Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia最新文献

{"title":"Clinical Outcomes of Catheter-Directed Thrombolysis versus Mechanical Aspiration in Patients with Acute Pulmonary Embolism.","authors":"Zhe Zhang, Shanshan Jin, Bin Liu, Hai Feng, Wenrui Li","doi":"10.5761/atcs.oa.25-00012","DOIUrl":"https://doi.org/10.5761/atcs.oa.25-00012","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) and mechanical aspiration (MA) for acute pulmonary embolism (PE).</p><p><strong>Methods: </strong>From February 2022 to October 2024, the clinical data of patients with high- and intermediate-risk PE who received endovascular therapy were retrospectively reviewed. Patients were categorized based on the treatment strategy.</p><p><strong>Results: </strong>Fifty-eight consecutive patients were identified. CDT was initiated in 29 patients, while the remaining 29 received MA treatment. The time of thrombolysis and the dosage of urokinase were both lower in the MA group (P <0.05). No differences were found in cardiac biomarkers after 48 hours, perioperative bleeding events, heart/valve injury, and mortality. The total cost of the MA group was much higher compared to CDT alone. The MA group showed better improvement in right ventricular (RV) function with a higher reduction in the right ventricular-to-left ventricular ratio (0.55 ± 0.46 vs. 0.13 ± 0.53, P = 0.017). No differences were found in the reduction of the CT obstruction index.</p><p><strong>Conclusion: </strong>CDT and MA seem to have similar outcomes for patients with acute high- and intermediate-risk PE. MA is more effective in improving RV function with less thrombolysis time and fewer thrombolytics.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memory of the Late Honorary Editor-in-Chief, Professor Yukiyasu Sezai.","authors":"","doi":"10.5761/atcs.ob.25-01000","DOIUrl":"10.5761/atcs.ob.25-01000","url":null,"abstract":"","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pulsatile Bidirectional Cavopulmonary Shunt on Pre-Fontan Hemodynamics in Single Ventricle Physiology: A Meta-Analysis Reveals Favorable Outcomes.","authors":"Ketut Putu Yasa, I Wayan Sudarma, I Komang Adhi Parama Harta, Putu Febry Krisna Pertiwi","doi":"10.5761/atcs.ra.24-00170","DOIUrl":"10.5761/atcs.ra.24-00170","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to determine the outcomes of maintaining antegrade pulmonary blood flow (APBF) during the bidirectional cavopulmonary shunt (BCPS) procedure in patients with single ventricle physiology undergoing staged palliative surgeries.</p><p><strong>Methods: </strong>A systematic search of electronic databases was conducted and focused on studies comparing pulsatile BCPS (with APBF) with non-pulsatile BCPS (without APBF). Outcomes were categorized into early (post-BCPS) and late (pre-Fontan). Data were analyzed using Mantel-Haenszel random effects model with odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). The study protocol was registered in the PROSPERO (CRD42024586369).</p><p><strong>Results: </strong>A total of 17 studies with 2504 patients were included. There was no significant difference in 30-day mortality (OR 1.11, 95% CI: 0.61-2.04, p = 0.73), but pulsatile BCPS led to a higher rate of prolonged chest drainage (OR 2.45, 95% CI: 1.43-4.20, p <0.001). Pulsatile BCPS resulted in significantly higher SaO₂ in both post-BCPS (MD 3.33%, 95% CI: 2.70-3.97, p <0.001) and pre-Fontan (MD 2.91%, 95% CI: 2.51-3.31, p <0.001). The Nakata index was also higher in the pulsatile group (MD 30.67, 95% CI: 16.68-44.65, p <0.001).</p><p><strong>Conclusions: </strong>Pulsatile BCPS can optimize pre-Fontan hemodynamics by improving oxygenation and pulmonary artery development. However, the increased risk of prolonged chest drainage requires careful patient selection and monitoring.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Purulent-Inflammatory Bronchogenic Cyst in the Context of a COVID-19 Infection: A Case Report.","authors":"Kennedy Weidner, Didier Lardinois, Mohamed Hassan","doi":"10.5761/atcs.cr.24-00159","DOIUrl":"10.5761/atcs.cr.24-00159","url":null,"abstract":"<p><p>Bronchogenic cysts (BCs) are often incidental findings during imaging and can cause compressive symptoms depending on their location and size. Infections of mediastinal BCs are serious complications that can lead to life-threatening mediastinitis. The impact of severe acute respiratory syndrome coronavirus 2 on BCs remains largely undocumented. We present a unique case of a purulent-inflammatory mediastinal BC complicated by sepsis in the context of a Coronavirus Disease 2019 infection. The Coronavirus Disease 2019 infection may result in a bacterial superinfection of the BC. However, the transmission path requires further investigation. For the surgical excision, we opted for a two-step surgical approach: thoracoscopic incision and drainage in the acute setting, followed by elective thoracotomy and resection of the BC. We confirm the safety and favorable outcome of this approach.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Endarterectomy and Stenting in the Treatment of Carotid Artery Stenosis: A Real-World Nationwide, Total Population-Based Study from Korea.","authors":"Sang Ah Lee, Dong-Hyuk Cho, Jimi Choi, Jun Gyo Gwon","doi":"10.5761/atcs.oa.24-00177","DOIUrl":"https://doi.org/10.5761/atcs.oa.24-00177","url":null,"abstract":"<p><strong>Purpose: </strong>Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are both well-established treatments for carotid artery stenosis. We analyzed real-world data from the Korean National Health Insurance Service (NHIS) database to compare the clinical outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with carotid artery stenosis registered in the NHIS from 2008 to 2018. Patients who underwent either treatment were divided into CEA or CAS groups and subjected to 1:4 propensity score matching.</p><p><strong>Results: </strong>The study cohort included 1521 CEA and 6768 CAS patients. In symptomatic patients, the stroke rate within 1 month was lower in the CAS group (hazard ratio [HR], 0.61). However, the incidence of cardiovascular disease (CVD) death was higher in the CAS group at 1 month, 1 year, and during the total follow-up (HRs, 4.18, 2.43, and 1.50). There were no significant differences in outcomes between asymptomatic patients in the 2 groups.</p><p><strong>Conclusion: </strong>The periprocedural stroke risk was higher in symptomatic carotid stenosis patients who underwent CEA, but mortality was higher in those who received CAS, both in the short and long term. In asymptomatic patients, however, the incidence of major adverse cardiovascular events and mortality was similar between the 2 groups.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Uniportal Video-Assisted Thoracoscopic Surgery in the Management of Lobectomy and Segmentectomy for Lung Cancer: A Systematic Review and Meta-Analysis of Propensity Score-Matched Cohorts.","authors":"I Wayan Sudarma, Putu Febry Krisna Pertiwi, Ketut Putu Yasa, I Komang Adhi Parama Harta","doi":"10.5761/atcs.ra.24-00137","DOIUrl":"10.5761/atcs.ra.24-00137","url":null,"abstract":"<p><strong>Purpose: </strong>Uniportal video-assisted thoracoscopic surgery (UVATS) has been increasingly adopted for lung cancer management. This study aims to compare the perioperative and oncological outcomes of UVATS versus multiportal VATS (MVATS).</p><p><strong>Methods: </strong>A comprehensive search was conducted on electronic databases. Perioperative outcomes evaluated were postoperative complications, conversion to open thoracotomy, and visual analog scale (VAS) scores on postoperative days 1 (POD1) and 3 (POD3). The oncological outcomes assessed were total lymph nodes retrieved. Individual patient time-to-event data were estimated from published Kaplan-Meier curves.</p><p><strong>Results: </strong>The analysis demonstrated that UVATS was associated with significantly lower postoperative complications (relative risk [RR]: 0.76; 95% confidence interval [CI]: 1.64-0.91; p = 0.002), lower VAS scores on POD1(MD: -0.44; 95% CI: -0.70, -0.17; p = 0.001) and POD3 (MD: 0.76; 95% CI: -1.17, -0.36; p <0.001) compared to MVATS. Although UVATS had a lower conversion rate, this difference was not statistically significant (RR: 0.63; 95% CI: 0.33-1.18; p = 0.15). MVATS retrieved a higher number of lymph nodes, but this difference was also not statistically significant (MD: 0.6; 95% CI: -1.39, 0.12, p = 0.1). The overall survival probability at 96 months was slightly higher in the MVATS group (82.49%) compared to the UVATS group (75.89%), with a p-value of 0.5. Disease-free survival was comparable between the groups (75.43% UVATS and 74.74% MVATS, p = 0.59).</p><p><strong>Conclusion: </strong>UVATS demonstrated favorable perioperative outcomes and comparable oncological efficacy to MVATS in the management of lobectomy and segmentectomy for lung cancer.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Positioning Method of Pulmonary Nodules in Thoracoscopic Surgery Based on CT Simulation Positioning System for Radiotherapy.","authors":"Jiandong Hong, Taobo Luo, Yan Zhang, Ying Chen, Yang Pan, Haoting Xu, Jian Zeng","doi":"10.5761/atcs.oa.24-00148","DOIUrl":"10.5761/atcs.oa.24-00148","url":null,"abstract":"<p><strong>Purpose: </strong>The application of wedge resection in thoracoscopic surgery is becoming more and more widely prevalent. However, achieving precise intraoperative positioning of the pulmonary nodules still poses challenges. This study proposed a method for surface positioning using a computed tomography (CT) simulation positioning system in the radiation physics room.</p><p><strong>Methods: </strong>After screening patients, the level of nodules was located under the CT simulation positioning system, and the pleural projection point of the nodule and the closest surface puncture point from this point to the body surface were determined by the laser positioning system. During the operation, a needle was inserted at a predetermined angle at the puncture point, leaving a pinhole in the visceral pleura. Finally, the distance between the true pleural projection point of the nodule and the pinhole was measured on the specimen.</p><p><strong>Results: </strong>The success rate of our positioning method was 97.2%. The average distance between the puncture pinhole location and the actual pleural projection point of the nodule was 8.1 mm. No related complications occurred during the perioperative period.</p><p><strong>Conclusion: </strong>The new method of preoperative surface positioning and intraoperative lung positioning through puncture has a high success rate, good positioning accuracy, and good safety, which is worthy of clinical application.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally Endoscopic Internal Thoracic Artery Harvesting with Efficient Setup Modifications for Minimally Invasive Direct Coronary Artery Bypass Grafting.","authors":"Yoshihiro Goto, Yui Ogihara, Sho Takagi, Junji Yanagisawa, Yasuhide Okawa","doi":"10.5761/atcs.nm.25-00007","DOIUrl":"10.5761/atcs.nm.25-00007","url":null,"abstract":"<p><p>Minimally invasive direct coronary artery bypass grafting for the left anterior descending artery is a well-established technique; however, harvesting the internal thoracic artery is challenging, particularly with endoscopic approaches. In this study, 12 patients underwent internal thoracic artery harvesting using a three-dimensional endoscope with a three-port system (one incision plus two ports). Working space was established by elevating the chest wall upward using hooks anchored at the main incision site. To enhance operability, the positions of the camera and instruments were strategically adjusted within the existing ports, obviating the need for additional access points. All patients achieved graft patency. No complications, such as internal thoracic artery injury, were observed, and no patient required conversion into median sternotomy. This approach minimizes invasiveness while maintaining effectiveness, allowing for adequate dissection of the internal thoracic artery without necessitating expansion of the existing surgical setup.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Elective Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm in Japanese Elderly Patients.","authors":"Toshiya Nishibe, Masaki Kano, Shinobu Akiyama, Toru Iwahashi, Shoji Fukuda","doi":"10.5761/atcs.oa.24-00185","DOIUrl":"10.5761/atcs.oa.24-00185","url":null,"abstract":"<p><strong>Purpose: </strong>Our primary concern was the risk of overtreating elderly patients with endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. We investigated the association between age at the time of EVAR and all-cause mortality in Japan's aging population by stratifying patients into age groups.</p><p><strong>Methods: </strong>Data from 175 patients who underwent elective EVAR from 2012 to 2016 were analyzed. Patients were categorized into 3 age groups: <75 years, 75-84 years, and ≥85 years, based on Japan's healthy life expectancy and average life expectancy. Survival rates and risk factors for mortality were assessed across these patient groups.</p><p><strong>Results: </strong>Among 175 patients, 3- and 5-year survival rates were significantly lower in elderly patients, with rates of 74.6% and 64.2% for those aged 75-84 years and 51.9% and 39.7% for those aged ≥85 years. Multivariate analysis identified age ≥85 years, chronic kidney disease, chronic obstructive pulmonary disease, and active cancer as independent adverse predictors of all-cause mortality, whereas obesity was identified as an independent protective predictor.</p><p><strong>Conclusions: </strong>Adjusting guidelines to incorporate not only comorbidities but also age could optimize outcomes and healthcare resource allocation by prioritizing EVAR for patients most likely to benefit in Japan's super-aging society.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Fluorescent Imaging with Indocyanine Green during Thoracoscopic Esophagectomy with Subcarinal Lymph Node Dissection for Esophageal Cancer with a Right Superior Pulmonary Vein Anomaly: A Case Report and Literature Review.","authors":"Naoto Ujiie, Takanobu Nakamura, Takahiro Heishi, Yusuke Taniyama, Takashi Kamei","doi":"10.5761/atcs.cr.25-00015","DOIUrl":"10.5761/atcs.cr.25-00015","url":null,"abstract":"<p><p>A 68-year-old woman was diagnosed with clinical T3N1M0 middle thoracic esophageal cancer. Preoperative three-dimensional computed tomography indicated a right superior posterior pulmonary vein (RSPPV) anomaly, which ran behind the right intermediate bronchus. The patient underwent thoracoscopic esophagectomy with mediastinal lymph node (LN) dissection. Before we began the dissection of the right subcarinal LN, we administered indocyanine green intravenously to confirm the running position of the anomalous RSPPV, and we were able to ascertain its placement accurately with correct recognition of the difference between the blood vessels and surrounding tissue. Although the patient had LN metastasis adjacent to this anomalous vessel and the dissection procedure was tough due to tightly adhesion, intraoperative fluorescent imaging enabled us to perform the dissection without any superfluous vascular injury. Intraoperative fluorescent imaging is very useful in such cases, providing accurate intraoperative information on the location of the anomaly and facilitating safer surgery.</p>","PeriodicalId":93877,"journal":{"name":"Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}