@article{MTMT:35131875, title = {External stenting for saphenous vein grafts reduces early postoperative graft failure}, url = {https://m2.mtmt.hu/api/publication/35131875}, author = {Dushaj, S. and Häussler, A. and Rings, L. and Ntinopoulos, V. and Papadopoulos, N. and Odavic, D. and Biefer, H.R.C. and Dzemali, O.}, doi = {10.1093/icvts/ivae099}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {38}, unique-id = {35131875}, issn = {1569-9293}, abstract = {OBJECTIVES: Multiple studies have shown that external stenting (ExSt) mitigates the progression of vein graft disease years after coronary artery bypass grafting (CABG). We used computed tomography to evaluate the effect of ExSt on perioperative vein graft patency. METHODS: This study assessed graft patency rates of saphenous vein grafts (SVG) in consecutive patients with isolated coronary artery bypass grafting (CABG) between 2018 and 2021. Logistic regression analyses were conducted to compare the outcomes of supported and non-supported groups at both patient and graft levels, with age, EuroSCORE II, gender, diabetes and arterial grafts as covariates. Subgroup analyses were performed based on different covariates. The goal of the study was to provide valuable insights into the clinical outcomes of SVG in patients having CABG. RESULTS: The study examined a total of 357 patients who met the inclusion criteria and evaluated 572 vein grafts. Of these, 150 patients (205 SVGs) received ExSt, whereas 207 patients (337 SVGs) did not receive ExSt. The study results indicated that the likelihood of overall SVG patency at discharge was higher in the stented group than in the non-stented group, both at the level of the grafts [93.8% vs 87.8%, odds ratio (OR) 2.1; 95% confidence interval (CI) 1.0–4.5; P ¼ 0.05] and at the patient level (90.1% vs 83.5%, OR 1.8; 95% CI 0.9–3.6; P ¼ 0.1). It is worth noting that the difference between the stented and non-stented groups was most significant in the subgroup that received 2 arterial grafts (96.5% vs 89.6%, OR 3.2; 95% CI 1.2–8.4; P ¼ 0.02) and in the subgroup with a higher EuroSCORE II (median >1.1) (98.6% vs 88.6%, OR 8.8; 95% CI 1.1–72.7; P ¼ 0.04). CONCLUSIONS: The ExSt is associated with improved perioperative SVG patency at both the graft and the patient levels. Moreover, SVGs to the right territory and high-risk patients appear to have an advantage using ExSt. © 2024 Oxford University Press. All rights reserved.}, year = {2024}, eissn = {1569-9285} } @article{MTMT:34534808, title = {Long-term follow-up of a consecutive cohort validating an epidermal growth factor receptor mutation as an independent risk factor for postoperative recurrence in lung adenocarcinoma}, url = {https://m2.mtmt.hu/api/publication/34534808}, author = {Matsumura, Y. and Hayasaka, K. and Ohira, T. and Shiono, S. and Abe, J. and Notsuda, H. and Sakurada, A. and Suzuki, H. and Okada, Y.}, doi = {10.1093/icvts/ivad174}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {37}, unique-id = {34534808}, issn = {1569-9293}, abstract = {Objectives: Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors were recently reported to be effective as adjuvant therapy for resected lung adenocarcinoma (ADC) harbouring common EGFR mutations. However, whether the EGFR mutation is a direct risk factor for postoperative recurrence remains unknown. Therefore, we conducted a multi-institutional observational study to compare postoperative survival according to EGFR mutation status. Methods: We collected the medical records of consecutive patients who underwent surgical resection for ADC between 2005 and 2012 at 4 participating institutions. Recurrence-free survival (RFS) and overall survival (OS) associated with EGFR mutation status were evaluated. We further analysed survival after pair-matching patients' clinicopathological characteristics. Results: EGFR mutations were harboured by 401 of 840 (48%) enrolled patients. The number of patients with an EGFR mutation (M group) differed from that with the EGFR wild-type sequence (W group) in terms of sex, smoking history and pathological stage. The median follow-up period was 85 months. The five-year RFS/OS rates of the M and W groups were 70%/85% and 61%/75%, respectively (P < 0.001 for both groups). However, multivariable analysis revealed that EGFR mutation status was not independently related with both RFS and OS. In pair-matched analysis, the RFS and OS curves of the patients with an EGFR mutation and wild-type sequence were not statistically different, either. Conclusions: Long-term follow-up of consecutive patients did not show that a common EGFR mutation was an independent risk factor of recurrence or prognostic factor for completely resected lung ADC. © 2023 The Author(s).}, keywords = {Recurrence; Aged; Adult; Female; Male; ARTICLE; human; risk factor; smoking; major clinical study; gene mutation; controlled study; cohort analysis; clinical feature; surgery; retrospective study; human tissue; epidermal growth factor receptor; cancer recurrence; cancer surgery; overall survival; cancer survival; follow up; postoperative complication; wild type; medical record review; observational study; protein tyrosine kinase inhibitor; lung adenocarcinoma; lung adenocarcinoma; cancer prognosis; recurrence free survival; Epidermal growth factor receptor mutation}, year = {2023}, eissn = {1569-9285} } @article{MTMT:32991890, title = {Protective continuous ventilation strategy during cardiopulmonary bypass in children undergoing surgery for congenital heart disease: a prospective study}, url = {https://m2.mtmt.hu/api/publication/32991890}, author = {Padalino, Massimo A. and Vedovelli, Luca and Simonato, Manuela and Bandini, Andrea and Paganini, Greta and Mezzalira, Laura and Faganello, Nicola and Carollo, Cristiana and Gregori, Dario and Vida, Vladimiro and Cogo, Paola}, doi = {10.1093/icvts/ivac084}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, unique-id = {32991890}, issn = {1569-9293}, abstract = {OBJECTIVES: The aim of this study was to evaluate if a 'protective' (low-tidal/low-frequency) ventilation strategy can shorten the postoperative ventilation time and minimize acute lung injury in children with congenital heart disease (CHD) undergoing repair with cardiopulmonary bypass (CPB).METHODS: This is a single-centre prospective, interventional study, including children with CHD under the age of 5 years, undergoing open-heart surgery with a CPB >60 min, in hypothermia, haemodynamically stable, and without evident genetic abnormalities. Assist-control ventilation (tidal volume of 4 ml/kg, 10 breaths/min, positive end-expiratory pressure 5 cmH(2)O and FiO(2) 0.21) was applied in a cohort of patients during CPB. We compared clinical outcomes and in fully ventilated versus non-ventilated (control) patients. Propensity score was used to weigh ventilated and control groups to correct for the effect of other confounding clinical variables. Clinical and ventilation parameters and lung inflammatory biomarkers in tracheal aspirates were measured. The primary outcome was the postoperative intubation time of more or less than 48 h.RESULTS: We included 140 children (53 ventilated, 87 non-ventilated) with different CHD. There were no deaths or adverse events in ventilated patients. Using a weighted generalized linear model, we found no sufficient evidence for an effect of intraoperative ventilation on postoperative intubation time [estimate 0.13 (95% confidence interval, -0.08; 0.35), P = 0.22].CONCLUSIONS: Continuous low-tidal/low-frequency mechanical ventilation during CPB is safe and harmless. However, no significant advantages were found when compared to non-ventilated patients in terms of postoperative ventilation time.}, keywords = {paediatric; LUNG INJURY; systemic inflammatory response syndrome; cardiopulmonary bypass; Congenital heart disease; Ventilation}, year = {2022}, eissn = {1569-9285}, orcid-numbers = {Vedovelli, Luca/0000-0003-4847-2333} } @article{MTMT:32962190, title = {Regional wall stress differences on tricuspid aortic valve-associated ascending aortic aneurysms}, url = {https://m2.mtmt.hu/api/publication/32962190}, author = {Gomez, Axel and Wang, Zhongjie and Xuan, Yue and Hope, Michael D. and Saloner, David A. and Guccione, Julius M. and Ge, Liang and Tseng, Elaine E.}, doi = {10.1093/icvts/ivab269}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {34}, unique-id = {32962190}, issn = {1569-9293}, abstract = {OBJECTIVES: Ascending thoracic aortic aneurysms (aTAAs) carry a risk of acute type A dissection. Elective repair guidelines are based on diameter, but complications often occur below diameter threshold. Biomechanically, dissection can occur when wall stress exceeds wall strength. Aneurysm wall stresses may better capture dissection risk. Our aim was to investigate patient-specific aTAA wall stresses associated with a tricuspid aortic valve (TAV) by anatomic region.METHODS: Patients with aneurysm diameter >= 4.0 cm underwent computed tomography angiography. Aneurysm geometries were reconstructed and loaded to systemic pressure while taking prestress into account. Finite element analyses were conducted to obtain wall stress distributions. The 99th percentile longitudinal and circumferential stresses were determined at systole. Wall stresses between regions were compared using one-way analysis of variance with post hoc Tukey HSD for pairwise comparisons.RESULTS: Peak longitudinal wall stresses on aneurysms (n = 204) were 326 [standard deviation (SD): 61.7], 246 (SD: 63.4) and 195 (SD: 38.7) kPa in sinuses of Valsalva, sinotubular junction (STJ) and ascending aorta (AscAo), respectively, with significant differences between AscAo and both sinuses (P <0.001) and STJ (P <0.001). Peak circumferential wall stresses were 416 (SD: 85.1), 501 (SD: 119) and 340 (SD: 57.6) kPa for sinuses, STJ and AscAo, respectively, with significant differences between AscAo and both sinuses (P < 0.001) and STJ (P <0.001).CONCLUSIONS: Circumferential and longitudinal wall stresses were greater in the aortic root than AscAo on aneurysm patients with a TAV. Aneurysm wall stress magnitudes and distribution relative to respective regional wall strength could improve understanding of aortic regions at greater risk of dissection in a particular patient.}, keywords = {finite element analysis; Aortic aneurysm; wall stress}, year = {2022}, eissn = {1569-9285}, pages = {1115-1123} } @article{MTMT:33330162, title = {Do in-hospital outcomes of isolated coronary artery bypass grafting vary between male and female octogenarians?}, url = {https://m2.mtmt.hu/api/publication/33330162}, author = {Attia, Rizwan Q. and Katumalla, Eve and Cyclewala, Shabnam and Rochon, Melissa and Marczin, Nandor and Raja, Shahzad G.}, doi = {10.1093/icvts/ivab281}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {34}, unique-id = {33330162}, issn = {1569-9293}, abstract = {OBJECTIVES: Female gender and advanced age are regarded as independent risk factors for adverse outcomes after isolated coronary artery bypass grafting (CABG). There is paucity of evidence comparing outcomes of CABG between male and female octogenarians. We aimed to analyse in-hospital outcomes of isolated CABG in this cohort.METHODS: All octogenarians that underwent isolated CABG, from January 2000 to October 2017, were included. A retrospective analysis of a prospectively collected cardiac surgery database (PATS; Dendrite Clinical Systems, Oxford, UK) was performed. A propensity score was generated for each patient from a multivariable logistic regression model based on 25 pre-treatment covariates. A total of 156 matching pairs were derived.RESULTS: Five hundred and sixty-seven octogenarians underwent isolated CABG. This included 156 females (mean age 82.1 [SD: 0.9]) and 411 males (mean age 82.4 [SD: 2.1 years]). More males were current smokers (P = 0.002) with renal impairment (P = 0.041), chronic obstructive pulmonary disease (P = 0.048), history of cerebrovascular accident (P = 0.039) and peripheral vascular disease (P = 0.027) while more females had New York Heart Association class 4 (P = 0.02), left ventricular ejection fraction 30-49% (P = 0.038) and left ventricular ejection fraction <30% (P = 0.049). On-pump, CABG was performed in 140 males and 52 females (P = 0.921). There was no difference in in-hospital mortality (5.4% vs 6.4%; P = 0.840), stroke (0.9% vs 1.3%; P = 0.689), need for renal replacement therapy (17.0% vs 13.5%; P = 0.732), pulmonary complications (9.5% vs 8.3%; P = 0.746) and sternal wound infection (2.7% vs 2.6%; P = 0.882). The outcomes were comparable for the propensity-matched cohorts.CONCLUSIONS: No gender difference in outcomes was seen in octogenarians undergoing isolated CABG.}, keywords = {MORTALITY; gender; outcome; octogenarians; coronary artery bypass grafting}, year = {2022}, eissn = {1569-9285}, pages = {958-965}, orcid-numbers = {Rochon, Melissa/0000-0002-1101-2256} } @article{MTMT:33615764, title = {Long-term outcomes of papillary muscle relocation anteriorly for functional mitral regurgitation}, url = {https://m2.mtmt.hu/api/publication/33615764}, author = {Oi, K. and Arai, H. and Nagaoka, E. and Fujiwara, T. and Oishi, K. and Takeshita, M. and Anzai, T. and Mizuno, T.}, doi = {10.1093/icvts/ivac245}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {35}, unique-id = {33615764}, issn = {1569-9293}, year = {2022}, eissn = {1569-9285} } @article{MTMT:35396882, title = {Laboratory signatures differentiate the tolerance to hypothermic circulatory arrest in acute type A aortic dissection surgery}, url = {https://m2.mtmt.hu/api/publication/35396882}, author = {Liu, Hong and Qian, Si-Chong and Han, Lu and Dong, Zhi-Qiang and Shao, Yong-Feng and Li, Hai-Yang and Zhang, Wei and Zhang, Hong-Jia}, doi = {10.1093/icvts/ivac267}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {35}, unique-id = {35396882}, issn = {1569-9293}, keywords = {MORTALITY; hypothermia; Aortic dissection; Risk model; CIRCULATORY ARREST}, year = {2022}, eissn = {1569-9285} } @article{MTMT:32993735, title = {Rapid evaporative ionization mass spectrometry (intelligent knife) for point-of-care testing in acute aortic dissection surgery}, url = {https://m2.mtmt.hu/api/publication/32993735}, author = {Davies, Hannah A. and Caamano-Gutierrez, Eva and Sarsby, Joscelyn and Chim, Ya Hua and Barrett, Steve and Nawaytou, Omar and Harky, Amer and Field, Mark and Akhtar, Riaz and Madine, Jillian}, doi = {10.1093/icvts/ivac019}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {34}, unique-id = {32993735}, issn = {1569-9293}, abstract = {OBJECTIVES: Rapid evaporative ionization mass spectrometry (REIMS) can discriminate aneurysmal from normal aortic tissue. Our objective in this work was to probe the integrity of acute dissection tissue using biomechanical, biochemical and histological techniques and demonstrate that REIMS can be used to discriminate identified differences.METHODS: Human aortic tissue was obtained from patients undergoing surgery for acute aortic dissection. Biomechanical, biochemical and histological assessment was carried out to probe mechanical properties and elastin, collagen and glycosaminoglycan composition of the tissue. Monopolar electrocautery was applied to samples and surgical aerosol aspirated and analysed by REIMS to produce mass spectral data.RESULTS: Tissue was obtained from 10 patients giving rise to 26 tissue pieces: 10 false lumen (FL), 10 dissection flap and 6 true lumen samples. Models generated from biomechanical and biochemical data showed that FL tissue was distinct from true lumen and dissection flap tissue. REIMS identified the same pattern being able to classify tissue types with 72.4% accuracy and 69.3% precision. Further analysis of REIMS data for FL tissue suggested patients formed 3 distinct clusters. Histological and biochemical assessment revealed patterns of extracellular matrix degradation within the clusters that are associated with altered tissue integrity identified using biomechanical testing.CONCLUSIONS: Structural integrity of the FL in acute Type A dissection could dictate future clinical distal disease progression. REIMS can detect differences in tissue integrity, supporting its development as a point-of-care test to guide surgical intraoperative decision-making.}, keywords = {Biomechanics; BIOCHEMISTRY; Tissue integrity; Rapid evaporative ionization mass spectrometry; Acute aortic dissection; false lumen}, year = {2022}, eissn = {1569-9285}, pages = {833-840}, orcid-numbers = {Caamano-Gutierrez, Eva/0000-0001-7737-5941; Barrett, Steve/0000-0003-2960-3334; Akhtar, Riaz/0000-0002-7963-6874; Madine, Jillian/0000-0001-9963-5871} } @article{MTMT:33129639, title = {The expression and role of tenascin C in abdominal aortic aneurysm formation and progression}, url = {https://m2.mtmt.hu/api/publication/33129639}, author = {Nagel, Felix and Schaefer, Anne-Kristin and Gonçalves, Inês Fonseca and Acar, Eylem and Oszwald, Andre and Kaiser, Philipp and Kain, Renate and Trescher, Karola and Eilenberg, Wolf H and Brostjan, Christine and Santer, David and Kiss, Attila and Podesser, Bruno K}, doi = {10.1093/icvts/ivac018}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {34}, unique-id = {33129639}, issn = {1569-9293}, year = {2022}, eissn = {1569-9285}, pages = {841-848}, orcid-numbers = {Schaefer, Anne-Kristin/0000-0002-9268-2461; Brostjan, Christine/0000-0003-1462-5397; Kiss, Attila/0000-0003-4652-1998; Podesser, Bruno K/0000-0002-4641-7202} } @article{MTMT:33132328, title = {Learning curve of uniportal video-Assisted thoracoscopic lobectomy: An analysis of the proficiency of 538 cases from a single centre}, url = {https://m2.mtmt.hu/api/publication/33132328}, author = {Li, W.-H. and Cheng, H. and Gan, X.-F. and Li, X.-J. and Wang, X.-J. and Wu, X.-W. and Zhong, H.-C. and Wu, T.-C. and Huo, W.-W. and Ju, S.-L. and Lv, L.-Z. and Cao, Q.-D.}, doi = {10.1093/icvts/ivab378}, journal-iso = {INTERACT CARDIOVAS THOR SURG}, journal = {INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY}, volume = {34}, unique-id = {33132328}, issn = {1569-9293}, abstract = {OBJECTIVES: Uniportal video-Assisted thoracoscopic surgery (UniVATS) is widely used as a minimally invasive thoracic operation. The goal of our study was to analyse the effect of long-Term experience with the UniVATS lobectomy on the learning curve. METHODS: The learning curves were quantitatively evaluated by the unadjusted cumulative sum, and they were segmented using joinpoint linear regression analysis. The variables were compared between subgroups using trend analysis, and linear regression analysis was applied to correlate clinical characteristics at different stages of the learning curve with the duration of the operation. RESULTS: The learning curve for the UniVATS lobectomy can be divided into 3 phases of proficiency at ?200-300 procedures, with a fourth phase as the number of procedures increases. The 1st-52nd, 52nd-156th, 156th-244th and 244th-538th procedures comprised the preliminary learning stage, preliminary proficiency stage, proficiency stage and advanced proficiency stage, respectively. Surgical outcomes and their variability between stages improved with increasing case numbers, with the most significant addition of an auxiliary operating port and conversions. In multivariable analysis, as stages progressed, influences other than surgical experience increased the operative time, with male and extensive pleural adhesions in the preliminary proficiency stage; male and incomplete pulmonary fissures in the proficiency stage; and male, extensive pleural adhesions and incomplete pulmonary fissures in the advanced proficiency stage. CONCLUSIONS: As the number of procedures increases, there may be 4 different proficiency stages in the UniVATS lobectomy learning curve. The surgeon enters the fourth stage at approximately the 244th procedure. Moreover, at stage 4, the perioperative indicators tend to stabilize, and influences other than surgical experience become more significant. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.}, keywords = {Adult; Male; Male; Humans; ARTICLE; human; Retrospective Studies; major clinical study; controlled study; clinical feature; quantitative analysis; learning; retrospective study; outcome assessment; lung tumor; Lung Neoplasms; surgeon; linear regression analysis; LOBECTOMY; LOBECTOMY; operation duration; Pneumonectomy; Pneumonectomy; Thoracic Surgery, Video-Assisted; video assisted thoracoscopic surgery; Operative Time; learning curve; learning curve; learning curve; procedures; adverse event; Univats; video assisted thoracoscopic lobectomy}, year = {2022}, eissn = {1569-9285}, pages = {799-807} }