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Paradigm Changes in Cardiac Surgery and Interventional Cardiology

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Dear Colleagues,

In this operative-focused Special Issue of JCM that is centred on cardiac surgery and trans-catheter interventions, we aim to gather modern, up-to-date techniques, strategies, and guidelines in the treatment of ischaemic, structural, and electrophysiological heart diseases.

Our purpose is to shed light on state-of-the-art techniques, propose new “golden standards” in the field of cardiac surgery and trans-catheter cardiac interventions, and summarise therapeutical guidelines in order to achieve the best and most suitable treatment of the patients suffering with cardiac issues.

We are looking forward to receiving your excellent contributions.

Dr. Miklos Bitay
Guest Editor

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Research

7 pages, 210 KB

Open AccessArticle

The Role of Markers of Myocardial Damage in Predicting Postoperative Multiple Organ Dysfunction Syndrome and 30-Day Mortality in Patients Undergoing Heart Valve Surgery

by Piotr Duchnowski, Witold Śmigielski and Krzysztof Kuśmierski

J. Clin. Med. 2026, 15(14), 5337; https://doi.org/10.3390/jcm15145337 - 8 Jul 2026

Viewed by 83

Abstract

Background: Multiple organ dysfunction syndrome (MODS) is a serious complication and a leading cause of death in patients undergoing heart valve surgery. The main aim of the present study was to assess the predictive capacity of selected perioperative parameters, including Troponin T levels, to predict the occurrence of postoperative MODS and 30-day mortality in patients undergoing heart valve surgery. Methods: This prospective study included a group of patients with hemodynamically severe symptomatic valvular heart disease who underwent valve surgery. The primary endpoint was postoperative multiple organ dysfunction syndrome (MODS), defined as the dysfunction of at least two organs/systems, including cardiogenic shock, perioperative stroke, respiratory failure requiring prolonged mechanical ventilation, and/or postoperative acute kidney injury requiring renal replacement therapy. The secondary endpoint was death during the 30-day follow-up. Logistic regression was used to assess the relationships between the variables. Results: In total, 739 patients undergoing valvular heart surgery were included in this study. The primary end point was observed in 45 patients. Preoperative hemoglobin level (p = 0.01), red cell distribution width (RDW) (p = 0.001) and troponin T level measured on the first day after surgery (TnT II) (p < 0.001) were independent predictors of the primary endpoint. EuroSCORE II (p = 0.002) and TnT II (p < 0.001) were independent predictors of 30-day mortality. Conclusions: MODS is a clinical condition that is associated with a high risk of death. Troponin T levels measured within the first 24 h postoperatively may be useful in predicting postoperative MODS and 30-day mortality in patients undergoing heart valve surgery as a complement to commonly used risk calculators. Full article

(This article belongs to the Special Issue Paradigm Changes in Cardiac Surgery and Interventional Cardiology)

13 pages, 753 KB

Open AccessArticle

Transvenous Lead Extraction in Patients with Congenital Heart Disease

by Andrea Csillik, Rita Beata Gagyi, Attila Kardos, Csaba Földesi, Zoltán Som, Mate Vamos and Tamas Szili-Torok

J. Clin. Med. 2025, 14(12), 4178; https://doi.org/10.3390/jcm14124178 - 12 Jun 2025

Cited by 1 | Viewed by 959

Abstract

Background/Objectives: A significant subset of congenital heart disease (CHD) patients undergo a transvenous pacemaker (PM)/implantable cardioverter defibrillator (ICD) lead extraction (TLE) in their lifetime. We aimed to report on the outcome and complexity of TLEs in CHD patients for whom a powered mechanical sheath was used. Methods: This retrospective study included 175 consecutive TLEs performed at our centre. Overall, 13 TLEs in CHD patients and 162 TLEs in non-CHD patients were performed. A total of 264 leads were extracted. Results: CHD patients were younger than non-CHD patients at the time of their first lead implant (21.2 ± 17 vs. 57.1 ± 18 years; p < 0.01) and at the time of lead extraction (33.38 ± 13 vs. 63.31 ± 16 years; p < 0.01). The leads extracted from CHD patients were significantly older than the leads extracted from non-CHD patients (median: 8.0 vs. 4.0 years; p < 0.01). CHD patients and non-CHD patients did not differ in terms of the procedural (92% vs. 87%; p = 0.581) and clinical success rates (100% vs. 91%; p = 0.269). The two patient groups did not differ in terms of their procedural complication rate (0% vs. 11%; p = 0.191). There were no differences in the extraction techniques used, i.e., rotational mechanical sheaths were used in 61% of CHD extractions and in 38% of non-CHD extractions; p = 0.11. Conclusions: TLEs that use rotational mechanical sheaths as an advanced technique can be safely and effectively performed in CHD patients. The outcome and complexity of TLEs in CHD patients are comparable with those in non-CHD patients that undergo this procedure. Full article

(This article belongs to the Special Issue Paradigm Changes in Cardiac Surgery and Interventional Cardiology)

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