Pub Date : 2026-03-01Epub Date: 2026-01-20DOI: 10.1016/j.hlc.2025.08.026
Alice Pearlman MBBS , Rachael Hellyer BSc(Biomed) DMU , Charlotte Burns MPH, PhD , Caroline Medi BMed, PhD , Belinda Gray MBBS, PhD, FCSANZ
Serial two-dimensional transthoracic echocardiograms (TTE) are critical for accurate diagnosis, observation of disease progression and therapeutic response for patients with hypertrophic cardiomyopathy (HCM). The first cardiac myosin ATPase inhibitor, mavacamten has recently been listed on the Pharmaceutic Benefit Scheme (PBS) in Australia. On the basis of the EXPLORER-HCM study and as part of the PBS requirements, protocolised imaging for baseline and regular serial follow-up are required for ongoing PBS approval due to the risk of inducing left ventricular dysfunction. Full echocardiograms are not required for surveillance nor are they time- or cost-effective. Therefore, we propose an abbreviated 15-minute protocol for use in this setting.
{"title":"Focused Transthoracic Echocardiogram Surveillance Protocol for Hypertrophic Cardiomyopathy Patients on Mavacamten Therapy","authors":"Alice Pearlman MBBS , Rachael Hellyer BSc(Biomed) DMU , Charlotte Burns MPH, PhD , Caroline Medi BMed, PhD , Belinda Gray MBBS, PhD, FCSANZ","doi":"10.1016/j.hlc.2025.08.026","DOIUrl":"10.1016/j.hlc.2025.08.026","url":null,"abstract":"<div><div>Serial two-dimensional transthoracic echocardiograms (TTE) are critical for accurate diagnosis, observation of disease progression and therapeutic response for patients with hypertrophic cardiomyopathy (HCM). The first cardiac myosin ATPase inhibitor, mavacamten has recently been listed on the Pharmaceutic Benefit Scheme (PBS) in Australia. On the basis of the EXPLORER-HCM study and as part of the PBS requirements, protocolised imaging for baseline and regular serial follow-up are required for ongoing PBS approval due to the risk of inducing left ventricular dysfunction. Full echocardiograms are not required for surveillance nor are they time- or cost-effective. Therefore, we propose an abbreviated 15-minute protocol for use in this setting.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 432-435"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010123","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}
Pub Date : 2026-03-01Epub Date: 2026-01-21DOI: 10.1016/j.hlc.2025.08.025
Carlotta Brega MD , Diego Sangiorgi MSc , Mikita Karalko MD , Matteo Pettinari MD , Vincent Chauvette MD , Alejandro Crespo de Hubsch MD , Igor Rudez MD, PhD , Olivier Bouchot MD , Frederiek de Heer MD , Rubina Rosa MD , Peter Verbrugghe MD, PhD , Bardia Arabkhani MD , Giulio Folino MD , Thierry Bourguignon MD, PhD , Adrian Kolesar MD , Zuzana Hlubocka MD , Vladislav Aminov MD , Maciej Matuszewski MD , Hans-Joachim Schäfers MD, PhD , Emmanuel Lansac MD, PhD , Carlo Savini MD, PhD
Aim
Whether aortic valve sparing (valve sparing root replacement [VSRR]) and Bentall surgery differently affect myocardial dysfunction is not clear. This study aimed to clarify whether the type of aortic root surgery, in case of at least grade 2 aortic regurgitation associated with myocardial dysfunction, affects the outcomes.
Method
Extraction from the Heart Valve Society aortic valve database (Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry [AVIATOR]) was performed and two groups of patients operated between July 2007 and December 2022 were identified: Group 1 including patients undergoing VSRR with ejection fraction (EF) ≤50% (n=279) and Group 2 including patients undergoing Bentall with EF ≤50% (n=46). All patients had at least grade 2 aortic regurgitation.
Results
Similar cardiopulmonary bypass and cross-clamping time were reported. No statistically significant difference was reported between the groups in terms of postoperative bleeding, transfusion rate, reoperations, pacemaker rate implantation, ischaemic complications, and acute kidney injury. Follow-up mortality was similar between the groups, without any significant differences, and the weighted mixed-effect linear models showed improvement in EF in both groups; progressive inverse left ventricular remodelling is significantly higher in Group 2.
Conclusions
While both techniques can improve left ventricular function in patients with reduced EF, the Bentall procedure offers marginally better results in terms of left ventricular inverse remodelling. However, the choice between Bentall and VSRR should ultimately be determined by the surgeon's expertise and familiarity with each technique.
{"title":"Does Preoperative Left Ventricular Ejection Fraction Impact the Results After Aortic Root Surgery? Decision-Making Between Aortic Valve–Sparing Techniques and Bentall Operation","authors":"Carlotta Brega MD , Diego Sangiorgi MSc , Mikita Karalko MD , Matteo Pettinari MD , Vincent Chauvette MD , Alejandro Crespo de Hubsch MD , Igor Rudez MD, PhD , Olivier Bouchot MD , Frederiek de Heer MD , Rubina Rosa MD , Peter Verbrugghe MD, PhD , Bardia Arabkhani MD , Giulio Folino MD , Thierry Bourguignon MD, PhD , Adrian Kolesar MD , Zuzana Hlubocka MD , Vladislav Aminov MD , Maciej Matuszewski MD , Hans-Joachim Schäfers MD, PhD , Emmanuel Lansac MD, PhD , Carlo Savini MD, PhD","doi":"10.1016/j.hlc.2025.08.025","DOIUrl":"10.1016/j.hlc.2025.08.025","url":null,"abstract":"<div><h3>Aim</h3><div>Whether aortic valve sparing (valve sparing root replacement [VSRR]) and Bentall surgery differently affect myocardial dysfunction is not clear. This study aimed to clarify whether the type of aortic root surgery, in case of at least grade 2 aortic regurgitation associated with myocardial dysfunction, affects the outcomes.</div></div><div><h3>Method</h3><div>Extraction from the Heart Valve Society aortic valve database (Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry [AVIATOR]) was performed and two groups of patients operated between July 2007 and December 2022 were identified: Group 1 including patients undergoing VSRR with ejection fraction (EF) ≤50% (n=279) and Group 2 including patients undergoing Bentall with EF ≤50% (n=46). All patients had at least grade 2 aortic regurgitation.</div></div><div><h3>Results</h3><div>Similar cardiopulmonary bypass and cross-clamping time were reported. No statistically significant difference was reported between the groups in terms of postoperative bleeding, transfusion rate, reoperations, pacemaker rate implantation, ischaemic complications, and acute kidney injury. Follow-up mortality was similar between the groups, without any significant differences, and the weighted mixed-effect linear models showed improvement in EF in both groups; progressive inverse left ventricular remodelling is significantly higher in Group 2.</div></div><div><h3>Conclusions</h3><div>While both techniques can improve left ventricular function in patients with reduced EF, the Bentall procedure offers marginally better results in terms of left ventricular inverse remodelling. However, the choice between Bentall and VSRR should ultimately be determined by the surgeon's expertise and familiarity with each technique.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 400-408"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029437","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}
Pub Date : 2026-03-01Epub Date: 2026-01-12DOI: 10.1016/j.hlc.2025.12.001
Susie Cartledge RN, PhD , Jonathan C. Rawstorn PhD , Carmel Bourne RN, MN , Carolyn M. Astley RN, DrPH , Heena Akbar PhD , Kimberley Bardsley NP, MN(Cardiothoracic) , Nicole K. Bart MBBS, DPhil , Andrea Driscoll NP, PhD , Rebecca Eddington MHlth , Andrew Goodman PhD , Tanya Hall , Jeroen M. Hendriks RN, PhD , Adam C. Scott PhD , Nicola Straiton RN, PhD , Emma E. Thomas MPH, PhD , Ulima Tofi BHSc, MHPrac , Dion Candelaria RN, PhD , Robyn A. Clark PhD , Patricia M. Davidson RN, PhD , Robyn Gallagher RN, PhD , Sally C. Inglis RN, PhD
{"title":"CSANZ and ACRA Position Statement on Quality Use of Telehealth in Cardiovascular Care","authors":"Susie Cartledge RN, PhD , Jonathan C. Rawstorn PhD , Carmel Bourne RN, MN , Carolyn M. Astley RN, DrPH , Heena Akbar PhD , Kimberley Bardsley NP, MN(Cardiothoracic) , Nicole K. Bart MBBS, DPhil , Andrea Driscoll NP, PhD , Rebecca Eddington MHlth , Andrew Goodman PhD , Tanya Hall , Jeroen M. Hendriks RN, PhD , Adam C. Scott PhD , Nicola Straiton RN, PhD , Emma E. Thomas MPH, PhD , Ulima Tofi BHSc, MHPrac , Dion Candelaria RN, PhD , Robyn A. Clark PhD , Patricia M. Davidson RN, PhD , Robyn Gallagher RN, PhD , Sally C. Inglis RN, PhD","doi":"10.1016/j.hlc.2025.12.001","DOIUrl":"10.1016/j.hlc.2025.12.001","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 298-314"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965719","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}
Bicuspid aortic valve (BAV) is a common congenital heart defect often associated with ascending aorta dilation. Current guidelines suggest surgical intervention for diameters ≥45 mm in conjunction with surgical aortic valve replacement (SAVR). However, the optimal management of ascending aortas measuring 40–44 mm remains under debate. This study aims to evaluate the evolution of aortic diameter in patients with BAV and ascending aorta diameters between 40 and 44 mm undergoing aortic valve replacement, assessing whether a conservative approach is justified.
Method
We conducted a retrospective observational study, analysing 88 patients with BAV who underwent SAVR between January 2012 and December 2018. Patients were divided into two groups based on preoperative ascending aorta diameters: <40 mm (Group 1, n=15) and the ≥40 and <45 mm (Group 2, n=11). Follow-up of at least 5 years included aortic dilation rates, survival, and reoperation rates.
Results
No significant differences were observed in aortic dilation between the two groups during follow-up, with overall annual dilation rates of 0.2±0.07 mm/year. Survival rates were 86.3% for Group 1 and 81.9% for Group 2, with no reoperations required in either group.
Conclusions
Patients with BAV and ascending aorta diameters of 40–44 mm do not require prophylactic aortic replacement during AVR, provided they undergo regular follow-up. These findings support current guidelines advocating conservative management for ascending aorta diameters in this range. However, in younger patients or those nearing the 45 mm threshold, surgical replacement may still be considered to pre-empt future complications.
{"title":"Evolution of the Aorta After Valve Replacement in Bicuspid Aortic Valves: Results at Mid-Term Follow-Up","authors":"Raffaele Giordano MD, PhD, Shadi Hamameh MD, Vincenzo Speranza MD, Concetta Calanni MD, Emanuele Pilato MD, PhD, Luigi Di Tommaso MD, PhD","doi":"10.1016/j.hlc.2025.09.009","DOIUrl":"10.1016/j.hlc.2025.09.009","url":null,"abstract":"<div><h3>Aim</h3><div>Bicuspid aortic valve (BAV) is a common congenital heart defect often associated with ascending aorta dilation. Current guidelines suggest surgical intervention for diameters ≥45 mm in conjunction with surgical aortic valve replacement (SAVR). However, the optimal management of ascending aortas measuring 40–44 mm remains under debate. This study aims to evaluate the evolution of aortic diameter in patients with BAV and ascending aorta diameters between 40 and 44 mm undergoing aortic valve replacement, assessing whether a conservative approach is justified.</div></div><div><h3>Method</h3><div>We conducted a retrospective observational study, analysing 88 patients with BAV who underwent SAVR between January 2012 and December 2018. Patients were divided into two groups based on preoperative ascending aorta diameters: <40 mm (Group 1, n=15) and the ≥40 and <45 mm (Group 2, n=11). Follow-up of at least 5 years included aortic dilation rates, survival, and reoperation rates.</div></div><div><h3>Results</h3><div>No significant differences were observed in aortic dilation between the two groups during follow-up, with overall annual dilation rates of 0.2±0.07 mm/year. Survival rates were 86.3% for Group 1 and 81.9% for Group 2, with no reoperations required in either group.</div></div><div><h3>Conclusions</h3><div>Patients with BAV and ascending aorta diameters of 40–44 mm do not require prophylactic aortic replacement during AVR, provided they undergo regular follow-up. These findings support current guidelines advocating conservative management for ascending aorta diameters in this range. However, in younger patients or those nearing the 45 mm threshold, surgical replacement may still be considered to pre-empt future complications.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 419-424"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010170","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}
It is unknown if internal mammary artery (IMA), radial artery (RA), or saphenous vein grafts (SVGs) supplying chronic total occlusion (CTO) coronary arteries exhibit increased failure over time compared with non-CTO targets.
Methods
Patients underwent predominantly symptom-indicated coronary angiography between 1997 and 2020 at the Royal Melbourne Hospital, after coronary artery bypass grafting. The primary outcome was the graft failure rate of IMA, RA, and SVGs with a CTO target compared with a non-CTO target, with failure additionally compared between conduits with a CTO target. Analysis was performed with an exchangeable generalised estimating equations multivariable binary logistic regression model.
Results
Overall, 313 patients had one or more CTO and 434 patients had only non-CTO targets, with follow-up at 8.7±5.6 years post-procedure. Grafts with CTO targets included 113 IMA, 240 RA, and 66 SVGs; grafts with non-CTO targets included 760 IMA, 940 RA, and 172 SVGs. IMA graft failure was less frequent with a CTO target than a non-CTO target; 0.9% vs 6.3% (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.03–0.82; p=0.029). RA graft failure was also less frequent with a CTO target than a non-CTO target; 3.8% vs 14.4% (OR 0.19; 95% CI 0.09–0.40; p<0.001). In the case of SVGs, failure with a CTO vs non-CTO target was similar; 28.8% vs 19.8% (OR 1.06; 95% CI 0.30–3.76; p=0.932). Of grafts with a CTO target, failure was greater for SVGs than for arterial grafts; 28.8% vs 2.8% (OR 10.38; 95% CI 3.71–29.04; p<0.001), whereas failure was not different between IMA and RA grafts; 0.9% vs 3.8% (OR 0.45; 95% CI 0.10-2.02; p=0.297).
Conclusion
Internal mammary and RA grafts had lower graft failure rates in the late term than SVGs when applied to CTO targets.
背景：目前尚不清楚提供慢性完全闭塞冠状动脉（CTO）的内乳动脉（IMA）、桡动脉（RA）或隐静脉移植物（SVGs）是否随着时间的推移比非CTO靶点表现出更多的衰竭。方法：1997年至2020年期间在皇家墨尔本医院接受冠状动脉搭桥术后的主要症状指征冠状动脉造影。主要结果是IMA、RA和svg的移植失败率，CTO靶点与非CTO靶点相比，CTO靶点与CTO靶点之间的失败率也进行了比较。采用可交换广义估计方程多变量二元logistic回归模型进行分析。结果：总体而言，313例患者有一个或多个CTO目标，434例患者只有非CTO目标，随访时间为术后8.7±5.6年。具有CTO靶点的移植物包括113个IMA、240个RA和66个svg；非cto目标的移植物包括760个IMA， 940个RA和172个svg。与非CTO靶点相比，CTO靶点的IMA移植失败的频率更低；0.9% vs 6.3%（优势比[OR] 0.14； 95%可信区间[CI] 0.03-0.82; p=0.029）。与非CTO靶点相比，CTO靶点的RA移植失败也更少；结论：当应用于CTO靶点时，乳腺内移植物和RA移植物的晚期移植物失败率低于svg。
{"title":"Long-Term Fate of Arterial or Venous Coronary Grafts to Chronic Total Occlusion Coronary Arteries","authors":"Christopher Siderakis BBiomedSc , Nilesh Srivastav MBBS , Justin Ren PhD , Colin Royse MBBS, MD , Alistair Royse MBBS, MD","doi":"10.1016/j.hlc.2025.10.009","DOIUrl":"10.1016/j.hlc.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>It is unknown if internal mammary artery (IMA), radial artery (RA), or saphenous vein grafts (SVGs) supplying chronic total occlusion (CTO) coronary arteries exhibit increased failure over time compared with non-CTO targets.</div></div><div><h3>Methods</h3><div>Patients underwent predominantly symptom-indicated coronary angiography between 1997 and 2020 at the Royal Melbourne Hospital, after coronary artery bypass grafting. The primary outcome was the graft failure rate of IMA, RA, and SVGs with a CTO target compared with a non-CTO target, with failure additionally compared between conduits with a CTO target. Analysis was performed with an exchangeable generalised estimating equations multivariable binary logistic regression model.</div></div><div><h3>Results</h3><div>Overall, 313 patients had one or more CTO and 434 patients had only non-CTO targets, with follow-up at 8.7±5.6 years post-procedure. Grafts with CTO targets included 113 IMA, 240 RA, and 66 SVGs; grafts with non-CTO targets included 760 IMA, 940 RA, and 172 SVGs. IMA graft failure was less frequent with a CTO target than a non-CTO target; 0.9% vs 6.3% (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.03–0.82; p=0.029). RA graft failure was also less frequent with a CTO target than a non-CTO target; 3.8% vs 14.4% (OR 0.19; 95% CI 0.09–0.40; p<0.001). In the case of SVGs, failure with a CTO vs non-CTO target was similar; 28.8% vs 19.8% (OR 1.06; 95% CI 0.30–3.76; p=0.932). Of grafts with a CTO target, failure was greater for SVGs than for arterial grafts; 28.8% vs 2.8% (OR 10.38; 95% CI 3.71–29.04; p<0.001), whereas failure was not different between IMA and RA grafts; 0.9% vs 3.8% (OR 0.45; 95% CI 0.10-2.02; p=0.297).</div></div><div><h3>Conclusion</h3><div>Internal mammary and RA grafts had lower graft failure rates in the late term than SVGs when applied to CTO targets.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 425-431"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984827","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}
Pub Date : 2026-03-01Epub Date: 2026-01-22DOI: 10.1016/j.hlc.2025.08.028
Dennis Lawin MD , Alina Hoffmann , Thorsten Lawrenz MD , Sophia Schulze Lammers MD , Sebastian Kuhn MD , Stijn Evens MSc , Thomas De Cooman PhD , Christoph Stellbrink MD
Background & Aim
Photoplethysmography (PPG) enables mobile health (mHealth) heart rhythm monitoring (HRM). We aimed to assess patient experience and detection rates of arrhythmia recurrence with a mHealth HRM after repeat ablation of atrial fibrillation (AF).
Methods
Patients undergoing repeat ablation of AF were instructed to perform three rhythm recordings daily using a PPG-based smartphone application over a follow-up (FU) period of 6 months. Compliance was assessed as the number of actual measurements per number of expected measurements. Motivation was calculated as the ratio of the total number of days where the expected measurements were performed to the total number of monitoring days. Arrhythmia recurrence was compared between mHealth and conventional HRM comprising of 12-lead- and Holter-ECGs at 3 and 6 months after ablation.
Results
A total of 58 patients (37.9% female; median age 66.0 years, interquartile range [IQR] 59.8–72.3) were enrolled and participated in FU. A total of 21,985 PPG recordings have been performed (27.7% symptomatic). The median compliance for performing three measurements per day was 73.8% (IQR 43.8–99.9) and the motivation rate was 33.6% (IQR 12.6–79.8). Freedom from AF/atrial flutter was observed in 58.6% of the patients in the mHealth HRM and 82.8% in the conventional HRM (HR 3.140; 95%CI 1.593–6.188; p=0.0012). Of the PPG measurements indicating AF or atrial flutter, symptoms were reported in only 43.0%.
Conclusions
Patients undergoing repeat ablation of AF have high compliance for participating in a prolonged mHealth HRM over 6 months. The detection rate of atrial arrhythmia recurrences was higher in the mHealth compared to conventional FU.
{"title":"Prolonged Smartphone-Based Photoplethysmography for Heart Rhythm Monitoring After Repeat Ablation of Atrial Fibrillation — A 6-Month Prospective Study on mHealth Compliance, Motivation and Arrhythmia Recurrence","authors":"Dennis Lawin MD , Alina Hoffmann , Thorsten Lawrenz MD , Sophia Schulze Lammers MD , Sebastian Kuhn MD , Stijn Evens MSc , Thomas De Cooman PhD , Christoph Stellbrink MD","doi":"10.1016/j.hlc.2025.08.028","DOIUrl":"10.1016/j.hlc.2025.08.028","url":null,"abstract":"<div><h3>Background & Aim</h3><div>Photoplethysmography (PPG) enables mobile health (mHealth) heart rhythm monitoring (HRM). We aimed to assess patient experience and detection rates of arrhythmia recurrence with a mHealth HRM after repeat ablation of atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>Patients undergoing repeat ablation of AF were instructed to perform three rhythm recordings daily using a PPG-based smartphone application over a follow-up (FU) period of 6 months. Compliance was assessed as the number of actual measurements per number of expected measurements. Motivation was calculated as the ratio of the total number of days where the expected measurements were performed to the total number of monitoring days. Arrhythmia recurrence was compared between mHealth and conventional HRM comprising of 12-lead- and Holter-ECGs at 3 and 6 months after ablation.</div></div><div><h3>Results</h3><div>A total of 58 patients (37.9% female; median age 66.0 years, interquartile range [IQR] 59.8–72.3) were enrolled and participated in FU. A total of 21,985 PPG recordings have been performed (27.7% symptomatic). The median compliance for performing three measurements per day was 73.8% (IQR 43.8–99.9) and the motivation rate was 33.6% (IQR 12.6–79.8). Freedom from AF/atrial flutter was observed in 58.6% of the patients in the mHealth HRM and 82.8% in the conventional HRM (HR 3.140; 95%CI 1.593–6.188; p=0.0012). Of the PPG measurements indicating AF or atrial flutter, symptoms were reported in only 43.0%.</div></div><div><h3>Conclusions</h3><div>Patients undergoing repeat ablation of AF have high compliance for participating in a prolonged mHealth HRM over 6 months. The detection rate of atrial arrhythmia recurrences was higher in the mHealth compared to conventional FU.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 375-384"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040547","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}
Pub Date : 2026-03-01Epub Date: 2026-01-22DOI: 10.1016/j.hlc.2025.08.022
Heqi Zhang MMed , Hua Cao MMed , Weijie Liang MD , Taibing Fan MD
Aim
This study aims to assess the safety, feasibility, and short-term outcomes of a modified right vertical infra-axillary thoracotomy (MRVIAT) technique, using a 2–5 cm incision without peripheral cannulation in patients of all ages with doubly committed subarterial ventricular septal defects (DCVSDs) and summarise associated surgical techniques.
Method
A retrospective review was performed on 171 patients with DCVSDs of all ages who underwent the MRVIAT procedure between 2022 and 2024.
Results
The procedure was successfully completed in all 171 patients without conversion to median sternotomy or in-hospital mortality. The median age was 1.3 years (range, 0.1–39.0 years), with seven patients (4.1%) aged ≥18 years. The median weight was 10.2 kg (range, 3.8–86.6 kg). Among them, nine patients (5.3%) weighed ≤5 kg, 83 (48.5%) weighed ≤10 kg, 81 (47.4%) weighed 10–50 kg, and seven (4.1%) weighed ≥50 kg. Complications included mild residual shunting in two cases (1.2%), incision infection in one case (0.6%), and pulmonary infection in one case (0.6%). Over a median follow-up of 1.3 years (range, 0.3–2.5 years), no thoracic deformities or moderate-to-severe valvular regurgitation were observed.
Conclusions
The MRVIAT technique is a safe and viable option for the surgical treatment of DCVSD in patients across all age groups. It provides a minimally invasive approach with a small, inconspicuous incision and avoids peripheral cannulation, making it a promising alternative to median sternotomy.
{"title":"Modified Right Vertical Infra-Axillary Thoracotomy: 2–5 cm Incision Approach for Repair Doubly Committed Subarterial Ventricular Septal Defect in All Age Groups","authors":"Heqi Zhang MMed , Hua Cao MMed , Weijie Liang MD , Taibing Fan MD","doi":"10.1016/j.hlc.2025.08.022","DOIUrl":"10.1016/j.hlc.2025.08.022","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to assess the safety, feasibility, and short-term outcomes of a modified right vertical infra-axillary thoracotomy (MRVIAT) technique, using a 2–5 cm incision without peripheral cannulation in patients of all ages with doubly committed subarterial ventricular septal defects (DCVSDs) and summarise associated surgical techniques.</div></div><div><h3>Method</h3><div>A retrospective review was performed on 171 patients with DCVSDs of all ages who underwent the MRVIAT procedure between 2022 and 2024.</div></div><div><h3>Results</h3><div>The procedure was successfully completed in all 171 patients without conversion to median sternotomy or in-hospital mortality. The median age was 1.3 years (range, 0.1–39.0 years), with seven patients (4.1%) aged ≥18 years. The median weight was 10.2 kg (range, 3.8–86.6 kg). Among them, nine patients (5.3%) weighed ≤5 kg, 83 (48.5%) weighed ≤10 kg, 81 (47.4%) weighed 10–50 kg, and seven (4.1%) weighed ≥50 kg. Complications included mild residual shunting in two cases (1.2%), incision infection in one case (0.6%), and pulmonary infection in one case (0.6%). Over a median follow-up of 1.3 years (range, 0.3–2.5 years), no thoracic deformities or moderate-to-severe valvular regurgitation were observed.</div></div><div><h3>Conclusions</h3><div>The MRVIAT technique is a safe and viable option for the surgical treatment of DCVSD in patients across all age groups. It provides a minimally invasive approach with a small, inconspicuous incision and avoids peripheral cannulation, making it a promising alternative to median sternotomy.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 3","pages":"Pages 392-399"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040544","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}
Pub Date : 2026-03-01Epub Date: 2026-03-05DOI: 10.1016/j.hlc.2026.02.003
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