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Surgical Treatment and Postoperative Recovery of Heart and Lung Disease
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Surgical Treatment and Postoperative Recovery of Heart and Lung Disease

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

Deadline for manuscript submissions: 20 June 2025 | Viewed by 4709

Special Issue Editor

Dr. Yasushige Shingu

E-Mail Website
Guest Editor
Department of Cardiovascular Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
Interests: cardiology; cardiothoracic surgery; echocardiography; heart failure

Special Issue Information

Dear Colleagues,

In 2020, a study published in BMJ Open outlined the top-10 research priorities in cardiac surgery, derived from two surveys and a consensus workshop in the UK. The highest priority identified was understanding changes in patient quality of life post-surgery, including factors that influence these changes. Research priorities also emphasized the management of frail patients, improving outcomes for those with chronic conditions, and exploring the benefits of prehabilitation. Questions were raised about preventing and treating postoperative atrial fibrillation and managing infections like surgical site and sternal wound infections, as well as pneumonia.

Concurrently, a 2023 JACC article highlighted the limited and retrospective studies available on postoperative atrial fibrillation in lung surgery, especially transplantation, underscoring a need for more comprehensive research to identify effective medical and interventional strategies.

This Special Issue focused on the surgical treatment and postoperative recovery of heart and lung disease, addressing complications such as frailty, atrial fibrillation, and infections.

Dr. Yasushige Shingu
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

  • heart and lung disease
  • complications
  • frailty
  • rehabilitation
  • atrial fibrillation
  • infections

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

Published Papers (4 papers)

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Research

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9 pages, 1289 KiB  
Article
Exploratory Study of the Measurement of Geometric Height in 3D Transesophageal Echocardiography as a Predictor of Valve-Sparing Root Replacement for Aortic Regurgitation
by Shota Yamanaka, Shuichiro Takanashi, Tomoki Shimokawa and Takashi Kunihara
J. Clin. Med. 2024, 13(24), 7835; https://doi.org/10.3390/jcm13247835 - 22 Dec 2024
Viewed by 674
Abstract
Background: Valve-sparing root replacement surgery is an alternative strategy for patients with aortic regurgitation with or without aortic root enlargement. A detailed understanding of the mechanisms of regurgitation and the morphology of the aortic root would be beneficial for predicting the feasibility [...] Read more.
Background: Valve-sparing root replacement surgery is an alternative strategy for patients with aortic regurgitation with or without aortic root enlargement. A detailed understanding of the mechanisms of regurgitation and the morphology of the aortic root would be beneficial for predicting the feasibility and success of valve-sparing surgery. This is an exploratory study of the measurement of geometric height in 3D transesophageal echocardiography as a predictor of valve-sparing root replacement for aortic regurgitation. Methods: Transesophageal echocardiographic findings and long-term outcomes were compared in 124 patients undergoing either valve-sparing root replacement (VSRR group) or composite valve graft replacement (Bentall group) from September 2014 to March 2019. Results: The VSRR group was younger and had better left ventricular function than the Bentall group. Three-dimensional transesophageal echocardiography showed that geometric height was significantly larger in the VSRR group. In receiver-operating curve analysis, the cutoff values of geometric height for the feasibility of valve-sparing surgery were 15.9 mm and 19.8 mm in the tricuspid and bicuspid aortic valve, respectively. The overall survival was 98.6% and the freedom from reoperation rate was 89.7% at 5 years in the VSRR group. Conclusions: Appropriate patient selection and adequate GH may contribute to the success of VSSR and improve long-term outcomes. Full article
(This article belongs to the Special Issue Surgical Treatment and Postoperative Recovery of Heart and Lung Disease)
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15 pages, 780 KiB  
Article
Haemodynamic Assessment and Outcomes of Aortic Valvuloplasty for Aortic Regurgitation in Patients with Bicuspid Aortic Valve
by Kosuke Saku, Satoshi Arimura, Tomomitsu Takagi, Akihiro Masuzawa, Yoko Matsumura, Michio Yoshitake, Ryuichi Nagahori, Kenta Murotani and Takashi Kunihara
J. Clin. Med. 2024, 13(24), 7544; https://doi.org/10.3390/jcm13247544 - 11 Dec 2024
Viewed by 599
Abstract
Background: Aortic valvuloplasty for bicuspid aortic valve carries a risk of postoperative stenosis. We evaluated the haemodynamic differences between aortic valvuloplasty for bicuspid aortic valve, tricuspid aortic valve, and aortic valve replacement by echocardiography. We also assessed whether a higher postoperative pressure gradient [...] Read more.
Background: Aortic valvuloplasty for bicuspid aortic valve carries a risk of postoperative stenosis. We evaluated the haemodynamic differences between aortic valvuloplasty for bicuspid aortic valve, tricuspid aortic valve, and aortic valve replacement by echocardiography. We also assessed whether a higher postoperative pressure gradient affects the outcomes of aortic valvuloplasty for bicuspid aortic valve. Methods: From 2014 to 2021, patients undergoing aortic valvuloplasty were classified into aortic valvuloplasty for bicuspid aortic valve (Group-PB) and aortic valvuloplasty for tricuspid aortic valve (Group-PT). We also enrolled patients undergoing aortic valve replacement (Group-R) between 2002 and 2021. Mid-term outcomes were compared within Group-PB based on peak pressure gradients of ≥20 mmHg (subgroup-H) and <20 mmHg (subgroup-L). Results: Group-PB included 42 patients and Group-PT included 70 patients. Both 7-day and 1-year echocardiography showed the highest peak/mean pressure gradients in Group-PB (n = 41) and the lowest values in Group-PT (n = 67). Propensity scoring analysis yielded similar results to an unadjusted analysis. The mid-term outcomes were not significantly different between subgroup-H (n = 20) and subgroup-L (n = 22), with rates of freedom from aortic regurgitation >II at 5 years of 94.4% vs. 94.4% (p = 0.749) and freedom from reoperation of 94.4% vs. 100.0% (p = 0.317), respectively. Conclusions: Aortic valvuloplasty for tricuspid aortic valve shows favourable valve function in the early postoperative period, whereas aortic valvuloplasty for bicuspid aortic valve has a risk of postoperative stenosis. However, a high pressure gradient (peak pressure gradient of ≥20 mmHg) after aortic valvuloplasty for bicuspid aortic valve does not impact mid-term outcomes. Full article
(This article belongs to the Special Issue Surgical Treatment and Postoperative Recovery of Heart and Lung Disease)
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8 pages, 723 KiB  
Article
L-Carnitine: A New Therapeutic Option for the Prevention of Atrial Fibrillation in Non-Cardiac Surgery—A Single-Group Interventional Pilot Study
by Yasushige Shingu, Isao Yokota, Tatsuya Kato, Yasuhiro Hida, Kichizo Kaga, Jingwen Gao and Satoru Wakasa
J. Clin. Med. 2024, 13(20), 6228; https://doi.org/10.3390/jcm13206228 - 18 Oct 2024
Viewed by 1354
Abstract
Background: L-carnitine is essential in lipid metabolism and reportedly has preventive effects for arrhythmia. Our objective was to examine the incidence of postoperative atrial fibrillation (POAF) and changes in serum biomarker levels following perioperative L-carnitine administration in patients with lung cancer. Methods: Thirteen [...] Read more.
Background: L-carnitine is essential in lipid metabolism and reportedly has preventive effects for arrhythmia. Our objective was to examine the incidence of postoperative atrial fibrillation (POAF) and changes in serum biomarker levels following perioperative L-carnitine administration in patients with lung cancer. Methods: Thirteen patients undergoing a lobectomy with preoperative serum brain natriuretic peptide levels >24 pg/mL were perioperatively administered L-carnitine for 5 days (3 g/3×). Accurate 95% confidence intervals (CI) for POAF incidence were calculated. Serum biomarkers for POAF in lung cancer and target proteins for L-carnitine were evaluated by using open-source data from proteomic analysis. Results: The incidence of POAF was 38.5% (95% CI 13.9%–68.4%). Fatty acid-binding protein 4 (FABP4) was selected as a candidate biomarker from 1472, 63, and 26 proteins related to lung cancer, L-carnitine, and AF, respectively. A positive correlation was observed between the predicted POAF incidence rate and preoperative FABP4 levels (Pearson’s r = 0.5183). The mean change in serum FABP4 after L-carnitine administration for 5 days was −2.9 ng/mL (95% CI −4.9 to −0.89 ng/mL). Conclusions: The incidence of POAF after a lobectomy was 38.5% after the perioperative administration of L-carnitine for patients at a high risk of POAF. The serum FABP4 level demonstrates potential as a candidate biomarker for POAF prediction. Full article
(This article belongs to the Special Issue Surgical Treatment and Postoperative Recovery of Heart and Lung Disease)
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Other

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14 pages, 679 KiB  
Brief Report
Sugammadex Safely Reduces Total Intubation Time in the Intensive Care Unit Following Coronary Artery Bypass Grafting (CABG) at a Real-World Community Hospital
by Kimberly Lam, Julia Jackson, Chelsey Bourgeois, Elina Delgado and Melissa A. Burmeister
J. Clin. Med. 2025, 14(5), 1660; https://doi.org/10.3390/jcm14051660 - 28 Feb 2025
Viewed by 1609
Abstract
Background/Objectives: Early extubation is crucial for enhancing recovery from coronary artery bypass grafting (CABG). Residual neuromuscular blockade (NMB) effects can hinder early extubation, potentially leading to reintubation, lung infection, and prolonged post-anesthesia stay. Sugammadex, a modified gamma-cyclodextrin, reverses the non-depolarizing NMB effects [...] Read more.
Background/Objectives: Early extubation is crucial for enhancing recovery from coronary artery bypass grafting (CABG). Residual neuromuscular blockade (NMB) effects can hinder early extubation, potentially leading to reintubation, lung infection, and prolonged post-anesthesia stay. Sugammadex, a modified gamma-cyclodextrin, reverses the non-depolarizing NMB effects of the steroidal muscle relaxants rocuronium and vecuronium. The American Society of Anesthesiologists recommends sugammadex administration when patients display a train-of-four (TOF) ratio of less than 0.9. Previous studies show that sugammadex decreases extubation times, reduces postoperative complications, and enhances patient comfort. Methods: This single-center, retrospective cohort study evaluated the efficacy of sugammadex in achieving extubation within six hours of intensive care unit (ICU) arrival post-CABG, defined as fast-track extubation (FTE). Results: Here, we report that although the total time of intubation in the ICU following CABG did not drop to the six-hour benchmark, it was substantially reduced by the administration of sugammadex in accordance with an FTE protocol. Furthermore, the risks of adverse events (e.g., anaphylaxis, heart failure) and postoperative complications (e.g., acidemia, hypoxemia, tachypnea) were unaltered. Conclusions: The use of sugammadex could, thus, reduce costs associated with prolonged intubation time and related complications without increasing morbidity or mortality. Full article
(This article belongs to the Special Issue Surgical Treatment and Postoperative Recovery of Heart and Lung Disease)
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