Cardiovascular Journal of Africa最新文献

{"title":"An analysis of imaging modalities to assess the right and left heart in pulmonary hypertension with left-to-right shunts.","authors":"Musawenkosi M F Henema, Stephen C Brown, Francis E Smit, Lezelle Botes","doi":"10.5830/CVJA-2026-033","DOIUrl":"10.5830/CVJA-2026-033","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) secondary to congenital left-to-right shunts leads to serious consequences in sub-Saharan Africa. This study used various imaging modalities to assess right and left heart dimensions and functions in patients with secondary PH.</p><p><strong>Methods: </strong>Patients with a mean pulmonary artery pressure ≥ 25 mmHg during right heart catheterisation underwent transthoracic echocardiography, cardiac magnetic resonance imaging (CMRI), and nuclear ventriculography.</p><p><strong>Results: </strong>Seventy-five patients (median age 9.98: 6.01-40.9 years) were included. Right-heart dilation was observed in all, with increased tricuspid valve annular diameter (median z-score 2.44) on echocardiography. Similarly, right ventricular (RV) end-diastolic indexed volumes were at least double the normal reference ranges in most patients (median 240: 165-268 mL/m²) on CMRI. The median normal RV systolic function was 49% for males (IQ1-IQ3, 48.0-50.0%) and 49% for females (IQ1-IQ3, 47.3-49.8%). CMRI showed that 70% of males had a normal RV systolic function compared to only 45% of females (p < 0.05). Echocardiographic markers of RV function correlated poorly with CMRI RV ejection fraction, with correlation coefficients of r = -0.28, r = -0.10, and r = -0.04. Notably, 80% of our patients demonstrated left heart dilation, and 35% had impaired left ventricular (LV) ejection fraction on echocardiography, radionuclide ventriculography, and CMRI.</p><p><strong>Conclusion: </strong>Echocardiography and CMRI consistently revealed right heart dilation but correlated poorly for right heart function. The evaluation of LV function should not be neglected, as some patients exhibited decreased LV ejection fraction. A holistic approach incorporating multiple modalities and clinical assessment is recommended, as the pathophysiology of PH may differ in patients with left-to-right shunts.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"345-353"},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of preoperative inflammatory and renal markers (SII, NLR, creatinine) on postoperative hospital stay and clinical outcomes in patients undergoing isolated coronary artery bypass graft surgery: a comprehensive analysis.","authors":"Umut Serhat Sanrı, Mehmet Aslan","doi":"10.5830/CVJA-2026-034","DOIUrl":"https://doi.org/10.5830/CVJA-2026-034","url":null,"abstract":"<p><strong>Aim: </strong>Coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) induces a systemic inflammatory response, often leading to delayed recovery. This study investigated the predictive value of preoperative inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII]) and serum creatinine on the length of hospital stay (LOS) following isolated CABG.</p><p><strong>Methods: </strong>A single-centre, retrospective cohort study was conducted on 120 patients undergoing elective isolated CABG between January 2023 and December 2025. Patients were categorised by LOS: Group 1 (≤ 7 days, n = 88) and Group 2 (> 7 days, n = 32). Preoperative demographic, intraoperative, and laboratory data were compared. Receiver operating characteristic (ROC) and multivariate logistic regression analyses - adjusted for clinical confounders including CPB time, cross-clamp time, diabetes mellitus (DM), hypertension (HT), and number of grafts - were performed to identify predictors of prolonged stay.</p><p><strong>Results: </strong>Group 2 patients were significantly older and had higher rates of male sex, DM, and HT. Operative times were also significantly longer in Group 2. Preoperative serum creatinine (1.28 ± 0.26 vs. 0.98 ± 0.19 mg/dL), NLR (3.77 ± 1.39 vs. 2.92 ± 0.96), and SII (911 ± 410 vs. 738 ± 306) were significantly elevated in the prolonged stay group (all p < 0.05). ROC analysis revealed creatinine as the strongest predictor (AUC: 0.826, cut-off > 1.1 mg/dL), followed by NLR (AUC: 0.749). In the expanded multivariate analysis adjusting for operative and clinical variables, advanced age (p < 0.001) and elevated creatinine levels (p = 0.042) remained strong independent risk factors for prolonged LOS, whereas NLR and SII did not retain independent statistical significance.</p><p><strong>Conclusions: </strong>Preoperative serum creatinine and advanced age are strong, independent predictors of prolonged hospital stay after isolated CABG. While NLR and SII are associated with longer stays, they serve better as supportive prognostic indicators in routine preoperative risk stratification.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"339-344"},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False-negative 99mTc-PYP bone scintigraphy in early cardiac amyloidosis: a rapidly progressive case in a young woman.","authors":"Esra Polat, Ömer Güler, Candan Güngör","doi":"10.5830/CVJA-2026-031","DOIUrl":"https://doi.org/10.5830/CVJA-2026-031","url":null,"abstract":"<p><p>Cardiac amyloidosis is one of the aetiologies of treatable heart failure. Cardiac amyloidosis is rare in young patients, but it can present atypically, leading to diagnostic delays. In this case, a 33-year-old female patient presenting with dyspnoea underwent echocardiography and cardiac magnetic resonance imaging, which showed left ventricular hypertrophy and raised suspicion for amyloidosis; however, no uptake was observed on technetium-99m pyrophosphate (99mTc-PYP) bone scintigraphy. Fourteen months later, the patient presented with decompensated heart failure and was diagnosed with cardiac amyloidosis based on Grade 2 uptake on repeat 99mTc-PYP bone scintigraphy, with an ejection fraction of 25%. As illustrated in this case, negative imaging findings in the early stages do not rule out a diagnosis of cardiac amyloidosis.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"315-317"},"PeriodicalIF":0.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission serum bicarbonate is associated with early diuretic resistance in acute decompensated heart failure.","authors":"Kayıhan Karaman, Sefa Erdi Ömür","doi":"10.5830/CVJA-2026-021","DOIUrl":"https://doi.org/10.5830/CVJA-2026-021","url":null,"abstract":"<p><strong>Background: </strong>Acute decompensated heart failure (ADHF) exhibits a heterogeneous diuretic response. Chloride-bicarbonate imbalances may reduce loop diuretic efficiency. The effect of admission bicarbonate levels on diuretic resistance in unselected ADHF patients remains unclear. We aimed to evaluate whether higher admission bicarbonate identifies patients at risk of early diuretic dose escalation and less effective early decongestion.</p><p><strong>Methods: </strong>Our study was planned as a retrospective, single-centre, consecutive ADHF cohort. This study included 1000 hospitalised patients with ADHF (mean age 69 years, ± 11.2 years, 42.7% female) who underwent arterial blood sampling and pH ranging from 7.35 to 7.45. Patients were divided into three groups according to their admission bicarbonate value (< 22 mmol/L-group 1, 22-28 mmol/L-group 2, > 28 mmol/L-group 3). The primary endpoint was early diuretic escalation within 48 hours (dose doubling and/or thiazide add-on or infusion switch). Secondary endpoints included diuretic efficiency, 24/48-hour net fluid balance, 48-hour weight change, early spot urine sodium, and safety/utilisation metrics. Multivariable models adjusted for prespecified clinical and laboratory covariates and baseline diuretic regimen.</p><p><strong>Results: </strong>Higher admission bicarbonate (particularly > 28 mmol/L) was independently associated with greater odds of early escalation and with less effective decongestion. Patients with higher bicarbonate demonstrated lower diuretic efficiency, smaller 24-48 hour net fluid losses, attenuated early weight reduction, and lower early urine sodium. Companion markers (lower chloride, higher pH and pCO₂) paralleled these findings, consistent with an alkalosis phenotype.</p><p><strong>Conclusion: </strong>Admission bicarbonate is a simple, physiologically coherent marker of early decongestion dynamics in ADHF. Embedding this chemistry-based flag within urine-sodium-guided protocols may enable earlier, objective intensification of pharmacologic therapy and more efficient decongestion. Prospective trials should test bicarbonate-informed pathways against usual care on clinical outcomes.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"275-281"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative complication incidences with different anaesthetic agents used in open heart surgery: a retrospective study.","authors":"Eyup Aydogan, Özgür Akkaya","doi":"10.5830/CVJA-2026-030","DOIUrl":"https://doi.org/10.5830/CVJA-2026-030","url":null,"abstract":"<p><strong>Background: </strong>The choice of anaesthetic agent for open-heart surgery (OHS) may influence perioperative physiology and outcomes. This study compared the effects of sevoflurane and propofol on intraoperative parameters and postoperative complications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 202 patients undergoing OHS (propofol: n = 71; sevoflurane: n = 131). Demographic data, intraoperative variables (cardiopulmonary bypass [CPB] duration, aortic cross-clamp time, heparin dose, cardioplegia volume), serial arterial blood gas (ABG) values, and postoperative complications were collected. Statistical analysis included parametric/non-parametric tests and a generalised linear model.</p><p><strong>Results: </strong>Demographic and baseline characteristics were comparable between groups. No significant differences were found in CPB time, cross-clamp time, or heparin dose. Cardioplegia volume differed significantly (p = 0.025). ABG analysis revealed that pH and O₂ levels were not significantly influenced by anaesthetic type but were affected by gender and surgical phase. CO₂ levels were significantly influenced by anaesthetic type, gender, and time (p < 0.001). Rates of postoperative bleeding/reoperation (propofol: 4.29%; sevoflurane: 4.55%) and other complications showed no significant differences.</p><p><strong>Conclusion: </strong>Both sevoflurane and propofol demonstrated comparable safety and efficacy in OHS, with no significant differences in major postoperative complications. However, anaesthetic choice and patient gender significantly influenced intraoperative CO₂ dynamics. These findings support the clinical equivalence of both agents while highlighting gender-specific physiological responses that may warrant consideration in perioperative management.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"293-297"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index predicts ventricular repolarisation in obese children: differential effects across obesity levels.","authors":"Metin Karayakalı, Kayıhan Karaman, Tuba Kasap, Volkan Yılmaz","doi":"10.5830/CVJA-2026-029","DOIUrl":"10.5830/CVJA-2026-029","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is associated with cardiac electrical remodelling, yet the relationship between body mass index (BMI) and ventricular repolarisation (VR) heterogeneity remains incompletely characterised in paediatric obesity.</p><p><strong>Methods: </strong>This prospective observational comparative study enrolled 184 children (112 obese, 72 normal-weight; age 8-17 years). Electrocardiographic analysis included traditional (QT, QTc, JT) and novel VR parameters (Tp-e interval, Tp-e/QT, Tp-e/QTc ratios). Multiple linear regression and receiver operating characteristic (ROC) analyses identified independent predictors and clinically applicable thresholds.</p><p><strong>Results: </strong>Obese children demonstrated significantly prolonged Tp-e intervals (87.83 ± 12.35 vs. 80.10 ± 16.80 ms, p = 0.002) and elevated Tp-e/QTcB ratios (0.211 ± 0.028 vs. 0.192 ± 0.034, p < 0.001). BMI emerged as the independent predictor of VR heterogeneity (β = 0.308, p < 0.001), after adjustment for insulin resistance, metabolic parameters, and echocardiographic findings. Regression analyses revealed differences in the BMI-repolarisation relationship: strong associations in normal-weight children (β = 0.353, p = 0.003), disappearing in established obesity (β = -0.041, p = 0.699), and a significant BMI × group interaction was observed (β = -2.079, p = 0.001). ROC analysis identified BMI ≥ 23.1 kg/m² as the optimal threshold for abnormal repolarisation (AUC = 0.682, sensitivity 76.1%, specificity 50.0%, p < 0.001).</p><p><strong>Conclusion: </strong>Childhood obesity is associated with VR abnormalities independently of metabolic dysfunction and structural cardiac changes. This study suggests that repolarisation abnormalities occur in the early stages of obesity and through different pathophysiological mechanisms. The defined BMI threshold provides a clinically applicable tool for early risk stratification, highlighting the critical importance of intervention before obesity becomes established.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"282-292"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressive surgical approach in diffuse coronary artery disease: coronary endarterectomy and early- to mid-term outcomes.","authors":"Umut Serhat Sanrı, Mehmet Aslan, Dolunay Odabaşı, Özgür Akkaya","doi":"10.5830/CVJA-2026-019","DOIUrl":"https://doi.org/10.5830/CVJA-2026-019","url":null,"abstract":"<p><strong>Aim: </strong>In patients with diffuse coronary artery disease (CAD), the absence of a suitable distal target vessel for standard coronary artery bypass grafting (CABG) is the main factor limiting the success of surgical revascularisation. The aim of this study was to evaluate the surgical outcomes, complication profile, and functional recovery of a high-risk patient cohort who underwent single or multiple coronary endarterectomy (CE) concomitantly with CABG in our clinic, in light of the current literature.</p><p><strong>Materials and methods: </strong>This retrospective single-centre study included 24 patients who underwent isolated CABG combined with single or multiple CE for diffuse CAD between January 2022 and December 2025. Clinical data were collected from hospital records. Patients were evaluated in terms of demographic characteristics, operative variables, blood product usage, postoperative complications, and functional outcomes. Left ventricular ejection fraction (EF) before surgery and at six-month follow-up were compared.</p><p><strong>Result: </strong>The mean age of the patients was 61 ± 10 years, and 41.7% (n = 10) underwent emergency surgery. A total of 34 coronary artery lesions were treated with endarterectomy in 24 patients (mean 1.41 vessels per patient). Multiple-vessel (two or three vessels) endarterectomy was performed in 33.3% of patients (n = 8). Endarterectomy was most frequently performed in the left anterior descending (LAD) artery (n = 16) and the right coronary artery (RCA) (n = 11). The 30-day mortality rate was 8.3%, and the one-year cumulative survival rate was 91.7%. At postoperative six months, a significant 12% increase in mean EF compared to preoperative values was observed (p < 0.05). However, parallel to procedural complexity, blood product usage was high (mean 4.3 units PRBC, 5.0 units FFP).</p><p><strong>Conclusion: </strong>In patients undergoing multiple endarterectomies due to diffuse CAD, acceptable mortality rates and significant improvement in left ventricular function can be achieved despite an increased risk of postoperative bleeding. Aggressive revascularisation using the closed technique represents a safe treatment option - even when applied to multiple coronary arteries - provided appropriate patient selection is ensured.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"309-314"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effect of sternum retractor opening distance on postoperative pain in cardiac surgery operations performed with median sternotomy.","authors":"Hakan Özçelik, Mesut Engin, Orhan Güvenç, Ufuk Aydın, Yusuf Ata, Miktat Arif Haberal, Şenol Yavuz","doi":"10.5830/CVJA-2026-023","DOIUrl":"https://doi.org/10.5830/CVJA-2026-023","url":null,"abstract":"<p><strong>Objectives: </strong>Pain that develops after cardiac surgery can negatively affect early recovery. In this study, we aimed to investigate the effect of sternal retractor opening on post-sternotomy pain in cardiac surgeries performed with median sternotomy.</p><p><strong>Methods: </strong>Patients who underwent open cardiac surgery with median sternotomy in our clinic between September 2023 and March 2025 were included in this retrospective study. Postoperative pain assessments were performed using the Visual Analogue Scale (VAS) at the 2nd hour (VAS0), 6th hour (VAS1), first day (postoperative 24th hour) (VAS2), and second day (postoperative 48th hour) (VAS3) after extubation. Patients were divided into two groups: those with sternum retractor opening less than 9 cm (Group 1) and those with 9 cm or more (Group 2).</p><p><strong>Results: </strong>A total of 124 patients were included in the study. The mean age of the patients was 59.8 ± 14.2 (Range: 19-81), and 67 (54%) patients were female. As a result of the analysis, a statistically significant difference was found between the groups only in VAS0 values. While the median VAS0 value was four (range: 0-10) in Group 1, it was found to be six (range: 0-10) in Group 2 (P = 0.033). Although VAS1, VAS2, and VAS3 values were higher in Group 2, there was no statistically significant difference (P values: P = 0.132, P = 0.421, P = 0.267, respectively).</p><p><strong>Conclusions: </strong>Although there was no statistically significant difference in the pain evaluations at the sixth postoperative hour, on the first day, and on the second day, we found that patients with smaller retractor openings had lower pain scores.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"294-298"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association and causality between triglycerides and hypertension: evidence from NHANES 2007-2018 and two-sample Mendelian randomisation analysis.","authors":"Shan Liang, Xueqin Pan, Xiaofeng Fan, Lin Gong","doi":"10.5830/CVJA-2026-017","DOIUrl":"https://doi.org/10.5830/CVJA-2026-017","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major global health issue, and elevated triglyceride levels may be an independent risk factor. However, existing studies are limited, and the association remains unclear across diverse populations. This study uses the National Health and Nutrition Examination Survey (NHANES) data to investigate this association, supporting hypertension prevention and management strategies.</p><p><strong>Methods: </strong>Data from NHANES (2007-2018) for adults aged 20 and older were analysed using a weighted multivariable logistic regression to assess the association between triglyceride levels and prevalence of hypertension. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Restricted cubic splines (RCS) explored the nonlinear associations, and subgroup analyses assessed variable impacts on this association. A two-sample Mendelian randomisation (TSMR) analysis based on genome-wide association study (GWAS) summary data was also conducted to investigate the potential causal relationship between triglyceride levels and hypertension.</p><p><strong>Results: </strong>A total of 14,567 participants were included in this study, among whom 6,428 were diagnosed with hypertension. After full adjustment for all covariates, a significant positive association was observed between triglyceride levels and the prevalence of hypertension (OR: 1.002, 95% CI: 1.001-1.003; P < 0.001). RCS regression analysis further demonstrated a significant nonlinear positive association between triglyceride levels and the prevalence of hypertension (P for non-linearity < 0.001; P for overall < 0.001). Subgroup analysis indicated a significant interaction effect by race (P for interaction < 0.001). Mendelian randomisation (MR) analysis also supported a causal effect of elevated triglyceride levels on increased hypertension risk, with no significant pleiotropy or heterogeneity observed.</p><p><strong>Conclusion: </strong>The findings of this study suggest that elevated triglyceride levels are significantly associated with increased prevalence of hypertension, highlighting the potential importance of lipid management in hypertension prevention.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"299-308"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical vs. sutureless aortic valve replacement: clinical outcomes and the contribution of preoperative multislice CT.","authors":"Özgür Çoban, İbrahim Özsöyler","doi":"10.5830/CVJA-2026-026","DOIUrl":"10.5830/CVJA-2026-026","url":null,"abstract":"<p><strong>Introduction: </strong>Heart valve disease is a significant cause of morbidity and mortality, and aortic valve replacement (AVR) is a common treatment option. Recently, sutureless biological valves have gained increasing use. This study aimed to evaluate the concordance between preoperative computed tomography-derived annulus measurements and valve sizes implanted during surgery rather than the direct clinical impact of imaging on prosthesis selection.</p><p><strong>Methods: </strong>A total of 40 patients with aortic valve stenosis who underwent elective open-heart surgery and preoperative multislice computed tomography between February 20 and May 20, 2024, were included and were randomly allocated into two groups: sutureless biological valve (n = 20) and mechanical valve (n = 20). Data were obtained from patient records and the hospital's data system and analysed statistically.</p><p><strong>Results: </strong>A total of 40 patients were included in the study: 20 received sutureless, rapidly implantable biological valves, and 20 underwent mechanical AVR. The mean age of the cohort was 61.5 ± 9.1 years, with 45% females and 55% males. Compared with the sutureless group, the mechanical valve group had significantly longer cross-clamp (73.5 vs. 53.0 minutes, p < 0.001) and cardiopulmonary bypass times (102 vs. 92 minutes, p = 0.011), as well as smaller sinotubular junction diameters (30.2 vs. 32.3 mm, p = 0.025). In contrast, the sutureless group demonstrated a significantly greater optimal effective orifice area index (1.58 vs. 0.77, p < 0.001).</p><p><strong>Conclusion: </strong>Preoperative computed tomography is a reliable tool for planning AVR. Sutureless biological valves provide shorter cross-clamp and bypass times and favourable haemodynamic performance, whereas mechanical valves are more often associated with smaller valve sizes and longer procedures. Early postoperative outcomes were comparable between groups.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 3","pages":"289-293"},"PeriodicalIF":0.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}