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State-of-the-Art in Cardiac Surgery: Progress, Challenges and Opportunities
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State-of-the-Art in Cardiac Surgery: Progress, Challenges and Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 25 December 2025 | Viewed by 1228

Special Issue Editors

Dr. Tomasz Plonek

E-Mail Website
Guest Editor
Department of Cardio-Thoracic Surgery, Thorax Centrum Twente Medisch Spectrum Twente, 7512 KZ Enschede, The Netherlands
Interests: aortic surgery; minimally invasive cardiac surgery; off-pump coronary surgery
Dr. Sleiman Sebastian Aboul-Hassan

E-Mail Website
Co-Guest Editor
1. Department of Cardiac Surgery, Zbigniew Religa Heart Center "MEDINET", 67-100 Nowa Sol, Poland
2. Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-046 Zielona Gora, Poland
Interests: minimally invasive cardiac surgery; total arterial coronary arterial bypass grafting

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to the Special Issue “State-of-the-Art in Cardiac Surgery: Progress, Challenges and Opportunities”, dedicated to the latest advancements in cardiac surgery. As our field continues to evolve, innovative techniques, emerging technologies, and improved treatment strategies are reshaping the standards of patient care.

The goal of this Special Issue is to highlight groundbreaking progress, address current challenges, and explore future directions in cardiac surgery. We particularly encourage submissions focusing on minimally invasive techniques, aortic surgery, advanced neuroprotection strategies, perfusion technologies, and state-of-the-art strategies in coronary artery bypass grafting.

We welcome original research articles and literature reviews that will contribute to shaping the future of cardiac surgery and inspire the next generation of surgeons.

We look forward to your valuable contributions.

Dr. Tomasz Plonek
Guest Editor

Dr. Sleiman Sebastian Aboul-Hassan
Co-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 Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • aorta ascendens
  • minimally invasive surgery
  • aortic arch surgery
  • off pump coronary surgery
  • arterial grafts

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Published Papers (2 papers)

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Research

11 pages, 694 KB  
Article
The Introduction of Impella 5.5 in Cardiogenic Shock: A Single-Center, Retrospective Propensity Score-Matched Analysis
by Maciej Bochenek, Mateusz Sokolski, Anna Kędziora, Barbara Barteczko-Grajek, Grzegorz Bielicki, Kinga Kosiorowska, Maciej Rachwalik, Rafał Nowicki, Michał Kosowski, Magdalena Cielecka, Michał Zakliczyński, Wiktor Kuliczkowski and Roman Przybylski
J. Clin. Med. 2025, 14(21), 7552; https://doi.org/10.3390/jcm14217552 (registering DOI) - 24 Oct 2025
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Abstract
Background/Objectives: Impella 5.5 provides a higher flow rate than smaller microaxial pumps and has been increasingly adopted for cardiogenic shock (CS). This study aimed to evaluate whether its introduction into our Shock Team program in 2023 improved outcomes compared with a historical cohort [...] Read more.
Background/Objectives: Impella 5.5 provides a higher flow rate than smaller microaxial pumps and has been increasingly adopted for cardiogenic shock (CS). This study aimed to evaluate whether its introduction into our Shock Team program in 2023 improved outcomes compared with a historical cohort supported with other mechanical circulatory support (MCS) devices. Methods: We retrospectively analyzed patients with CS treated with MCS between 2020 and 2024 at a tertiary center. The Impella 5.5 group (n = 17) included patients managed after device implementation, either as stand-alone or sequential therapy. The historical cohort comprised 40 patients treated with ECMO, Impella CP, CentriMag, or IABP prior to 2023. Propensity score matching (age, sex, etiology, lactate, SCAI stage) generated 17 matched pairs. The primary outcome was survival at discharge, 30 days, 3 months, and 6 months. Secondary outcomes included bridging to recovery, heart transplantation (HTx), durable LVAD, and major complications. Results: Impella 5.5 was associated with higher survival at discharge (94.1% vs. 58.8%, p = 0.039), 30 days (94.1% vs. 58.8%, p = 0.039), and 3 months (94.1% vs. 58.8%, p = 0.039). At 6 months, survival remained higher (88.2% vs. 58.8%) but did not reach statistical significance in point analysis (p = 0.118). Bridging occurred more frequently with Impella 5.5 (HTx 64.7% vs. 52.9% (p = 0.464), recovery 17.6% vs. 5.9% (p = 0.292)), while LVAD implantation rates were similar (11.8% vs. 17.6%, p = 1.0). Major bleeding (17.6% vs. 47.1%, p = 0.141), stroke/TIA (5.9% vs. 17.6%, p = 0.601), and the need for renal replacement therapy (5.9% vs. 23.5%, p = 0.335) were numerically lower with Impella 5.5. Conclusions: In this single-center, retrospective analysis, the introduction of Impella 5.5 was associated with higher short-term survival and favorable bridging metrics; estimates are imprecise due to small, heterogeneous samples. These hypothesis-generating findings warrant confirmation in larger, prospective multicenter cohorts Full article
(This article belongs to the Special Issue State-of-the-Art in Cardiac Surgery: Progress, Challenges and Opportunities)
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10 pages, 960 KB  
Article
No-Touch Aorta Off-Pump LIMA-Radial Artery Y-Graft CABG as a Safe Strategy for All-Comers: Long-Term Survival
by Tomasz Plonek, Dominik Mendyka and Frank R. Halfwerk
J. Clin. Med. 2025, 14(14), 4878; https://doi.org/10.3390/jcm14144878 - 9 Jul 2025
Viewed by 854
Abstract
Objectives: To assess the long-term survival outcomes of patients undergoing no-touch aorta, total arterial off-pump coronary artery bypass grafting (OPCAB) using a left internal mammary artery (LIMA)–radial artery (RA) Y-graft configuration. This approach was applied uniformly to all-comers undergoing isolated CABG between 2004 [...] Read more.
Objectives: To assess the long-term survival outcomes of patients undergoing no-touch aorta, total arterial off-pump coronary artery bypass grafting (OPCAB) using a left internal mammary artery (LIMA)–radial artery (RA) Y-graft configuration. This approach was applied uniformly to all-comers undergoing isolated CABG between 2004 and 2021, irrespective of preoperative risk profile. Methods: We included all patients treated with total arterial OPCAB using the LIMA–RA Y-graft without additional concomitant procedures. Patients were stratified into five age groups (<50, 50–59, 60–69, 70–79, and >80 years). Survival at 5 years was analyzed using Kaplan–Meier curves and Cox regression analysis. Results: A total of 2174 patients were analyzed, with a median follow-up of 3266 days. In-hospital mortality was 0.6%, whereas postoperative stroke was 0.3% without residual trauma and 0.2% with residual trauma, respectively, without differences between age groups. The mean number of grafts per patient was 3.7, with no significant variation between age groups (p = 0.09). Overall, 5-year survival was 90% (n = 1767), ranging from 98% in the youngest group to 65% in the oldest (log-rank p < 0.0001). Conclusions: No-touch aorta, total arterial OPCAB using the LIMA–RA Y-graft is a safe and effective revascularization strategy for a broad spectrum of patients, including those with advanced age and comorbidities. Full article
(This article belongs to the Special Issue State-of-the-Art in Cardiac Surgery: Progress, Challenges and Opportunities)
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