June Yeop Lee, Hyoung Woo Chang, Sang Yoon Kim, Joon Chul Jung, Jae Hang Lee, Sanghon Park, Jun Sung Kim, Kay-Hyun Park
Objectives: In February 2024, a nationwide resident resignation occurred in South Korea that persisted for more than one and a half years and caused unprecedented disruptions in teaching hospitals. This study evaluated the clinical and socioeconomic impact of resident absence on cardiovascular surgery at a tertiary teaching hospital.
Methods: We retrospectively reviewed 681 patients who underwent open-heart or aortic surgery between February 20 and November 30, 2023 (before resident absence) and in 2024 (resident absence). Each year was divided into three periods (Q1, Q2, and Q3) for temporal comparison. The primary outcomes were 30-day mortality, failure-to-rescue complications and failure-to-rescue. Failure-to-rescue was defined as in-hospital mortality after more than one of the following failure-to-rescue complications: acute renal failure, respiratory complications (prolonged ventilation >24 hours, pneumonia or tracheostomy), stroke, reoperation, life-threatening arrhythmia, postoperative myocardial infarction or culture-positive sepsis. Multivariable logistic regression was performed to identify independent risk factors.
Results: When comparing 2023 Q1 with 2024 Q1, surgical volume decreased from 154 to 65 cases (-58%) and did not return to 2023 Q1 baseline. Compared with the 2023 group, the median surgical waiting time of the 2024 group increased from 17[IQR: 8-28] to 36[IQR: 20-58] days (p < 0.001). Resident absence was not a risk factor for 30-day mortality but was an independent risk factor for both failure-to-rescue complications (OR 1.50, 95% CI 1.03-2.19, p = 0.035) and failure-to-rescue (OR 3.64, 95% CI 1.33-9.98, p = 0.012).
Conclusions: The nationwide resignation of residents revealed the structural vulnerability of South Korea's healthcare system, which relies heavily on residents' workforce. Surgical capacity decreased, waiting times increased, and rescue outcomes deteriorated. The resident-dependent healthcare system requires reform, with teaching hospitals treating residents primarily as trainees rather than as inexpensive labour.
{"title":"Impact of Residents' Mass Resignation in Cardiovascular Surgery: A System Sustainability Perspective.","authors":"June Yeop Lee, Hyoung Woo Chang, Sang Yoon Kim, Joon Chul Jung, Jae Hang Lee, Sanghon Park, Jun Sung Kim, Kay-Hyun Park","doi":"10.1093/icvts/ivag037","DOIUrl":"https://doi.org/10.1093/icvts/ivag037","url":null,"abstract":"<p><strong>Objectives: </strong>In February 2024, a nationwide resident resignation occurred in South Korea that persisted for more than one and a half years and caused unprecedented disruptions in teaching hospitals. This study evaluated the clinical and socioeconomic impact of resident absence on cardiovascular surgery at a tertiary teaching hospital.</p><p><strong>Methods: </strong>We retrospectively reviewed 681 patients who underwent open-heart or aortic surgery between February 20 and November 30, 2023 (before resident absence) and in 2024 (resident absence). Each year was divided into three periods (Q1, Q2, and Q3) for temporal comparison. The primary outcomes were 30-day mortality, failure-to-rescue complications and failure-to-rescue. Failure-to-rescue was defined as in-hospital mortality after more than one of the following failure-to-rescue complications: acute renal failure, respiratory complications (prolonged ventilation >24 hours, pneumonia or tracheostomy), stroke, reoperation, life-threatening arrhythmia, postoperative myocardial infarction or culture-positive sepsis. Multivariable logistic regression was performed to identify independent risk factors.</p><p><strong>Results: </strong>When comparing 2023 Q1 with 2024 Q1, surgical volume decreased from 154 to 65 cases (-58%) and did not return to 2023 Q1 baseline. Compared with the 2023 group, the median surgical waiting time of the 2024 group increased from 17[IQR: 8-28] to 36[IQR: 20-58] days (p < 0.001). Resident absence was not a risk factor for 30-day mortality but was an independent risk factor for both failure-to-rescue complications (OR 1.50, 95% CI 1.03-2.19, p = 0.035) and failure-to-rescue (OR 3.64, 95% CI 1.33-9.98, p = 0.012).</p><p><strong>Conclusions: </strong>The nationwide resignation of residents revealed the structural vulnerability of South Korea's healthcare system, which relies heavily on residents' workforce. Surgical capacity decreased, waiting times increased, and rescue outcomes deteriorated. The resident-dependent healthcare system requires reform, with teaching hospitals treating residents primarily as trainees rather than as inexpensive labour.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133764","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}
You Kyeong Park, Hyoung Woo Chang, Kay-Hyun Park, Joon Chul Jung, Jae Hang Lee, Jun Sung Kim
Objectives: For surgical repair of acute type I aortic dissection, total arch replacement (TAR) with a frozen elephant trunk (FET) has been known to result in better long-term remodelling of a residual false lumen. This study was designed to investigate the impact of the elephant trunk by comparing long-term remodelling features among different extents and strategies of aortic replacement.
Methods: We conducted a single-centre retrospective analysis of patients who underwent surgical repair for acute type I aortic dissection from January 2004 to June 2022. Patients were categorized based on the surgical strategy employed: non-TAR, conventional TAR, TAR with a classic elephant trunk (CET) and TAR-FET. The primary outcomes were positive remodelling of the residual false lumen and composite aortic events, with secondary outcomes focusing on early postoperative results.
Results: A total of 327 patients were included. TAR, when combined with the insertion of an ET, whether it was stented or not, significantly promoted favourable aortic remodelling (P < .001). Compared with TAR-CET, the FET group tended towards faster false lumen thrombosis and regression, albeit without a significant difference in ultimate remodelling rates; 1-year and 5-year rates of proximal descending false lumen thrombosis were 85.4% (95% confidence interval [CI], 69.2-100) and 90.3% (95% CI, 75.9-100), respectively, after TAR-FET; additionally, these aforementioned rates were 65.7% (95% CI, 54.7-76.6) and 81.9% (95% CI, 71.8-91.9), respectively, after TAR-CET. No significant differences were observed in early postoperative outcomes or overall survival.
Conclusions: The favourable remodelling of the residual false lumen after TAR-FET shown in this study is in line with results from previous studies. CET might be a reasonable alternative to FET according to the individual patient risk profiles and institutional logistics situation.
{"title":"Impact of the Elephant Trunk on Distal Remodelling After Surgery for Acute Type I Aortic Dissection.","authors":"You Kyeong Park, Hyoung Woo Chang, Kay-Hyun Park, Joon Chul Jung, Jae Hang Lee, Jun Sung Kim","doi":"10.1093/icvts/ivag023","DOIUrl":"10.1093/icvts/ivag023","url":null,"abstract":"<p><strong>Objectives: </strong>For surgical repair of acute type I aortic dissection, total arch replacement (TAR) with a frozen elephant trunk (FET) has been known to result in better long-term remodelling of a residual false lumen. This study was designed to investigate the impact of the elephant trunk by comparing long-term remodelling features among different extents and strategies of aortic replacement.</p><p><strong>Methods: </strong>We conducted a single-centre retrospective analysis of patients who underwent surgical repair for acute type I aortic dissection from January 2004 to June 2022. Patients were categorized based on the surgical strategy employed: non-TAR, conventional TAR, TAR with a classic elephant trunk (CET) and TAR-FET. The primary outcomes were positive remodelling of the residual false lumen and composite aortic events, with secondary outcomes focusing on early postoperative results.</p><p><strong>Results: </strong>A total of 327 patients were included. TAR, when combined with the insertion of an ET, whether it was stented or not, significantly promoted favourable aortic remodelling (P < .001). Compared with TAR-CET, the FET group tended towards faster false lumen thrombosis and regression, albeit without a significant difference in ultimate remodelling rates; 1-year and 5-year rates of proximal descending false lumen thrombosis were 85.4% (95% confidence interval [CI], 69.2-100) and 90.3% (95% CI, 75.9-100), respectively, after TAR-FET; additionally, these aforementioned rates were 65.7% (95% CI, 54.7-76.6) and 81.9% (95% CI, 71.8-91.9), respectively, after TAR-CET. No significant differences were observed in early postoperative outcomes or overall survival.</p><p><strong>Conclusions: </strong>The favourable remodelling of the residual false lumen after TAR-FET shown in this study is in line with results from previous studies. CET might be a reasonable alternative to FET according to the individual patient risk profiles and institutional logistics situation.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Tjon Joek Tjien, Kinsing Ko, Samuel Heuts, Saskia Houterman, Maaike Roefs, Sjoerd Bouwmeester, Pim Tonino, Sandeep Singh, Robert Storm van Leeuwen, Jos Maessen, Peyman Sardari Nia, Niels Verberkmoes, Jules Olsthoorn
Objectives: Older patients are more prone to postoperative morbidity and mortality after mitral valve (MV) surgery. Minimally invasive MV surgery (MIMVS) is increasingly adopted worldwide, with a potential benefit in the elderly. This study compares short-term and mid-term outcomes in patients above 70 years, undergoing MIMVS versus median sternotomy (MST), in a nationwide registry.
Methods: All patients above 70 years undergoing primary elective MV surgery (±tricuspid valve [TV] surgery, atrial septal defect closure, rhythm surgery) between 2013 and 2021 were included. All data were extracted from the Netherlands Heart Registration. Primary outcomes were short-term morbidity, mortality, and 5-year survival.
Results: In total, 1418 patients were included (MST n = 797, MIMVS n = 621). No statistically significant differences in baseline characteristics were found. Median Logistic EuroSCORE I was 6.3 [4.7-8.5] vs 6.0 [4.6-8.5], P = .27 for MST and MIMVS, respectively. Mitral valve repair (77.7% vs 64.7% P < .001) and concomitant TV surgery (43.9% vs 18.2%, P < .001) was more frequently performed in MST. Lower 30-day mortality was observed in MIMVS (0.6% [n = 4] vs 2.5% [n = 21], P = .01). Furthermore, the incidence of pneumonia, prolonged intubation, readmission to intensive care unit, kidney failure, and new-onset arrhythmia were lower for MIMVS. No difference in 5-year survival was found (MST: 89.1 ± 4.6% vs MIMVS: 91.6 ± 4.7% Log-Rank P = .51).
Conclusions: Minimally invasive MV surgery in patients above 70 years may be associated with lower 30-day mortality and incidence of postoperative complications compared with sternotomy.
目的:老年患者在二尖瓣(MV)手术后更容易出现术后发病率和死亡率。微创MV手术(MIMVS)在世界范围内越来越多地被采用,在老年人中具有潜在的益处。这项研究比较了70岁以上患者在全国范围内接受MIMVS和中位胸骨切开术(MST)的短期和中期结果。方法:纳入2013年至2021年间所有70岁以上接受初级选择性MV手术(±三尖瓣[TV]手术、房间隔缺损闭合、心律失常手术)的患者。所有数据均来自荷兰心脏登记。主要结局是短期发病率、死亡率和5年生存率。结果:共纳入1418例患者(MST n = 797, MIMVS n = 621)。在基线特征方面没有发现统计学上的显著差异。Logistic Logistic EuroSCORE I中位数为6.3 [4.7-8.5]vs 6.0 [4.6-8.5], P =。MST和MIMVS分别为27。结论:与胸骨切开术相比,微创二尖瓣手术治疗70岁以上患者的30天死亡率和术后并发症发生率较低。
{"title":"Minimally Invasive Mitral Valve Surgery Compared to Sternotomy in Patients Over 70 Years Old: A Retrospective Nationwide Multicentre Study in The Netherlands.","authors":"Andrew Tjon Joek Tjien, Kinsing Ko, Samuel Heuts, Saskia Houterman, Maaike Roefs, Sjoerd Bouwmeester, Pim Tonino, Sandeep Singh, Robert Storm van Leeuwen, Jos Maessen, Peyman Sardari Nia, Niels Verberkmoes, Jules Olsthoorn","doi":"10.1093/icvts/ivag026","DOIUrl":"10.1093/icvts/ivag026","url":null,"abstract":"<p><strong>Objectives: </strong>Older patients are more prone to postoperative morbidity and mortality after mitral valve (MV) surgery. Minimally invasive MV surgery (MIMVS) is increasingly adopted worldwide, with a potential benefit in the elderly. This study compares short-term and mid-term outcomes in patients above 70 years, undergoing MIMVS versus median sternotomy (MST), in a nationwide registry.</p><p><strong>Methods: </strong>All patients above 70 years undergoing primary elective MV surgery (±tricuspid valve [TV] surgery, atrial septal defect closure, rhythm surgery) between 2013 and 2021 were included. All data were extracted from the Netherlands Heart Registration. Primary outcomes were short-term morbidity, mortality, and 5-year survival.</p><p><strong>Results: </strong>In total, 1418 patients were included (MST n = 797, MIMVS n = 621). No statistically significant differences in baseline characteristics were found. Median Logistic EuroSCORE I was 6.3 [4.7-8.5] vs 6.0 [4.6-8.5], P = .27 for MST and MIMVS, respectively. Mitral valve repair (77.7% vs 64.7% P < .001) and concomitant TV surgery (43.9% vs 18.2%, P < .001) was more frequently performed in MST. Lower 30-day mortality was observed in MIMVS (0.6% [n = 4] vs 2.5% [n = 21], P = .01). Furthermore, the incidence of pneumonia, prolonged intubation, readmission to intensive care unit, kidney failure, and new-onset arrhythmia were lower for MIMVS. No difference in 5-year survival was found (MST: 89.1 ± 4.6% vs MIMVS: 91.6 ± 4.7% Log-Rank P = .51).</p><p><strong>Conclusions: </strong>Minimally invasive MV surgery in patients above 70 years may be associated with lower 30-day mortality and incidence of postoperative complications compared with sternotomy.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert Pruna-Guillen, Thanakorn Rojanathagoon, Aung Oo, Ana Lopez-Marco
{"title":"Reply to Katkuri et al.","authors":"Robert Pruna-Guillen, Thanakorn Rojanathagoon, Aung Oo, Ana Lopez-Marco","doi":"10.1093/icvts/ivag015","DOIUrl":"10.1093/icvts/ivag015","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Neoadjuvant therapy (NAT) significantly improves the pathologic complete response (pCR) rates in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Emerging evidence suggests that patients with pCR may experience favourable outcomes and could be considered for active surveillance strategies to delay surgery. This study aims to develop a clinical-radiomics model to predict pCR after NAT in ESCC.
Methods: We retrospectively enrolled 236 patients with locally advanced ESCC who received NAT at our centre and randomly assigned them to training and test cohorts (3:2 ratio). Radiomics features were extracted from tumour regions segmented on post-NAT contrast-enhanced computed tomography (CT) scans. After feature selection, a predictive model integrating radiomics and clinical variables was developed using logistic regression and visualized as a nomogram. Model performance was evaluated using area under the curve (AUC), accuracy, sensitivity, and specificity.
Results: The clinical-radiomics model achieved an AUC of 0.91 (95% confidence interval [CI]: 0.86-0.95), accuracy of 0.84, sensitivity of 0.89, and specificity of 0.81 in the training cohort, and an AUC of 0.84 (95% CI: 0.76-0.92), accuracy of 0.78, sensitivity of 0.84, and specificity of 0.74 in the test cohort. Calibration curves demonstrated good agreement between predicted and observed outcomes, and decision curve analysis confirmed the model's clinical utility.
Conclusions: The clinical-radiomics model accurately predicts pCR following NAT in ESCC and may guide personalized treatment strategies.
{"title":"Clinical-Radiomics Signature Predicts Pathologic Complete Response After Neoadjuvant Therapy in Oesophageal Squamous Cell Carcinoma.","authors":"Liqiang Shi, Xipeng Wang, Xueyu Chen, Yuqin Cao, Chengqiang Li, Yaya Bai, Zenghui Cheng, Dong Dong, Xiaoyan Chen, Yajie Zhang, Hecheng Li","doi":"10.1093/icvts/ivag024","DOIUrl":"10.1093/icvts/ivag024","url":null,"abstract":"<p><strong>Objectives: </strong>Neoadjuvant therapy (NAT) significantly improves the pathologic complete response (pCR) rates in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Emerging evidence suggests that patients with pCR may experience favourable outcomes and could be considered for active surveillance strategies to delay surgery. This study aims to develop a clinical-radiomics model to predict pCR after NAT in ESCC.</p><p><strong>Methods: </strong>We retrospectively enrolled 236 patients with locally advanced ESCC who received NAT at our centre and randomly assigned them to training and test cohorts (3:2 ratio). Radiomics features were extracted from tumour regions segmented on post-NAT contrast-enhanced computed tomography (CT) scans. After feature selection, a predictive model integrating radiomics and clinical variables was developed using logistic regression and visualized as a nomogram. Model performance was evaluated using area under the curve (AUC), accuracy, sensitivity, and specificity.</p><p><strong>Results: </strong>The clinical-radiomics model achieved an AUC of 0.91 (95% confidence interval [CI]: 0.86-0.95), accuracy of 0.84, sensitivity of 0.89, and specificity of 0.81 in the training cohort, and an AUC of 0.84 (95% CI: 0.76-0.92), accuracy of 0.78, sensitivity of 0.84, and specificity of 0.74 in the test cohort. Calibration curves demonstrated good agreement between predicted and observed outcomes, and decision curve analysis confirmed the model's clinical utility.</p><p><strong>Conclusions: </strong>The clinical-radiomics model accurately predicts pCR following NAT in ESCC and may guide personalized treatment strategies.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gao-Feng Liu, Yong Zhang, Su-Juan Cui, Xiao-Yong Ding, Yan Liu, Yan-Bin Xu, Hui-Ling Zheng, Li Zhou
Objectives: To investigate the application of a mechanical side-to-side oesophagogastric anastomosis in the reconstruction of the digestive tract of beagles after an oesophagectomy.
Methods: Eighteen beagles were randomly divided into 3 groups: the hand-sewn (HS) group, the linear-stapled anastomosis in the oesophagus and anterior portion of the stomach (LESA) group and the linear-stapled anastomosis in the oesophagus and the posterior portion of the stomach (LESP) group. The gastro-oesophageal reflux, anastomotic area, anastomotic bursting pressure and the breaking strength in the beagles at 1 week and 12 weeks after the operations were compared. The histopathological morphology was observed using haematoxylin-eosin staining and Masson staining, and the expression of the vascular endothelial growth factor (VEGF) was detected by immunohistochemical analysis.
Results: At 1 and 12 weeks after the operation, the percentage of gastro-oesophageal reflux time and the longest reflux time in the HS group and the LESP group were higher than those in the LESA group (P < .05). The anastomotic areas in the HS group were significantly smaller than those in the LESA and LESP groups at 1 and 12 weeks postoperatively (P < .05); there were no differences in the anastomotic areas in the LESA and LESP groups. At 1 and 12 weeks postoperatively, the bursting pressure and breaking strength of the anastomosis, the collagen-fibre area ratio and VEGF positive expression in the LESA group were significantly higher than those in the HS group (P < .05).
Conclusions: The mechanical side-to-side oesophagogastric anastomosis of the oesophagus and the anterior wall of the stomach can reduce the occurrence of gastro-oesophageal reflux, increase the bursting pressure and breaking strength, promote collagen fibre and VEGF expression, to promote healing of the anastomosis.
{"title":"The Application of a Mechanical Side-to-Side Oesophagogastric Anastomosis in the Reconstruction of the Digestive Tract After an Oesophagectomy in a Beagle Model.","authors":"Gao-Feng Liu, Yong Zhang, Su-Juan Cui, Xiao-Yong Ding, Yan Liu, Yan-Bin Xu, Hui-Ling Zheng, Li Zhou","doi":"10.1093/icvts/ivag010","DOIUrl":"10.1093/icvts/ivag010","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the application of a mechanical side-to-side oesophagogastric anastomosis in the reconstruction of the digestive tract of beagles after an oesophagectomy.</p><p><strong>Methods: </strong>Eighteen beagles were randomly divided into 3 groups: the hand-sewn (HS) group, the linear-stapled anastomosis in the oesophagus and anterior portion of the stomach (LESA) group and the linear-stapled anastomosis in the oesophagus and the posterior portion of the stomach (LESP) group. The gastro-oesophageal reflux, anastomotic area, anastomotic bursting pressure and the breaking strength in the beagles at 1 week and 12 weeks after the operations were compared. The histopathological morphology was observed using haematoxylin-eosin staining and Masson staining, and the expression of the vascular endothelial growth factor (VEGF) was detected by immunohistochemical analysis.</p><p><strong>Results: </strong>At 1 and 12 weeks after the operation, the percentage of gastro-oesophageal reflux time and the longest reflux time in the HS group and the LESP group were higher than those in the LESA group (P < .05). The anastomotic areas in the HS group were significantly smaller than those in the LESA and LESP groups at 1 and 12 weeks postoperatively (P < .05); there were no differences in the anastomotic areas in the LESA and LESP groups. At 1 and 12 weeks postoperatively, the bursting pressure and breaking strength of the anastomosis, the collagen-fibre area ratio and VEGF positive expression in the LESA group were significantly higher than those in the HS group (P < .05).</p><p><strong>Conclusions: </strong>The mechanical side-to-side oesophagogastric anastomosis of the oesophagus and the anterior wall of the stomach can reduce the occurrence of gastro-oesophageal reflux, increase the bursting pressure and breaking strength, promote collagen fibre and VEGF expression, to promote healing of the anastomosis.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comments in \"Impact of an on-Call Specialist Aortic Rota Implementation in Acute Type an Aortic Dissection on Outcomes and Repair Complexity: A Retrospective Cohort Study\".","authors":"Ankur Sharma, Varshini Vadhithala, Arun Kumar, Sushma Verma, Sushma Narsing Katkuri","doi":"10.1093/icvts/ivag014","DOIUrl":"10.1093/icvts/ivag014","url":null,"abstract":"","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case series reports four paediatric patients (aged 2-11 years old) who sustained traumatic cardiac rupture following blunt trauma, all of whom were successfully treated at our institution. In contrast to common adult presentations, each case featured a rupture localized specifically to the superior vena cava-right atrial (SVC-RA) junction. Diagnosis was confirmed by echocardiography on the presence of cardiac tamponade. All patients underwent urgent median sternotomy, during which primary repair was accomplished without cardiopulmonary bypass. Postoperatively, both shock index and mean arterial pressure showed significant improvement (P = 0.003 and P = 0.028, respectively), and all children recovered fully without complications. This series highlights the SVC-RA junction as a uniquely vulnerable site in paediatric blunt cardiac injury and demonstrates that rapid diagnosis coupled with timely surgical intervention is paramount for survival.
{"title":"Traumatic cardiac rupture at the superior vena cava-right atrial junction in four pediatric patients: a case series in China national children's medical center.","authors":"Jia Zheng, Zhiqiang Li, Song Bai, Jian Guo","doi":"10.1093/icvts/ivag032","DOIUrl":"https://doi.org/10.1093/icvts/ivag032","url":null,"abstract":"<p><p>This case series reports four paediatric patients (aged 2-11 years old) who sustained traumatic cardiac rupture following blunt trauma, all of whom were successfully treated at our institution. In contrast to common adult presentations, each case featured a rupture localized specifically to the superior vena cava-right atrial (SVC-RA) junction. Diagnosis was confirmed by echocardiography on the presence of cardiac tamponade. All patients underwent urgent median sternotomy, during which primary repair was accomplished without cardiopulmonary bypass. Postoperatively, both shock index and mean arterial pressure showed significant improvement (P = 0.003 and P = 0.028, respectively), and all children recovered fully without complications. This series highlights the SVC-RA junction as a uniquely vulnerable site in paediatric blunt cardiac injury and demonstrates that rapid diagnosis coupled with timely surgical intervention is paramount for survival.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108598","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}
Kenta Yasuoka, Kanji Matsuzaki, Akito Imai, Masataka Sato, Yasunori Watanabe
We report a rare case of a 52-year-old woman with a recurrent intimal sarcoma adjacent to the mitral prosthesis in the left atrium. She had previously undergone initial surgery for mitral valve intimal sarcoma at age 48. At this presentation, we resected a 25-mm tumour as well as the surrounding lesions. Cryoablation was applied using cryoICE on all resection margins and the posterior mitral annulus. The use of a malleable probe facilitated the redo surgery. The patient has remained alive for more than five years following the initial operation and for 11 months after the subsequent redo surgery. Cryoablation may play an important role in improving surgical radicality in cardiac sarcoma.
{"title":"Cryoablation in redo surgery for a recurrent intimal sarcoma of the left atrium.","authors":"Kenta Yasuoka, Kanji Matsuzaki, Akito Imai, Masataka Sato, Yasunori Watanabe","doi":"10.1093/icvts/ivag030","DOIUrl":"https://doi.org/10.1093/icvts/ivag030","url":null,"abstract":"<p><p>We report a rare case of a 52-year-old woman with a recurrent intimal sarcoma adjacent to the mitral prosthesis in the left atrium. She had previously undergone initial surgery for mitral valve intimal sarcoma at age 48. At this presentation, we resected a 25-mm tumour as well as the surrounding lesions. Cryoablation was applied using cryoICE on all resection margins and the posterior mitral annulus. The use of a malleable probe facilitated the redo surgery. The patient has remained alive for more than five years following the initial operation and for 11 months after the subsequent redo surgery. Cryoablation may play an important role in improving surgical radicality in cardiac sarcoma.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108397","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}
Arman Hasanzade, Fariba Ghorbani, Amir Ali Mahboobipour, Morteza Yaqini, Saviz Pejhan, Mohammad Behgam Shadmehr
Objectives: The high intubation rate due to COVID-19 infection has increased the prevalence of post-intubation tracheal stenosis (PITS). We aimed to compare PITS induced by COVID-19 infection with PITS from non-COVID-19 etiologies.
Methods: This cohort study utilized PITS data collected prospectively between January 2018 and May 2023. 337 PITS patients were identified and those with direct neck trauma, burn inhalation injuries, and a prior history of tracheal surgery were excluded. Sixty-one COVID-19-related (CR) and 243 non-COVID-19-related (NCR) patients were compared before and after Propensity Score Matching (PSM) including demographics, comorbidities, intubation duration, clinical presentation, stenosis characteristics, the need for resectional airway surgery, and outcomes.
Results: Before matching, CR patients were older, more diabetic, less smoker, and they experienced longer intubation durations. After PSM, 59 CR and 59 NCR PITS patients, were included for comparison.Although no statistically significant differences were observed in stenosis, CR PITS patients required significantly more airway resection (81.4%) for definitive management than NCR (42.4%), P-value < 0.001. Postoperative complications, recurrence, and outcomes revealed no significant differences after PSM.
Conclusions: Given the increased need for surgical resection in CR PITS patients, thoracic surgeons should consider the increased likelihood of conservative therapy failure in them. Considering this finding and that no statistically significant difference was observed in postoperative outcomes in our study, we recommend a sooner decision for resectional airway surgery in CR than NCR PITS patients.
{"title":"Management and outcomes of post-intubation tracheal stenosis after covid-19: A propensity score-matched study.","authors":"Arman Hasanzade, Fariba Ghorbani, Amir Ali Mahboobipour, Morteza Yaqini, Saviz Pejhan, Mohammad Behgam Shadmehr","doi":"10.1093/icvts/ivaf282","DOIUrl":"https://doi.org/10.1093/icvts/ivaf282","url":null,"abstract":"<p><strong>Objectives: </strong>The high intubation rate due to COVID-19 infection has increased the prevalence of post-intubation tracheal stenosis (PITS). We aimed to compare PITS induced by COVID-19 infection with PITS from non-COVID-19 etiologies.</p><p><strong>Methods: </strong>This cohort study utilized PITS data collected prospectively between January 2018 and May 2023. 337 PITS patients were identified and those with direct neck trauma, burn inhalation injuries, and a prior history of tracheal surgery were excluded. Sixty-one COVID-19-related (CR) and 243 non-COVID-19-related (NCR) patients were compared before and after Propensity Score Matching (PSM) including demographics, comorbidities, intubation duration, clinical presentation, stenosis characteristics, the need for resectional airway surgery, and outcomes.</p><p><strong>Results: </strong>Before matching, CR patients were older, more diabetic, less smoker, and they experienced longer intubation durations. After PSM, 59 CR and 59 NCR PITS patients, were included for comparison.Although no statistically significant differences were observed in stenosis, CR PITS patients required significantly more airway resection (81.4%) for definitive management than NCR (42.4%), P-value < 0.001. Postoperative complications, recurrence, and outcomes revealed no significant differences after PSM.</p><p><strong>Conclusions: </strong>Given the increased need for surgical resection in CR PITS patients, thoracic surgeons should consider the increased likelihood of conservative therapy failure in them. Considering this finding and that no statistically significant difference was observed in postoperative outcomes in our study, we recommend a sooner decision for resectional airway surgery in CR than NCR PITS patients.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108621","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}