Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia最新文献_第3页

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

Stapler-Less Uniportal Video-Assisted Thoracoscopic Surgery: A Case Series and Review of the Literature. 无订书机单门静脉电视胸腔镜手术：病例系列及文献回顾。

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.25-00009

Rawan F Ayyad, Alaa Ayyad, Raghad Sweity, Mayar Idkedek, Firas Abu Akar

{"title":"Stapler-Less Uniportal Video-Assisted Thoracoscopic Surgery: A Case Series and Review of the Literature.","authors":"Rawan F Ayyad, Alaa Ayyad, Raghad Sweity, Mayar Idkedek, Firas Abu Akar","doi":"10.5761/atcs.oa.25-00009","DOIUrl":"10.5761/atcs.oa.25-00009","url":null,"abstract":"Purpose: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach widely used for lung resections. However, reliance on staplers increases costs, limiting its adoption in resource-constrained settings. This study evaluates the feasibility, safety, and cost-effectiveness of uniportal stapler-less VATS lobectomies and segmentectomies.Methods: A retrospective analysis of 7 stapler-less uniportal VATS surgeries performed between March 2021 and February 2022 was conducted. Data on operative time, blood loss, postoperative outcomes, and complications were collected from patient records.Results: Seven procedures were completed with an average operative time of 80 min (range: 48-118 min). Estimated blood loss was minimal (10-100 mL) in 6 cases. One patient required conversion to open thoracotomy due to vessel injury. Postoperatively, all patients were stable with no major complications.Conclusion: Stapler-less VATS is a viable, cost-effective alternative to conventional techniques, offering comparable safety and outcomes. This approach supports broader adoption of minimally invasive surgery, particularly in low-income settings, where reducing procedural costs is critical.","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/PMC12173480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328080","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082776","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

Patient Outcomes after Introduction of Novel Myocardial Protection Protocol for Prolonged Aortic Cross-Clamping. 采用新型心肌保护方案治疗延长主动脉交叉夹紧后的患者预后。

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.25-00079

Masahide Komagamine, Takuma Fukunishi, Yoshiki Yamasaki, Masahiro Tomita, Satoshi Kinebuchi, Daijun Tomimoto, Kan Nawata

{"title":"Patient Outcomes after Introduction of Novel Myocardial Protection Protocol for Prolonged Aortic Cross-Clamping.","authors":"Masahide Komagamine, Takuma Fukunishi, Yoshiki Yamasaki, Masahiro Tomita, Satoshi Kinebuchi, Daijun Tomimoto, Kan Nawata","doi":"10.5761/atcs.oa.25-00079","DOIUrl":"10.5761/atcs.oa.25-00079","url":null,"abstract":"Purpose: Cardioplegia directly affects patient outcomes after cardiac surgery with prolonged aortic cross-clamping. Our hospital revised its myocardial protection protocol in April 2021 and compared the clinical outcomes of patients with prolonged aortic cross-clamping before versus after the revision.Methods: This study included 36 patients who underwent cardiac surgery via a median sternotomy and prolonged aortic cross-clamping for >4 h at our hospital from 2018 to 2024. Patients treated between 2018 and March 2021 (before the protocol revision) were designated as Group 1, while those treated from April 2021 to 2024 (after the revision) were designated as Group 2.Results: Groups 1 and 2 comprised 17 and 19 patients, respectively. The mean creatine kinase level immediately postoperative was significantly lower in Group 2 versus Group 1 (P = 0.018). The mean hospital stay was also significantly shorter in Group 2 versus Group 1 (P = 0.017). Regarding new postoperative right-ventricular dysfunction, there were 3 cases (15.8%) in Group 2 versus 5 cases (29.4%) in Group 1, but the difference was not statistically significant.Conclusion: These findings suggest that our hospital's revised myocardial protection protocol, which requires no alteration of the solution itself, achieves safe and favorable surgical results, even in cardiac surgeries requiring prolonged aortic cross-clamping.","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/PMC12169755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277008","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

Eight-Year Clinical Outcomes of Transcatheter Aortic Valve Replacement with J-Valve System. j -瓣膜系统经导管主动脉瓣置换术8年临床疗效观察

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.24-00152

Fei Li, Yuetang Wang, Donghui Xu, Xu Wang, Wei Wang

{"title":"Eight-Year Clinical Outcomes of Transcatheter Aortic Valve Replacement with J-Valve System.","authors":"Fei Li, Yuetang Wang, Donghui Xu, Xu Wang, Wei Wang","doi":"10.5761/atcs.oa.24-00152","DOIUrl":"https://doi.org/10.5761/atcs.oa.24-00152","url":null,"abstract":"Purpose: This study aimed to summarize 8-year clinical outcomes for patients who underwent transcatheter aortic valve replacement (TAVR) with the J-Valve system and evaluate the long-term durability and hemodynamic performance of the valve.Methods: Between July 2014 and June 2015, 21 patients underwent transapical TAVR with the J-Valve system. Systematic clinical and echocardiographic follow-up was conducted on 18 patients for up to 8 years.Results: Eight years post-TAVR with the J-Valve system, the all-cause mortality rate was 16.7%, with no prosthesis failures or thrombosis. Moderate to severe valve deterioration was observed in 50% of patients with aortic stenosis (AS), whereas no such deterioration was noted in patients with pure aortic regurgitation (PAR). At 8 years following TAVR, the effective orifice area measured 2.27 ± 0.50 cm2 in patients with PAR and 1.35 ± 0.38 cm2 in those with AS. Additionally, patients with AS exhibited a mean pressure gradient of 17.90 ± 10.61 mmHg. Over 8 years, PAR patients experienced a significant reduction in left ventricular end-diastolic diameter from 61.50 ± 2.08 mm to 48.67 ± 7.23 mm (p < 0.001), whereas AS patients showed no significant change.Conclusion: The J-Valve system demonstrates favorable long-term outcomes in TAVR, with excellent durability and hemodynamic performance in PAR patients.","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/PMC12055277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043826","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

Usefulness of Artificial Pneumothorax during Totally Endoscopic Off-Pump Left Atrial Appendage Closure and Surgical Ablation. 人工气胸在全内镜下无泵左心耳闭合和手术消融中的应用。

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.24-00156

Shunsuke Sato, Takashi Azami, Jun Fujisue, Kyozo Inoue, Kenji Okada

{"title":"Usefulness of Artificial Pneumothorax during Totally Endoscopic Off-Pump Left Atrial Appendage Closure and Surgical Ablation.","authors":"Shunsuke Sato, Takashi Azami, Jun Fujisue, Kyozo Inoue, Kenji Okada","doi":"10.5761/atcs.oa.24-00156","DOIUrl":"10.5761/atcs.oa.24-00156","url":null,"abstract":"Purpose: In totally endoscopic off-pump left atrial appendage (LAA) closure and surgical ablation, securing the operative field is sometimes difficult in some patients because of a narrow working space caused by an elevated diaphragm or ventricles. In this study, we aimed to investigate the effectiveness of a method that facilitates securing the operative field using an artificial pneumothorax.Methods: We analyzed 71 consecutive patients who underwent totally endoscopic off-pump LAA closure and bilateral pulmonary vein isolation. The factors contributing to the reduction in operative time were examined. The patients were divided into the following 2 groups according to whether or not an artificial pneumothorax was used: Group C comprised 24 patients without an artificial pneumothorax and Group A comprised 47 patients with an artificial pneumothorax.Results: There were no hospital deaths or major complications. The operative time was significantly shorter in Group A (108 ± 26 minutes) than in Group C (198 ± 77 minutes) (p <0.0001).Conclusions: In totally endoscopic off-pump LAA closure and surgical ablation, an artificial pneumothorax may be useful in reducing the operative time.","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/PMC11781967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070300","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

Case Series of Blowhole Creation with or without Negative Pressure Wound Therapy for Severe Subcutaneous Emphysema. 造气孔加或不加负压创面治疗严重皮下肺气肿的病例系列。

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.25-00034

Toshiko Kamata, Shigetoshi Yoshida, Yuki Hirai, Ryo Karita, Yuki Onozato, Hironobu Wada, Takashi Anayama

{"title":"Case Series of Blowhole Creation with or without Negative Pressure Wound Therapy for Severe Subcutaneous Emphysema.","authors":"Toshiko Kamata, Shigetoshi Yoshida, Yuki Hirai, Ryo Karita, Yuki Onozato, Hironobu Wada, Takashi Anayama","doi":"10.5761/atcs.cr.25-00034","DOIUrl":"10.5761/atcs.cr.25-00034","url":null,"abstract":"Severe subcutaneous emphysema that is refractory to chest tube drainage can result in significant patient discomfort, airway compromise, and hemodynamic instability. Various interventional approaches, including subcutaneous drain insertion and the blowhole technique, with or without negative pressure wound therapy (NPWT), have been proposed to manage this condition. In this case series, we describe 10 patients who developed severe subcutaneous emphysema following surgery or pneumothorax and were treated using the blowhole technique, with or without NPWT. A Wound Protector/Retractor XXS or LapProtector was used to maintain the patency of the blowhole, facilitating continuous decompression. In cases with more extensive emphysema, the application of NPWT led to rapid respiratory improvement, thereby enabling additional invasive interventions to address the underlying pulmonary air leak. These findings highlight the potential utility of a structured approach incorporating NPWT for the management of severe subcutaneous emphysema, particularly in cases refractory to conventional chest tube drainage.","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/PMC12127076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176358","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 Leaflet Overlay Patch Reinforcement for Mitral Valve Posterior Tethering: The Elbow Patch Repair. 后侧小叶覆盖补片加固二尖瓣后栓：肘关节补片修复。

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.25-00068

Hyeon A Kim, Jae Suk Yoo

{"title":"Posterior Leaflet Overlay Patch Reinforcement for Mitral Valve Posterior Tethering: The Elbow Patch Repair.","authors":"Hyeon A Kim, Jae Suk Yoo","doi":"10.5761/atcs.nm.25-00068","DOIUrl":"10.5761/atcs.nm.25-00068","url":null,"abstract":"The scarcity of leaflet tissue and restricted systolic motion remain challenges in mitral valve repair. In addition to functional or secondary mitral regurgitation, atrial functional mitral regurgitation, characterized by chronic atrial fibrillation, preserved left ventricular function, and atriogenic leaflet tethering, exacerbates leaflet scarcity, complicating mitral valve repair. To address this, we introduce the \"elbow patch repair,\" a novel technique using an autologous pericardium overlay patch to reinforce the posterior mitral valve leaflet. A 65-year-old male patient with chronic atrial fibrillation and severe mitral regurgitation consistent with atrial functional mitral regurgitation underwent the \"elbow patch repair\" combined with annuloplasty and neochordae placement. This approach effectively managed posterior mitral valve leaflet deficiency and restored the coaptation surface. The \"elbow patch repair\" offers a straightforward and effective solution for leaflet shortage in atrial functional mitral regurgitation and select cases of Carpentier Class IIIb. Further studies are needed to assess its long-term durability.","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/PMC12117500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144904","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

Left Atrial Mitral Valve Chordae Which Disturbed the Mitral Leaflet Motion and Induced Mitral Regurgitation. 左心房二尖瓣索，干扰二尖瓣小叶运动，诱发二尖瓣返流。

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.25-00030

Toru Kameda, Tomohiro Mizuno, Kota Kawada, Tsubasa Yoshikawa, Koichi Sugiyama, Yuzo Katayama, Takeshiro Fujii

引用次数: 0

"A Bridge-over-the Bar": A Novel Strategy to Prevent Paravalvular Regurgitation during Mitral Valve Replacement for Severe Mitral Annular Calcifications. “桥上桥”：一种预防重度二尖瓣钙化二尖瓣置换术中瓣旁反流的新策略。

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.24-00081

Khaled F Salhab, Sameh M Said

{"title":"\"A Bridge-over-the Bar\": A Novel Strategy to Prevent Paravalvular Regurgitation during Mitral Valve Replacement for Severe Mitral Annular Calcifications.","authors":"Khaled F Salhab, Sameh M Said","doi":"10.5761/atcs.nm.24-00081","DOIUrl":"10.5761/atcs.nm.24-00081","url":null,"abstract":"Mitral annular calcifications have been known to increase complexity during mitral valve replacement (MVR). Standard procedure requires decalcification followed by reconstruction of the mitral annulus prior to placing the prosthesis. While this is the ideal technique, it is not feasible in every patient due to the associated risks. The mere attempt at valve replacement without proper annular decalcification has been associated with a high incidence of periprosthetic leak which complicates the postoperative course and has been associated with increased morbidity and mortality. With the advances in transcatheter therapy, postoperative periprosthetic regurgitation can be managed with devices and primary transcatheter valve implantation could be alternative to standard valve replacement; however, these alternate strategies are not without its own limitations and drawbacks. In the current report, we present a novel strategy to be used in a select group of patients with severe but non-circumferential annular calcifications to prevent/minimize periprosthetic regurgitation during MVR. This involves placing a patch over the posteriorly located calcium bar, thus minimizing tension on the posterior suture line and contain any periprosthetic regurgitation if to develop. This modification has been performed in a total of nine cases with acceptable early results.","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/PMC11744194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980999","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