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Contemporary Controversies and Evolving Paradigms in Cardiovascular Surgery
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Contemporary Controversies and Evolving Paradigms in Cardiovascular Surgery

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiac Surgery".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 465

Special Issue Editor

Dr. Dimitrios E. Magouliotis

E-Mail Website
Guest Editor
Department of Cardiac Surgery Research, Lankenau Institute of Medical Research, Wynnewood, PA 19096, USA
Interests: cardio-thoracic surgery; surgical oncology; bariatric surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular surgery continues to evolve rapidly, driven by technological innovations, minimally invasive approaches, and an ever-growing emphasis on personalized medicine. However, several debates remain unresolved, influencing daily clinical practice and long-term patient outcomes. This Special Issue aims to highlight and critically appraise the most pressing controversies in modern cardiovascular surgery. Topics of interest include, but are not limited to, the optimal approach for aortic valve replacement (TAVR vs. SAVR), management of thoracic aortic aneurysms, timing and technique of surgical revascularization in ischemic heart failure, surgical vs. hybrid approaches in aortic arch disease, and the role of mechanical circulatory support in advanced heart failure. We invite original research articles, systematic reviews, expert opinions, and perspectives that explore these contentious areas and propose pathways toward consensus or individualized care. By bringing together diverse viewpoints and the latest evidence, this Special Issue aims to serve as a valuable resource for clinicians, researchers, and policymakers navigating the complexities of cardiovascular surgery today.

Dr. Dimitrios E. Magouliotis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular surgery
  • aortic valve replacement (TAVR vs. SAVR)
  • thoracic aortic aneurysms
  • surgical revascularization
  • aortic arch disease
  • ischemic heart failure

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Published Papers (1 paper)

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13 pages, 4136 KiB  
Systematic Review
Surgical vs. Medical Management of Infective Endocarditis Following TAVR: A Systematic Review and Meta-Analysis
by Dimitrios E. Magouliotis, Serge Sicouri, Massimo Baudo, Francesco Cabrucci, Yoshiyuki Yamashita and Basel Ramlawi
J. Cardiovasc. Dev. Dis. 2025, 12(7), 263; https://doi.org/10.3390/jcdd12070263 - 9 Jul 2025
Viewed by 313
Abstract
Background: Infective endocarditis after transcatheter aortic valve replacement (TAVR-IE) is a rare but severe complication associated with high morbidity and mortality. The optimal treatment strategy—surgical explantation versus medical therapy—remains uncertain, particularly given the technical demands of TAVR removal and the advanced age of [...] Read more.
Background: Infective endocarditis after transcatheter aortic valve replacement (TAVR-IE) is a rare but severe complication associated with high morbidity and mortality. The optimal treatment strategy—surgical explantation versus medical therapy—remains uncertain, particularly given the technical demands of TAVR removal and the advanced age of many affected patients. Methods: We conducted a systematic review and meta-analysis of studies comparing the surgical and medical management of TAVR-IE. Primary outcomes included 30-day mortality and 1-year survival. Secondary analyses explored microbiological profiles, patient demographics, prosthesis type, postoperative complications, and surgical indications. A qualitative synthesis of surgical explantation techniques and reconstructive strategies was also performed based on recent consensus recommendations. Results: Three studies comprising 1557 patients with TAVR-IE were included; 155 (10.0%) underwent surgical treatment. Thirty-day mortality was comparable between groups (surgical: 9.7%; medical: 8.4%), while the pooled odds ratio for one-year survival did not reach statistical significance (OR: 1.91, 95% CI: 0.36–10.22; I2 = 88%). However, single-center outcomes demonstrated markedly improved survival with surgery (96% vs. 51%). The most common surgical indications included severe valvular dysfunction (50.3%), aortic root abscess (26.5%), and large vegetations (21.3%), in line with current guideline recommendations. Postoperative complications included acute renal failure (10%) and longer hospitalizations (19.8 vs. 18 days), although these were not statistically different. Contemporary explant strategies—such as the Double Kocher, Tourniquet, and Y-incision aortic enlargement techniques—were highlighted as critical tools for surgical success. Conclusions: While underutilized, surgical intervention for TAVR-IE may offer significant survival benefits in select patients, particularly when guided by established indications and performed at high-volume centers. Outcomes depend heavily on timing, surgical expertise, and appropriate patient selection. As TAVR expands to younger populations, TAVR-IE will become increasingly relevant, necessitating early multidisciplinary involvement and broader familiarity with advanced explant techniques among cardiac surgeons. Full article
(This article belongs to the Special Issue Contemporary Controversies and Evolving Paradigms in Cardiovascular Surgery)
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