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Current Advances and Future Perspectives in Cardiothoracic Surgery
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Current Advances and Future Perspectives in Cardiothoracic Surgery

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

Deadline for manuscript submissions: 30 November 2026 | Viewed by 910

Editor

Dr. Tomislav Kopjar

E-Mail Website
Guest Editor
1. Department of Cardiac Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia
2. School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Interests: cardiothoracic surgery; mechanical circulatory support; atrial fibrillation surgery; mitral valve repair; heart and lung transplantation

Special Issue Information

Dear Colleagues,

The Special Issue titled “Current Advances and Future Perspectives in Cardiothoracic Surgery” aims to delve into the cutting-edge developments and emerging trends in this rapidly evolving field. With ongoing innovations in minimally invasive techniques, robotic-assisted procedures, and personalized therapies, the Special Issue underscores the significant strides made in enhancing patient outcomes and surgical precision. However, despite these advancements, several core challenges persist, including optimizing the long-term durability of prosthetic devices, improving perioperative management, and addressing disparities in access to advanced care.

The scope of this Special Issue is broad, encompassing a wide range of topics such as novel surgical techniques and technological integrations, translational research, and perioperative care. By bringing together multidisciplinary expertise, the Special Issue seeks to foster collaboration, identify unresolved problems, and guide future research priorities. Ultimately, this collection serves as a comprehensive resource for clinicians, researchers, and policymakers committed to advancing cardiothoracic surgery and improving patient prognoses in both current practice and future innovations.

We look forward to your important contributions to this Special Issue.

Dr. Tomislav Kopjar
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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

  • cardiothoracic surgery
  • minimally invasive techniques
  • robotic-assisted surgery
  • personalized therapy
  • surgical innovation
  • prosthetic devices
  • perioperative management
  • transplantation
  • technological advances
  • postoperative care
  • surgical outcomes
  • future perspectives
  • healthcare disparities

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

Published Papers (2 papers)

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Review

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13 pages, 535 KB  
Review
Artificial Intelligence in Cardiac Surgery and Surgical Training: Opportunities, Risks, and Safeguards for Preserving Expertise
by Lazar Velicki, Aleksandra Milovancev, Andrej Preveden, Jelena Vuckovic, Miodrag Belopavlovic, Milan Rodic, Nenad Filipovic and Djordje Jakovljevic
J. Clin. Med. 2026, 15(16), 6313; https://doi.org/10.3390/jcm15166313 - 15 Aug 2026
Viewed by 177
Abstract
Artificial intelligence (AI) is entering cardiac surgery through predictive modelling, multimodal imaging, perioperative monitoring, workflow automation, and emerging computer-vision applications. The most mature evidence concerns risk prediction before and after surgery. Even in this domain, however, systematic reviews show that improvements over conventional [...] Read more.
Artificial intelligence (AI) is entering cardiac surgery through predictive modelling, multimodal imaging, perioperative monitoring, workflow automation, and emerging computer-vision applications. The most mature evidence concerns risk prediction before and after surgery. Even in this domain, however, systematic reviews show that improvements over conventional statistical models are often modest and that routine clinical implementation remains limited. In surgical education, simulation, automated video analysis, and objective performance metrics may expand opportunities for deliberate practice and provide feedback that is less dependent on individual observers. Most of this evidence comes from general, laparoscopic, urological, and robotic surgery rather than cardiac-specific training, and its transferability should not be assumed. The same technologies also create risks. Automation bias, cognitive off-loading, reduced exposure to failure management, and displacement of mentor–trainee interaction may weaken the independent judgement on which safe cardiac surgery depends. Opaque models, dataset shift, inequitable performance, and uncertain accountability add further clinical and ethical concerns. This narrative review examines the current and emerging roles of AI across the cardiac surgical pathway and in cardiothoracic training, while distinguishing demonstrated applications from plausible but unproven uses. We propose a human-in-command framework based on external validation, local performance testing, transparent intended use, preserved manual and crisis-management competencies, simulation of technology failure, faculty oversight, competency-based credentialing, and continuous audit. AI should be judged not by technical novelty alone but by whether it improves care while preserving the ability of surgeons and teams to operate safely when the technology is unavailable or wrong. Full article
(This article belongs to the Special Issue Current Advances and Future Perspectives in Cardiothoracic Surgery)
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Other

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14 pages, 2414 KB  
Case Report
Redefining Access: Transition from Conventional to Transaxillary Endoscopic Aortic Valve and Ascending Aorta Replacement—A Case Report with Literature Review
by Tanja Josic and Mirko Doss
J. Clin. Med. 2026, 15(15), 5996; https://doi.org/10.3390/jcm15155996 - 1 Aug 2026
Viewed by 361
Abstract
Background: Minimally invasive approaches for combined aortic valve and ascending aortic surgery remain challenging. We report a case of utilizing a transaxillary approach (TAX) in combination with the RAM® system. Methods: A 65-year-old male presented with exertional angina and palpitations. He reported [...] Read more.
Background: Minimally invasive approaches for combined aortic valve and ascending aortic surgery remain challenging. We report a case of utilizing a transaxillary approach (TAX) in combination with the RAM® system. Methods: A 65-year-old male presented with exertional angina and palpitations. He reported a one-year history of dizziness. Diagnostics revealed severe aortic regurgitation due to a calcified bicuspid aortic valve and an ascending aortic aneurysm measuring 57 × 54 mm. Left ventricular ejection fraction was reduced to 42%. Coronary artery disease was excluded. Surgery was performed via a right transaxillary mini-thoracotomy (3rd intercostal space) using endoscopic visualization. Cardiopulmonary bypass was established through femoral cannulation. After aortic cross-clamping and cardioplegic arrest, the bicuspid valve was excised and replaced with a bioprosthesis. A supracoronary ascending aortic replacement was performed using a Dacron graft. The RAM® system was used for annular suturing and proximal anastomosis, with automated fastener fixation. Results: The patient was extubated on postoperative day 1 and transferred to intermediate care on day 2. Postoperative recovery was uneventful, with no neurological deficits, bleeding, or other complications. Discharge occurred on postoperative day 9 in stable condition. Conclusions: This case highlights the feasibility and safety of a minimally invasive transaxillary approach for combined aortic valve and ascending aortic replacement using the RAM® system. This technique may expand the surgical armamentarium for complex aortic pathology while avoiding sternotomy. Further studies are required to evaluate reproducibility, long-term outcomes, and broader applicability. Full article
(This article belongs to the Special Issue Current Advances and Future Perspectives in Cardiothoracic Surgery)
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