Advances in Cardiovascular Surgery

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

Deadline for manuscript submissions: closed (10 January 2024) | Viewed by 4554

Special Issue Editor


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Guest Editor
Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
Interests: minimally invasive cardiovascular surgery; advanced imaging; surgical electrophysiology; emergency surgery; aortic surgery; valvular surgery; arrhythmic surgery;coronary artery bypass surgery

Special Issue Information

Dear Colleagues,

Our medical knowledge has continued to grow alongside technological developments and social progress. In recent years, the COVID-19 pandemic created life stagnation, leading to a breakdown in medical care. However, the field of cardiovascular surgery has still been advancing with the goal of overcoming life-threatening diseases. Surgical treatment in this field requires various strategies in accordance with the types of disease and treatment situation. Recently, minimally invasive techniques have frequently been adopted in surgeries, in which surgical assist technology, including imaging systems and surgical devices, are essential. Conversely, classical surgery is still selected for the patient’s benefit. Furthermore, multidisciplinary surgery is occasionally necessary in the treatment of cardiovascular disease with a complex pathology. Surgeons working in this field are requested to deal with the ideal of treatment and its conflict of surgical strategy through trial and error.

This Special Issue aims to provide an overview of the current cardiovascular surgery knowledge based on novel ideas, technologies, and research trials, as well as the experiences of experts of various specialties, such as cardiac surgeons, vascular surgery cardiologists, and interventional radiologists. We look forward to receiving  manuscripts that contribute to the advancements in cardiovascular surgery.

Dr. Shun-Ichiro Sakamoto
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

  • minimally invasive cardiovascular surgery
  • innovative technique
  • patient-based strategy
  • aortic surgery
  • valvular surgery
  • arrhythmic surgery
  • coronary artery bypass surgery

Published Papers (3 papers)

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Research

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18 pages, 1103 KiB  
Article
Lactate-Based Difference as a Determinant of Outcomes following Surgery for Type A Acute Aortic Dissection: A Multi-Centre Study
by Francesco Nappi, Almothana Alzamil, Antonio Salsano, Sanjeet Singh Avtaar Singh, Ivancarmine Gambardella, Francesco Santini, Antonio Fiore, Giacomo Perocchio, Pierre Demondion, Patrick Mesnildrey, Thibaut Schoell, Nicolas Bonnet and Pascal Leprince
J. Clin. Med. 2023, 12(19), 6177; https://doi.org/10.3390/jcm12196177 - 25 Sep 2023
Cited by 1 | Viewed by 893
Abstract
Type A acute aortic dissection (TAAAD) is a serious condition within the acute aortic syndromes that demands immediate treatment. Despite advancements in diagnostic and referral pathways, the survival rate post-surgery currently sits at almost 20%. Our objective was to pinpoint clinical indicators for [...] Read more.
Type A acute aortic dissection (TAAAD) is a serious condition within the acute aortic syndromes that demands immediate treatment. Despite advancements in diagnostic and referral pathways, the survival rate post-surgery currently sits at almost 20%. Our objective was to pinpoint clinical indicators for mortality and morbidity, particularly raised arterial lactate as a key factor for negative outcomes. Methods: All patients referred to the three cardiovascular centres between January 2005 and December 2022 were included in the study. The inclusion criteria required the presence of a lesion involving the ascending aorta, symptoms within 7 days of surgery, and referral for primary surgical repair of TAAAD based on recommendations, with consideration for other concomitant major cardiac surgical procedures needed during TAAAD and retrograde extension of TAAAD. We conducted an analysis of both continuous and categorical variables and utilised predictive mean matching to fill in missing numeric features. For missing binary variables, we used logistic regression to impute values. We specifically targeted early postoperative mortality and employed LASSO regression to minimise potential collinearity of over-fitting variables and variables measured from the same patient. Results: A total of 633 patients were recruited for the study, out of which 449 patients had complete preoperative arterial lactate data. The average age of the patients was 64 years, and 304 patients were male (67.6%). The crude early postoperative mortality rate was 24.5% (110 out of 449 patients). The mortality rate did not show any significant difference when comparing conservative and extensive surgeries. However, malperfusion had a significant impact on mortality [48/131 (36.6%) vs. 62/318 (19.5%), p < 0.001]. Preoperative arterial lactates were significantly elevated in patients with malperfusion. The optimal prognostic threshold of arterial lactate for predicting early postoperative mortality in our cohort was ≥2.6 mmol/L. Conclusion: The arterial lactate concentration in patients referred for TAAAD is an independent factor for both operative mortality and postoperative complications. In addition to mortality, patients with an upper arterial lactate cut-off of ≥2.6 mmol/L face significant risks of VA ECMO and the need for dialysis within the first 48 h after surgery. To improve recognition and facilitate rapid transfer and surgical treatment protocol, more diligent efforts are required in the management of malperfusion in TAAAD. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Surgery)
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9 pages, 1358 KiB  
Article
Clinical Results of a Modified Doty’s Technique for Supravalvular Aortic Stenosis
by Lizhi Lv, Xinyue Lang, Simeng Zhang, Cheng Wang, Yuanhao Jin and Qiang Wang
J. Clin. Med. 2023, 12(5), 1731; https://doi.org/10.3390/jcm12051731 - 21 Feb 2023
Cited by 1 | Viewed by 1232
Abstract
This study aimed to assess the early and mid-term results of the modified Doty’s technique compared with the traditional Doty’s technique in patients with congenital supravalvular aortic stenosis (SVAS). We retrospectively included 73 consecutive SVAS patients in Beijing and Yunnan Fuwai Hospitals between [...] Read more.
This study aimed to assess the early and mid-term results of the modified Doty’s technique compared with the traditional Doty’s technique in patients with congenital supravalvular aortic stenosis (SVAS). We retrospectively included 73 consecutive SVAS patients in Beijing and Yunnan Fuwai Hospitals between 2014 and 2021. Patients were divided into the modified technique (n = 9) and the traditional technique group (n = 64). The modified technique involves altering the right head of the symmetrical inverted pantaloon-shaped patch into an asymmetrical triangular form to prevent compression of the right coronary artery ostium. The primary safety outcome was in-hospital surgery-related complications and the primary effectiveness outcome was re-operation at follow-up. The Mann–Whitney U test and Fisher’s exact test were used to test the group difference. The median age at operation was 50 months (IQR 27.0–96.0). Twenty-two (30.1%) of the patients were female. The median follow-up was 23.5 months (IQR 3.0–46.0). No in-hospital surgery-related complications and follow-up re-operation occurred in the modified technique group, but the traditional technique group had 14 (21.8%) surgery-related complications and 5 (7.9%) re-operation. Patients with the modified technique had a well-developed aortic root and no aortic regurgitation occurred. A modified technique could be considered for patients with poor aortic root development to reduce postoperative surgery-related complications. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Surgery)
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Review

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11 pages, 838 KiB  
Review
Heart Failure after Aortic Valve Replacement: Incidence, Risk Factors, and Implications
by Roopesh Sai Jakulla, Satya Preetham Gunta and Chetan P. Huded
J. Clin. Med. 2023, 12(18), 6048; https://doi.org/10.3390/jcm12186048 - 19 Sep 2023
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Abstract
Severe aortic stenosis (AS) carries a poor prognosis with the onset of heart failure (HF) symptoms, and surgical or transcatheter aortic valve replacement (AVR) is its only definitive treatment. The management of AS has seen a paradigm shift with the adoption of transcatheter [...] Read more.
Severe aortic stenosis (AS) carries a poor prognosis with the onset of heart failure (HF) symptoms, and surgical or transcatheter aortic valve replacement (AVR) is its only definitive treatment. The management of AS has seen a paradigm shift with the adoption of transcatheter aortic valve replacement (TAVR), allowing for the treatment of AS in patients who would not otherwise be candidates for surgical AVR. Despite improving long-term survival after TAVR in recent years, residual HF symptoms and HF hospitalization are common and are associated with an increased mortality and a poor health status. This review article summarizes the incidence and risk factors for HF after AVR. Strategies for preventing and better managing HF after AVR are necessary to improve outcomes in this patient population. Extensive research is underway to assess whether earlier timing for AVR, prior to the development of severe symptomatic AS and associated extra-valvular cardiac damage, can improve post-AVR patient outcomes. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Surgery)
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