JTCVS Techniques最新文献

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Robotic-assisted redo resection of invasive thymoma with en bloc pericardial and diaphragm resection with reconstruction 机器人辅助浸润性胸腺瘤重做切除术，心包和膈肌全切并重建

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.06.007

Constantine M. Poulos MD , Elliot L. Servais MD

引用次数: 0

Complete excision of mitral annular calcification and double valve replacement with aortomitral curtain reconstruction 二尖瓣环钙化完全切除术（MAC）和双瓣膜置换术（DVR）与主动脉瓣-二尖瓣瓣帘重建术（AMCR）

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.06.025

Margaret R. Connolly MD, Svitlana Bielichenko MD, Serguei Melnitchouk MD, MPH

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Computed tomography and transesophageal echocardiography for left atrial appendage evaluation: How much is too much? 计算机断层扫描和经食道超声心动图评估左房阑尾：多少才算多？

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.08.003

Simon Pecha MD , Johannes Petersen MD , Hermann Reichenspurner MD, PhD

引用次数: 0

Thoracic endovascular aortic repair (TEVAR) explantation and left lower lobectomy for aortobronchial fistula repair 胸腔内血管主动脉修补术（TEVAR）切除术和左下肺叶切除术用于主动脉支气管瘘修补术

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.07.020

Jonathan Zurcher MD, Alexander Nissen MD, Felix Fernandez MD, Woodrow Farrington MD, Bradley G. Leshnower MD

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Systemic thrombolysis for a mechanical atrioventricular valve thrombosis in a child with a single-ventricle palliation at Fontan stage 全身溶栓治疗丰坦期单心室姑息术患儿的机械性房室瓣血栓形成

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.07.017

Vladimir L. Cousin MD , Raphael Joye MD , Alice Bordessoule MD , Tomasz Nalecz MD , Veneranda Mattiello MD , Helia Robert-Ebadi MD , Pierre Fontana MD , Tornike Sologashvili MD , Maurice Beghetti MD , Julie Wacker MD

引用次数: 0

Clarificaton on the similarity of the floating Bentall technique with our previously defined existing technique known as the flange technique 澄清浮动本塔尔技术与我们之前定义的现有技术（即法兰技术）的相似性

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.08.002

Kaan Kırali MD, Taylan Adademir MD, FEBCTS (Cardiac)

引用次数: 0

Outcomes of fenestrated frozen elephant trunk technique in 150 patients with acute type A aortic dissection 在 150 名急性 A 型主动脉夹层患者中采用栅栏式冷冻象鼻技术的疗效

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.08.004

Homare Okamura MD, PhD , Shuhei Azuma MD , Yuichiro Kitada MD , Ryo Shimada MD , Yohei Nomura MD , Hideo Adachi MD, PhD

Objective

The fenestrated frozen elephant trunk (FET) technique provides proximalization of distal anastomosis and antegrade blood flow into supra-aortic vessels through fenestration in a FET. We investigated the outcomes of the fenestrated FET technique in acute type A aortic dissection.

Methods

We evaluated 150 patients who underwent arch repair using the fenestrated FET technique for acute type A aortic dissection between July 2014 and January 2023. FET was deployed under hypothermic circulatory arrest and manually fenestrated under direct vision on the supra-aortic vessel aspect. Fenestration was performed for the left subclavian artery alone in 139 patients, 2 supra-aortic vessels in 9 patients, and total supra-aortic vessels in 2 patients. Fixation around fenestration site for endoleak prevention was performed in 48 patients.

Results

The overall 30-day mortality rate was 4.7% (7 out of 150). Two patients developed paraparesis. Adequate blood flow into the supra-aortic vessels through fenestrations were confirmed in all patients at discharge. The false lumen thrombosis rate at the distal edge of FET was 96.6%. The median follow-up period was 28 months. The 1-year and 3-year overall survival rate was 89.1% and 84.5%, respectively. During the follow-up period, neither fenestration occlusion nor stroke was noted in the cerebral area perfused via the fenestration. Distal stent graft-induced new entry was noted in 2 patients.

Conclusions

The fenestrated FET technique is a straightforward and secure procedure for selected patients with acute type A aortic dissection. This technique can facilitate arch repair.

目的通过在 FET 中进行栅栏式冷冻象鼻躯干（FET）技术，可实现远端吻合的近端化和主动脉上血管的逆行血流。方法我们评估了2014年7月至2023年1月期间，150例因急性A型主动脉夹层而使用冷冻大象干（FET）技术进行拱形修复的患者。在低体温循环停止状态下展开 FET，并在直视下手动在主动脉上血管方面进行瓣膜缝合。139例患者仅对左锁骨下动脉进行了瓣膜切割，9例患者对2条主动脉上血管进行了瓣膜切割，2例患者对全部主动脉上血管进行了瓣膜切割。结果 30 天内的总死亡率为 4.7%（150 例中有 7 例）。两名患者出现偏瘫。所有患者出院时均证实通过瓣膜进入主动脉瓣上血管的血流充足。FET 远端假腔血栓形成率为 96.6%。中位随访期为 28 个月。1年和3年总生存率分别为89.1%和84.5%。在随访期间，经瘘管灌注的脑区未发现瘘管闭塞或中风。结论对于选定的急性 A 型主动脉夹层患者，栅栏式 FET 技术是一种简单、安全的手术。该技术可促进拱形修复。

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引用次数: 0

Hemi-Commando with aortic homograft and atrioventricular septal defect repair for recurrent triple valve endocarditis 采用主动脉同源移植和房室间隔缺损修补术治疗复发性三瓣心内膜炎的 Hemi-Commando

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.07.021

Gabe Weininger MD, Hanjay Wang MD, Y. Joseph Woo MD

引用次数: 0

Clinical utility of artificial intelligence–augmented endobronchial ultrasound elastography in lymph node staging for lung cancer 人工智能增强支气管内超声弹性成像在肺癌淋巴结分期中的临床应用

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.06.024

Yogita S. Patel BSc , Anthony A. Gatti PhD , Forough Farrokhyar MPhil, PhD , Feng Xie PhD , Waël C. Hanna MDCM, MBA

Objective

Endobronchial ultrasound elastography produces a color map of mediastinal lymph nodes, with the color blue (level 60) indicating stiffness. Our pilot study demonstrated that predominantly blue lymph nodes, with a stiffness area ratio greater than 0.496, are likely malignant. This large-scale study aims to validate this stiffness area ratio compared with pathology.

Methods

This is a single-center prospective clinical trial where B-mode ultrasound and endobronchial ultrasound elastography lymph node images were collected from patients undergoing endobronchial ultrasound transbronchial needle aspiration for suspected or diagnosed non–small cell lung cancer. Images were fed to a trained deep neural network algorithm (NeuralSeg), which segmented the lymph nodes, identified the percent of lymph node area above the color blue threshold of level 60, and assigned a malignant label to lymph nodes with a stiffness area ratio above 0.496. Diagnostic statistics and receiver operating characteristic analyses were conducted. NeuralSeg predictions were compared with pathology.

Results

B-mode ultrasound and endobronchial ultrasound elastography lymph node images (n = 210) were collected from 124 enrolled patients. Only lymph nodes with conclusive pathology results (n = 187) were analyzed. NeuralSeg was able to predict 98 of 143 true negatives and 34 of 44 true positives, resulting in an overall accuracy of 70.59% (95% CI, 63.50-77.01), sensitivity of 43.04% (95% CI, 31.94-54.67), specificity of 90.74% (95% CI, 83.63-95.47), positive predictive value of 77.27% (95% CI, 64.13-86.60), negative predictive value of 68.53% (95% CI, 64.05-72.70), and area under the curve of 0.820 (95% CI, 0.758-0.883).

Conclusions

NeuralSeg was able to predict nodal malignancy based on endobronchial ultrasound elastography lymph node images with high area under the receiver operating characteristic curve and specificity. This technology should be refined further by testing its validity and applicability through a larger dataset in a multicenter trial.

目的支气管内超声弹性成像可生成纵隔淋巴结的彩色图，蓝色（60 级）表示僵硬度。我们的试点研究表明，以蓝色为主的淋巴结（硬度面积比大于 0.496）很可能是恶性的。这是一项单中心前瞻性临床试验，从因疑似或确诊为非小细胞肺癌而接受支气管内超声经支气管针吸术的患者身上收集 B 型超声和支气管内超声弹性成像淋巴结图像。图像被输入到训练有素的深度神经网络算法（NeuralSeg）中，该算法对淋巴结进行分割，识别超过 60 级蓝色阈值的淋巴结面积百分比，并对僵硬度面积比超过 0.496 的淋巴结贴上恶性标签。进行了诊断统计和接收者操作特征分析。结果从124名入选患者中收集了B型超声和支气管内超声弹性成像淋巴结图像（n = 210）。只分析了有确诊病理结果的淋巴结（n = 187）。NeuralSeg 能够预测 143 个真阴性淋巴结中的 98 个和 44 个真阳性淋巴结中的 34 个，总体准确率为 70.59%（95% CI，63.50-77.01），灵敏度为 43.04%（95% CI，31.94-54.67），特异性为 90.74%（95% CI，83.63-95.47），阳性预测值为 77.27%（95% CI，64.13-86.60），阴性预测值为 90.74%（95% CI，83.63-95.47）。结论NeuralSeg能根据支气管内超声弹性成像淋巴结图像预测结节恶性程度，接收者操作特征曲线下面积大，特异性高。这项技术应在多中心试验中通过更大的数据集测试其有效性和适用性，从而进一步完善。

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The devil is in the details 细节决定成败

IF 1.7 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2024-10-01 DOI: 10.1016/j.xjtc.2024.06.017

Desiree Steimer MD, Michael T. Jaklitsch MD, Scott J. Swanson MD

引用次数: 0

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