Aortic stenosis with a small annulus recently has been more frequently managed with the posterior annular enlargement technique. However, the risk of a short valve-to-coronary distance of the right coronary artery may remain in patients with small sinus of Valsalva. This report presents the case of a patient with severe bicuspid aortic stenosis with a small annulus and a small sinus of Valsalva who was treated with the “Y and I” incision technique, including posterior annular enlargement using the Y-incision technique and anterior extended aortoplasty.
{"title":"Y Incision Plus Anterior Extended Aortoplasty for Aortic Stenosis With Small Annulus and Sinus of Valsalva: The “Y and I” Incision Technique","authors":"Tadashi Kitamura MD, PhD , Yusuke Motoji MD, PhD , Masaomi Fukuzumi MD, PhD , Toshiaki Mishima MD, PhD , Ryoichi Kondo MD, PhD , Yoshimi Tamura MD , Saya Ishikawa MD , Kagami Miyaji MD, PhD","doi":"10.1016/j.atssr.2025.04.013","DOIUrl":"10.1016/j.atssr.2025.04.013","url":null,"abstract":"<div><div>Aortic stenosis with a small annulus recently has been more frequently managed with the posterior annular enlargement technique. However, the risk of a short valve-to-coronary distance of the right coronary artery may remain in patients with small sinus of Valsalva. This report presents the case of a patient with severe bicuspid aortic stenosis with a small annulus and a small sinus of Valsalva who was treated with the “Y and I” incision technique, including posterior annular enlargement using the Y-incision technique and anterior extended aortoplasty.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1074-1076"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645952","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}
We present the case of a 79-year-old man with synchronous multiple primary lung cancers who underwent right upper and right lower bilobectomy. In the bilobectomy, the pedicled pericardial fat was fixed to the middle lobe hilum and sutured to the lower lobe bronchial stump. Polyglycolic acid sheets and fibrin glue were used to anatomically position and adhere the expanded middle lobe to the diaphragm. He recovered uneventfully. An examination 2 years later showed that he was well and had not experienced dyspnea or recurrence. Chest computed tomography revealed considerable expansion and emphysematous changes in the middle lobe, but his pulmonary function was well preserved.
{"title":"Postoperative Outcome of Procedure for Middle Lobe Torsion Involving Right Upper and Lower Bilobectomy in Multiple Primary Lung Cancers","authors":"Hiroki Watanabe MD , Shuhei Hakiri MD , Hiromu Yoshioka MD , Toyofumi Fengshi Chen-Yoshikawa MD","doi":"10.1016/j.atssr.2025.04.007","DOIUrl":"10.1016/j.atssr.2025.04.007","url":null,"abstract":"<div><div>We present the case of a 79-year-old man with synchronous multiple primary lung cancers who underwent right upper and right lower bilobectomy. In the bilobectomy, the pedicled pericardial fat was fixed to the middle lobe hilum and sutured to the lower lobe bronchial stump. Polyglycolic acid sheets and fibrin glue were used to anatomically position and adhere the expanded middle lobe to the diaphragm. He recovered uneventfully. An examination 2 years later showed that he was well and had not experienced dyspnea or recurrence. Chest computed tomography revealed considerable expansion and emphysematous changes in the middle lobe, but his pulmonary function was well preserved.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 875-878"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645978","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.04.023
John L. Wiegand MD , Zainab B. Ezzi MD , Maher N. Abadeer MD , James A. Quintessenza MD , Brandi B. Scully MD
Despite advances in surgical repair of tetralogy of Fallot, long-term complications such as pulmonary regurgitation occur frequently. We present a case of a 10-year-old boy who underwent transannular repair of tetralogy of Fallot at 6 months of age. Chronic severe pulmonary regurgitation necessitated late primary repair of his pulmonary valve with resection of the transannular patch, improving his right ventricular function. Postoperative recovery was uneventful. This case underscores the importance of high-resolution preoperative imaging in guiding surgical management and timely intervention for complications after repair and highlights an alternative strategy to minimize the need for repeated valve replacements.
{"title":"Late Repair of Native Pulmonary Valve for Severe Pulmonary Regurgitation After Transannular Patch Repair in Tetralogy of Fallot","authors":"John L. Wiegand MD , Zainab B. Ezzi MD , Maher N. Abadeer MD , James A. Quintessenza MD , Brandi B. Scully MD","doi":"10.1016/j.atssr.2025.04.023","DOIUrl":"10.1016/j.atssr.2025.04.023","url":null,"abstract":"<div><div>Despite advances in surgical repair of tetralogy of Fallot, long-term complications such as pulmonary regurgitation occur frequently. We present a case of a 10-year-old boy who underwent transannular repair of tetralogy of Fallot at 6 months of age. Chronic severe pulmonary regurgitation necessitated late primary repair of his pulmonary valve with resection of the transannular patch, improving his right ventricular function. Postoperative recovery was uneventful. This case underscores the importance of high-resolution preoperative imaging in guiding surgical management and timely intervention for complications after repair and highlights an alternative strategy to minimize the need for repeated valve replacements.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1090-1092"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646008","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.032
Asanish Kalyanasundaram MD , Lisa C. Harling MD , Mohammad A. Zafar MBBS , Hesham Ellauzi MB, BCh , Bulat A. Ziganshin MD, PhD , John A. Elefteriades MD
Background
The Laplace law is commonly applied to calculate aortic wall stress by using the luminal pressure and the aortic diameter. Wall stress bears on the likelihood of aortic dissection in dilated aortas. However, the Laplace law applies only to circles and cylinders. It is not applicable for the aortic root, which can be more closely described as a cloverleaf shape, rather than a circle. We have recently developed a mathematically based measuring technique specifically for the aortic root. This Laplacediameter provides an appropriate means to measure a “diameter” for the cloverleaf shape of the aortic root.
Methods
In this study, we assessed the predictive ability of the Laplace diameter vs the standard sinus-to-commissure measurement in 33 patients who underwent predissection computed tomographic scans for unrelated reasons in close temporal proximity to their acute aortic event. We analyzed 14 chest computed tomographic scans of 33 patients who received predissection scans for unrelated reasons.
Results
We observed a 16.1% increase in the mean root diameter using the Laplace diameter. We found that 21.4% of the analyzed predissection scans could have resulted in detection and prevention of the aortic dissection through surgery if the Laplace diameter had been applied.
Conclusions
We validated the novel method of the Laplace diameter clinically in determining the aortic root diameter and detecting the risk of aortic dissection.
{"title":"Novel Aortic Root Measurement Technique Using the Laplace Diameter for Identifying Patients at Risk for Type A Dissection","authors":"Asanish Kalyanasundaram MD , Lisa C. Harling MD , Mohammad A. Zafar MBBS , Hesham Ellauzi MB, BCh , Bulat A. Ziganshin MD, PhD , John A. Elefteriades MD","doi":"10.1016/j.atssr.2025.06.032","DOIUrl":"10.1016/j.atssr.2025.06.032","url":null,"abstract":"<div><h3>Background</h3><div>The Laplace law is commonly applied to calculate aortic wall stress by using the luminal pressure and the aortic diameter. Wall stress bears on the likelihood of aortic dissection in dilated aortas. However, the Laplace law applies only to circles and cylinders. It is not applicable for the aortic root, which can be more closely described as a cloverleaf shape, rather than a circle. We have recently developed a mathematically based measuring technique specifically for the aortic root. This <em>Laplace</em> <em>diameter</em> provides an appropriate means to measure a “diameter” for the cloverleaf shape of the aortic root.</div></div><div><h3>Methods</h3><div>In this study, we assessed the predictive ability of the Laplace diameter vs the standard sinus-to-commissure measurement in 33 patients who underwent predissection computed tomographic scans for unrelated reasons in close temporal proximity to their acute aortic event. We analyzed 14 chest computed tomographic scans of 33 patients who received predissection scans for unrelated reasons.</div></div><div><h3>Results</h3><div>We observed a 16.1% increase in the mean root diameter using the Laplace diameter. We found that 21.4% of the analyzed predissection scans could have resulted in detection and prevention of the aortic dissection through surgery if the Laplace diameter had been applied.</div></div><div><h3>Conclusions</h3><div>We validated the novel method of the Laplace diameter clinically in determining the aortic root diameter and detecting the risk of aortic dissection.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 962-966"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646019","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.012
Sophia R. Pyeatte MD , Maxwell C. Braasch MD, MPH , Cameran Jones BS , Theodore Marghitu BS , Kyle Stumbaugh EMTP , June He MBBS, MS , Alexander A. Brescia MD, MSc , Harold G. Roberts Jr MD , Nicholas Kouchoukos MD , Tsuyoshi Kaneko MD
Background
Valve guidelines recommend mitral valve transcatheter edge-to-edge repair (M-TEER) be offered at comprehensive valve centers along with complex mitral valve surgery (MVS). We evaluated mitral valve surgery (MVS) outcomes based on center availability of M-TEER on a national scale.
Methods
The National Readmissions Database was used to review adult patients who underwent MVS at centers with and without M-TEER from 2016 to 2020. Patients with a history of endocarditis or prosthetic valve dysfunction were excluded. The primary outcome was 30-day mortality. Multivariable logistic regression analysis was conducted to determine the effect of M-TEER availability on postoperative mortality.
Results
Of the 50,179 patients who underwent MVS from 2016 to 2020, 15,485 underwent MVS at a non–M-TEER hospital. During this period, the number of centers with M-TEER significantly increased from 2539 in 2016 to 6326 in 2020 (P < .05). The annual volume of M-TEER procedures performed significantly increased, whereas there was no significant change in the annual volume of MVS. Patients at non–M-TEER hospitals tended to be older, male, with higher rates of comorbidities and prior cardiac interventions (all P < .05). MVS 30-day mortality was significantly higher at non–M-TEER centers than at M-TEER centers (6.7% vs 5.0%, P < .001). Multivariable analysis showed non–M-TEER hospital status was independently associated with higher 30-day mortality (odds ratio 1.21; 95% CI 1.09-1.33) after MVS.
Conclusions
Centers with M-TEER have significantly lower 30-day mortality after MVS than centers without M-TEER. This study supports the concept of a comprehensive valve center in the treatment of mitral valve disease.
背景：瓣膜指南推荐在综合瓣膜中心和复杂的二尖瓣手术（MVS）一起进行二尖瓣经导管边缘到边缘修复（M-TEER）。我们根据全国范围内M-TEER的中心可用性评估二尖瓣手术（MVS）的结果。方法使用国家再入院数据库对2016年至2020年在有M-TEER和没有M-TEER的中心接受MVS的成年患者进行回顾性分析。排除有心内膜炎或人工瓣膜功能障碍病史的患者。主要终点为30天死亡率。采用多变量logistic回归分析确定M-TEER可用性对术后死亡率的影响。在2016年至2020年接受MVS的50179例患者中，15485例在非m - teer医院接受了MVS。在此期间，M-TEER中心数量从2016年的2539个显著增加到2020年的6326个（P < 0.05）。M-TEER手术的年量显著增加，而MVS的年量没有显著变化。非m - teer医院的患者往往年龄较大，男性，合并症和既往心脏干预率较高（均P <； 0.05）。非M-TEER中心的MVS 30天死亡率显著高于M-TEER中心（6.7% vs 5.0%, P < 0.001）。多变量分析显示，非m - teer医院状况与MVS后较高的30天死亡率独立相关（优势比1.21;95% CI 1.09-1.33）。结论M-TEER中心的MVS术后30天死亡率明显低于无M-TEER中心。本研究支持综合瓣膜中心治疗二尖瓣疾病的概念。
{"title":"National Trends in Mitral Valve Surgery Outcomes in Centers With and Without Mitral Transcatheter Edge-to-Edge Repair","authors":"Sophia R. Pyeatte MD , Maxwell C. Braasch MD, MPH , Cameran Jones BS , Theodore Marghitu BS , Kyle Stumbaugh EMTP , June He MBBS, MS , Alexander A. Brescia MD, MSc , Harold G. Roberts Jr MD , Nicholas Kouchoukos MD , Tsuyoshi Kaneko MD","doi":"10.1016/j.atssr.2025.06.012","DOIUrl":"10.1016/j.atssr.2025.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Valve guidelines recommend mitral valve transcatheter edge-to-edge repair (M-TEER) be offered at comprehensive valve centers along with complex mitral valve surgery (MVS). We evaluated mitral valve surgery (MVS) outcomes based on center availability of M-TEER on a national scale.</div></div><div><h3>Methods</h3><div>The National Readmissions Database was used to review adult patients who underwent MVS at centers with and without M-TEER from 2016 to 2020. Patients with a history of endocarditis or prosthetic valve dysfunction were excluded. The primary outcome was 30-day mortality. Multivariable logistic regression analysis was conducted to determine the effect of M-TEER availability on postoperative mortality.</div></div><div><h3>Results</h3><div>Of the 50,179 patients who underwent MVS from 2016 to 2020, 15,485 underwent MVS at a non–M-TEER hospital. During this period, the number of centers with M-TEER significantly increased from 2539 in 2016 to 6326 in 2020 (<em>P</em> < .05). The annual volume of M-TEER procedures performed significantly increased, whereas there was no significant change in the annual volume of MVS. Patients at non–M-TEER hospitals tended to be older, male, with higher rates of comorbidities and prior cardiac interventions (all <em>P</em> < .05). MVS 30-day mortality was significantly higher at non–M-TEER centers than at M-TEER centers (6.7% vs 5.0%, <em>P</em> < .001). Multivariable analysis showed non–M-TEER hospital status was independently associated with higher 30-day mortality (odds ratio 1.21; 95% CI 1.09-1.33) after MVS.</div></div><div><h3>Conclusions</h3><div>Centers with M-TEER have significantly lower 30-day mortality after MVS than centers without M-TEER. This study supports the concept of a comprehensive valve center in the treatment of mitral valve disease.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1023-1028"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646034","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}
We report a patient with a case of lung cancer invading the right brachiocephalic vein (BCV) and superior vena cava (SVC) that was managed with single prosthetic graft reconstruction. A 63-year-old patient with stage IIIA squamous cell carcinoma underwent right upper and middle lobectomy, rib resection, and vascular reconstruction after neoadjuvant chemoradiotherapy. The right BCV was clamped and transected, and the SVC was stapled obliquely at its bifurcation. A polytetrafluoroethylene graft was interposed from the right BCV to the right atrium, preserving SVC flow without cross-clamping. This technique minimized hemodynamic instability and reduced the risk of graft occlusion in tumors involving the upper SVC.
{"title":"Cross-Vascular Graft Reconstruction for Lung Cancer Involving the Upper Superior Vena Cava","authors":"Naru Kitade MD , Naoya Kitamura MD , Ryo Yokoyama MD , Toshihiro Ojima MD , Norimasa Miyoshi MD , Tomoshi Tsuchiya MD, PhD","doi":"10.1016/j.atssr.2025.05.012","DOIUrl":"10.1016/j.atssr.2025.05.012","url":null,"abstract":"<div><div>We report a patient with a case of lung cancer invading the right brachiocephalic vein (BCV) and superior vena cava (SVC) that was managed with single prosthetic graft reconstruction. A 63-year-old patient with stage IIIA squamous cell carcinoma underwent right upper and middle lobectomy, rib resection, and vascular reconstruction after neoadjuvant chemoradiotherapy. The right BCV was clamped and transected, and the SVC was stapled obliquely at its bifurcation. A polytetrafluoroethylene graft was interposed from the right BCV to the right atrium, preserving SVC flow without cross-clamping. This technique minimized hemodynamic instability and reduced the risk of graft occlusion in tumors involving the upper SVC.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 897-900"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646054","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.014
Ka Lam Jay Hung MBBS , Hong Yee Teddy Wong FRCSEd (CTS), FCSHK , Shuishen Zhang MD , Shun Chan FRCSEd (CTS), FCSHK , Kin Hoi Thung FRCSEd (CTS), FCSHK
A 32-year-old man was treated in our unit (Tuen Mun Hospital, Hong Kong, China), for a chest wall tumor. He had initially presented to another center because of right-sided chest pain. Computed tomography detected a chest wall mass with invasion to his ribs. He was given a diagnosis of immunoglobulin G4–related disease and was started on immunosuppression. The mass regressed, but his symptoms progressed. Open rib biopsy was performed at our center. Culture grew Salmonella group D, and a diagnosis of chronic osteomyelitis of the rib was made. He completed a course of antibiotics and currently follows up at our outpatient clinic and is symptom free.
{"title":"Salmonella Osteomyelitis of the Rib","authors":"Ka Lam Jay Hung MBBS , Hong Yee Teddy Wong FRCSEd (CTS), FCSHK , Shuishen Zhang MD , Shun Chan FRCSEd (CTS), FCSHK , Kin Hoi Thung FRCSEd (CTS), FCSHK","doi":"10.1016/j.atssr.2025.06.014","DOIUrl":"10.1016/j.atssr.2025.06.014","url":null,"abstract":"<div><div>A 32-year-old man was treated in our unit (Tuen Mun Hospital, Hong Kong, China), for a chest wall tumor. He had initially presented to another center because of right-sided chest pain. Computed tomography detected a chest wall mass with invasion to his ribs. He was given a diagnosis of immunoglobulin G4–related disease and was started on immunosuppression. The mass regressed, but his symptoms progressed. Open rib biopsy was performed at our center. Culture grew <em>Salmonella</em> group D, and a diagnosis of chronic osteomyelitis of the rib was made. He completed a course of antibiotics and currently follows up at our outpatient clinic and is symptom free.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 901-903"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646055","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.05.019
Jagdip Kang MD , Mateo Marin-Cuartas MD , Philipp Kiefer MD , Wolfgang Otto PhD , Sergey Leontiev MD , Alexey Dashkevich MD , Bettina Pfannmüller MD , David Holzhey MD , Friedrich W. Mohr MD , Michael A. Borger MD, PhD , Thilo Noack MD , Martin Misfeld MD, PhD
Background
Minimally invasive mitral valve repair (MVr) is a reproducible, widely adopted, and routinely performed surgical procedure. It is often performed in combination with tricuspid valve (TV) surgery. However, evidence on long-term results and their evolution over time is limited. This study evaluated whether outcomes of isolated minimally invasive MVr or minimally invasive MVr with concomitant TV surgery have improved over the last decades.
Methods
All patients undergoing minimally invasive MVr between 1996 and 2023 were included and split into 5 periods depending on the year of surgery (period 1, 1996-2001; period 2, 2002-2007; period 3, 2008-2013; period 4, 2014-2019; period 5, 2020-2023). The primary study outcome was 10-year survival during different periods. A subanalysis was performed for patients undergoing concomitant TV surgery.
Results
A total of 5559 patients with a median age of 59 years (interquartile range, 50–68 years) were included. Among them, 66.0% (n = 3217) of these patients were male, and 12.4% (n = 687) underwent combined MVr and TV surgery. The 30-day mortality steadily improved, ranging from 0.3% in period 5 to 1.1% in period 1. The 10-year estimated survival ranged from 68.1% in period 1 to 83.7% in period 4 (log-rank P < .0001). The estimated 1- and 10-year survival in patients with concomitant TV surgery steadily improved, with the lowest survival in period 1 (1-year, 62.3%; 10-year, 8.9%) and the highest survival in period 4 (1-year, 92.5%; 10-year, 62.7%).
Conclusions
Minimally invasive MVr surgery, isolated or in combination with TV surgery, is a safe and reproducible surgical approach with low complication rates, infrequent conversion to sternotomy, and excellent early and long-term survival.
{"title":"Evolution of Minimally Invasive Mitral Valve Repair: 30-Year Experience From a High-Volume Center","authors":"Jagdip Kang MD , Mateo Marin-Cuartas MD , Philipp Kiefer MD , Wolfgang Otto PhD , Sergey Leontiev MD , Alexey Dashkevich MD , Bettina Pfannmüller MD , David Holzhey MD , Friedrich W. Mohr MD , Michael A. Borger MD, PhD , Thilo Noack MD , Martin Misfeld MD, PhD","doi":"10.1016/j.atssr.2025.05.019","DOIUrl":"10.1016/j.atssr.2025.05.019","url":null,"abstract":"<div><h3>Background</h3><div>Minimally invasive mitral valve repair (MVr) is a reproducible, widely adopted, and routinely performed surgical procedure. It is often performed in combination with tricuspid valve (TV) surgery. However, evidence on long-term results and their evolution over time is limited. This study evaluated whether outcomes of isolated minimally invasive MVr or minimally invasive MVr with concomitant TV surgery have improved over the last decades.</div></div><div><h3>Methods</h3><div>All patients undergoing minimally invasive MVr between 1996 and 2023 were included and split into 5 periods depending on the year of surgery (period 1, 1996-2001; period 2, 2002-2007; period 3, 2008-2013; period 4, 2014-2019; period 5, 2020-2023). The primary study outcome was 10-year survival during different periods. A subanalysis was performed for patients undergoing concomitant TV surgery.</div></div><div><h3>Results</h3><div>A total of 5559 patients with a median age of 59 years (interquartile range, 50–68 years) were included. Among them, 66.0% (n = 3217) of these patients were male, and 12.4% (n = 687) underwent combined MVr and TV surgery. The 30-day mortality steadily improved, ranging from 0.3% in period 5 to 1.1% in period 1. The 10-year estimated survival ranged from 68.1% in period 1 to 83.7% in period 4 (log-rank <em>P</em> < .0001). The estimated 1- and 10-year survival in patients with concomitant TV surgery steadily improved, with the lowest survival in period 1 (1-year, 62.3%; 10-year, 8.9%) and the highest survival in period 4 (1-year, 92.5%; 10-year, 62.7%).</div></div><div><h3>Conclusions</h3><div>Minimally invasive MVr surgery, isolated or in combination with TV surgery, is a safe and reproducible surgical approach with low complication rates, infrequent conversion to sternotomy, and excellent early and long-term survival.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1040-1044"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645708","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}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.027
Gustavo Prieto MD , María Alejandra Gomez-Gutiérrez MD , Johiner Vanegas MD , Lorena Montes MD
Pulmonary artery pseudoaneurysms are rare, life-threatening conditions linked to trauma, infection, or congenital anomalies such as patent ductus arteriosus. A 40-year-old man with an untreated patent ductus arteriosus and endocarditis presented in mixed cardiogenic and septic shock. Imaging identified a large pseudoaneurysm, a restrictive patent ductus arteriosus, and severe aortic valve disease. He underwent successful open surgical repair with aortic valve replacement, ductus closure, and pseudoaneurysm resection using a pericardial patch. A surgical video documenting the procedure offers an educational resource for managing similar cases. This case emphasizes the importance of individualized surgical strategies and multidisciplinary care for optimizing outcomes in high-risk patients.
{"title":"Chronic Pulmonary Artery Pseudoaneurysm Associated With Patent Ductus Arteriosus and Endocarditis","authors":"Gustavo Prieto MD , María Alejandra Gomez-Gutiérrez MD , Johiner Vanegas MD , Lorena Montes MD","doi":"10.1016/j.atssr.2025.06.027","DOIUrl":"10.1016/j.atssr.2025.06.027","url":null,"abstract":"<div><div>Pulmonary artery pseudoaneurysms are rare, life-threatening conditions linked to trauma, infection, or congenital anomalies such as patent ductus arteriosus. A 40-year-old man with an untreated patent ductus arteriosus and endocarditis presented in mixed cardiogenic and septic shock. Imaging identified a large pseudoaneurysm, a restrictive patent ductus arteriosus, and severe aortic valve disease. He underwent successful open surgical repair with aortic valve replacement, ductus closure, and pseudoaneurysm resection using a pericardial patch. A surgical video documenting the procedure offers an educational resource for managing similar cases. This case emphasizes the importance of individualized surgical strategies and multidisciplinary care for optimizing outcomes in high-risk patients.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1056-1059"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645711","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}
Conventional aortotomy in aortic valve replacement (AVR) is transverse or oblique. However, traditional aortotomy is difficult in patients with a high takeoff right coronary artery. Studies have reported aortotomy techniques for AVR through sternotomy, but not through right anterior minithoracotomy. We report 6 patients who underwent AVR by means of right anterior minithoracotomy through a straight longitudinal aortotomy, which provided good aortic valve exposure and facilitated hemostasis. The procedure was successfully performed without major complications, with favorable postoperative outcomes. This technique may be a viable alternative to traditional aortotomy, thus offering improved surgical field visibility and ease of closure.
{"title":"Straight Longitudinal Aortotomy for Aortic Valve Replacement Through Right Anterior Minithoracotomy","authors":"Masaya Nakamizo MD , Naonori Kawamoto MD, PhD , Satoshi Kainuma MD, PhD , Kota Suzuki MD, PhD , Takashi Kakuta MD, PhD , Masaya Hirayama MD , Kohei Tonai MD , Satsuki Fukushima MD, PhD","doi":"10.1016/j.atssr.2025.05.011","DOIUrl":"10.1016/j.atssr.2025.05.011","url":null,"abstract":"<div><div>Conventional aortotomy in aortic valve replacement (AVR) is transverse or oblique. However, traditional aortotomy is difficult in patients with a high takeoff right coronary artery. Studies have reported aortotomy techniques for AVR through sternotomy, but not through right anterior minithoracotomy. We report 6 patients who underwent AVR by means of right anterior minithoracotomy through a straight longitudinal aortotomy, which provided good aortic valve exposure and facilitated hemostasis. The procedure was successfully performed without major complications, with favorable postoperative outcomes. This technique may be a viable alternative to traditional aortotomy, thus offering improved surgical field visibility and ease of closure.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1064-1066"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645713","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}
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