Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia最新文献_第2页

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection. A型主动脉夹层致冠状动脉灌注不良患者转运类型及冠状动脉再灌注的分层手术结果

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.24-00182

Kazuki Noda, Yosuke Inoue, Yoshimasa Seike, Hitoshi Matsuda

{"title":"Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection.","authors":"Kazuki Noda, Yosuke Inoue, Yoshimasa Seike, Hitoshi Matsuda","doi":"10.5761/atcs.oa.24-00182","DOIUrl":"10.5761/atcs.oa.24-00182","url":null,"abstract":"Purpose: Owing to the time-sensitive nature of myocardial ischemia, challenging clinical scenarios should be considered in patients with type A acute aortic dissection (AAAD) complicated by coronary malperfusion. In clinical settings, the diagnosis and reperfusion strategies for coronary malperfusion often depend on institutional resources. This study evaluated early surgical outcomes in such patients, focusing on transportation type and clinical management.Methods: We retrospectively reviewed 70 patients who underwent emergency surgery for AAAD with coronary malperfusion, excluding those with cardiac tamponade on arrival, between 1997 and February 2024. Patients were divided into 2 groups based on transportation: direct transfer and referral.Results: Overall, in-hospital mortality was 27%, with only 1 of 9 patients surviving with preoperative peripheral extracorporeal membrane oxygenation (ECMO). Mortality and morbidity did not significantly differ between groups. Univariate analysis identified left coronary artery involvement and preoperative hemodynamic instability as significant risk factors. Additionally, preoperative diagnostic-only coronary angiography (CAG) with unsuccessful reperfusion was a potential risk factor (P = 0.06).Conclusions: Regardless of transportation type, preoperative peripheral ECMO itself could not be a definitive solution in AAAD patients with coronary malperfusion. Also, patients who underwent preoperative CAG with unsuccessful reperfusion might be fatal, especially with suspected left coronary artery involvement.","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/PMC11873597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082593","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}

引用次数: 0

Risk Factors of Middle Lobe Torsion in Patients Who Underwent Thoracoscopic Right Upper Lobectomy. 胸腔镜右上肺叶切除术患者中肺叶扭转的危险因素。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.25-00022

Hidenori Goto, Kozo Nakanishi

{"title":"Risk Factors of Middle Lobe Torsion in Patients Who Underwent Thoracoscopic Right Upper Lobectomy.","authors":"Hidenori Goto, Kozo Nakanishi","doi":"10.5761/atcs.oa.25-00022","DOIUrl":"https://doi.org/10.5761/atcs.oa.25-00022","url":null,"abstract":"Purpose: Lung torsion is a rare postoperative complication of pulmonary resection caused by lobe displacement. This condition leads to bronchial or pulmonary vascular kinking, which results in airway obstruction or blood flow impairment. In particular, middle lobe torsion is commonly observed after right upper lobectomy. However, the conditions under which it occurs remain unclear. This study aimed to identify the risk factors for middle lobe torsion following right upper lobectomy.Methods: From November 2012 to December 2024, 127 patients underwent thoracoscopic right upper lobectomy at our institution. Four patients diagnosed with postoperative middle lobe torsion were classified into the torsion group. These patients were retrospectively compared with those without torsion.Results: Simultaneous partial middle lobe resection and the number of staples used for interlobar fissure formation between the upper and middle lobes were significantly associated with lung torsion. The cutoff value for the number of staples used in the upper-middle fissure formation was 4, demonstrating fair accuracy.Conclusions: The risk factors for middle lobe torsion after thoracoscopic right upper lobectomy were simultaneous partial resection of the middle lobe and the number of staples used for interlobar fissure formation between the upper and middle lobes.","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/PMC12022997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058727","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}

引用次数: 0

Robotic-Assisted Redo Coronary Artery Bypass Grafting: A Single-Center Experience. 机器人辅助重做冠状动脉旁路移植术：单中心体验。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.25-00026

Yoshiyuki Yamashita, Gianluca Torregrossa, Serge Sicouri, Mary Ann C Wertan, Danielle D Spragan, Basel Ramlawi, Francis P Sutter

{"title":"Robotic-Assisted Redo Coronary Artery Bypass Grafting: A Single-Center Experience.","authors":"Yoshiyuki Yamashita, Gianluca Torregrossa, Serge Sicouri, Mary Ann C Wertan, Danielle D Spragan, Basel Ramlawi, Francis P Sutter","doi":"10.5761/atcs.oa.25-00026","DOIUrl":"https://doi.org/10.5761/atcs.oa.25-00026","url":null,"abstract":"Purpose: To report our experience with robotic-assisted redo coronary artery bypass grafting (CABG).Methods: This single-center retrospective study included patients undergoing robotic-assisted redo CABG between 2016 and 2023. Patient demographics and operative outcomes were compared with those of initial robotic-assisted CABG procedures performed during the same period.Results: There were 12 patients undergoing robotic-assisted redo CABG, with a median age of 73 years. Compared to initial CABG patients (n = 1415), the Society of Thoracic Surgeons scores were significantly higher (median: 0.90 vs. 7.05, p <0.001) in the redo group. Six patients had de novo internal mammary artery (IMA) to left anterior descending (LAD) bypass, 4 had redo LAD bypass, and 2 had non-LAD bypass. Among the 10 patients with LAD bypass, 4 also underwent hybrid percutaneous coronary intervention. While operating room time (5.4 vs. 7.4 hours, p <0.001), postoperative lengths of stay (4.0 vs. 5.5 days, p = 0.02) and the need for blood transfusion (15% vs. 42%, p = 0.02) were significantly greater in the redo group compared to the initial group, there were no conversions to sternotomy, unplanned revascularization, or in-hospital mortality in the redo patients.Conclusion: Robotic-assisted redo CABG demonstrated promising operative outcomes in appropriately selected patients despite the higher-risk cohort.","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/PMC12022765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033684","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}

引用次数: 0

Comparison of Liposomal Bupivacaine versus Bupivacaine in Superficial Parasternal Intercostal Plane Block for Cardiac Surgery with Median Sternotomy. 布比卡因脂质体与布比卡因在胸骨正中切开心脏手术胸骨旁浅肋间平面阻滞中的比较。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.25-00008

Rong-En Qiu, Yun-Ping Lan, Shan Liu, Xiang-Yu Fang, Yun-Feng Zhang

{"title":"Comparison of Liposomal Bupivacaine versus Bupivacaine in Superficial Parasternal Intercostal Plane Block for Cardiac Surgery with Median Sternotomy.","authors":"Rong-En Qiu, Yun-Ping Lan, Shan Liu, Xiang-Yu Fang, Yun-Feng Zhang","doi":"10.5761/atcs.oa.25-00008","DOIUrl":"10.5761/atcs.oa.25-00008","url":null,"abstract":"Purpose: This study aimed to compare the efficacy and safety of liposomal bupivacaine (Lip-BPVC) versus standard bupivacaine (BPVC) for superficial parasternal intercostal plane block in patients undergoing elective coronary artery bypass grafting (CABG) via median sternotomy.Methods: A total of 82 adult patients were randomly assigned to the BPVC group (n = 41) or the Lip-BPVC group (n = 41).Results: The Lip-BPVC group demonstrated significantly lower pain scores at all postinjection time points compared to the BPVC group with fewer opioid analgesics. Lip-BPVC demonstrated an initial heightened inflammatory response postoperatively compared to standard BPVC, indicated by significantly lower levels of pro-inflammatory markers at 24 and 48 hours postinjection with BPVC. However, by 72 hours, inflammatory markers did not differ significantly between Lip-BPVC and BPVC groups. No significant differences were observed between the groups in terms of surgery duration, extubation time, intensive care unit and hospital length of stay, or incidence of postoperative nausea and vomiting.Conclusions: Lip-BPVC initially increased inflammatory markers postoperatively, but levels were comparable to BPVC by 72 hours. It provided superior pain control and reduced opioid use compared to standard BPVC in CABG patients, with similar safety and recovery outcomes.","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/PMC11972696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797180","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}

引用次数: 0

Total Robot-Assisted Minimally Invasive Esophagectomy for De Novo Esophageal Cancer after Liver Transplantation: The Potential of Robotic Surgery in a Complex Posttransplant Case. 全机器人辅助微创食管切除术治疗肝移植后新生食管癌：机器人手术在复杂移植后病例中的潜力。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.cr.25-00065

Toshikatsu Tsuji, Noriyuki Inaki, Jun Kinoshita, Hideki Moriyama, Daisuke Yamamoto, Hiroto Saito, Kenta Doden

{"title":"Total Robot-Assisted Minimally Invasive Esophagectomy for De Novo Esophageal Cancer after Liver Transplantation: The Potential of Robotic Surgery in a Complex Posttransplant Case.","authors":"Toshikatsu Tsuji, Noriyuki Inaki, Jun Kinoshita, Hideki Moriyama, Daisuke Yamamoto, Hiroto Saito, Kenta Doden","doi":"10.5761/atcs.cr.25-00065","DOIUrl":"https://doi.org/10.5761/atcs.cr.25-00065","url":null,"abstract":"The malignancy risk has increased following improvements in the long-term survival rates after liver transplantation. Reports show a 23.4-fold increase in the risk of de novo esophageal cancer after liver transplantation compared to the general population. We report the case of a 47-year-old female diagnosed with early esophageal cancer after liver transplantation. Endoscopic submucosal dissection was performed; however, due to it being a noncurative resection, additional treatment was required. Total robot-assisted minimally invasive esophagectomy (RAMIE) was performed using a robot for thoracic and abdominal procedures. Although extensive adhesions were observed after liver transplantation, precise surgery using the robot did not damage any vital organs, such as the graft blood vessels. The patient was discharged without postoperative complications. Total RAMIE for esophageal cancer after liver transplantation is a feasible and safe option following careful evaluation of the patient's condition, and expands the possibilities of successful complex posttransplant surgeries through robotic precision.","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/PMC12055276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060846","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}

引用次数: 0

Lobectomy Increases Postoperative Pulmonary Artery Enlargement to a Greater Extent than Segmentectomy. 肺叶切除术比节段切除术在更大程度上增加术后肺动脉扩张。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.24-00083

Megumi Nishikubo, Yugo Tanaka, Shinya Tane, Daisuke Hokka, Yoshimasa Maniwa

{"title":"Lobectomy Increases Postoperative Pulmonary Artery Enlargement to a Greater Extent than Segmentectomy.","authors":"Megumi Nishikubo, Yugo Tanaka, Shinya Tane, Daisuke Hokka, Yoshimasa Maniwa","doi":"10.5761/atcs.oa.24-00083","DOIUrl":"10.5761/atcs.oa.24-00083","url":null,"abstract":"Purpose: The underlying mechanism why segmentectomy has demonstrated the non-inferiority to lobectomy in several randomized trials remains unclear. Computed tomography (CT)-measured pulmonary artery (PA) enlargement reflects PA pressure and predicts the prognosis of certain respiratory diseases. We compared the preoperative and postoperative PA diameter to the ascending aorta diameter (PA/A) ratio, investigating its impact on right ventricular function in lung resection.Methods: This retrospective study was conducted in patients with lower-lobe lung tumors who underwent anatomical lung resection between 2017 and 2022. The PA diameter at the bifurcation and the ascending aorta diameter at the same CT image slice were measured preoperatively and postoperatively. We calculated the enlargement of PA/A ratio (PA/A change) and compared lobectomy and segmentectomy.Results: This analysis included 279 patients (235 with lobectomy and 44 with segmentectomy). The PA/A change was significantly greater in patients with lobectomy than segmentectomy (104% vs. 102%, P = 0.02). In the multivariable analysis, airflow obstruction (yes, P = 0.04) and the type of surgery (segmentectomy, P = 0.04) were independent prognostic factors for PA/A change.Conclusions: The PA/A change was greater in lobectomy than in segmentectomy. This change could reflect a burden on right ventricular function after lobectomy.","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/PMC11781968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070296","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}

引用次数: 0

Pathological Features and Differential Efficacy of Cisplatin-Based Adjuvant Chemotherapy in Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations. 以顺铂为基础的辅助化疗治疗表皮生长因子受体突变肺癌的病理特征及疗效差异

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.24-00149

Takafumi Kabuto, Toshi Menju, Shigeto Nishikawa, Kazuhiro Terada, Akihiko Yoshizawa, Hiroshi Date

{"title":"Pathological Features and Differential Efficacy of Cisplatin-Based Adjuvant Chemotherapy in Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations.","authors":"Takafumi Kabuto, Toshi Menju, Shigeto Nishikawa, Kazuhiro Terada, Akihiko Yoshizawa, Hiroshi Date","doi":"10.5761/atcs.oa.24-00149","DOIUrl":"10.5761/atcs.oa.24-00149","url":null,"abstract":"Purpose: We aimed to elucidate the efficacy of conventional cisplatin-based adjuvant chemotherapy for patients with lung cancers harboring epidermal growth factor receptor (EGFR) mutation.Methods: This retrospective cohort study included 110 patients (EGFR mutation group: n = 51; EGFR wild-type group: n = 59) receiving cisplatin-based adjuvant chemotherapy following complete resection of non-small-cell non-squamous-cell lung cancer (2010-2021). Clinicopathological characteristics, recurrence-free survival (RFS), and overall survival (OS) were investigated.Results: The pStage distribution was not statistically different. The EGFR mutation group was characterized by more advanced pN, papillary predominance, and presence of micropapillary components, whereas the EGFR wild-type group exhibited more advanced pT and solid predominant patterns. The median RFS was significantly worse in the EGFR mutation group (23.0 vs. 76.1 months, p = 0.017). Nevertheless, the median OS was not significantly different (85.6 months vs. not reached, p = 0.151). Multivariable analysis demonstrated that EGFR mutation and lymphatic invasion were significant risk factors in RFS; however, no independent factors were identified in OS.Conclusions: Cisplatin-based adjuvant chemotherapy might be less effective in patients with EGFR-mutated lung cancer. The style of progression and histological pattern related with EGFR mutation may be associated with the efficacy of adjuvant chemotherapy and poor RFS.","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/PMC11769713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026035","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}

引用次数: 0

Transjugular Tricuspid Valve Implantation of Valve-in-Ring Bioprosthesis: Feasibility in a Preclinical, Pilot Trial. 经颈静脉三尖瓣环形瓣膜植入生物假体：临床前试验的可行性。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.nm.24-00171

Lishan Zhong, Qiuji Wang, Shuo Xiao, Junfei Zhao, Yingjie Ke, Zhaolong Zhang, Huanlei Huang

{"title":"Transjugular Tricuspid Valve Implantation of Valve-in-Ring Bioprosthesis: Feasibility in a Preclinical, Pilot Trial.","authors":"Lishan Zhong, Qiuji Wang, Shuo Xiao, Junfei Zhao, Yingjie Ke, Zhaolong Zhang, Huanlei Huang","doi":"10.5761/atcs.nm.24-00171","DOIUrl":"10.5761/atcs.nm.24-00171","url":null,"abstract":"This preclinical study in a porcine model of recurrent regurgitation following tricuspid valvuloplasty aims to confirm the feasibility and safety of a novel transjugular tricuspid valve (TV) replacement device and to optimize the implantation procedure prior to first-in-human study. The novel device was implanted via a transjugular approach in a large white pig model (n = 2). No perivalvular leakage (PVL) or central tricuspid regurgitation (TR) was observed on post-operative echocardiography. The mean transvalvular gradient at 3 months follow-up was 1.69 ± 0.7 mmHg with mild central TR but no PVL. There was no right ventricular outflow tract obstruction, III atrioventricular block, device malposition, pericardial effusion, coronary artery compression, or myocardial infarction. This technique may be a promising option for patients after TV valvuloplasty and is ideal for high-risk patients undergoing open-heart surgery.","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/PMC11972695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797187","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}

引用次数: 0

Long-Term Outcomes of Concomitant Modified Cox-Maze and Mitral Surgery. 改良Cox-Maze联合二尖瓣手术的远期疗效。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.24-00119

Choosak Kasemsarn, Pramote Porapakkham, Sahaporn Wathanawanichakun, Piyawat Lerdsomboon, Krisulang Chanpa

{"title":"Long-Term Outcomes of Concomitant Modified Cox-Maze and Mitral Surgery.","authors":"Choosak Kasemsarn, Pramote Porapakkham, Sahaporn Wathanawanichakun, Piyawat Lerdsomboon, Krisulang Chanpa","doi":"10.5761/atcs.oa.24-00119","DOIUrl":"10.5761/atcs.oa.24-00119","url":null,"abstract":"Purpose: There are limited data on outcomes of combined Maze and mitral valve procedures beyond 10 years. This study analyzed the efficacy of this operation.Methods: Between June 2004 and December 2022, 406 patients underwent mitral surgery concomitant with Maze procedure were evaluated. Rhythm outcomes, predictors of recurrence, and survival were assessed.Results: The median follow-up period was 100 months. Rheumatic disease was present in 58%. Mitral valve repair was performed in 57.1%. Freedom from atrial fibrillation (AF) at 5, 10, and 15 years was 82.5%, 70.8%, and 52.7%, respectively. Overall survival rates were not different between patients in sinus rhythm (SR) and those who remained in AF (p = 0.172). However, patients in SR experienced fewer neurological complication (p = 0.001). Predictors of AF recurrence included preoperative AF duration (p = 0.005), left atrial diameter (LAD) >50 mm (p <0.001), concomitant tricuspid valve surgery (p = 0.049), and the presence of AF on postoperative day 7 (p <0.001). Factors influencing survival were age >60 years (p <0.001) and a postoperative left ventricular ejection fraction <40% (p <0.001).Conclusions: The combined Maze and mitral valve surgery provides significant benefits in managing AF with mitral disease. Predictors of recurrence included AF duration, LAD size >50 mm, associated tricuspid valve disease, and AF on day 7. SR patients had fewer neurological complications.","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/PMC11931737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702454","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}

引用次数: 0

Machine Learning-Based Random Forest to Predict 3-Year Survival after Endovascular Aneurysm Repair. 基于机器学习的随机森林预测血管内动脉瘤修复后3年生存率。

Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia Pub Date : 2025-01-01 DOI: 10.5761/atcs.oa.25-00036

Toshiya Nishibe, Tsuyoshi Iwasa, Seiji Matsuda, Masaki Kano, Shinobu Akiyama, Shoji Fukuda, Masayasu Nishibe

{"title":"Machine Learning-Based Random Forest to Predict 3-Year Survival after Endovascular Aneurysm Repair.","authors":"Toshiya Nishibe, Tsuyoshi Iwasa, Seiji Matsuda, Masaki Kano, Shinobu Akiyama, Shoji Fukuda, Masayasu Nishibe","doi":"10.5761/atcs.oa.25-00036","DOIUrl":"https://doi.org/10.5761/atcs.oa.25-00036","url":null,"abstract":"Purpose: Endovascular aneurysm repair (EVAR) is widely used to treat abdominal aortic aneurysms (AAAs), but mid-term survival remains a concern. This study aims to develop a machine learning-based random forest model to predict 3-year survival after EVAR.Methods: A random forest model was trained using data from 176 EVAR patients, of whom 169 patients were retained for analysis, incorporating 23 preoperative and perioperative variables. Model performance was evaluated using 5-fold cross-validation.Results: The model achieved an area under the receiver-operating characteristic curve (AUC) of 0.91, with an accuracy of 81.1%, a sensitivity of 81.6%, a specificity of 80.9%, and an F1 score of 0.66. Feature importance analysis identified poor nutritional status (geriatric nutritional risk index <101.4), compromised immunity (neutrophil-to-lymphocyte ratio >3.19), chronic kidney disease (CKD), octogenarian status, chronic obstructive pulmonary disease (COPD), small aneurysm size, and statin use as the top predictors of 3-year mortality. The average values of the AUC, accuracy, sensitivity, specificity, and F1 score across the 5-folds were 0.76 ± 0.10, 73.9 ± 5.8%, 60.4 ± 1.9%, 77.8 ± 0.7%, and 0.59 ± 0.17, indicating consistent performance across different data subsets.Conclusions: The random forest model effectively predicts 3-year survival after EVAR, indicating key factors such as poor nutritional status, compromised immunity, CKD, octogenarian status, COPD, small aneurysm size, and statin use.","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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082776","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}

引用次数: 0