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Advances in Cardiothoracic Surgery
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Advances in Cardiothoracic Surgery

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: 15 August 2025 | Viewed by 2374

Special Issue Editor

Dr. Castigliano Murthy Bhamidipati

E-Mail Website
Guest Editor
Division of Cardiothoracic Surgery, Oregon Health & Science University, Portland, OR, USA
Interests: adult congenital heart disease surgery; complex aortic surgery

Special Issue Information

Dear Colleagues,

Cardiothoracic surgery has been a revolutionary field since the very beginning. Developing and refining techniques to reduce mortality and morbidity, along with creating the best evidence-based treatment plan for each patient, is crucial. Interventions such as robotic cardiac surgery, minimally invasive surgery, thoracoscopy-based access, transcatheter valve replacements, closed-chest coronary artery bypass grafting and other innovative strategies will reduce complications.

This Special Issue focuses on the advances and innovations in new devices, procedures, and disease management, which have been the hallmark of cardiothoracic surgery. We invite you to submit original research, clinical studies, systematic reviews, state-of-the-art reviews, or other submissions related to these and other advances in cardiothoracic surgery.

Dr. Castigliano Murthy Bhamidipati
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 Personalized Medicine is an international peer-reviewed open access monthly 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

  • adult congenital heart disease
  • electrophysiology
  • complex aortic surgery
  • endocarditis
  • coronary artery disease
  • valvular heart disease

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  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

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

Published Papers (3 papers)

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Research

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11 pages, 735 KiB  
Article
Personalized Antithrombotic Strategies in Patients with Atrial Fibrillation Following Transcatheter Aortic Valve Replacement
by Razan Awan, Monirah A. Albabtain, Aisha AlRasheedi, Maha AlHarthi, Zaid Alanazi and Amr A. Arafat
J. Pers. Med. 2025, 15(4), 149; https://doi.org/10.3390/jpm15040149 - 9 Apr 2025
Viewed by 393
Abstract
Background: Atrial fibrillation (AF) is prevalent in patients undergoing transcatheter aortic valve replacement (TAVR). However, the optimal antithrombotic strategy tailored to individual patient profiles remains unclear. This study aims to evaluate the outcomes of personalized antithrombotic regimens in patients with AF after TAVR. [...] Read more.
Background: Atrial fibrillation (AF) is prevalent in patients undergoing transcatheter aortic valve replacement (TAVR). However, the optimal antithrombotic strategy tailored to individual patient profiles remains unclear. This study aims to evaluate the outcomes of personalized antithrombotic regimens in patients with AF after TAVR. Methods: We enrolled 121 AF patients who underwent TAVR from 2009 to 2023. Patients were grouped into seven groups based on individualized post-procedural antithrombotic regimens. The regimens included the following: single antiplatelet therapy (SAPT) + direct oral anticoagulant (DOAC) (n = 44, 36.3%); DOACs only (n = 25, 20.6%), SAPT + warfarin (n = 17, 14%); dual antiplatelet therapy (DAPT) (n = 13, 10.7%); warfarin only (n = 8, 6.6%); DAPT + warfarin (n = 7, 5.8%); and DAPT + DOACs (n = 7, 5.8%). The study outcomes included incidences of strokes or transient ischemic attacks (TIAs), major bleeding, and survival. Results: The median follow-up was 27 months. The incidence of stroke, TIA, or major bleeding was similar among the seven treatment groups. However, a trend toward a higher rate of stroke was observed in the triple regimen containing warfarin (28.6%); also, the highest rate of major bleeding was observed in the warfarin-only group (25%). Survival for patients discharged and placed under various antithrombotic regimens did not differ significantly despite some numerical variations being present across the groups, with the lowest mortality reported with SAPT + warfarin (7%) and the highest with DAPT + warfarin (57%). Conclusions: This study highlights the outcomes related to stroke, major bleeding, and mortality across personalized antithrombotic regimens in patients with AF after TAVR. While no statistically significant differences were observed, findings emphasize the need for further large-scale studies to define optimal personalized antithrombotic strategies based on individual patient characteristics. Full article
(This article belongs to the Special Issue Advances in Cardiothoracic Surgery)
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Review

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10 pages, 640 KiB  
Review
Lactate as a Preoperative Predictor of Mortality in Patients Undergoing Emergency Type A Aortic Dissection Repair
by Sombuddha Bhadra, Rachel H. Drgastin, Howard K. Song, Frederick A. Tibayan, Gurion Lantz, Julie W. Doberne and Castigliano M. Bhamidipati
J. Pers. Med. 2025, 15(5), 211; https://doi.org/10.3390/jpm15050211 - 21 May 2025
Abstract
Background: Aortic dissection is a life-threatening condition where emergent surgical repair is the standard of care. However, despite operative intervention, mortality is 10–15% in all patients. Objective markers to distinguish when surgical repair is more beneficial versus being futile are warranted. Currently, no [...] Read more.
Background: Aortic dissection is a life-threatening condition where emergent surgical repair is the standard of care. However, despite operative intervention, mortality is 10–15% in all patients. Objective markers to distinguish when surgical repair is more beneficial versus being futile are warranted. Currently, no such known measures are widely agreed upon. Since most complications from aortic dissection stem from malperfusion, serum lactate is thought to be a surrogate marker for malperfusion. This scoping review aims to examine the preoperative predictive value of lactate or lactate dehydrogenase (LDH) in assessing postoperative mortality in patients undergoing surgical repair for acute Stanford Type A aortic dissection (ATAAD). Methods: PubMed was searched for the following search terms: “Dissection, Ascending Aorta”, “Dissection, Thoracic Aorta”, or “Aortic Dissection”. Prospective and retrospective randomized controlled trials, case reports, and cohort studies were included in the initial search. Studies were first screened for inclusion of preoperative lactate or LDH level with a search of “lac” or “LDH”. Included studies consisted of patients aged 18 or older diagnosed with Stanford Type A/Debakey Type I and II aortic dissection with reported preoperative lactate or LDH levels and postoperative mortality treated within 14 days of symptom onset. Preoperative laboratory values were measured from samples collected prior to patient transfer to the operating room or before utilization of ECMO intraoperatively. Results: A comprehensive database search identified a total of 4722 articles. After a rigid screening process, 46 studies fit the inclusion criteria. These papers reported a combined 4696 participants with either preoperative lactate or LDH levels and postoperative mortality. The mean preoperative lactate level was 2.4 mmol/L, whereas the LDH level was 424.9 U/L. Postoperative mortality was 16.51%. Average creatinine, BUN, platelets, INR, PT, PTT, and hemoglobin were all within normal lab analysis limits. Conclusions: Neither lactate nor LDH should be used as a solo predictor of postoperative mortality after ATAAD due to lack of consensus on the cut-off values. Accompanying clinical signs, lab abnormalities, and radiographic findings taken together may be better predictors of prognosis. Full article
(This article belongs to the Special Issue Advances in Cardiothoracic Surgery)
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12 pages, 2877 KiB  
Review
A Systematic Review of Individualized Heart Surgery with a Personalized Prosthesis
by Faizus Sazzad, Kollengode Ramanathan, Irwan Shah Moideen, Abdulrahman El Gohary, John Carey Stevens and Theo Kofidis
J. Pers. Med. 2023, 13(10), 1483; https://doi.org/10.3390/jpm13101483 - 11 Oct 2023
Cited by 1 | Viewed by 1348
Abstract
Personalized surgery is not just a new trend but rather a patient-specific approach to therapy that makes it possible to adopt a targeted approach for a specific patient and closely mirrors the approach of personalized medicine. However, the application of tailored surgery in [...] Read more.
Personalized surgery is not just a new trend but rather a patient-specific approach to therapy that makes it possible to adopt a targeted approach for a specific patient and closely mirrors the approach of personalized medicine. However, the application of tailored surgery in the context of cardiovascular replacement surgery has not been systematically reviewed. The ability to customize a device is highly dependent on the collection of radiological image data for precise prosthesis modeling. These facts are essential to “tailor-made” device design for precise prosthesis implantation. According to this study, computed tomography (CT) was the most prominent imaging modality; however, transesophageal echocardiography and echocardiography were also found to be helpful. Additionally, a dynamic finite element simulation was also found to be an attractive alternative to the finite element analysis for an in-silico experiment. Nonetheless, there is a paucity of relevant publications and only sporadic evidence. More clinical studies have been warranted, notwithstanding that the derived data and results from this insight into the use of therapeutic interventions may be evidence of multiple directives in clinical practices and beyond. This study may help the integration of personalized devices for better comprehension of predicted clinical outcomes, thus leading towards enhanced performance gains. Full article
(This article belongs to the Special Issue Advances in Cardiothoracic Surgery)
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