TY - JOUR AU - Dushaj, S. AU - Häussler, A. AU - Rings, L. AU - Ntinopoulos, V. AU - Papadopoulos, N. AU - Odavic, D. AU - Biefer, H.R.C. AU - Dzemali, O. TI - External stenting for saphenous vein grafts reduces early postoperative graft failure JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 38 PY - 2024 IS - 6 PG - 9 SN - 1569-9293 DO - 10.1093/icvts/ivae099 UR - https://m2.mtmt.hu/api/publication/35131875 ID - 35131875 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Matsumura, Y. AU - Hayasaka, K. AU - Ohira, T. AU - Shiono, S. AU - Abe, J. AU - Notsuda, H. AU - Sakurada, A. AU - Suzuki, H. AU - Okada, Y. TI - 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 JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 37 PY - 2023 IS - 5 SN - 1569-9293 DO - 10.1093/icvts/ivad174 UR - https://m2.mtmt.hu/api/publication/34534808 ID - 34534808 N1 - Department of Chest Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan Department of Thoracic Surgery, Institute of Development, Ageing and Cancer, Tohoku University, Sendai, Miyagi, Japan Department of Epidemiology, Fukushima Medical University, School of Medicine, Fukushima, Japan Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan Export Date: 26 January 2024 Correspondence Address: Matsumura, Y.; Department of Chest Surgery, 1 Hikarigaoka, Japan; email: yukimatsumura1980@gmail.com Chemicals/CAS: epidermal growth factor receptor, 79079-06-4 Funding text 1: We thank the members of Japan North-East Thoracic Surgery group for their cooperation and Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript. We have no conflict of interest and no source of funding related to the current analysis. AB - 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). LA - English DB - MTMT ER - TY - JOUR AU - Padalino, Massimo A. AU - Vedovelli, Luca AU - Simonato, Manuela AU - Bandini, Andrea AU - Paganini, Greta AU - Mezzalira, Laura AU - Faganello, Nicola AU - Carollo, Cristiana AU - Gregori, Dario AU - Vida, Vladimiro AU - Cogo, Paola TI - Protective continuous ventilation strategy during cardiopulmonary bypass in children undergoing surgery for congenital heart disease: a prospective study JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG PY - 2022 PG - 8 SN - 1569-9293 DO - 10.1093/icvts/ivac084 UR - https://m2.mtmt.hu/api/publication/32991890 ID - 32991890 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Liu, Hong AU - Qian, Si-Chong AU - Han, Lu AU - Dong, Zhi-Qiang AU - Shao, Yong-Feng AU - Li, Hai-Yang AU - Zhang, Wei AU - Zhang, Hong-Jia TI - Laboratory signatures differentiate the tolerance to hypothermic circulatory arrest in acute type A aortic dissection surgery JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 35 PY - 2022 IS - 6 PG - 11 SN - 1569-9293 DO - 10.1093/icvts/ivac267 UR - https://m2.mtmt.hu/api/publication/35396882 ID - 35396882 LA - English DB - MTMT ER - TY - JOUR AU - Oi, K. AU - Arai, H. AU - Nagaoka, E. AU - Fujiwara, T. AU - Oishi, K. AU - Takeshita, M. AU - Anzai, T. AU - Mizuno, T. TI - Long-term outcomes of papillary muscle relocation anteriorly for functional mitral regurgitation JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 35 PY - 2022 IS - 6 SN - 1569-9293 DO - 10.1093/icvts/ivac245 UR - https://m2.mtmt.hu/api/publication/33615764 ID - 33615764 N1 - Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan Department of Biostatistics, MandD Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan Export Date: 3 February 2023 CODEN: ICTSC Correspondence Address: Arai, H.; Department of Cardiovascular Surgery, 113-8519 1-5-45 Yushima Bunkyo-ku, Japan; email: hiro.cvsg@tmd.ac.jp LA - English DB - MTMT ER - TY - JOUR AU - Attia, Rizwan Q. AU - Katumalla, Eve AU - Cyclewala, Shabnam AU - Rochon, Melissa AU - Marczin, Nandor AU - Raja, Shahzad G. TI - Do in-hospital outcomes of isolated coronary artery bypass grafting vary between male and female octogenarians? JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 34 PY - 2022 IS - 6 SP - 958 EP - 965 PG - 8 SN - 1569-9293 DO - 10.1093/icvts/ivab281 UR - https://m2.mtmt.hu/api/publication/33330162 ID - 33330162 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Gomez, Axel AU - Wang, Zhongjie AU - Xuan, Yue AU - Hope, Michael D. AU - Saloner, David A. AU - Guccione, Julius M. AU - Ge, Liang AU - Tseng, Elaine E. TI - Regional wall stress differences on tricuspid aortic valve-associated ascending aortic aneurysms JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 34 PY - 2022 IS - 6 SP - 1115 EP - 1123 PG - 9 SN - 1569-9293 DO - 10.1093/icvts/ivab269 UR - https://m2.mtmt.hu/api/publication/32962190 ID - 32962190 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Berezowski, Mikolaj AU - Scheumann, Johannes AU - Beyersdorf, Friedhelm AU - Jasinski, Marek AU - Plonek, Tomasz AU - Siepe, Matthias AU - Czerny, Martin AU - Rylski, Bartosz TI - Early aortic growth in acute descending aortic dissection JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 34 PY - 2022 IS - 5 SP - 857 EP - 864 PG - 8 SN - 1569-9293 DO - 10.1093/icvts/ivab351 UR - https://m2.mtmt.hu/api/publication/35397016 ID - 35397016 LA - English DB - MTMT ER - TY - JOUR AU - Puiu, Paul-Catalin AU - Pingpoh, Clarence AU - Kreibich, Maximilian AU - Czerny, Martin AU - Zimmer, Emmanuel AU - Beyersdorf, Friedhelm AU - Siepe, Matthias TI - Recannulation of the right axillary artery in reoperative proximal thoracic aortic surgery is safe JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 34 PY - 2022 IS - 5 SP - 872 EP - 877 PG - 6 SN - 1569-9293 DO - 10.1093/icvts/ivac020 UR - https://m2.mtmt.hu/api/publication/35397015 ID - 35397015 LA - English DB - MTMT ER - TY - JOUR AU - Magro, P.L. AU - Sousa-Uva, M. TI - Are NOACs as safe and efficient as VKA regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3 months of surgery? JF - INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY J2 - INTERACT CARDIOVAS THOR SURG VL - 34 PY - 2022 IS - 5 SP - 739 EP - 743 PG - 5 SN - 1569-9293 DO - 10.1093/icvts/ivab363 UR - https://m2.mtmt.hu/api/publication/33194834 ID - 33194834 N1 - Export Date: 27 October 2022 CODEN: ICTSC Correspondence Address: Magro, P.L.; Department of Cardiothoracic Surgery, Portugal; email: pedromagro@gmail.com AB - A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Are NOACs as safe and efficient as vitamin K antagonist regarding thromboembolic prophylaxis and major bleeding in patients with surgical bioprosthesis and atrial fibrillation within 3 months of surgery?' Altogether more than 324 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The RIVER and ENAVLE trials showed non-inferiority of rivaroxaban (regarding mean time free from composite of death, major cardiovascular events or major bleeding at 12 months) and edoxaban (composite of death, clinical thromboembolic events or asymptomatic intracardiac thrombosis; and major bleeding) when compared with vitamin K antagonist. These studies include a low number of patients within 3 months of index surgery and overall low statistical power regarding this particular subgroup of patients. Data derived from lower evidence studies are compatible with the aforementioned findings. The available evidence suggests that non-vitamin K antagonist anticoagulants are as safe and as efficient as vitamin K antagonist regarding thromboembolic prophylaxis and bleeding event rates in patients with surgical bioprosthesis and atrial fibrillation within 3 months of bioprosthesis implantation. However, this evidence is derived from a limited number of studies with important methodological limitations. Expanding non-vitamin K antagonist anticoagulant recommendation to the early postoperative period warrants more confirmatory research. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. LA - English DB - MTMT ER -