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Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives
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Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives

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

Deadline for manuscript submissions: 25 May 2025 | Viewed by 3601

Special Issue Editor

Dr. Edris A.F. Mahtab

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Leiden University Medical Center, (LUMC), Albinusdreef 2, P.O. Box 9600, Post Zone D6-Q, 2300 RC Leiden, The Netherlands
Interests: thoracic surgery; cardiac surgery; virtual reality; coronary artery; aortic valve replacement

Special Issue Information

Dear Colleagues,

The Special Issue titled "Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives" delves into the evolving landscape of cardiothoracic surgery and enhanced recovery protocols. With a focus on improving patient outcomes and reducing recovery times, this compilation aims to address the challenges and opportunities encountered in perioperative care across various cardiothoracic surgical procedures.

Aims:

This Special Issue aims to provide a comprehensive overview of recent advancements in cardiothoracic surgery and enhanced recovery protocols. It seeks to identify core problems in perioperative care, pain management, and postoperative complications associated with cardiothoracic surgical interventions.

Scope:

Encompassing a wide array of topics, including minimally invasive techniques, perioperative care protocols, and multidisciplinary approaches, this scope covers innovative strategies to optimize patient recovery in cardiothoracic surgical settings. Contributions exploring novel surgical interventions, perioperative care protocols, and outcomes assessment tools are welcome.

Mobilization:

We invite researchers, clinicians, and practitioners to contribute original research, reviews, and perspectives that advance our understanding of cardiothoracic surgery and enhanced recovery. By fostering collaboration and knowledge exchange, this Special Issue aims to drive improvements in patient care and outcomes in cardiothoracic surgical settings. Join us in exploring these recent advances and charting a course towards enhanced recovery in cardiothoracic surgery.

Dr. Edris A.F. Mahtab
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

  • coronary artery bypass surgery
  • valve repair/replacement
  • minimally invasive cardiac procedures
  • aortic dissection repair
  • thoracic aortic aneurysm surgery
  • lung transplantation
  • ventricular assist devices
  • esophagectomy
  • lung surgery
  • heart transplantation
  • use of XR and AI in Enhanced recovery

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

17 pages, 857 KiB  
Article
A Retrospective Review of the Deep Parasternal Intercostal Plane Block in Patients Undergoing Cardiac Surgery with Median Sternotomy
by Tzonghuei Chen, Leslie Annette Vargas Galvan, Kendra L. Walsh, Andrew Winegarner, Patricia Apruzzese, Shyamal Asher and Andrew Maslow
J. Clin. Med. 2025, 14(6), 2074; https://doi.org/10.3390/jcm14062074 - 18 Mar 2025
Viewed by 417
Abstract
Background/Objectives: Regional anesthesia is an important part of Enhanced Recovery after Cardiac Surgery (ERACS) protocols designed to enhance analgesia, reduce opioid use, and improve postoperative outcomes. The deep parasternal intercostal plane (Deep-PIP) block is a fascial plane block in which local anesthetics [...] Read more.
Background/Objectives: Regional anesthesia is an important part of Enhanced Recovery after Cardiac Surgery (ERACS) protocols designed to enhance analgesia, reduce opioid use, and improve postoperative outcomes. The deep parasternal intercostal plane (Deep-PIP) block is a fascial plane block in which local anesthetics are injected between the intercostal and transversus thoracis muscles to block neural transmission through the anterior cutaneous branches of the intercostal nerve. This study evaluates the impact of the Deep-PIP block in patients undergoing cardiac surgery via median sternotomy. Methods: In this retrospective cohort study, patients were divided into cohorts of 232 patients who had a block (BLOCK group) and 351 patients who did not receive a block (NOBlock group) using propensity score matching. Pain scores and opioid consumption over 24 h, extubation times, and ICU and hospital length of stay were compared for the two groups. Several subgroup analyses were also performed to evaluate the effects of block technique and block adjuvants. Results: While there was not a statistically significant difference in opioid consumption between the two groups, the BLOCK group had significantly lower pain scores, extubation times, and hospital length of stay. The subgroup analyses showed that modifications to block technique and use of block adjuvants were associated with reduced opioid consumption, but did not significantly affect pain scores, extubation time, or ICU or hospital length of stay. Conclusions: This study demonstrates the benefits of the deep parasternal intercostal plane block as part of an ERACS protocol. Routine implementation of the Deep-PIP block is reasonable given its potential benefits combined with its positive safety profile. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives)
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9 pages, 405 KiB  
Article
From Survival to Recovery: Understanding the Life Impact of an Acute Aortic Dissection Through Activity, Sleep, and Quality of Life
by Nora Bacour, Simran Grewal, Rutger T. Theijsse, Robert J. M. Klautz and Nimrat Grewal
J. Clin. Med. 2025, 14(3), 859; https://doi.org/10.3390/jcm14030859 - 28 Jan 2025
Cited by 1 | Viewed by 749
Abstract
Background/Objectives: An acute aortic dissection (AAD) is a cardiovascular emergency with high mortality rates if left untreated. Survival has increased due to improvements in diagnosis and therapy. However, during their recovery, survivors frequently encounter major social, psychological, and physical challenges. This study aimed [...] Read more.
Background/Objectives: An acute aortic dissection (AAD) is a cardiovascular emergency with high mortality rates if left untreated. Survival has increased due to improvements in diagnosis and therapy. However, during their recovery, survivors frequently encounter major social, psychological, and physical challenges. This study aimed to evaluate the recovery experience of AAD survivors in The Netherlands. Insights on sleep quality, physical activity, and quality of life were collected from a unique nationwide cohort of AAD survivors recruited through the national patient support network ‘Stichting Aorta Dissectie Nederland’. Methods: This study was conducted among AAD survivors who were recruited through a national association for aortic dissection known as ‘Stichting Aorta Dissectie Nederland (SADN)’. The participants (n = 61) completed questionnaires assessing demographic data, physical activity, sleep quality, and health-related QoL. Results: The cohort had a mean age of 60.1 years, and 47.5% of the participants were female. The prevalence of sleep disruptions was high, as 55.7% of the people were categorized as bad sleepers (PSQI > 5). Poor sleep was associated with low physical activity and a higher BMI. The physical activity levels varied, with 47.5% reporting moderate activity levels and 44.3% reporting high activity levels. The QoL scores varied greatly among the participants, with significant impairment across all fields and reduced enthusiasm for daily activities. Poor sleepers reported significantly lower QoL (p < 0.001). Conclusions: Our study highlights significant gaps in post-AAD care, particularly addressing QoL, sleep, and physical activity. By acknowledging the multifaceted nature of recovery, healthcare providers can develop tailored interventions that empower survivors to achieve better quality of life. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives)
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15 pages, 2122 KiB  
Article
Evaluating Virtual Reality Patient Education in Cardiac Surgery: Impact on Preoperative Anxiety and Postoperative Patient Satisfaction
by Sulayman el Mathari, Lieke Kuitert, Noor Boulidam, Saadullah Shehadeh, Robert J. M. Klautz, Robert de Lind van Wijngaarden and Jolanda Kluin
J. Clin. Med. 2024, 13(21), 6567; https://doi.org/10.3390/jcm13216567 - 31 Oct 2024
Cited by 1 | Viewed by 1716
Abstract
Background/Objectives: Preoperative anxiety in cardiac surgery patients can adversely affect mental well-being and postoperative outcomes. Virtual reality (VR) patient education has been proposed as a novel method to enhance patient education and potentially reduce preoperative anxiety. The VR Patient Journey Trial aimed [...] Read more.
Background/Objectives: Preoperative anxiety in cardiac surgery patients can adversely affect mental well-being and postoperative outcomes. Virtual reality (VR) patient education has been proposed as a novel method to enhance patient education and potentially reduce preoperative anxiety. The VR Patient Journey Trial aimed to evaluate the impact of VR patient education on preoperative anxiety and patient satisfaction compared to traditional education methods. Methods: This randomized controlled trial included 121 patients undergoing cardiac surgery. Participants were randomized to receive either VR patient education (intervention group) or traditional education (control group). Preoperative anxiety was measured using the State–Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information scale (APAIS). Patient satisfaction was assessed postoperatively through a custom questionnaire. Statistical analyses included linear regression and non-parametric testing. Results: Neither STAI nor APAIS scores showed differences in preoperative anxiety between both groups. However, the intervention group reported significantly higher patient satisfaction with the information provided (median score 9 vs. 8; p < 0.001). Furthermore, women reported higher levels of anxiety than men (p = 0.01), and open-ended feedback from participants indicated a need for more detailed information on postoperative rehabilitation and potential risks. Conclusions: The VR Patient Journey Trial revealed that, although VR patient education did not significantly reduce preoperative anxiety levels, it significantly improved patient satisfaction with the information provided. These results suggest that VR patient education can be a valuable addition to preoperative patient programs. Full article
(This article belongs to the Special Issue Cardiothoracic Surgery and Enhanced Recovery: Recent Advances and Perspectives)
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