Annals of Thoracic and Cardiovascular Surgery最新文献

{"title":"Perioperative Bypassing Agent Therapy for Pulmonary Pleomorphic Carcinoma with Acquired Hemophilia.","authors":"Takashi Sakai,&nbsp;Yoko Azuma,&nbsp;Atsushi Sano,&nbsp;Sota Sadamoto,&nbsp;Naobumi Tochigi,&nbsp;Daisuke Nagase,&nbsp;Akira Iyoda","doi":"10.5761/atcs.cr.20-00257","DOIUrl":"https://doi.org/10.5761/atcs.cr.20-00257","url":null,"abstract":"<p><p>A 74-year-old man was admitted with lung cancer, and preoperative blood test showed abnormal activated partial thromboplastin time (APTT). Coagulation factor screening and APTT mixing test achieved a diagnosis of acquired hemophilia A (AHA). Bypassing agent therapy was indicated and lobectomy was successfully performed without bleeding complications. APTT returned to normal after the operation without any additional treatment for AHA. The pathogenesis of AHA is still unknown and there is no evidence for hemostatic strategy for AHA patients requiring surgery. This study supports the importance of hemostatic therapy and suggests that malignancy might cause AHA.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/51/30/atcs-28-302.PMC9433887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38841017","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}

{"title":"Randomized Controlled Trial of Oral Tranexamic Acid Intervention for the Prevention of Type II Endoleak after Endovascular Abdominal Aneurysm Repair.","authors":"Yusuke Imaeda,&nbsp;Hiroyuki Ishibashi,&nbsp;Yuki Orimoto,&nbsp;Yuki Maruyama,&nbsp;Hiroki Mitsuoka,&nbsp;Takahiro Arima","doi":"10.5761/atcs.oa.22-00100","DOIUrl":"https://doi.org/10.5761/atcs.oa.22-00100","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate tranexamic acid (TA) for the prevention of type II endoleak (EL2) at a high level of evidence by a randomized controlled trial.</p><p><strong>Methods: </strong>Patients who underwent endovascular aneurysm repair (EVAR) between May 2017 and January 2020 were included. Patients in the TA group were given 750 mg of TA daily for a month after EVAR. The incidence of EL2, blood coagulation/fibrinolytic ability, and changes in aneurysm diameter were compared between two groups.</p><p><strong>Result: </strong>On the 7th day after EVAR, EL2 was found in 14 patients (34.1%) in the TA group and in 7 patients (15.9%) in the non-TA group. It was also found in 12 patients (29.3%) in the TA group and 6 patients (13.6%) in the non-TA group at 1 month after EVAR. There was no significant difference in the incidence of EL2 between the two groups (p = 0.051, 0.08). Blood tests revealed that fibrin degradation product and D-dimer were significantly suppressed in the TA group, there was no significant difference in the change of diameter regardless of the TA intake.</p><p><strong>Conclusion: </strong>This study proved anti-fibrinolytic effect of the TA, but it alone had not enough power to decrease EL2 after EVAR.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/58/atcs-28-286.PMC9433891.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40588375","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}

{"title":"Surgical Management for Systolic Anterior Motion (SAM) of the Mitral Valve in Obstructive Hypertrophic Myopathy.","authors":"Akihiko Usui,&nbsp;Masato Mutsuga","doi":"10.5761/atcs.ra.22-00103","DOIUrl":"https://doi.org/10.5761/atcs.ra.22-00103","url":null,"abstract":"<p><p>In patients with obstructive hypertrophic cardiomyopathy, left ventricular outflow tract (LVOT) obstruction can be created by the hypertrophic interventricular septum (IVS) as well as systolic anterior motion (SAM) of the anterior mitral leaflet (AML). Sufficient septal myectomy is a fundamental surgical technique to treat LVOT obstruction, however, direct surgical management for SAM is another key aspect. Besides the hypertrophic IVS, mitral valve, subvalvular apparatus, and papillary muscle may play important role for SAM and several surgical techniques have been proposed to treat SAM in literature. In this review, each surgical technique is classified by the anatomical structure on which the surgical procedure is applied. The AML is the main surgical site and is applied with plication (vertical plication, resection-plication-release strategy), extension (the AML extension, transverse incision of the AML), sutured (edge-to-edge repair, anterior leaflet retention plasty), or traction (floating stitch, papillary muscle-to-anterior annulus stitches, paradoxical stitches, transposition of a directed chorda tendinea to the AML). Height reduction of the posterior mitral valve leaflet and papillary muscle reorientation are other techniques. We should understand theoretical aspects of each technique on correction of anatomical and functional abnormalities of the structure and should apply them under proper indication.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/91/fa/atcs-28-239.PMC9433892.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605865","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}

{"title":"IgG4-Related Lung Disease Exhibiting the Invasion into the Diaphragm: A Case Report.","authors":"Yuki Ono,&nbsp;Gouji Toyokawa,&nbsp;Tetsuzo Tagawa,&nbsp;Kayo Ijichi,&nbsp;Yoshinao Oda,&nbsp;Masaki Mori","doi":"10.5761/atcs.cr.19-00244","DOIUrl":"https://doi.org/10.5761/atcs.cr.19-00244","url":null,"abstract":"<p><p>Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition which involves various organs. This is a very rare case of IgG4-related lung disease (IgG4-RLD) with the invasion into diaphragm. The patient was a 71-year-old man with a long-term exposure to asbestos who had a mass shadow in the left lower lung lobe, which was suspected to invade the left diaphragm on computed tomography (CT). Positron emission tomography (PET)/CT also presented an avid intake of fluorodeoxyglucose in the mass, which suspected lung cancer. Although bronchoscopic biopsy could not lead to the definite diagnosis, we performed left lower lobectomy combined with the resection of left diaphragm. The specimen showed the features of IgG4-RLD on pathology: the vein stenosis and fibrosis around the vein, the infiltration of IgG4-positive cells, and IgG cells to IgG4 cells ratio of 40%. Furthermore, there were inflammatory cells infiltrating to the diaphragm.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5761/atcs.cr.19-00244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37679707","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}

{"title":"Prognostic Impact of Pretreatment Serum CYFRA Status in 1047 Patients with Esophageal Squamous Cell Carcinoma Who Underwent Radical Resection: A Japan Esophageal Society Promotion Research.","authors":"Nobuki Ishioka,&nbsp;Takashi Suzuki,&nbsp;Satoshi Yajima,&nbsp;Kentaro Murakami,&nbsp;Yu Ohkura,&nbsp;Takashi Fukuda,&nbsp;Koichi Yagi,&nbsp;Akihiko Okamura,&nbsp;Isamu Hoshino,&nbsp;Chikara Kunisaki,&nbsp;Yasuaki Nakajima,&nbsp;Kosuke Narumiya,&nbsp;Ryo Ogawa,&nbsp;Hideaki Shimada","doi":"10.5761/atcs.oa.21-00195","DOIUrl":"https://doi.org/10.5761/atcs.oa.21-00195","url":null,"abstract":"<p><strong>Purpose: </strong>The prognostic significance of pretreatment serum C-terminus of cytokeratin 19 (CYFRA21-1, CYFRA) status was evaluated in the patients with surgically treated esophageal squamous cell carcinoma.</p><p><strong>Methods: </strong>A total of 1047 patients with surgically treated esophageal cancer were enrolled in a multi-institutional study promoted by the Japanese Esophageal Society. This study included an up-front surgery group (n = 412), a neoadjuvant chemotherapy (NAC) group (n = 486), and a neoadjuvant chemoradiation/radiation therapy (NACRT/RT) group (n = 149). The pretreatment CYFRA status was analyzed to assess prognostic significance using multivariate analysis according to treatment modalities.</p><p><strong>Results: </strong>The CYFRA-positive group was significantly associated with deep tumor. Univariate analysis showed that the overall survival of the CYFRA-positive group was significantly worse than that of the CYFRA-negative group, but the difference was not significant in the multivariate analysis. CYFRA was an independent risk factor for poor prognosis just in the NACRT/RT group.</p><p><strong>Conclusions: </strong>The CYFRA-positive group was associated with deep tumor and poor survival. Pretreatment CYFRA was not an independent risk factor for poor prognosis in the up-front surgery group or NAC group. It was an independent risk factor for poor prognosis just in the NACRT/RT group.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/11/atcs-28-163.PMC9209890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39551703","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}

{"title":"Hemoadsorption of Rivaroxaban and Ticagrelor during Acute Type A Aortic Dissection Operations.","authors":"Kambiz Hassan,&nbsp;Tabea Brüning,&nbsp;Michael Caspary,&nbsp;Peter Wohlmuth,&nbsp;Holger Pioch,&nbsp;Michael Schmoeckel,&nbsp;Stephan Geidel","doi":"10.5761/atcs.oa.21-00154","DOIUrl":"https://doi.org/10.5761/atcs.oa.21-00154","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the results of hemoadsorption in patients with cardiac surgery to thoracic aortic surgery, who had been loaded beforehand with either Factor Xa inhibitor rivaroxaban or P2Y12 receptor antagonist ticagrelor.</p><p><strong>Methods: </strong>We investigated 21 of 171 consecutive patients (median age 71 [interquartile range 62, 76] years) who underwent emergency cardiac operations for acute type A aortic dissection between 2014 and 2020. These patients were pretreated with rivaroxaban (n = 9) or ticagrelor (n = 12). In ten of 21 cases (since 2017), we installed a hemoadsorber into the heart-lung machine and compared the results to eleven patients done without hemoadsorber before that time.</p><p><strong>Results: </strong>The operation time was significantly shorter in the adsorber group (286 ± 40 min vs. 348 ± 79 min; p = 0.045). The postoperative 24-hour drainage volume was significantly lower after adsorption (p <0.001; 482 ± 122 ml vs. 907 ± 427 ml) and no rethoracotomy had to be performed (compared to two rethoracotomies [18.9%] among patients without adsorber use). Also, patients without hemoadsorption required significantly more platelet transfusions (p = 0.049).</p><p><strong>Conclusions: </strong>In patients with acute type A aortic dissection who were pretreated with rivaroxaban and ticagrelor, the intraoperative use of CytoSorb hemoadsorption during cardiopulmonary bypass is reported for the first time. The method was found to be effective to prevent from bleeding and to improve the outcome in aortic dissection.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/2e/atcs-28-186.PMC9209888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39923425","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}

{"title":"A Surgical Case of Bronchial Artery Aneurysm Connecting to a Pulmonary Artery and Vein Complicated by Racemose Hemangioma.","authors":"Tomoki Nishida,&nbsp;Naoko Isogai,&nbsp;Rai Shimoyama,&nbsp;Jun Kawachi,&nbsp;Toshitaka Tsukiyama,&nbsp;Ken-Ichiro Noguchi,&nbsp;Ryuta Fukai","doi":"10.5761/atcs.cr.19-00302","DOIUrl":"https://doi.org/10.5761/atcs.cr.19-00302","url":null,"abstract":"<p><p>We report a surgical case of bronchial artery aneurysm (BAA) that directly connected to a pulmonary artery and a pulmonary vein through an abnormal vessel. It was complicated by racemose hemangioma. This is a rare vascular malformation. An 82-year-old female had a large BAA that was found incidentally. First, we consider treating the BAA with embolization by interventional radiology (IVR). However, because of strong meandering of the bronchial artery, we could not advance a microcatheter into the BAA. Therefore, a surgical operation was performed through a standard posterior lateral thoracotomy. The BAA was located between the upper and lower lobes and directly connected to the pulmonary artery. Some bronchial artery branches that provided inflow to the aneurysm were ligated, and the abnormal vessel that connected the BAA to the upper pulmonary vein was ligated easily. A fistula between the BAA and pulmonary artery was sutured by the cardiovascular surgeon using an artificial cardiopulmonary device, with permissive stenosis of A2b (ascending A2).</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5761/atcs.cr.19-00302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37945684","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}

{"title":"Early and Mid-Term Outcomes of Open versus Endovascular Left Subclavian Artery Debranching for Thoracic Aortic Diseases.","authors":"Philip Dueppers,&nbsp;Lorenz Meuli,&nbsp;Benedikt Reutersberg,&nbsp;Michael Hofmann,&nbsp;Florian Messmer,&nbsp;Alexander Zimmermann","doi":"10.5761/atcs.oa.21-00206","DOIUrl":"https://doi.org/10.5761/atcs.oa.21-00206","url":null,"abstract":"<p><strong>Purpose: </strong>To compare open versus endovascular left subclavian artery debranching for thoracic endovascular aortic repair of thoracic aortic pathologies.</p><p><strong>Methods: </strong>This is a retrospective study of patients receiving left subclavian artery debranching in our institution from October 2009 to January 2020. The primary outcome was freedom from aortic reintervention. Secondary outcomes were type I endoleaks, left subclavian artery (LSA) debranching failure, stroke, technical or clinical success, procedure-related reintervention, as well as 30-day or overall all-cause and aorta-related mortality.</p><p><strong>Results: </strong>Forty-eight patients received parallel graft-based (n = 24, ENDO; median age 75 years [70-80 years]) or open (n = 24, OPEN; median age 71 years [59-75 years]) debranching for type B aortic dissection (n = 25), degenerative aneurysm (n = 12), type IA endoleak (n = 6), suture-associated (n = 3) or ostial LSA aneurysm (n = 1), or penetrating aortic ulcer (n = 1). The median follow-up was 36 months (13-61 months). After 16 months, aortic reintervention-free survival in groups OPEN and ENDO was 91% (95% confidence interval [CI]: 79 to 100%) and 86% (73 to 100%) (p = 0.71), respectively. After 36 months, all-cause survival in groups OPEN and ENDO was 74% (95% CI: 55 to 99%) and 79% (95% CI: 64 to 97%) (p = 0.74), respectively; freedom from aorta-related mortality was 81% (95% CI: 62 to 100%) and 91% (95% CI: 80 to 100%) (p = 0.78), respectively. Group OPEN presented less type I endoleaks (OPEN/ENDO = 3/19, p <0.001) and higher technical (OPEN/ENDO = 81/36%, p = 0.003) and clinical success rates (OPEN/ENDO = 67/36%, p = 0.047). No statistical differences were found for other outcomes.</p><p><strong>Conclusion: </strong>Both strategies achieved comparable reintervention and mortality rates, but open debranching should be preferred due to its higher technical and clinical success and less type I endoleaks.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/d0/atcs-28-193.PMC9209886.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39747603","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}

{"title":"A Blinded Randomized Trial Comparing Standard Activated Clotting Time Heparin Management to High Target Active Clotting Time and Individualized Hepcon HMS Heparin Management in Cardiopulmonary Bypass Cardiac Surgical Patients.","authors":"Gregory A Nuttall,&nbsp;Mark M Smith,&nbsp;Bradford B Smith,&nbsp;Jon M Christensen,&nbsp;Paula J Santrach,&nbsp;Hartzell V Schaff","doi":"10.5761/atcs.oa.21-00222","DOIUrl":"https://doi.org/10.5761/atcs.oa.21-00222","url":null,"abstract":"<p><strong>Purpose: </strong>High-dose heparin has been suggested to reduce consumption coagulopathy.</p><p><strong>Materials and methods: </strong>In a randomized, blinded, prospective trial of patients undergoing elective, complex cardiac surgery with cardiopulmonary bypass, patients were randomized to one of three groups: 1) high-dose heparin (HH) receiving an initial heparin dose of 450 u/kg, 2) heparin concentration monitoring (HC) with Hepcon Hemostasis Management System (HMS; Medtronic, Minneapolis, MN, USA) monitoring, or 3) a control group (C) receiving a standard heparin dose of 300 u/kg. Primary outcome measures were blood loss and transfusion requirements.</p><p><strong>Results: </strong>There were 269 patients block randomized based on primary versus redo sternotomy to one of the three groups from August 2001 to August 2003. There was no difference in operative bleeding between the groups. Chest tube drainage did not differ between treatment groups at 8 hours (median [25th percentile, 75th percentile] for control group was 321 [211, 490] compared to 340 [210, 443] and 327 [250, 545], p = 0.998 and p = 0.540, for HH and HC treatment groups, respectively). The percentage of patients receiving transfusion was not different among the groups.</p><p><strong>Conclusion: </strong>Higher heparin dosing accomplished by either activated clot time or HC monitoring did not reduce 24-hour intensive care unit blood loss or transfusion requirements.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/6f/atcs-28-204.PMC9209891.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39747604","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}

{"title":"Concomitant Mitral Regurgitation in Patients Undergoing Surgical Aortic Valve Replacement for Aortic Stenosis: A Systematic Review.","authors":"Francis P Cheung,&nbsp;Cheng He,&nbsp;Philippa R Eaton,&nbsp;Jim Dimitriou,&nbsp;Andrew E Newcomb","doi":"10.5761/atcs.oa.21-00170","DOIUrl":"https://doi.org/10.5761/atcs.oa.21-00170","url":null,"abstract":"Background: Concomitant mitral regurgitation (MR) is frequently seen in patients undergoing surgical aortic valve replacement (AVR) for severe aortic stenosis (AS). When the severity of MR is moderate or less, the decision to undertake simultaneous mitral valve intervention can be challenging. Methods: A systematic search of Medline, PubMed (NCBI), Embase and Cochrane Library was conducted to qualitatively assess the current evidence for concomitant mitral valve intervention for MR in patients with AS undergoing AVR. The primary outcome for this systematic review was the postoperative change in the severity of MR and other outcomes of interest included factors that predict improvement or persistence of MR and long-term impacts of residual MR. Results: A total of 17 studies were included. The percentage of patients demonstrating improvement in MR severity following AVR ranged from 17.2% to 72%; the studies that exclusively included patients with moderate functional MR and reported longer term echocardiographic follow-up of greater than 12 months demonstrated an improvement in MR severity of 45% to 72%. Conclusion: This systematic review demonstrates that a proportion of patients can exhibit an improvement in MR following isolated surgical AVR, but whether this confers any long-term morbidity and mortality benefit remains unclear.","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/26/atcs-28-214.PMC9209887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39901210","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}