JTCVS Techniques最新文献

英文中文

The weeping graft: Severe fluid loss from a polytetrafluoroethylene graft in a patient with congenital cardiac disease with a single-ventricle assist device 哭泣移植物：先天性心脏病患者单心室辅助装置的聚四氟乙烯移植物严重液体流失

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-04 DOI: 10.1016/j.xjtc.2025.08.029

Stephan J. Wu MD , Abhay Divekar MD, FPCIS , Ryan R. Davies MD

引用次数: 0

Reintervention for recurrence of mitral valve regurgitation: Transventricular beating heart neochordae implantation versus on-pump surgery 二尖瓣返流复发的再干预：经心室跳动心脏新索植入与无泵手术

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-02 DOI: 10.1016/j.xjtc.2025.09.020

Cristina Barbero MD, PhD , Alessandro Vairo MD , Matteo Marro MD , Claudia Filippini PhD , Cecilia Capozza MD , Giulia Agostini MD , Marco Pocar MD , Mauro Rinaldi MD , Stefano Salizzoni MD, PhD

Objective

Recurrence of mitral valve regurgitation after prior repair remains a challenge, even in experienced centers. Reoperation is associated with increased morbidity and mortality risks, prompting the exploration of less-invasive alternatives. This study aimed to compare outcomes in patients with failed mitral valve repair undergoing on-pump surgery versus micro-invasive re-repair surgery using neochordae (the NeoChord system).

Methods

Thirty-seven patients were retrospectively enrolled; 22 patients underwent on-pump surgery, and 15 patients underwent NeoChord repair. All patients had recurrent mitral valve prolapse after prior annuloplasty. The primary end point was freedom from a composite event, defined as mitral valve reoperation or the presence of moderate-or-severe mitral regurgitation at 1 year. All patients provided informed written consent for the publication of their data.

Results

Baseline characteristics, including mean age (63.9 ± 8.5 vs 67.5 ± 7.8 years, P = .210), female gender (27.3% vs 26.7%, P > .99), left ventricular ejection fraction (57.6% ± 8.2% vs 58.7% ± 4.3%, P = .574), and European System for Cardiac Operative Risk Evaluation II (4.3% ± 2.9% vs 3.4% ± 1.4%, P = .632), were comparable between the 2 groups. In the on-pump surgery group, 40.9% of surgeries were performed via sternotomy, and 54.5% required mitral valve replacement. All NeoChord procedures were successfully performed via left minithoracotomy. Operative time was significantly longer for on-pump surgery (310.2 ± 79.2 vs 146.1 ± 30.7 minutes, P < .0001). There were no 30-day mortalities. One patient in the on-pump surgery group experienced a disabling stroke, and 1 patient in each group required reexploration for bleeding. Blood transfusion requirements were significantly higher with on-pump surgery (1.5 ± 2.1 vs 0.1 ± 0.5 units, P = .012). Patients undergoing NeoChord procedure had significantly shorter ventilation times (12 vs 3 hours, P < .0001) and hospital length-of-stay (6 vs 4 days, P < .0001). Follow-up echocardiographic findings and cardiovascular readmissions were comparable between the 2 groups.

Conclusions

In patients with recurrent prolapse after mitral valve repair, NeoChord re-repair offers comparable 1-year outcomes to on-pump surgery, with significantly faster recovery and reduced transfusion needs.

目的即使在经验丰富的中心，二尖瓣修复后返流的复发仍然是一个挑战。再手术与发病率和死亡率增加有关，促使人们探索微创替代方法。本研究的目的是比较二尖瓣修复失败的患者进行非泵手术和使用新索（NeoChord系统）微创再修复手术的结果。方法回顾性纳入37例患者；22名患者接受了泵上手术，15名患者接受了新脐带修复。所有患者在先前的二尖瓣成形术后复发二尖瓣脱垂。主要终点是1年内没有二尖瓣再手术或出现中度或重度二尖瓣反流的复合事件。所有患者都对其数据的发表提供了知情的书面同意。结果两组患者的基线特征，包括平均年龄（63.9±8.5岁vs 67.5±7.8岁，P = 0.210）、女性（27.3% vs 26.7%, P > 0.99）、左室射血分数（57.6%±8.2% vs 58.7%±4.3%,P = 0.574）和欧洲心脏手术风险评估系统II(4.3%±2.9% vs 3.4%±1.4%,P = 0.632)，具有可比性。在无泵手术组中，40.9%的手术通过胸骨切开术进行，54.5%的手术需要二尖瓣置换术。所有NeoChord手术均通过左侧小开胸成功完成。无泵手术的手术时间明显更长（310.2±79.2 vs 146.1±30.7分钟，P < 0.0001）。没有30天死亡率。非泵手术组有1例患者发生致残性卒中，每组有1例患者因出血需要重新探查。无泵手术的输血需要量明显高于无泵手术（1.5±2.1 vs 0.1±0.5单位，P = 0.012）。接受NeoChord手术的患者通气时间（12小时vs 3小时，P < 0.0001）和住院时间（6天vs 4天，P < 0.0001）显著缩短。两组随访超声心动图结果和心血管再入院率具有可比性。结论：在二尖瓣修复术后复发性脱垂患者中，NeoChord再修复术与无泵手术相比具有相当的1年预后，恢复速度明显更快，输血需求减少。

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引用次数: 0

Double expansible ring annuloplasty for a dynamic Ross procedure 双伸缩环成形术的动态罗斯程序

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-02 DOI: 10.1016/j.xjtc.2025.09.018

Claudia Côté MD, MHA, FRCSC , Luigi Garufi MD , Pavel Zacek MD , Margaux Bernardini MD , Pascal Leprince MD, PhD , Emmanuel Lansac MD, PhD , Pichoy Danial MD

引用次数: 0

Totally 3-dimensional endoscopic aortic valve replacement for situs inversus totalis using a 2-window port configuration 全三维内窥镜主动脉瓣置换术，采用双窗口配置

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-02 DOI: 10.1016/j.xjtc.2025.09.019

Akitoshi Yamada MD, PhD, Chihiro Okubo MD, Ryo Tohma MD, Hidekazu Nakai MD, PhD, Yoshihisa Morimoto MD, PhD, Kunio Gan MD, PhD, Tatsuro Asada MD, PhD

引用次数: 0

Autogenous paneled femoral vein grafts for mycotic thoracic aortic aneurysms 自体股静脉移植治疗真菌性胸主动脉瘤

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.008

Ningzhi Gu MD , Eimaan Shergill , D. Kirk Lawlor MD, MSc , Michael Janusz MD , Jong Moo Kim MD, MHSc , Joel Price MD, MPH , Jason Faulds MD, MHSc

Objective

Mycotic thoracic aortic aneurysms (MTAAs) are rare. The most common management has been aortic resection, wide debridement, and in-line reconstruction using prosthetic grafts. We have used autogenous femoral vein (FV) for the repair of all MTAA in our institution since 2017. This is the initial description of this technique, and the first comparative study of autogenous vein compared with prosthetic for MTAAs.

Methods

This is a single-center retrospective cohort study of all patients with MTAA who underwent operative repair. Patients were assigned to the FV or prosthetic grafts cohorts. Perioperative and long-term outcomes were collected. Univariate logistic regression models were fitted to quantify the strength of differences between the cohorts.

Results

Nineteen patients were included. The first 9 consecutive patients had prosthetic grafts, whereas the 10 subsequent patients were treated with FV grafts. Patients in the FV cohort were more likely to have positive intraoperative cultures (90% vs 33.3%; P = .02), receive intraoperative transfusions (10 vs 8 units; P = .08), and have a longer operation (629 vs 500 minutes; P = .07). There was a trend toward improved in-hospital (0 vs 33%; P = .09) and long-term mortality (10% vs 55.6%; P = .57) in the FV cohort. Patients in the FV cohort were more likely to be discharged home (90% vs 44.4%; P = .05).

Conclusions

Paneled autogenous FV repair is a durable and safe treatment for patients with MTAA. There were no in-hospital deaths in our series and there have been no long-term complications related to the vein graft repair.

目的：真菌性胸主动脉瘤（MTAAs）是一种罕见的疾病。最常见的治疗方法是主动脉切除术、广泛清创和使用假体移植物进行在线重建。自2017年以来，我们一直使用自体股静脉（FV）修复我院所有MTAA。这是对该技术的初步描述，也是首次将自体静脉与假体进行MTAAs的比较研究。方法：本研究为单中心回顾性队列研究，纳入所有行手术修复的MTAA患者。患者被分配到FV组或假体移植物组。收集围手术期和远期结果。拟合单变量logistic回归模型来量化队列之间差异的强度。结果共纳入19例患者。前9例患者连续接受假体移植，随后10例患者接受FV移植。FV组患者术中培养阳性（90% vs 33.3%, P = 0.02），术中输血（10 vs 8单位，P = 0.08），手术时间较长（629 vs 500分钟，P = 0.07）。在FV队列中，住院死亡率（0比33%，P = 0.09）和长期死亡率（10%比55.6%,P = 0.57）均有改善的趋势。FV组患者出院回家的可能性更大（90% vs 44.4%; P = 0.05）。结论自体FV修复是一种持久、安全的治疗MTAA的方法。在我们的研究中没有住院死亡病例，也没有与静脉移植修复相关的长期并发症。

{"title":"Autogenous paneled femoral vein grafts for mycotic thoracic aortic aneurysms","authors":"Ningzhi Gu MD , Eimaan Shergill , D. Kirk Lawlor MD, MSc , Michael Janusz MD , Jong Moo Kim MD, MHSc , Joel Price MD, MPH , Jason Faulds MD, MHSc","doi":"10.1016/j.xjtc.2025.07.008","DOIUrl":"10.1016/j.xjtc.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>Mycotic thoracic aortic aneurysms (MTAAs) are rare. The most common management has been aortic resection, wide debridement, and in-line reconstruction using prosthetic grafts. We have used autogenous femoral vein (FV) for the repair of all MTAA in our institution since 2017. This is the initial description of this technique, and the first comparative study of autogenous vein compared with prosthetic for MTAAs.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective cohort study of all patients with MTAA who underwent operative repair. Patients were assigned to the FV or prosthetic grafts cohorts. Perioperative and long-term outcomes were collected. Univariate logistic regression models were fitted to quantify the strength of differences between the cohorts.</div></div><div><h3>Results</h3><div>Nineteen patients were included. The first 9 consecutive patients had prosthetic grafts, whereas the 10 subsequent patients were treated with FV grafts. Patients in the FV cohort were more likely to have positive intraoperative cultures (90% vs 33.3%; <em>P</em> = .02), receive intraoperative transfusions (10 vs 8 units; <em>P</em> = .08), and have a longer operation (629 vs 500 minutes; <em>P</em> = .07). There was a trend toward improved in-hospital (0 vs 33%; <em>P</em> = .09) and long-term mortality (10% vs 55.6%; <em>P</em> = .57) in the FV cohort. Patients in the FV cohort were more likely to be discharged home (90% vs 44.4%; <em>P</em> = .05).</div></div><div><h3>Conclusions</h3><div>Paneled autogenous FV repair is a durable and safe treatment for patients with MTAA. There were no in-hospital deaths in our series and there have been no long-term complications related to the vein graft repair.</div></div>","PeriodicalId":53413,"journal":{"name":"JTCVS Techniques","volume":"33 ","pages":"Pages 21-26"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189887","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

Should minimally invasive surgery be the standard approach for early-stage thymoma? A 20-year experience 微创手术应该是早期胸腺瘤的标准治疗方法吗？20年的经验

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.06.007

Oliver J. Harrison MD , Kay See Tan PhD , Joseph Dycoco BA , Katherine Gray MD , Smita Sihag MD , Daniela Molena MD , Matthew Bott MD , Gaetano Rocco MD , James Isbell MD , Prasad Adusumilli MD , David Jones MD , James Huang MD , Valerie Rusch MD , Manjit Bains MD , Bernard Park MD

Background

Minimally invasive surgery (MIS) has become the prevailing technique for resecting early-stage thymoma; however, studies evaluating the oncologic impact of this evolution are lacking. This study aimed to characterize the transition from open surgery to MIS and to evaluate outcomes.

Methods

This was a retrospective, single-institution review of resections performed for pathologic TNM stage I-II thymomas between January 2000 and September 2023. The relationships between factors and recurrence were quantified using competing risk regression before and after applying overlap propensity score weights.

Results

A total of 296 patients were identified, including 118 who underwent open surgery and 178 who underwent MIS (25 with video-assisted thoracic surgery and 153 with robotic-assisted thoracic surgery). Open surgery composed the vast majority of cases (92.3%) performed between 2000 and 2009, compared to 26.7% between 2010 and 2023 (P < .0001). Median blood loss (125 mL vs 25 mL; P < .0001), tumor dimension (6.5 cm vs 4.1 cm; P < .0001), rate of major complications (35% vs 16%; P = .003), and length of stay (LOS; 4 days vs 2 days; P < .0001) were significantly greater in the open surgery cohort. Eighteen patients developed recurrence (open, n = 12; MIS, n = 6). Univariable analyses revealed that World Health Organization class (P < .001), higher TNM (P = .043) and Masaoka-Koga stage (P = .017), and R1/R2 resection (P < .001) were associated with a greater risk of recurrence. Overlap propensity score weighting revealed a cumulative incidence of recurrence at 5 years of 5.1% (95% confidence interval [CI], 0.97%-9.2%) for open surgery (n = 47) compared to 7.1% (95% CI, 2.0%-12.9%) for MIS (n = 47), a non-statistically significant difference.

Conclusions

MIS has become the principal approach for resecting early-stage thymoma over the last 2 decades. MIS is associated with a lower complication rate and shorter LOS but may be associated with a higher risk of recurrence in certain situations. Larger studies to evaluate the appropriate role of MIS are warranted.

背景：微创手术（MIS）已成为早期胸腺瘤切除术的主流技术；然而，缺乏评估这种进化对肿瘤影响的研究。本研究旨在描述从开放手术到MIS的转变，并评估结果。方法：本研究是对2000年1月至2023年9月间病理性TNM I-II期胸腺瘤手术的回顾性、单机构综述。运用重叠倾向评分权重前后的竞争风险回归，量化各因素与复发之间的关系。结果共发现296例患者，其中开放手术118例，MIS手术178例（视频胸外科25例，机器人胸外科153例）。2000年至2009年期间进行的开放手术占绝大多数（92.3%），而2010年至2023年期间为26.7% （P < .0001）。中位失血量（125 mL vs 25 mL; P < 0.0001）、肿瘤尺寸（6.5 cm vs 4.1 cm; P < 0.0001）、主要并发症发生率（35% vs 16%; P = 0.003）和住院时间（LOS； 4天vs 2天；P < 0.0001）在开放手术组中显著高于开放手术组。18例复发（open, n = 12； MIS, n = 6）。单变量分析显示，世界卫生组织分级（P < .001）、较高的TNM （P = .043）和Masaoka-Koga分期（P = .017）以及R1/R2切除（P < .001）与较高的复发风险相关。重叠倾向评分加权显示，开放手术（n = 47）的5年累积复发率为5.1%(95%可信区间[CI]， 0.97%-9.2%)，而MIS （n = 47）的5年累积复发率为7.1% (95% CI, 2.0%-12.9%)，差异无统计学意义。结论近20年来，smis已成为切除早期胸腺瘤的主要方法。MIS与较低的并发症发生率和较短的LOS相关，但在某些情况下可能与较高的复发风险相关。有必要进行更大规模的研究，以评估信息管理系统的适当作用。

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引用次数: 0

First comprehensive case report of surgical resection of a cardiac Merkel cell carcinoma metastasis 心脏梅克尔细胞癌转移手术切除首例综合病例报告

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.011

Christian Burgard MD , Willem Hendrik te Gussinklo MD , Thomas Ritz MD , Sameer Al-Maisary MD

引用次数: 0

A case of descending aortic rupture and aortoesophageal fistula secondary to fish bone–induced esophageal perforation 鱼骨致食管穿孔继发降主动脉破裂及主动脉食管瘘1例

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.016

Masashi Bungo MD, Ken-ichi Watanabe MD, PhD, Yoshio Teshima MD, Yuji Sakashita MD, Hisashi Uemura MD, PhD, Hiroe Tanaka MD, PhD, Mitsuhiro Yamamura MD, PhD, Taichi Sakaguchi MD, PhD

引用次数: 0

Innovative triple-directional robotic extended thymectomy using the rotatable patient cart of a robot-assisted thoracic surgical system 创新的三方向机器人扩展胸腺切除术使用机器人辅助胸外科系统的可旋转病人车

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.07.003

Shota Nakamura MD, PhD, Keita Nakanishi MD, Yuka Kadomatsu MD, PhD, Harushi Ueno MD, Taketo Kato MD, PhD, Tetsuya Mizuno MD, PhD, Toyofumi F. Chen-Yoshikawa MD, PhD

引用次数: 0

Robot-assisted anatomical lung resection with a modular robotic system: Preliminary experience from a single-arm, prospective trial 模块化机器人系统的机器人辅助解剖肺切除术：单臂前瞻性试验的初步经验

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

JTCVS Techniques

Pub Date : 2025-10-01 DOI: 10.1016/j.xjtc.2025.05.027

Yajie Zhang MD, PhD , Tianzheng Shen MD , Yichao Han MD, PhD , Yuqin Cao MD , Hecheng Li MD, PhD, FACS

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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JTCVS Techniques

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