Journal of cardiothoracic and vascular anesthesia最新文献

英文中文

Remimazolam Besylate Versus Propofol for Procedural Sedation in Patients Undergoing Electrical Cardioversion: A Prospective, Noninferiority Cohort Study 一项前瞻性、非劣效性队列研究：贝磺酸雷马唑仑与异丙酚在电复律患者中的程序性镇静作用。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.10.044

Jacopo D’Andria Ursoleo MD , Alice Bottussi MD , Viviana Teresa Agosta MD , Gaia Barucco MD , Juan G. Ripoll MD , Raphaël Cinotti MD, PhD , Patrick M. Wieruszewski PharmD , Fabrizio Monaco MD

Objective

Remimazolam besylate is a novel, short-acting benzodiazepine with a more favorable hemodynamic and respiratory profile than traditional anesthetics and may be suitable for procedural sedation. The objective of this study was to assess the safety, feasibility, and clinical advantages of remimazolam compared to propofol for procedural sedation during electrical cardioversion.

Design

A prospective observational study.

Setting

The Electrophysiology Department of a tertiary referral center university hospital.

Participants

Sixty consecutive adult patients undergoing procedural sedation during electrical cardioversion for atrial fibrillation.

Intervention

Patients receiving remimazolam (n = 30) were compared to those receiving propofol (n = 30) for procedural sedation.

Measurements and Main Results

The primary outcome of time to loss of consciousness was evaluated in a prespecified noninferiority analysis. Other outcomes included adequacy of sedation, the time course of hemodynamics, time to recovery of consciousness, and adverse drug events. The achievement of satisfactory sedation was similar between the remimazolam (n = 29, 97%) and propofol (n = 30, 100%) groups. The mean difference in time to loss of consciousness between the groups was within the margin of noninferiority (0.41 minutes; 95% confidence interval, –0.38 to 1.20 minutes). In the linear mixed-effects model, remimazolam produced significantly more favorable blood pressure indexes but similar oxygen saturations compared to propofol over the course of the procedure. Three patients in the propofol group required rescue ventilation.

Conclusions

Remimazolam was associated with similar sedation adequacy but more favorable hemodynamics over time compared to propofol when used for procedural sedation in adults undergoing electrical cardioversion for atrial arrhythmias.

目的：苯磺酸雷马唑仑是一种新型短效苯二氮卓类药物，与传统麻醉药相比，具有更好的血流动力学和呼吸特性，可能适用于手术镇静。本研究的目的是评估雷马唑仑与异丙酚在电转复过程中程序性镇静的安全性、可行性和临床优势。设计：前瞻性观察性研究。单位：某三级转诊中心大学医院电生理科。参与者：连续60例房颤电复律期间接受程序性镇静治疗的成年患者。干预：将接受雷马唑仑（n = 30）的患者与接受异丙酚（n = 30）进行程序性镇静的患者进行比较。测量和主要结果：在预先指定的非劣效性分析中评估了意识丧失时间的主要结局。其他结果包括镇静的充分性、血流动力学的时间过程、意识恢复的时间和药物不良事件。雷马唑仑组（n = 29, 97%）和异丙酚组（n = 30, 100%）的镇静效果相似。两组之间意识丧失时间的平均差异在非劣效性范围内（0.41分钟；95%置信区间，-0.38至1.20分钟）。在线性混合效应模型中，与异丙酚相比，雷马唑仑在整个手术过程中产生了更有利的血压指数，但氧饱和度相似。异丙酚组3例患者需要抢救通气。结论：与异丙酚相比，雷马唑仑与类似的镇静充足性相关，但随着时间的推移，雷马唑仑用于心房心律失常电复律的成人手术镇静时，血流动力学更有利。

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引用次数: 0

Renin Is an Important Prognostic and Predictive Biomarker in Cardiac Surgery-associated Acute Kidney Injury 肾素是心脏手术相关急性肾损伤的重要预后和预测性生物标志物。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.12.002

Patrick M. Wieruszewski PharmD

引用次数: 0

Impact of Intraoperative Hyperoxia Versus Normoxia on Mortality and Organ Injury in Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials 术中高氧与常氧对心脏手术死亡率和器官损伤的影响：随机临床试验的系统回顾和荟萃分析。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.09.042

Iago T.C. Grillo MD , Evelyn S.P. de Santana , Felipe S. Passos MD , Larissa E. Tanimoto , Jeane C. de Melo , Amanda M. Kondo , Ricardo E. Treml MD, DESAIC , Tulio Caldonazo MD, MSc

Objective

To compare mortality and organ injury associated with intraoperative hyperoxia and normoxia in cardiac surgery patients.

Design

Systematic review and meta-analysis of randomized clinical trials (RCTs).

Setting

Tertiary care.

Participants

Patients who underwent cardiac surgery with cardiopulmonary bypass or off-pump procedures.

Interventions

Intraoperative hyperoxia or normoxia.

Measurements and Main Results

A systematic search of PubMed, Embase, and the Cochrane Library identified RCTs comparing hyperoxia versus normoxia in cardiac surgery. Primary outcomes were in-hospital and 30-day mortality; secondary outcomes included postoperative clinical and biochemical measures. Risk ratios (RRs), mean differences (MDs), and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Trial sequential analysis and subgroup analysis based on the variable used to define oxygenation (PaO₂-based v FiO₂-based thresholds) were performed to address heterogeneity in oxygenation strategies. Nineteen RCTs (2,001 patients) were included, with 982 patients (49.1%) experiencing hyperoxia. In-hospital (9/798 [1.1%] v 10/799 [1.3%], RR 0.84, 95% CI 0.36 to 1.94, p = 0.684) and 30-day mortality (1/282 [0.4%] v 4/280 [1.4%], RR 0.41, 95% CI 0.08 to 2.28, p = 0.311) were not different between the groups. However, the normoxia group had a higher postoperative PaO₂/FiO₂ ratio (MD –31.49, 95% CI –47.13 to –15.85, p < 0.01), whereas creatine kinase-MB (SMD 1.65, 95% CI 0.12 to 3.18, p = 0.03) and malondialdehyde (SMD 3.77, 95% CI 2.99 to 4.55, p < 0.01) were higher in the hyperoxia group.

Conclusions

Compared with normoxia, hyperoxia during cardiac surgery does not impact in-hospital or 30-day mortality but is associated with worsening physiological and biochemical parameters.

目的：比较心脏手术患者术中高氧与常氧相关的死亡率和器官损伤。设计：随机临床试验（rct）的系统评价和荟萃分析。环境：三级保健。参与者：接受体外循环或非体外泵手术的心脏手术患者。干预措施：术中高氧或常氧。测量结果和主要结果：对PubMed、Embase和Cochrane图书馆进行系统检索，确定了比较心脏手术中高氧和常氧的随机对照试验。主要结局是住院死亡率和30天死亡率；次要结局包括术后临床和生化指标。计算95%置信区间（ci）的风险比（rr）、平均差异（MDs）和标准化平均差异（SMDs）。通过试验序列分析和基于定义氧合变量的亚组分析（基于PaO₂的阈值和基于FiO₂的阈值）来解决氧合策略的异质性。纳入19项随机对照试验（2001例患者），其中982例患者（49.1%）出现高氧。住院（9/798 [1.1%]vs 10/799 [1.3%], RR 0.84, 95% CI 0.36 ~ 1.94, p = 0.684）和30天死亡率（1/282 [0.4%]vs 4/280 [1.4%], RR 0.41, 95% CI 0.08 ~ 2.28, p = 0.311）组间无差异。然而，低氧组术后PaO2/FiO2比值较高（MD为-31.49,95% CI为-47.13 ~ -15.85,p < 0.01），而高氧组术后肌酸激酶- mb （SMD 1.65, 95% CI 0.12 ~ 3.18, p = 0.03）和丙二醛（SMD 3.77, 95% CI 2.99 ~ 4.55, p < 0.01）较高。结论：与正常氧合相比，心脏手术期间的高氧不影响住院死亡率或30天死亡率，但与生理生化参数恶化有关。

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引用次数: 0

Comparison of Arterial Partial Pressure of Carbon Dioxide with That at Oxygenator Exhaust During Cardiopulmonary Bypass for Pediatric Cardiac Surgery 小儿心脏外科体外循环时动脉血二氧化碳分压与氧合器排气分压的比较。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.10.028

Bhargava V. Devarakonda MD, DNB, DM DESAIC, MNAMS , Shrinivas V. Gadhinglajkar MD, PDCC , Kiranmai Vadapalli MD, MBA , Subin Sukesan MD, DM, MBA , Rupa Sreedhar MD, PDCC , Baiju S. Dharan MS, MCh

Objective

To evaluate whether carbon dioxide tension (PeCO₂) derived from oxygenator exhaust capnography is comparable to temperature-corrected arterial partial pressure of carbon dioxide (PaCO₂) measured via blood gas analysis during mild hypothermic cardiopulmonary bypass (CPB) in pediatric patients undergoing elective cardiac surgery.

Design

A prospective observational study.

Setting

A tertiary care hospital with a specialized pediatric cardiac surgery unit.

Participants

Eighty paired measurements of PeCO₂ and PaCO₂ were obtained from 40 pediatric patients (aged between 1 and 12 years) undergoing elective cardiac surgery for biventricular repair with stable mild hypothermic CPB using a membrane oxygenator.

Interventions

No interventions were performed. The study involved continuous measurement of PeCO₂ from the oxygenator exhaust and periodic arterial blood gas analysis to assess PaCO₂ during stable mild hypothermia.

Measurements and Main Results

A Bland-Altman analysis was conducted to determine the agreement between PeCO₂ and temperature-corrected PaCO₂. The correlation coefficient was 0.81, with a bias of 0.036, standard deviation of 2.76, and limits of agreement ranging from –5.37 to 5.44. A linear regression equation was established: temperature-corrected PaCO₂ = 0.71 × PeCO₂ + 8.28. No significant correlation was observed between PeCO₂ and temperature-uncorrected PaCO₂.

Conclusions

Under stable mild hypothermic CPB conditions, PeCO₂ demonstrates a strong correlation with temperature-corrected PaCO₂ and can be predicted using a simple linear equation in pediatric patients undergoing elective cardiac surgery. Oxygenator exhaust capnography may serve as a continuous, cost-effective, non-invasive, pragmatic surrogate for PaCO₂ monitoring during a stable hypothermic CPB period in the pediatric population undergoing elective cardiac surgery.

目的：评价在接受择期心脏手术的儿科患者进行轻度低温体外循环（CPB）时，氧合器排气摄氧量（PeCO₂）与血气分析测量的温度校正动脉二氧化碳分压（PaCO₂）是否相当。设计：前瞻性观察性研究。环境：三级保健医院，设有儿科心脏外科专科。参与者：从40名儿童患者（年龄在1至12岁之间）中获得了80对PeCO₂和PaCO₂的成对测量，这些患者接受了选择性心脏手术，使用膜氧合器进行稳定的轻度低温CPB双心室修复。干预措施：未进行干预。该研究包括持续测量氧合器排气中的PaCO₂和定期动脉血气分析，以评估稳定的轻度低温期间的PaCO₂。测量和主要结果：进行了Bland-Altman分析，以确定PeCO₂和温度校正PaCO₂之间的一致性。相关系数为0.81，偏差为0.036，标准差为2.76，一致性限为-5.37 ~ 5.44。建立了温度校正后的PaCO₂= 0.71 × PeCO₂+ 8.28的线性回归方程。未观察到PeCO₂与温度未校正的PaCO₂之间的显著相关性。结论：在稳定的轻度低温CPB条件下，PeCO₂与温度校正后的PaCO₂有很强的相关性，可以用简单的线性方程来预测儿童择期心脏手术患者的PeCO₂。在接受择期心脏手术的儿童低体温CPB期间，氧合器排气造影可作为一种持续、经济、无创、实用的替代方法来监测PaCO₂。

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引用次数: 0

Vasodilators for Pharmacologic Afterload Reduction in On-pump Cardiac Surgery 血管扩张剂用于无泵心脏手术后负荷的药理学降低。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.10.042

Patrick M. Wieruszewski PharmD , Abigail G. Elliott PharmD , Jamel P. Ortoleva MD , Alice Bottussi MD , Jacopo D’Andria Ursoleo MD , Fabrizio Monaco MD

引用次数: 0

Predicting Placement Depth for Right-Side Double Lumen Tube in an Adult Patient 预测成人右侧双腔管放置深度。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.11.025

Gabriel Fregoso MD , Elizabeth Korn MPH , Hovig Chitilian MD , Paul Alfille MD , Xiaodong Bao MD, PhD

引用次数: 0

Driving Pressure–Guided Tidal Volume Titration Reduces Lung Injury in Thoracic Surgery With One-Lung Ventilation: A Randomized Clinical Trial 驱动压力引导潮汐容量滴定减少单肺通气胸外科手术中的肺损伤：一项随机临床试验。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.11.020

Yun Yan MSc , Xiaowen Liu MD , Zhen Liu MD , Zhe Li MSc , Huamei Cai MSc , Weixia Li MD , Jing Zhao MD

Objective

The optimal tidal volume for patients undergoing thoracic surgery with one-lung ventilation (OLV) remains unclear. This study aimed to evaluate whether driving pressure–guided tidal volume titration could reduce lung injury in these patients.

Design

Prospective, single-center, randomized controlled trial.

Setting

Single-center academic hospital in China.

Participants

A total of 96 patients undergoing thoracic surgery with OLV.

Interventions

Patients were randomly assigned to either the driving pressure–guided tidal volume group (n = 46) or the control group (n = 50). In the control group, tidal volume was set at 8 mL/kg of predicted body weight (PBW) during OLV. In the driving pressure–guided group, tidal volume was adjusted to maintain a driving pressure between 8 and 10 cm H₂O, with modifications within 4 to 8 mL/kg PBW during OLV.

Measurements and Main Results

The primary outcome was the concentration of interleukin 6 (IL-6) in the dependent lung following OLV. The tidal volume in the driving pressure–guided group was 4.65 [4.23-5.65] mL/kg at 15 minutes and 4.58 [4.27-5.41] mL/kg at 45 minutes of OLV. The concentration of IL-6 in the dependent lung after OLV was significantly lower in the driving pressure group (5.31 [3.62]) compared to the control group (7.37 [5.21]) (mean difference: –0.46 [–0.86 to –0.05] cm H₂O; p = 0.025). There were no significant differences between groups in the incidence of postoperative pulmonary complications or in the oxygenation index 45 minutes after the start of OLV.

Conclusions

Driving pressure–guided tidal volume titration significantly reduces IL-6 levels in bronchoalveolar lavage fluid from the dependent lung following OLV in patients undergoing thoracic surgery, compared to conventional ventilation using 8 mL/kg PBW.

目的：胸外科单肺通气（OLV）患者的最佳潮气量尚不清楚。本研究旨在评估驱动压力引导潮汐容量滴定是否可以减轻这些患者的肺损伤。设计：前瞻性、单中心、随机对照试验。环境：中国的单中心学术医院。参与者：共96例接受胸外科手术的OLV患者。干预措施：患者被随机分为驱动压力引导潮气量组（n = 46）和对照组（n = 50）。在对照组中，OLV期间潮气量设定为8 mL/kg预测体重（PBW）。在驱动压力引导组，调整潮气量使驱动压力维持在8 - 10 cm H2O之间，在OLV期间调整在4 - 8 mL/kg PBW之间。测量和主要结果：主要观察指标为OLV后依赖肺中白细胞介素6 （IL-6）的浓度。驱动压力引导组15分钟潮气量为4.65 [4.23-5.65]mL/kg， 45分钟潮气量为4.58 [4.27-5.41]mL/kg。驱动压组OLV后依赖肺IL-6浓度（5.31[3.62]）明显低于对照组（7.37[5.21]）（平均差值：-0.46 [-0.86 ~ -0.05]cm H2O, p = 0.025）。两组术后肺部并发症发生率及OLV启动后45分钟氧合指数差异无统计学意义。结论：与使用8 mL/kg PBW的常规通气相比，驱动压力引导潮汐容量滴定可显著降低胸外科手术患者OLV后依赖肺的支气管肺泡灌洗液中IL-6水平。

{"title":"Driving Pressure–Guided Tidal Volume Titration Reduces Lung Injury in Thoracic Surgery With One-Lung Ventilation: A Randomized Clinical Trial","authors":"Yun Yan MSc , Xiaowen Liu MD , Zhen Liu MD , Zhe Li MSc , Huamei Cai MSc , Weixia Li MD , Jing Zhao MD","doi":"10.1053/j.jvca.2025.11.020","DOIUrl":"10.1053/j.jvca.2025.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal tidal volume for patients undergoing thoracic surgery with one-lung ventilation (OLV) remains unclear. This study aimed to evaluate whether driving pressure–guided tidal volume titration could reduce lung injury in these patients.</div></div><div><h3>Design</h3><div>Prospective, single-center, randomized controlled trial.</div></div><div><h3>Setting</h3><div>Single-center academic hospital in China.</div></div><div><h3>Participants</h3><div>A total of 96 patients undergoing thoracic surgery with OLV.</div></div><div><h3>Interventions</h3><div>Patients were randomly assigned to either the driving pressure–guided tidal volume group (n = 46) or the control group (n = 50). In the control group, tidal volume was set at 8 mL/kg of predicted body weight (PBW) during OLV. In the driving pressure–guided group, tidal volume was adjusted to maintain a driving pressure between 8 and 10 cm H<sub>2</sub>O, with modifications within 4 to 8 mL/kg PBW during OLV.</div></div><div><h3>Measurements and Main Results</h3><div>The primary outcome was the concentration of interleukin 6 (IL-6) in the dependent lung following OLV. The tidal volume in the driving pressure–guided group was 4.65 [4.23-5.65] mL/kg at 15 minutes and 4.58 [4.27-5.41] mL/kg at 45 minutes of OLV. The concentration of IL-6 in the dependent lung after OLV was significantly lower in the driving pressure group (5.31 [3.62]) compared to the control group (7.37 [5.21]) (mean difference: –0.46 [–0.86 to –0.05] cm H<sub>2</sub>O; p = 0.025). There were no significant differences between groups in the incidence of postoperative pulmonary complications or in the oxygenation index 45 minutes after the start of OLV.</div></div><div><h3>Conclusions</h3><div>Driving pressure–guided tidal volume titration significantly reduces IL-6 levels in bronchoalveolar lavage fluid from the dependent lung following OLV in patients undergoing thoracic surgery, compared to conventional ventilation using 8 mL/kg PBW.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"40 2","pages":"Pages 652-659"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781433","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}

引用次数: 0

Clinical Trials of Physiological Monitors: Learning from the Mistakes of the Past 生理监测仪的临床试验：从过去的错误中吸取教训。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.11.026

Jamel Ortoleva MD, FASE , Patrick M Wieruszewski PharmD, RPh, FCCM , Dominic Pisano MD , Edward Bittner MD, PhD, FCCM

引用次数: 0

Tracheal Wall Anomaly During One-lung Isolation for a Right Lower Lobectomy 右下肺叶切除术单肺隔离时气管壁异常。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.10.006

Cynthia Karam MD , Nancy Abou Nafeh MD , Adeeb Oweidat MD , Kelly Merheb MD , Maher El Shami MD , Frida Atallah MD , Amro Khalili MD , Carine Zeeni MD

引用次数: 0

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights From 2025 心胸血管麻醉之年：2025年精选亮点。

IF 2.1 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia

Pub Date : 2026-02-01 DOI: 10.1053/j.jvca.2025.10.029

Himani V. Bhatt DO, MPA, FASE , Ashley Virginia Fritz DO , Jared W. Feinman MD, FASE , Sudhakar Subramani MD, MMed, MME, FASE , Anita K. Malhotra MD , Matthew M. Townsley MD, FASA, FASE , Menachem M. Weiner MD , Archit Sharma MD, FASE , John Choi DO , Jennifer Shmukler MD , Anna Bovill Shapiro MD , Andrea Rivero MD , Jacob King DO , Samuel Fallon MD , Stuart M. Sacks MD , Satoshi Hanada MD, FASE , Archer Kilbourne Martin MD , Harish Ramakrishna MD, FACC, FASE, FESC

This special article is the 18th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, Dr. Augoustides, and the editorial board for the opportunity to continue this series, namely, the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology. The major themes selected for 2025 are outlined in this introduction, and each highlight is reviewed in detail in the main article. The literature highlights in the specialty for 2025 begin with an update on perioperative rehabilitation and enhanced recovery in cardiothoracic surgery, with a focus on prehabilitation and the impact of implementing enhanced recovery care models on outcomes. The second major theme is focused on cardiac surgery, with the authors discussing new insights into blood conservation methods and updates on coronary artery bypass grafting. The third theme is focused on cardiothoracic transplantation, with discussions focusing on techniques related to lung transplantation including extracorporeal life support. The fourth theme is focused on mechanical circulatory support, with discussions exploring advancements in left ventricular assist devices, highlighting the evolving landscape of mechanical circulatory support in cardiogenic shock and discussing anticoagulation practices. The fifth and final theme is an update on medical cardiology, with a focus on outcomes of transcatheter management of aortic valve pathology, tricuspid valve regurgitation, and surgical versus transcatheter management of mitral valve disease. The themes selected for this article are only a few of the diverse advances in the specialty during 2025. These highlights will inform the reader of key updates on a variety of topics, leading to the improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.

这篇特别的文章是《心胸血管麻醉杂志》年度系列文章的第十八篇。作者感谢总编辑、Kaplan博士、Augoustides博士和编委会给我们继续这个系列的机会，也就是过去一年心胸血管麻醉学专业的研究亮点。在本引言中概述了2025年选定的主要主题，并在正文中详细回顾了每个重点。2025年的专业文献重点从心外科围手术期康复和增强康复的更新开始，重点是康复前的康复和实施增强康复护理模式对结果的影响。第二个主要主题是心脏外科，作者讨论了血液保存方法的新见解和冠状动脉旁路移植术的最新进展。第三个主题是心胸移植，重点讨论肺移植相关技术，包括体外生命支持。第四个主题是机械循环支持，讨论了左心室辅助装置的进展，强调了心源性休克中机械循环支持的发展前景，并讨论了抗凝实践。第五个也是最后一个主题是医学心脏病学的最新进展，重点是经导管治疗主动脉瓣病理、三尖瓣反流的结果，以及二尖瓣疾病的手术与经导管治疗的对比。本文选择的主题只是2025年该专业各种进展中的一小部分。这些重点将告知读者关于各种主题的关键更新，从而改善心胸和血管疾病患者的围手术期预后。

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