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

Preoperative Blood Lactate Level as a Simple Point-of-Care Predictor of Surgical Mortality in Acute Type A Aortic Dissection. 术前血乳酸水平作为急性a型主动脉夹层手术死亡率的简单预测指标。

IF 1.3

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.25-00087

Hirohiko Akutsu, Koji Kawahito

{"title":"Preoperative Blood Lactate Level as a Simple Point-of-Care Predictor of Surgical Mortality in Acute Type A Aortic Dissection.","authors":"Hirohiko Akutsu, Koji Kawahito","doi":"10.5761/atcs.oa.25-00087","DOIUrl":"10.5761/atcs.oa.25-00087","url":null,"abstract":"Purpose: Rapid risk stratification is crucial in patients with acute type A aortic dissection (ATAAD), particularly those presenting with circulatory collapse or malperfusion. This study investigated whether preoperative blood lactate levels could predict surgical outcomes.Methods: A retrospective analysis was conducted on 166 patients who underwent emergency surgery for ATAAD between 2014 and 2022. Preoperative arterial lactate levels were measured at admission. Multivariate logistic regression identified risk factors for in-hospital mortality. The optimal lactate cutoff value was determined using receiver-operating characteristic curve analysis. Correlation with the Penn classification was also assessed.Results: In-hospital mortality was 4.2%. A lactate level ≥3.7 mmol/L was independently associated with in-hospital mortality (hazard ratio, 1.41, p = 0.026) and was strongly correlated with Penn classes Ac and Abc. Patients with elevated lactate levels had more severe clinical presentations, prolonged intensive care unit stays, and more postoperative complications. Long-term mortality was also significantly higher in the high-lactate group (p = 0.013).Conclusions: A preoperative lactate level ≥3.7 mmol/L is a practical and effective point-of-care predictor of surgical outcomes in ATAAD. It reflects circulatory collapse and severe malperfusion, and may assist nonspecialist clinicians in early triage and decision-making.","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":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982262","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 Elective Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm in Japanese Elderly Patients. 日本老年腹主动脉瘤患者择期血管内动脉瘤修复术的远期疗效。

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.24-00185

Toshiya Nishibe, Masaki Kano, Shinobu Akiyama, Toru Iwahashi, Shoji Fukuda

{"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":"Purpose: 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.Methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

Staple Formations in Bronchial Closure with Equal-Height Staples to Those with Graduated-Height Staples Using Motorized Staplers. 等高订书机与电动订书机等高订书机在支气管闭合中的订书机形成。

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.25-00031

Kenji Tomizawa, Hana Oiki, Shota Fukuda, Masaya Nishino, Katsuaki Sato, Tetsuya Mitsudomi

{"title":"Staple Formations in Bronchial Closure with Equal-Height Staples to Those with Graduated-Height Staples Using Motorized Staplers.","authors":"Kenji Tomizawa, Hana Oiki, Shota Fukuda, Masaya Nishino, Katsuaki Sato, Tetsuya Mitsudomi","doi":"10.5761/atcs.oa.25-00031","DOIUrl":"10.5761/atcs.oa.25-00031","url":null,"abstract":"Purpose: Motorized automatic staplers are used for bronchial closure following pulmonary resection. This study aimed to compare the completeness of staple formation in bronchial closure using 2 commonly adopted staple cartridges with motorized automatic staplers as follows: graduated-height staples (GHS) and equal-height staples (EHS).Methods: This prospective observational study included 103 patients (105 bronchial stumps) undergoing pulmonary resections for lung cancer. Resected bronchi were embedded in paraffin, X-rays were taken, and staple formations were scored on a 0-4 scale, with a score of 4 indicating complete staple formation. Stump scores represented the average score of all staples per bronchial stump.Results: The GHS exhibited a higher incidence of staple scores above the median (3.91) than that of the EHS (37/59 [62.7%] vs. 19/46 [41.3%], respectively; p = 0.033). Additionally, the GHS had a higher rate of complete staple formation than that in the EHS (84.7% vs. 75.1%; p <0.0001). This difference was more evident in calcified bronchi (84.2% vs. 57.6%, respectively; p <0.0001). No bronchopleural fistula was observed in any patients during the year.Conclusion: Staple formations were generally more complete in the GHS than in the EHS. This difference was particularly notable in calcified bronchi.","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/PMC12198601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369644","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

Midterm Outcomes of Graft Insertion Technique for Redo Aortic Root Surgery. 重做主动脉根部手术移植物插入技术的中期结果。

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.25-00047

Takuya Narita, Ai Ishizawa, Nobuyuki Inoue, Tetsuro Uchida, Yoshitsugu Nakamura

{"title":"Midterm Outcomes of Graft Insertion Technique for Redo Aortic Root Surgery.","authors":"Takuya Narita, Ai Ishizawa, Nobuyuki Inoue, Tetsuro Uchida, Yoshitsugu Nakamura","doi":"10.5761/atcs.oa.25-00047","DOIUrl":"10.5761/atcs.oa.25-00047","url":null,"abstract":"Purpose: This study evaluated the midterm outcomes, including adverse aortic events (AAEs), of the \"graft insertion technique\" (GIT) for left ventricular outflow tract (LVOT) and aortic root reconstruction.Methods: From August 2014 to March 2024, 14 consecutive patients underwent GIT for LVOT and aortic root reconstruction. The indications for surgery were prosthetic valve endocarditis in 9 cases and noninfectious pseudoaneurysm in 5 cases. Among these patients, seven (50.0%) underwent aortic root surgery, while the other seven (50.0%) underwent aortic valve replacement alone or in combination with other procedures without aortic root surgery. Their mean EuroSCORE II was 28.8 ± 17.6.Results: The mean total operation time was 504 ± 87 min. The mean cardiopulmonary bypass and aortic cross-clamp times were 311 ± 41 and 240 ± 45 min, respectively. Operative mortality occurred in one case (7.1%), and five patients (35.7%) died during the first year of follow-up. No surviving patients experienced recurrent endocarditis. No patients died from cardiovascular events or infections after the second year of follow-up. Furthermore, no AAEs were observed on computed tomography during the follow-up period after hospital discharge.Conclusion: GIT is a feasible alternative for high-risk cases of redo aortic root 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/PMC12256150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602454","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

Previous Suture Type and Diameter of Fistula Predict Overall Repair Success for Post-Pneumonectomy Bronchopleural Fistulas. 先前缝合类型和瘘管直径预测全肺切除术后支气管胸膜瘘的整体修复成功。

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.25-00029

Mustafa Akyıl, Volkan Baysungur

{"title":"Previous Suture Type and Diameter of Fistula Predict Overall Repair Success for Post-Pneumonectomy Bronchopleural Fistulas.","authors":"Mustafa Akyıl, Volkan Baysungur","doi":"10.5761/atcs.oa.25-00029","DOIUrl":"10.5761/atcs.oa.25-00029","url":null,"abstract":"Purpose: This study aims to evaluate the treatment outcomes for patients who developed post-pneumonectomy bronchopleural fistula (BPF) and to identify factors that may influence the success of these treatment methods.Methods: A cohort of 60 patients diagnosed with resistant BPF following pneumonectomy for non-small cell lung cancer was included in the study. Patients were categorized into 2 groups based on the efficacy of the BPF closure methods: successful closure and failed closure. Data on demographic, clinical, and pathological characteristics, surgical procedures, oncologic treatment status, laboratory parameters at the time of BPF diagnosis, fistula diameter, and bronchial stump length were collected. The effectiveness of bronchoscopic treatments and advanced surgical procedures was analyzed.Results: Of the 60 patients included in the study, 55 (95%) were male, with a mean age of 61.6 ± 9.4 years. Multivariate analysis identified fistula diameter and the type of previous suture as significant predictors of BPF closure success ( p = 0.024 and 0.008, respectively).Conclusion: Fistula diameter and previous suture type are critical determinants of the success of post-pneumonectomy BPF closure.","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/PMC12256148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602455","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

Posterior Pericardiotomy and Its Impact on Cardiac Tamponade and Pericardial Effusion after Cardiac Surgery. 心包后切开术对心脏术后心包填塞和心包积液的影响。

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.25-00075

Ismail Al-Shameri, Abudar A Al-Ganadi, Tarq Noman, Mahdi A Kadry, Ihab M Elsharkawy, Naseem Al-Wsabi, Ayman A Mohammed

{"title":"Posterior Pericardiotomy and Its Impact on Cardiac Tamponade and Pericardial Effusion after Cardiac Surgery.","authors":"Ismail Al-Shameri, Abudar A Al-Ganadi, Tarq Noman, Mahdi A Kadry, Ihab M Elsharkawy, Naseem Al-Wsabi, Ayman A Mohammed","doi":"10.5761/atcs.oa.25-00075","DOIUrl":"10.5761/atcs.oa.25-00075","url":null,"abstract":"Purpose: Pericardial effusion (PE), tamponade, and atrial fibrillation are challenging complications after cardiac surgeries. This prospective randomized study was conducted to evaluate the impact of posterior pericardiotomy (PP) in the prevention of PE and cardiac tamponed after adult cardiac surgery.Methods: This single-center, prospective, randomized controlled trial included 330 patients undergoing open-heart surgery. They were randomly assigned to either a PP group or a control group.Results: Of 703 screened patients, 330 were enrolled from January 2022 to June 2024 (mean age: 50.2 ± 14.7 years, 64.2% males). Compared to controls, the PP group had significantly lower early and late PE (19.4% vs. 44.8%, and 4.2% vs. 17%, respectively), tamponade (2.4% vs. 11.5%), and postoperative atrial fibrillation (10.3% vs. 19.4%). PP also significantly reduced the need for surgical re-exploration, duration of mechanical ventilation, and both intensive care unit and overall hospital stays (all P <0.05). Adjusted multivariate analysis confirmed the benefits of PP after correcting for baseline imbalances in left ventricular ejection fraction and operative time. No adverse events directly attributable to PP were noted.Conclusions: PP is a simple, safe, and effective technique for reducing postoperative PE, and cardiac tamponade after cardiac 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/PMC12229714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556159","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

Evaluating the 1-Minute Sit-to-Stand Test for Predicting Postoperative Complications after Video-Assisted Thoracic Surgery Lung Lobectomy. 评价1分钟坐立试验对预测胸腔镜肺叶切除术术后并发症的价值。

IF 1.3

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.25-00144

Noriyoshi Sawabata, Masatsugu Hamaji

{"title":"Evaluating the 1-Minute Sit-to-Stand Test for Predicting Postoperative Complications after Video-Assisted Thoracic Surgery Lung Lobectomy.","authors":"Noriyoshi Sawabata, Masatsugu Hamaji","doi":"10.5761/atcs.oa.25-00144","DOIUrl":"10.5761/atcs.oa.25-00144","url":null,"abstract":"Purpose: This study aimed to determine whether the 1-minute sit-to-stand test (1-min STST) can be a predictor of postoperative complications following video-assisted thoracic surgery (VATS) lung lobectomy.Methods: This retrospective cohort study included 152 patients who underwent VATS lobectomy. Preoperative evaluations included pulmonary function tests, the bendopnea test, and the 1-min STST. The predictive value of these assessments for postoperative complications, graded by the Clavien-Dindo (C-D) classification, was analyzed using logistic regression and receiver-operating characteristic curves.Results: For predicting C-D grade II or III complications, a 1-min STST repetition count of ≤20 had an area under the curve (AUC) of 0.70, with 90% sensitivity and 46% specificity. For predicting C-D grade III complications, a repetition count of ≤15 showed an AUC of 0.72 (95% confidence interval [CI], 0.39-1.00), with 97% sensitivity and 60% specificity. In multivariate analysis for C-D grade III complications, a lower 1-min STST repetition count was a significant predictor (p <0.01).Conclusion: The 1-min STST shows potential as a simple tool for preoperative risk stratification in patients undergoing VATS 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":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034521","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

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. 食管癌伴右上肺静脉异常胸腔镜食管切除术伴隆突下淋巴结清扫术中吲哚菁绿荧光显像1例并文献复习。

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.25-00015

Naoto Ujiie, Takanobu Nakamura, Takahiro Heishi, Yusuke Taniyama, Takashi Kamei

{"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":"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.","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}

引用次数: 0

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