JTCVS Techniques最新文献

英文中文

Najm transconal unroofing and left anterior descending exteriorization with intraventricular course Najm经鼻开顶术及左前降行外置术伴脑室内行

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-19 DOI: 10.1016/j.xjtc.2025.11.004

Kaoutar Farahi MD , Praise Chovwen MD , Munir Ahmed MD , John P. Costello MD , Nicholas Szugye MD , Shinya Unai MD , Hani K. Najm MD, MSc

引用次数: 0

Global epicardial peeling: A novel approach for patients with “incurable” constrictive pericarditis resistant to conventional pericardiectomy 整体心外膜剥离：一种治疗无法治愈的缩窄性心包炎的新方法

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-17 DOI: 10.1016/j.xjtc.2025.11.003

Masashi Komeda MD, PhD , Hiroto Suenaga MD, PhD , Shinji Mizuta MD , Junpei Yamamoto MD , Akira Osanai MD , Shintaro Nakajima MD , Satoru Satoh MD , Masaru Sawazaki MD, PhD

引用次数: 0

Controlled patient blood management under visceral perfusion in open treatment of complex aortic pathologies 复杂主动脉病变开放治疗中内脏灌注控制患者血液管理

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-11 DOI: 10.1016/j.xjtc.2025.11.002

Melanie Rusch MD, Grischa Hoffmann MD, PhD, Nawar Alasad MD, Rene Rusch MD, PhD

引用次数: 0

Uniportal thoracoscopic mediastinal lymph node dissection: Technical pearls and anatomical considerations 单门胸腔镜纵隔淋巴结清扫：技术要点和解剖学考虑

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-11 DOI: 10.1016/j.xjtc.2025.10.009

Tong Li MD, PhD , Yang Zhang MD, PhD

引用次数: 0

Deformable lung models for anatomical lung resections: The introduction of simulated reality for imaging guidance 解剖肺切除的可变形肺模型：引入模拟现实进行成像引导

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-10 DOI: 10.1016/j.xjtc.2025.10.022

Quinten J. Mank MSc , Tjerko Kieft MSc , Sabrina Siregar MD, PhD , Alexander P.W.M. Maat MD, PhD , Jolanda Kluin MD, PhD , Amir H. Sadeghi MD, PhD

Objective

This study introduces PulmoSimulatedReality (Pulmo-SR), a novel technique combining artificial intelligence, finite element method, 3-dimensional (3D) visualization, and 4-dimensional (4D) interaction for preoperative imaging and intraoperative surgical guidance in pulmonary resections, such as lobectomy and segmentectomy. The clinical applicability of this 3D modeling approach is evaluated through a preliminary validation protocol.

Methods

A deep learning algorithm was employed to generate 3D segmentations of patient anatomy. 3D models were created for 30 patients undergoing pulmonary resection, and 4D models were developed using the Pulmo-SR platform, incorporating finite element methods for dynamic deformation. Clinical validation was conducted by assessing accuracy, precision, and sensitivity using retrospective intraoperative video recordings alongside dynamic 4D models. Latency and 3D model reconstruction time were also measured.

Results

Validation of 30 cases yielded high average scores for accuracy, precision, and sensitivity, respectively: artery (0.987 ± 0.047, 0.993 ± 0.037, and 0.994 ± 0.031), vein (0.976 ± 0.099, 0.976 ± 0.099, and 1.00 ± 0.00), and bronchus (1.00 ± 0.00, 1.00 ± 0.00, and 1.00 ± 0.00). Latency was 0.23 ± 0.06 seconds, and 4D model reconstruction was completed in 8.47 seconds.

Conclusions

Pulmo-SR integrates artificial intelligence, finite element method, and 3D modeling to provide a 4D deformable reconstruction of patient anatomy, offering realistic simulations for complex lung resections. Clinical validation demonstrated high accuracy, precision, and sensitivity, indicating the potential as a valuable tool in preoperative and intraoperative workflows for anatomical lung resections.

目的介绍PulmoSimulatedReality （Pulmo-SR）技术，这是一种结合人工智能、有限元方法、三维可视化和四维交互的新技术，可用于肺叶切除术和肺节段切除术等肺切除术的术前成像和术中手术指导。通过初步验证方案评估该3D建模方法的临床适用性。方法采用深度学习算法生成患者解剖结构的三维分割。对30例肺切除术患者建立三维模型，并利用Pulmo-SR平台建立4D模型，结合有限元方法进行动态变形。通过回顾性术中视频记录和动态4D模型评估准确性、精密度和敏感性，进行临床验证。同时测量潜伏期和三维模型重建时间。结果30例患者的准确性、精密度和灵敏度均获得较高的平均评分，分别为动脉（0.987±0.047、0.993±0.037、0.994±0.031）、静脉（0.976±0.099、0.976±0.099、1.00±0.00）和支气管（1.00±0.00、1.00±0.00）。潜伏期为0.23±0.06秒，4D模型重建完成时间为8.47秒。结论spulmo - sr将人工智能、有限元方法和三维建模相结合，提供了4D可变形的患者解剖结构重建，为复杂的肺切除术提供了逼真的模拟。临床验证显示出较高的准确性、精密度和敏感性，表明其有潜力成为解剖性肺切除术术前和术中工作流程中有价值的工具。

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引用次数: 0

Uniportal fully robotic-assisted lobectomy via the fifth intercostal space with a cross-arm technique 采用交叉臂技术经第五肋间隙进行单门静脉全机器人辅助肺叶切除术

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-08 DOI: 10.1016/j.xjtc.2025.10.024

Kumiko Hashimoto MD , Yuji Nomata MD , Kunio Narita MD, PhD , Hiroyasu Sengoku MD , Shunsuke Date MD , Diego Gonzalez-Rivas MD, PhD , Toyofumi Fengshi Chen-Yoshikawa MD, PhD

引用次数: 0

A novel technique for placement of a right ventricular assist device 一种放置右心室辅助装置的新技术

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-08 DOI: 10.1016/j.xjtc.2025.10.023

Nayeem Nasher MD, Joshua R. Chen MD, Vishal N. Shah DO, Konstadinos A. Plestis MD, Keshava Rajagopal MD, PhD

引用次数: 0

Combined emergency cesarean section followed by immediate repair of acute type A aortic dissection in Marfan patient at 27 weeks gestation 妊娠27周马凡氏急性A型主动脉夹层即刻修复联合急诊剖宫产

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-08 DOI: 10.1016/j.xjtc.2025.10.026

Mason Darner BS , Aaron Guo MD , Ammu V. Alvarez MD , John Bozinovski MD , Brett L. Worly MD , Lauren T. Lastinger MD , Matthew C. Henn MD

引用次数: 0

Totally endoscopic port access for rheumatic mitral valve replacement: Clinical outcomes and a single surgeon's learning curve experience 风湿病二尖瓣置换术的完全内窥镜通道：临床结果和单个外科医生的学习曲线经验

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-07 DOI: 10.1016/j.xjtc.2025.10.025

Huy Q. Dang PhD, MD , Huong T. Le MD , Reinel M.A. Plasencia MD , Hoa Q. Nguyen MD , Oai Q. Vu MD , Tuan Q. Nguyen PhD, MD

Objectives

This study evaluates the safety and efficacy of totally endoscopic surgery for rheumatic mitral valve disease (RMVD) and analyzes the learning curve using cumulative sum control chart (CUSUM) and risk-adjusted (RA)-CUSUM failure models.

Methods

From March 2018 to November 2023, 242 consecutive patients with RMVD underwent totally endoscopic surgery via three 5.5-mm trocars and a 3- to 4-cm working port. Optimized management for atrial fibrillation (AF) included (1) mitral valve replacement, (2) tricuspid valve repair, (3) AF ablation, and (4) left atrial reduction. CUSUM and RA-CUSUM failure analyses were used to evaluate the learning curve progression, and comparisons were made between different learning curve phases.

Results

The median aortic crossclamp and cardiopulmonary bypass times were 98.5 (81-116) minutes and 178 (146-202) minutes, respectively, with a median follow-up of 37 months. Among 187 patients with long-standing persistent AF, 53 received optimized treatment, and a 91% AF-free rate was achieved at 1-year follow-up. In-hospital mortality occurred in 2 cases, attributable to intestinal infarction, and 1 late mortality resulted from massive intracranial hemorrhage. Major complications included 5 reoperations, 5 cases of severe unilateral pulmonary edema, and 4 cases of low cardiac output syndrome. CUSUM_ACCtime and RA-CUSUM failure analyses in 130 patients demonstrated significant improvements in operative times and recovery across different learning curve phases.

Conclusions

Totally endoscopic surgery for RMVD, including optimized AF management, is safe and feasible. Mastery of isolated endoscopic mitral valve replacement requires 86 cases to optimize aortic crossclamp time and 60 cases to effectively manage perioperative complications.

目的评价全内镜下手术治疗风湿性二尖瓣疾病（RMVD）的安全性和有效性，并利用累积和控制图（CUSUM）和风险调整(RA)-CUSUM失效模型分析学习曲线。方法2018年3月至2023年11月，242例RMVD患者通过3个5.5 mm套管和3- 4cm工作口接受了全内镜手术。房颤（AF）的优化治疗包括(1)二尖瓣置换术，(2)三尖瓣修复，(3)房颤消融，(4)左房减位术。采用CUSUM和RA-CUSUM失效分析来评价学习曲线的进展，并对不同学习曲线阶段进行比较。结果主动脉交叉夹和体外循环的中位时间分别为98.5 (81 ~ 116)min和178 (146 ~ 202)min，中位随访时间为37个月。187例长期持续性房颤患者中，53例接受优化治疗，1年随访房颤无发作率达91%。2例因肠梗死住院死亡，1例因颅内大出血晚期死亡。主要并发症包括再手术5例，严重单侧肺水肿5例，低心输出量综合征4例。130例患者的CUSUMACCtime和RA-CUSUM失败分析显示，在不同的学习曲线阶段，手术时间和恢复有显著改善。结论内镜下手术治疗RMVD，包括优化AF治疗是安全可行的。掌握孤立性内窥镜二尖瓣置换术需要86例优化主动脉夹持时间，60例有效处理围手术期并发症。

{"title":"Totally endoscopic port access for rheumatic mitral valve replacement: Clinical outcomes and a single surgeon's learning curve experience","authors":"Huy Q. Dang PhD, MD , Huong T. Le MD , Reinel M.A. Plasencia MD , Hoa Q. Nguyen MD , Oai Q. Vu MD , Tuan Q. Nguyen PhD, MD","doi":"10.1016/j.xjtc.2025.10.025","DOIUrl":"10.1016/j.xjtc.2025.10.025","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluates the safety and efficacy of totally endoscopic surgery for rheumatic mitral valve disease (RMVD) and analyzes the learning curve using cumulative sum control chart (CUSUM) and risk-adjusted (RA)-CUSUM failure models.</div></div><div><h3>Methods</h3><div>From March 2018 to November 2023, 242 consecutive patients with RMVD underwent totally endoscopic surgery via three 5.5-mm trocars and a 3- to 4-cm working port. Optimized management for atrial fibrillation (AF) included (1) mitral valve replacement, (2) tricuspid valve repair, (3) AF ablation, and (4) left atrial reduction. CUSUM and RA-CUSUM failure analyses were used to evaluate the learning curve progression, and comparisons were made between different learning curve phases.</div></div><div><h3>Results</h3><div>The median aortic crossclamp and cardiopulmonary bypass times were 98.5 (81-116) minutes and 178 (146-202) minutes, respectively, with a median follow-up of 37 months. Among 187 patients with long-standing persistent AF, 53 received optimized treatment, and a 91% AF-free rate was achieved at 1-year follow-up. In-hospital mortality occurred in 2 cases, attributable to intestinal infarction, and 1 late mortality resulted from massive intracranial hemorrhage. Major complications included 5 reoperations, 5 cases of severe unilateral pulmonary edema, and 4 cases of low cardiac output syndrome. CUSUM<sub>ACCtime</sub> and RA-CUSUM failure analyses in 130 patients demonstrated significant improvements in operative times and recovery across different learning curve phases.</div></div><div><h3>Conclusions</h3><div>Totally endoscopic surgery for RMVD, including optimized AF management, is safe and feasible. Mastery of isolated endoscopic mitral valve replacement requires 86 cases to optimize aortic crossclamp time and 60 cases to effectively manage perioperative complications.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"35 ","pages":"Article 102150"},"PeriodicalIF":1.9,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and efficacy of water jet technology for internal thoracic artery harvesting in coronary artery bypass grafting: Initial results 水射流技术在冠状动脉搭桥术中胸内动脉采集的安全性和有效性：初步结果

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-11-07 DOI: 10.1016/j.xjtc.2025.10.021

Yoshinori Nakahara MD , Akira Marui MD, PhD , Kohei Sumi MD , Ryogen Yun MD , Makoto Ono MD, PhD , Tomohiro Iwakura MD, PhD , Tatsuya Murai MD, PhD

Objective

To evaluate the safety and feasibility of water jet technology for internal thoracic artery (ITA) harvesting in coronary artery bypass grafting.

Methods

We retrospectively reviewed 5 consecutive patients who underwent coronary artery bypass grafting with ITA harvesting using water jet technology. ITAs were harvested using water jet technology at 10 bar pressure and anastomosed to the target coronary arteries. Primary end points included technical success rate, intraoperative flow measurements, and postoperative graft patency by computed tomography. Secondary end points included histologic evaluation of excess graft segments when available.

Results

Nine ITAs were successfully harvested in all 5 cases without complications. Mean harvest time was 29.7 ± 5.7 minutes, with excellent graft flow of 30.9 ± 13.1 mL/minutes. Postoperative computed tomography confirmed 100% graft patency (9/9 ITAs). Histologic examination of 6 ITAs with available excess segments revealed minimal tissue change with microhemorrhages and minimal perivascular coagulation, without thermal injury to medial or intimal layers.

Conclusions

Water jet technology demonstrates feasibility and safety for ITA harvesting with excellent clinical outcomes and minimal tissue trauma. This thermal-free approach may offer advantages over conventional energy-based harvesting methods.

目的评价水射流技术在冠状动脉搭桥术中采集胸内动脉的安全性和可行性。方法对连续5例采用水射流技术行ITA采集冠状动脉旁路移植术的患者进行回顾性分析。利用水射流技术在10 bar压力下获取ita，并将其与目标冠状动脉吻合。主要终点包括技术成功率、术中血流测量和术后计算机断层扫描的移植物通畅度。次要终点包括可用时多余移植物节段的组织学评估。结果5例患者均成功摘取9个肿瘤，无并发症发生。平均收获时间为29.7±5.7 min，移植物流量为30.9±13.1 mL/min。术后计算机断层扫描证实移植物100%通畅（9/9 ita）。6例有多余节段的ita的组织学检查显示，微小的组织变化，微出血和最小的血管周围凝血，没有对内侧或内膜的热损伤。结论水射流技术用于ITA采集具有可行性和安全性，临床效果好，组织损伤小。这种无热的方法可能比传统的基于能量的收集方法有优势。

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