwent pulmonary resection for solitary metastases. At the median follow-up time of 45.6 months (range, 4.8-106.8 months), five patients experienced a recurrence of gastric cancer after metastasectomy. The 5-year recurrence-free survival rate was 44.4%, and the 5-year OS rate after pulmonary resection was 45.3%. Univariate analysis revealed that visceral pleural invasion (VPI) was an unfavorable prognostic factor for both recurrence-free and OS.Conclusion: Pulmonary resection of solitary metastases from gastric cancer may be an effective therapeutic option to improve survival. VPI in gastric cancer metastasis is a negative prognostic factor.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"279-286"},"PeriodicalIF":1.3,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10767656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9633597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case Series of Early Structural Valve Deterioration of Trifecta Bioprosthesis - New Zealand Experience. Trifecta生物瓣膜早期结构瓣膜恶化病例系列-新西兰经验。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-10-20 Epub Date: 2023-03-18 DOI: 10.5761/atcs.oa.23-00007

Trevor D Tnay, Lily Kang, Andrew Mekhail, Sean D Galvin

{"title":"Case Series of Early Structural Valve Deterioration of Trifecta Bioprosthesis - New Zealand Experience.","authors":"Trevor D Tnay, Lily Kang, Andrew Mekhail, Sean D Galvin","doi":"10.5761/atcs.oa.23-00007","DOIUrl":"10.5761/atcs.oa.23-00007","url":null,"abstract":"Purpose: Structural valve deterioration (SVD) remains a limitation on the use of bioprosthetic valves, with patient and valve-related factors contributing to early SVD. The Trifecta valve has been reported to have excellent hemodynamics but studies have highlighted early failure. We present a review and case series at a New Zealand tertiary hospital defining early SVD as failure within 3 years of implant.Methods: A retrospective review from January 2015 to July 2019 included 525 patients undergoing surgical aortic valve replacement with 263 patients receiving an Abbott Trifecta or Trifecta Glide Technology (GT) valve. Our review found an acceptable safety profile for the valve with excellent hemodynamics, with a low mortality, stroke, and permanent pacemaker rate.Results: Three patients out of 263 were identified from the study period as having early SVD requiring reintervention within 3 years of valve implantation leading to a 1.14% failure rate. One of the valves that had early SVD was a new generation Trifecta GT. An additional four patients were identified to have valves implanted prior to the study period and had valve failure at greater than 3 years post implantation. Five cases had cusp tears as their mechanism of failure, raising concerns about durability.Conclusion: The Trifecta valve has an acceptable safety profile and offers good hemodynamics due to the externally mounted leaflets. However, our experience of early SVD and failure is concerning for valve durability. Further comparison to other bioprosthetic valves and longer term follow-up are required to characterize the mechanism of failures.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"233-240"},"PeriodicalIF":1.3,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/e2/atcs-29-233.PMC10587479.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9133417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Graft Strategies on the Outcome of Octogenarians Undergoing Coronary Artery Bypass Grafting. 移植物策略对八旬老人冠状动脉搭桥术后疗效的影响。

IF 1.3 4区医学

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2023-10-20 Epub Date: 2023-03-29 DOI: 10.5761/atcs.oa.22-00193

Nicolai Bayer, Michael Schmoeckel, Peter Wohlmuth, Stephan Geidel

{"title":"Impact of Graft Strategies on the Outcome of Octogenarians Undergoing Coronary Artery Bypass Grafting.","authors":"Nicolai Bayer, Michael Schmoeckel, Peter Wohlmuth, Stephan Geidel","doi":"10.5761/atcs.oa.22-00193","DOIUrl":"10.5761/atcs.oa.22-00193","url":null,"abstract":"Purpose: To analyse the outcome of coronary artery bypass grafting (CABG) in octogenarians with coronary multivessel disease and the impact of different graft strategies and other factors.Methods: Out of 1654 patients with multivessel disease who underwent CABG at our institution between January 2014 and March 2020, we investigated 225 consecutive patients with a median age of 82.1 years for survival prediction and need for coronary reintervention; a detailed outcome analysis was performed.Results: At mean follow-up of 3.3 years, the overall survival was 76.4%. An indication for emergency operation (p = 0.002), age (p <0.001), chronic pulmonary disease (p = 0.024), and reduced renal or ventricular function (p <0.001) had the highest impact on limited survival. The combination outcome of survival and coronary reintervention was 1.7-fold improved (p = 0.024) after use of the bilateral internal thoracic artery (BITA) (66.2%). Off-pump CABG (12%) revealed no impact on survival. Smokers showed a poorer outcome (p = 0.004). The logistic European System for Cardiac Operative Risk Evaluation was highly effective for evaluating long-term outcomes (p <0.001).Conclusions: BITA grafting normalizes survival and reveals a better outcome in octogenarians with multivessel disease. However, patients at risk of poorer survival were operated under emergency conditions and those with pulmonary disease and reduced ventricular or renal function.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":" ","pages":"241-248"},"PeriodicalIF":1.3,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/59/atcs-29-241.PMC10587474.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9205159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0