Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Information for readers","authors":"","doi":"10.1016/S0022-5223(25)01080-3","DOIUrl":"10.1016/S0022-5223(25)01080-3","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Page 558"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining preoperative diabetes assessment: Implications for acute myocardial infarction-coronary artery bypass grafting management and long-term outcomes","authors":"Mengxia Qi MM , Xiangying Yang MM","doi":"10.1016/j.jtcvs.2025.02.017","DOIUrl":"10.1016/j.jtcvs.2025.02.017","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages e41-e42"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue perfusion pressure: A novel hemodynamic measure to assess risk of acute kidney injury after cardiac surgery","authors":"Travis J. Miles MD ,&nbsp;Michael T. Guinn MD ,&nbsp;Xin Tan BS ,&nbsp;Hao Qi BS ,&nbsp;Vicente Orozco-Sevilla MD ,&nbsp;Marc R. Moon MD ,&nbsp;Joseph S. Coselli MD ,&nbsp;Todd K. Rosengart MD ,&nbsp;Meng Li PhD ,&nbsp;Subhasis Chatterjee MD ,&nbsp;Ravi K. Ghanta MD","doi":"10.1016/j.jtcvs.2025.07.009","DOIUrl":"10.1016/j.jtcvs.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Optimal hemodynamic targets for preventing acute kidney injury (AKI) have remained elusive. We hypothesized that lower tissue perfusion pressure (TPP), a novel perfusion index representing the difference between mean arterial pressure and the critical closing pressure, is predictive of AKI after cardiac surgery.</div></div><div><h3>Methods</h3><div>Individual patient TPP waveforms were constructed from continuous hemodynamic data in 1224 patients after cardiac surgery. The relationship of TPP and AKI was determined and stratified by vasoactive inotrope score. Logistic regression was performed to identify the optimal TPP threshold for predicting AKI. Unsupervised machine learning was used to explore different hemodynamic phenotypes and their association with AKI.</div></div><div><h3>Results</h3><div>AKI occurred in 17.6% of patients and was associated with higher rates of mortality (15.8% vs 2.0%; <em>P</em> &lt; .001) and major morbidity (45.1% vs 14.2%; <em>P</em> &lt; .001) and significantly lower average TPP (37.6 mm Hg [33.7-41.0 mm Hg] vs 39.0 mm Hg [34.6-42.6 mm Hg], <em>P</em> &lt; .001). A threshold TPP &lt;38 mm Hg effectively stratified patients by AKI risk (odds ratio, 1.75; 95% CI, 1.30-2.35). For patients requiring vasoactive medications, average TPP &lt;38 mm Hg indicated higher risk of AKI independent of average mean arterial pressure (adjusted odds ratio, 1.69; 95% CI, 1.17-2.45). <em>K</em>-means clustering identified a high-risk phenotype with lower average TPP (35.6 mm Hg [30.9-39.8 mm Hg] vs 40.4 mm Hg [35.9-44.5 mm Hg]; <em>P</em> &lt; .001), higher average vasoactive inotrope score (2.8 [0.3-6.8] vs 0.5 [0.0-2.5], <em>P</em> &lt; .001), and greater incidence of AKI (29.8% vs 10.1%; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Lower TPP is associated with greater risk of AKI after cardiac surgery. TPP could serve as an adjunct to traditional hemodynamic measures to guide hemodynamic management, especially in patients with higher vasopressor requirements.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 455-462.e3"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet responsiveness to aspirin in pediatric patients undergoing cardiac surgery: A prospective cohort study","authors":"Supreet P. Marathe FRACS ,&nbsp;Stacey Van Dyk BN ,&nbsp;Sally Campbell FRACP ,&nbsp;Kim S. Betts PhD ,&nbsp;Pasquale Barbaro FRACP ,&nbsp;Siddharth Amboli MCh ,&nbsp;Benjamin Anderson FRACP ,&nbsp;Adrian Mattke FCICM ,&nbsp;Prem Venugopal FRACS ,&nbsp;Nelson Alphonso FRACS","doi":"10.1016/j.jtcvs.2025.09.013","DOIUrl":"10.1016/j.jtcvs.2025.09.013","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Aspirin at 3 to 5 mg/kg is the cornerstone of thromboprophylaxis in pediatric cardiac surgery. The reported prevalence of aspirin unresponsiveness is 1% to 35% in adults and 10% to 15% in children. The present study aimed to (1) describe the prevalence of aspirin responsiveness in the pediatric cardiac surgical population using light transmission aggregometry (LTA), the gold standard; (2) evaluate the dose-dependent response to aspirin; (3) compare LTA with point-of-care thromboelastography with platelet mapping (TEG-PM); and (4) describe adverse events and report a risk factor analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This prospective cohort study (Clinical Trials Registry ACTRN12618001879257) was conducted from 2022 to 2024 in a quaternary children's hospital and included patients age 0 to 18 years who required aspirin prophylaxis after cardiac surgery. Patients who were allergic to aspirin or received other anticoagulants, such as warfarin, were excluded. Aspirin responsiveness was tested after at least 3 days of a standard aspirin dose of 5 mg/kg or 150 mg (whichever was less). LTA showing ≥20% platelet aggregation stimulated by arachidonic acid or ≥70% platelet aggregation to adenosine diphosphate denoted aspirin unresponsiveness. To evaluate TEG-PM compared to the gold standard (LTA), TEG-PM showing ≥50% platelet aggregation denoted aspirin unresponsiveness. The dose was increased to 10 mg/kg in these patients, and aspirin responsiveness was reevaluated. Those patients still not responding were labeled “aspirin-resistant.”&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The 133 eligible patients included 77 males (58%), 49 with a single ventricle (37%), and 119 who underwent surgery using cardiopulmonary bypass (89%). The most common indications for aspirin were shunts/Fontan in single ventricle patients (n = 44; 33%) and valve repair/replacement (n = 25; 19%). The median patient age was 1.9 years (interquartile range [IQR], 0.13-12 years), and the median weight was 15.1 kg (IQR, 4.2-44.1 kg). Twenty-four patients (18%) did not respond to the standard aspirin dose, and the dose was increased in 23 patients (17%). Twenty patients (15%) were tested a second time; 13 (10%) responded to the increased aspirin dose (10 mg/kg). Seven patients (5%) were aspirin-resistant. There was no correlation between the results of aspirin responsiveness tested using LTA and TEG-PM (&lt;em&gt;P&lt;/em&gt; = .167). There were no identifiable risk factors for aspirin unresponsiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Almost 20% of pediatric cardiac surgical patients do not respond to a standard 5 mg/kg aspirin dose. Most non-responders have a dose-dependent response to aspirin. Only 5% of patients are genuinely aspirin-resistant (as defined by LTA). TEG-PM does not correlate with the gold standard LTA test to determine aspirin responsiveness. Testing for aspirin responsiveness should be considered in patients undergoing pediatric cardiac surger","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 338-347.e1"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute type A dissection with iliofemoral or renal malperfusion: Is frozen elephant trunk necessary?","authors":"Alexander P. Nissen MD ,&nbsp;Ross Michael Reul MD ,&nbsp;Muhammad Naeem MD ,&nbsp;Jonathan R. Zurcher MD ,&nbsp;Woodrow J. Farrington MD ,&nbsp;William Brent Keeling MD ,&nbsp;Bradley G. Leshnower MD","doi":"10.1016/j.jtcvs.2025.09.014","DOIUrl":"10.1016/j.jtcvs.2025.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Frozen elephant trunk (FET) is being increasingly used for acute type A aortic dissection (ATAAD) with distal malperfusion. The efficacy of adding a stent graft remains unclear, however. This study investigated the efficacy of adding FET to conventional arch repair when treating ATAAD with iliofemoral or renal malperfusion.</div></div><div><h3>Methods</h3><div>A review of the Emory Aortic Database identified 969 patients with acute DeBakey 1 dissection from 2004 to February 2025. One hundred fifty-three patients with iliofemoral and/or renal malperfusion underwent emergent central aortic repair alone (conventional group; n = 102) or central repair plus FET (FET group; n = 51). Univariate statistics were used to compare the 2 groups. Multivariable logistic regression was used to examine factors associated with postoperative limb revascularization and new renal failure. Selection bias was addressed through inverse-probability treatment weighting adjustment.</div></div><div><h3>Results</h3><div>Age and preoperative comorbidities were equivalent in the 2 groups. Limb ischemia requiring revascularization (17.6% for conventional vs 15.7% for FET; <em>P</em> = .856), or new dialysis (21.6% for conventional vs 17.6% for FET; <em>P</em> = .547) also was similar between the groups. Multivariable regression did not identify FET as independently associated with a reduced need for limb revascularization in iliofemoral malperfusion patients (odds ratio [OR], 1.334; 95% confidence interval [CI], 0.434-4.098; <em>P</em> = .614) or with avoiding dialysis in renal malperfusion patients (OR, 1.166; 95% CI, 0.252-5.382; <em>P</em> = .844). Mid-term survival (71.1% for conventional 71.1% vs 75.5% for FET; log-rank <em>P</em> = .753) and distal reintervention-free survival (64.9% for conventional vs 69.4% for FET; log-rank <em>P</em> = .902) were equivalent.</div></div><div><h3>Conclusions</h3><div>The addition of FET to conventional repair did not impact limb revascularization, new dialysis, or mid-term reintervention or improve mid-term survival in ATAAD with iliofemoral or renal malperfusion.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 366-373.e1"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between subclavian vein patency and health-related quality of life outcomes among patients with venous thoracic outlet syndrome","authors":"Michaela E. Corvi BA ,&nbsp;Nikhil Panda MD, MPH ,&nbsp;Beverly J. Fu BA, MA ,&nbsp;Jacob C. Hurd BS ,&nbsp;Margaret E. Yang BS ,&nbsp;Jacob N. Anderson BS ,&nbsp;Sangkavi Kuhan BS ,&nbsp;Chi-Fu Jeffery Yang MD ,&nbsp;Dean M. Donahue MD","doi":"10.1016/j.jtcvs.2025.08.035","DOIUrl":"10.1016/j.jtcvs.2025.08.035","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to evaluate the association between subclavian vein patency and health-related quality of life after supraclavicular thoracic outlet decompression among patients with venous thoracic outlet syndrome.</div></div><div><h3>Methods</h3><div>Patients who underwent supraclavicular thoracic outlet decompression (ie, first thoracic rib resection, scalenectomy, and subclavian venolysis) were identified from a prospectively maintained database. Demography, perioperative venography, and catheter-directed interventions were recorded. The primary end points were subclavian vein patency and health-related quality of life after decompression. The association between subclavian vein patency and health-related quality of life was evaluated in unadjusted and logistic regression analyses.</div></div><div><h3>Results</h3><div>Among 1032 patients with thoracic outlet syndrome who underwent surgery (2007-2021), 275 patients presented with venous thoracic outlet syndrome. A total of 225 patients (81.8%) underwent preoperative venography; 221 patients (98.2%) had completely or partially stenosed subclavian veins. Preoperative catheter-based interventions were performed in 166 patients (60.4%); stenosis remained in 130 patients (78.3%). Postoperatively, 216 patients (78.5%) underwent routine venography; improvement in stenosis was observed in 54 patients (25.0%). Additional catheter-based interventions were performed in 155 patients (56.4%) with improvement in stenosis observed in 131 patients (84.5%). At a median follow-up of 279 days (interquartile range, 95-674), 94.0% of patients reported improvement in health-related quality of life. Improvement in subclavian vein patency was associated with improved health-related quality of life (adjusted odds ratio, 2.19 [95% CI, 1.12-4.28], <em>P</em> = .021).</div></div><div><h3>Conclusions</h3><div>Subclavian vein patency is associated with improved health-related quality of life among patients with venous thoracic outlet syndrome. Effective venolysis during thoracic outlet decompression with perioperative catheter-directed intervention contributes most significantly to vein patency.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 551-557.e1"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival and operative outcomes of the Bentall procedure for aortic root aneurysm, aortic dissection, and endocarditis","authors":"Christopher Lau MD,&nbsp;Alexander Gregg MD,&nbsp;Eilon Ram MD,&nbsp;Charles Mack MD,&nbsp;Katherine Krieger BS,&nbsp;Mohamed Rahouma MD,&nbsp;Ivancarmine Gambardella MD,&nbsp;Giovanni Soletti Jr. MD,&nbsp;Mario Gaudino MD,&nbsp;Leonard N. Girardi MD","doi":"10.1016/j.jtcvs.2025.09.018","DOIUrl":"10.1016/j.jtcvs.2025.09.018","url":null,"abstract":"<div><h3>Objective</h3><div>To assess outcomes after aortic root replacement with Bentall procedure for aortic aneurysm, dissection, and endocarditis.</div></div><div><h3>Methods</h3><div>We identified consecutive patients undergoing Bentall procedures from 1997 to 2023, with stratification based on the primary diagnosis. Operative outcomes and long-term survival were compared.</div></div><div><h3>Results</h3><div>Of 1493 patients, 1378 (92.3%) underwent surgery for aneurysms, 75 (5%) for dissections, and 40 (2.7%) for endocarditis. The aneurysm group was older (61 years [range, 50-70 years] vs 57 years [range, 47-66.5 years] vs 56 years [range, 49-64 years]; <em>P</em> = .024). Patients with dissection or endocarditis had more preoperative myocardial infarctions (7.4% vs 12% vs 17.5%; <em>P</em> = .026), cerebrovascular accidents (9.6% vs 18.7% vs 45%; <em>P</em> &lt; .001), renal dysfunction (8.3% vs 22.7% vs 45%; <em>P</em> &lt; .001), shock (0.1% vs 10.7% vs 15%; <em>P</em> &lt; .001), and ruptures (0.4% vs 10.7% vs 10%; <em>P</em> &lt; .001). Regarding outcomes, acute renal failure (0.6% vs 1.3% vs 7.5%; <em>P</em> &lt; .001) and operative mortality (0.4% vs 1.3% vs 7.5%; <em>P</em> = .001) were higher for endocarditis. Reexploration for bleeding was highest for dissections (4.1% vs 12% vs 2.5%; <em>P</em> = .004). Ten-year survival was similar between groups (71.8% vs 67% vs 83.7%; <em>P</em> = .94), with mean follow-up 68.2 ± 2.08 months. Multivariable analysis found age (hazard ratio [HR], 1.04; 95% CI, 1.03-1.05; <em>P</em> &lt; .001), chronic obstructive pulmonary disease (HR, 2.12; 95% CI, 1.44-3.11; <em>P</em> &lt; .001), renal dysfunction (HR, 1.97; 95% CI, 1.4-2.78; <em>P</em> &lt; .001), and ejection fraction (HR, 0.97; 95% CI, 0.95-0.98; <em>P</em> &lt; .001) were associated with late mortality but primary diagnosis was not.</div></div><div><h3>Conclusions</h3><div>The Bentall procedure can be performed with low operative risk for aneurysms and selected dissections. Endocarditis is associated with higher but acceptable operative mortality. Excellent long-term survival can be expected after surviving initial operative risk.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 357-365.e2"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Symptomatic myocardial bridges—Bridging the unknown","authors":"Anusha Jegatheeswaran MD, PhD, FRCSC ,&nbsp;Ruchika Kamojjala BA","doi":"10.1016/j.jtcvs.2025.10.005","DOIUrl":"10.1016/j.jtcvs.2025.10.005","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 427-428"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel anastomotic device for the sandwich technique in type A aortic dissections: A human cadaver study","authors":"Emilio Osorio-Jaramillo MD ,&nbsp;Jasmine El-Nashar MD ,&nbsp;Ewald Unger BE ,&nbsp;Paata Pruidze MD ,&nbsp;Stefan Geyer MD ,&nbsp;Thomas Poschner MD ,&nbsp;Wilhelm Schreiner BSc ,&nbsp;Wolfgang J. Weninger MD ,&nbsp;Daniel Zimpfer MD ,&nbsp;Marek P. Ehrlich MD","doi":"10.1016/j.jtcvs.2025.09.015","DOIUrl":"10.1016/j.jtcvs.2025.09.015","url":null,"abstract":"<div><h3>Objective</h3><div>To assess a new aortic anastomotic device for the repair of acute type A aortic dissection (ATAAD) designed to facilitate and expedite ATAAD repair, potentially minimizing the occurrence of distal anastomotic new entry (DANE) and progression of the disease.</div></div><div><h3>Methods</h3><div>Ten repairs were conducted in an iatrogenically induced ATAAD model using fresh human cadavers and the felt sandwich technique. Five were repaired with conventional 4-0 polypropylene, and 5 were repaired with the new device. With the device, pins were stapled circumferentially through the sandwich and fixed outside with a cap. The sandwich anastomosis was timed. The aortic arch and vascular prosthesis were explanted and connected to a pressure pump filled with glycerol/H₂O solution pressurized at 170/90 mm Hg over 5 minutes. Fluid loss was measured. The anastomoses were checked for DANE, false lumen perfusion (FLP), and dissection progression.</div></div><div><h3>Results</h3><div>Fifty-four pins (100%) were successfully deployed, with a median of 11 pins (interquartile range [IQR], 10-11.5) per cadaver. Sandwich median time was significantly shorter with the stapler (02:22 [IQR, 01:49-03:05] min/sec vs 06:40 [IQR, 06:23-07:47] min:sec; <em>P</em> = .008). The time for end-to-end anastomosis with the vascular prosthesis (<em>P</em> = .31), as well as measured fluid loss (<em>P</em> = 1.00), were similar in the 2 groups. The suture group showed DANE in 2 specimens, FLP in 3 specimens, and dissection progression in 1 specimen, whereas the stapler group showed none of these conditions. Microscopy showed tearing at stitch channels in all sutured samples and no tears in the stapler group (<em>P</em> = .008).</div></div><div><h3>Conclusions</h3><div>The new aortic anastomotic device was safe and faster than the conventional technique and may produce more homogeneous and stronger sealing, potentially reducing DANE through less tissue trauma. Further studies in humans are needed to confirm the potential benefits of this novel device.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages 349-356.e5"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rwanda as a model for integrated surgical care of women of reproductive age with rheumatic heart disease","authors":"Valdano Manuel MD, PhD ,&nbsp;Adriana Bernardo MD ,&nbsp;Joaquim Gouveia MD","doi":"10.1016/j.jtcvs.2025.09.007","DOIUrl":"10.1016/j.jtcvs.2025.09.007","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"171 2","pages":"Pages e44-e45"},"PeriodicalIF":4.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}