Annals of cardiothoracic surgery最新文献

{"title":"Tips and tricks in transaxillary aortic root surgery: the Bentall procedure.","authors":"Daniel-Sebastian Dohle, Husain Jaber, Philipp Pfeiffer, Edoardo Zancanaro, Ahmed Ghazy, Hendrik Treede","doi":"10.21037/acs-2026-0334-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0334-tdv","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"76"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The transaxillary approach and enhanced recovery after surgery: the perfect wedding.","authors":"Christopher Maria Münch","doi":"10.21037/acs-2026-0250-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0250-tdv","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"66"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transaxillary valve surgery: innovation through simplicity in minimally invasive cardiac surgery.","authors":"Marco Di Eusanio","doi":"10.21037/acs-2026-0261-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0261-tdv","url":null,"abstract":"<p><p>Minimally invasive cardiac surgery (MICS) is widely recognized as an essential component of contemporary cardiac surgical practice, offering reduced surgical trauma, faster recovery, and improved patient satisfaction while maintaining excellent clinical outcomes. Nevertheless, despite decades of technological progress and growing clinical evidence, its adoption remains limited. One of the principal barriers to wider dissemination is the procedural complexity associated with many minimally invasive platforms. Reduced operative exposure, indirect visualization, and dependence on dedicated technology frequently result in demanding workflows, prolonged learning curves, and limited reproducibility. The right transaxillary mini-thoracotomy direct vision approach was developed according to a different philosophy. Rather than relying on additional technology to compensate for the constraints of minimally invasive access, it simplifies the operative platform by preserving the natural interaction between the surgeon and the operative field. By combining favorable surgical geometry, direct visualization, and a standardized operative platform, the transaxillary approach facilitates procedural efficiency, reproducibility, and potential applicability across a broad spectrum of minimally invasive valve surgery while relying primarily on conventional surgical instrumentation. More broadly, the transaxillary concept suggests that the future dissemination of MICS may depend not only on technological innovation, but also on the ability to simplify procedural execution, facilitate reproducibility, and lower the barriers to adoption.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"62"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing errors in measuring the effective orifice diameter as a new sizing parameter of surgical valve prostheses.","authors":"Astrid Gerritje Maria van Boxtel, Tjark Ebels","doi":"10.21037/acs-2026-1-0038","DOIUrl":"https://doi.org/10.21037/acs-2026-1-0038","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"77"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transaxillary direct view mitral and tricuspid valve repair.","authors":"Marco Di Eusanio, Michele Galeazzi, Jacopo Alfonsi, Mariano Cefarelli, Erlil Mali, Pietro Giorgio Malvindi","doi":"10.21037/acs-2026-0299-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0299-tdv","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"73"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined transfemoral TAVI and direct-vision valve-in-MAC through the transaxillary approach.","authors":"Michele Galeazzi, Erlil Mali, Olimpia Bifulco, Beatrice Buratto, Filippo Capestro, Marco Di Eusanio","doi":"10.21037/acs-2026-0300-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0300-tdv","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"75"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transaxillary aortic valve replacement with a sutured valve.","authors":"Gianluca Lucchese, Rajdeep Bilkhu, Jacopo Gardellini","doi":"10.21037/acs-2026-0336-tdv","DOIUrl":"https://doi.org/10.21037/acs-2026-0336-tdv","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 5","pages":"71"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current options and recommendations for the treatment of aortic arch diseases.","authors":"Tim Berger, Martin Czerny, Stoyan Kondov, Mario Lescan, Maximilian Kreibich, Martin Grabenwöger","doi":"10.21037/acs-2026-0169-aar","DOIUrl":"https://doi.org/10.21037/acs-2026-0169-aar","url":null,"abstract":"<p><strong>Background: </strong>Diseases of the aortic arch represent some of the most complex conditions in cardiovascular medicine due to the segment's unique anatomy and its involvement in cerebral perfusion. Although isolated aortic arch pathology is relatively uncommon, the arch is frequently affected as part of more extensive thoracic aortic disease, including aneurysms, acute and chronic aortic dissections as well as penetrating aortic ulcers. The close relationship of the arch to the supra-aortic vessels and adjacent mediastinal structures contributes to the significant morbidity and mortality associated with these conditions and complicates therapeutic decision-making.</p><p><strong>Methods: </strong>This review provides a comprehensive overview of the spectrum of diseases involving the aortic arch and summarizes contemporary treatment strategies. Particular emphasis is placed on anatomical considerations and classification systems, including the Ishimaru zones and variations in aortic arch morphology, which are essential for standardized reporting and procedural planning. Key pathological entities discussed include aortic arch aneurysms, acute and chronic dissections involving the arch, and residual aortic dissection following repair of type A dissection.</p><p><strong>Results: </strong>Current treatment options encompass guideline-directed medical therapy, open surgical reconstruction, and evolving endovascular approaches. Open aortic arch replacement, often performed with hypothermic circulatory arrest and selective antegrade cerebral perfusion, remains the reference standard for patients with acceptable operative risk due to its durability and favorable long-term outcomes. In parallel, technological advances have enabled the development of branched thoracic endovascular aortic repair (B-TEVAR) and fenestrated thoracic endovascular aortic repair (F-TEVAR) devices, including both custom-made and off-the-shelf solutions, expanding treatment possibilities for patients at high surgical risk.</p><p><strong>Conclusions: </strong>Careful patient selection based on anatomical characteristics, disease acuity, comorbidities, and institutional expertise is essential to optimize outcomes. Contemporary management of aortic arch disease therefore requires an individualized, multidisciplinary approach integrating both open and endovascular strategies.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 4","pages":"50"},"PeriodicalIF":4.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training the next generation in complex aortic surgery: needs and challenges.","authors":"Joseph S Coselli, Anna Xue, Vicente Orozco-Sevilla, Marc R Moon","doi":"10.21037/acs-2026-0165-aar","DOIUrl":"https://doi.org/10.21037/acs-2026-0165-aar","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 4","pages":"53"},"PeriodicalIF":4.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normothermic frozen elephant trunk surgery without circulatory arrest: is this the future?","authors":"Marco Di Eusanio, Erlil Mali, Pietro Giorgio Malvindi, Vincenzo Vento, Simone D'Alessio, Michele Galeazzi, Olimpia Bifulco, Francesca Spagnolo, Emanuele Gatta, Paolo Berretta","doi":"10.21037/acs-2026-0131-aar","DOIUrl":"https://doi.org/10.21037/acs-2026-0131-aar","url":null,"abstract":"<p><p>Frozen elephant trunk (FET) repair has expanded the treatment of complex aortic arch pathology but continues to rely on hypothermic circulatory arrest (HCA), which remains a major physiological limitation of the procedure. In this Keynote, we describe our current normothermic FET strategy, designed to perform arch reconstruction under continuous cerebral and systemic perfusion, through the integration of open and endovascular techniques. Retrograde stent-graft deployment and balloon occlusion within the prosthesis allow controlled distal aortic clamping while maintaining uninterrupted systemic circulation. In our initial experience, the technique was technically feasible and associated with acceptable perioperative hemodynamic and metabolic profiles; however, given the limited clinical experience, these findings should be interpreted as preliminary and require further evaluation. Beyond its technical aspects, this approach reflects a conceptual shift in arch surgery from mitigating the consequences of circulatory arrest to pursuing strategies aimed at avoiding it. In selected patients, normothermic FET may represent a physiologically oriented option within the ongoing evolution of contemporary aortic arch repair.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"15 4","pages":"46"},"PeriodicalIF":4.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}