Journal of Cardiothoracic Surgery最新文献

Background: Secondary cardiac tumors of hepatic origin are extremely rare in clinical practice, although they have been described more frequently in postmortem autopsy studies. This is most likely due to local invasion through the inferior vena cava into the right atrium.

Case presentation: Here, we present a very rare case of an asymptomatic, aggressive right heart mass that was identified as hepatocellular carcinoma in the absence of a detectable primary tumor. The diagnosis was made incidentally in a 65-year-old male patient.

Conclusion: Given its silent presentation, poor prognosis and complex approach, it remains an unfortunate diagnosis with limited survival.

Background: This research investigated the expression of microRNA-92a (miR-92a) in chronic heart failure (CHF) patients and assessed its regulatory mechanism using a transverse aortic constriction (TAC) mouse model.

Methods: Thirty patients with CHF (NYHA class II-IV) and 30 age and sex-matched healthy controls were enrolled from January 2021 to April 2022. Plasma levels of miR-92a were analyzed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). In addition, we utilized the TAC heart failure mouse model (n = 12) to evaluate the change in cardiac function following adeno-associated virus (AAV) mediated inhibition or overexpression of miR-92a. The following echocardiographic variables were evaluated: ejection fraction (EF), fractional shortening (FS), left ventricular internal diameter diastole (LVIDd), and left ventricular internal diameter systole (LVIDs).

Results: miR-92a levels were significantly increased in CHF patients and mice following tac application (p < 0.01). Inhibition of miR-92a expression improved cardiac function as evidenced by increased EF and FSs, and decreased LVIDd and LVIDs (p < 0.05).

Conclusion: miR-92a may serve as a novel diagnostic and therapeutic biomarker for heart failure by altering cardiac remodeling.

Background: There are controversies regarding managing anterior mediastinal mass greater than 5 cm by video-assisted thoracoscopic surgery (VATS). This study aims to present a single-center experience in using VATS to resect large anterior mediastinal masses using either unilateral or bilateral approach.

Methods: This is a retrospective case series, including consecutive patients referred for surgical management of anterior mediastinal mass, provided the mass was equal to or larger than five centimeters. Only phase I (unilateral VATS) was performed for those with a single approach, while phase one and phase II (bilateral VATS) were performed for those with dual approach.

Results: The study included eight cases; 4 (50%) were male, and 4 (50%) were female. All of the cases had features of myasthenia gravis. The average diameter of the mass on the computed tomography scan was 7 cm, ranging from 5 to 12 cm. Dual VATS was utilized in three (37.5%) cases, which showed both left and right extension. The average blood loss was 180 ml, ranging from 130 to 250 ml. All of the cases were thymoma. Complete resection was achieved in all cases with R0. Neither mortality nor recurrence was reported in the follow-up period (14 months average ranging from 6 to 36 months).

Conclusions: VATS is a safe and effective approach for large anterior mediastinal masses, with satisfactory operative outcomes, minimal morbidity, and promising oncological results. Dual VATS may be particularly useful for lesions with significant bilateral extension.