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Clinical Outcomes of Cardiac Surgery
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Clinical Outcomes of Cardiac Surgery

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

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3303

Special Issue Editors

Prof. Dr. Ugolino Livi

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Guest Editor
Department of Cardiothoracic Science, Department of Medical Area (DAME), University of Udine, Piazzale Santa Maria della Misericordia, 15, 33100 Udine, Italy
Interests: heart transplantation; mechanical circulatory support; mitral valve disease; prosthetic cardiac valves; aortic disease
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Igor Vendramin

E-Mail Website
Guest Editor
Division of Cardiac Surgery, University of Udine Medical School, Udine, Italy
Interests: aortic surgery; mitral valve disease; aortic valve disease; heart transplantation; mechanical circulatory support
Prof. Dr. Uberto Bortolotti

E-Mail Website
Guest Editor
Cardio-Thoracic and Vascular Department, University of Pisa, Pisa, Italy
Interests: mitral valve disease; aortic valve disease; prosthetic cardiac valves; aorta and great vessels

Special Issue Information

Dear Colleagues,

Cardiac surgery has undergone incredible developments over the last decades, achieving results, particularly in terms of patient outcomes, unexpected many years ago. Improvements in patient care and technological advancements have allowed for providing more favorable outlooks in the majority of patients with various cardiovascular diseases. We believe that there is a need to periodically assess the status of established, as well as new surgical procedures. Therefore, we felt that this should be the right time to verify up-to-date achievements and where we plan, expect or hope to arrive in the next future. The aim of this publication is to gather data, opinions and results on the most important topics of cardiovascular surgery, providing an update on many aspects of both congenital and acquired heart diseases. The Special Issue is open to those willing to participate and share experiences and results by submitting pertinent contributions which will undergo a peer review process.

We really hope that many of you will join us in what we expect to be an exciting journey at the end of which knowledge in various fields of cardiovascular diseases will be enhanced.

Prof. Dr. Ugolino Livi
Prof. Dr. Igor Vendramin
Prof. Dr. Uberto Bortolotti
Guest Editors

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

  • acquired heart disease
  • congenital heart disease
  • early and long-term results
  • minimally invasive techniques
  • trans-catheter techniques

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Published Papers (3 papers)

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Research

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8 pages, 1028 KiB  
Article
A Historical Perspective and Update on Robotic Mitral Valve Surgery
by Amy Chartrain, Alfredo Trento, George Gill, Dominic Emerson, Wen Cheng, Danny Ramzy and Joanna Chikwe
J. Clin. Med. 2024, 13(21), 6375; https://doi.org/10.3390/jcm13216375 - 24 Oct 2024
Viewed by 473
Abstract
Background/Objectives: Minimally invasive techniques for mitral valve repair have evolved over the past thirty years and include mini-thoracotomies and the robotic platform. This study provides a historical perspective on minimally invasive mitral valve approaches and evaluates long-term outcomes of a large series [...] Read more.
Background/Objectives: Minimally invasive techniques for mitral valve repair have evolved over the past thirty years and include mini-thoracotomies and the robotic platform. This study provides a historical perspective on minimally invasive mitral valve approaches and evaluates long-term outcomes of a large series of robotic mitral valve repairs. Methods: A single-institution, prospectively maintained registry was used to evaluate robotic mitral valve repairs performed by four surgeons from 2005 to 2023. There were 1412 robotic mitral valve repairs performed during this time and stratified by the first 120 and subsequent patients. We evaluated operative outcomes and freedom from more than 2+ mitral regurgitation at five years as well as ten-year survival. Results: Of the 1412 robotic mitral valve repairs performed, 93.6% (n = 1322) were for degenerative disease. Compared to the first 120 patients, the subsequent patients had a significant reduction in cross-clamp time (112 (IQR = 103–130) versus 75 (IQR = 65–88) min) and cardiopulmonary bypass time (153.5 (IQR = 134.5–177.5) versus 116 (IQR = 103–136) min), and all with p < 0.01. The majority of patients had posterior leaflet prolapse (65.6%, n = 926). The repair rate was 98.1%, n = 1385. Survival at ten-year follow-up for the patients included in the first 120 procedures was 91.5% (95% confidence interval (CI) = 86.4–96.6%) versus 92.8% (95% CI = 91.7–93.9%) for the patients who were in the latter group, p = 0.58. Freedom from >2+ mitral regurgitation at 5 years was 97.0% (95% CI = 95.3–98.7%) for the patients in the first 120 procedures and 92.7% (95% CI = 91.5–93.9%), p = 0.22, for those in the latter group. Conclusions: The robotic platform offers an excellent durable repair for mitral regurgitation in our experience of over 1400 patients. The robotic platform for mitral valve repair offers a teachable and safe approach to mitral valve disease for patients. Full article
(This article belongs to the Special Issue Clinical Outcomes of Cardiac Surgery)
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12 pages, 2562 KiB  
Article
Gender Differences in Survival after Coronary Artery Bypass Grafting—13-Year Results from KROK Registry
by Grzegorz Hirnle, Adrian Stankiewicz, Maciej Mitrosz, Sleiman Sebastian Aboul-Hassan, Marek Deja, Jan Rogowski, Romuald Cichoń, Lech Anisimowicz, Paweł Bugajski, Zdzisław Tobota, Bohdan Maruszewski and Tomasz Hrapkowicz
J. Clin. Med. 2024, 13(14), 4080; https://doi.org/10.3390/jcm13144080 - 12 Jul 2024
Viewed by 893
Abstract
The influence of gender on both early and long-term outcomes of coronary artery bypass grafting (CABG) is not clearly defined. Objectives: This study aimed to assess the impact of gender on early and long-term mortality after CABG using data from the KROK Registry. [...] Read more.
The influence of gender on both early and long-term outcomes of coronary artery bypass grafting (CABG) is not clearly defined. Objectives: This study aimed to assess the impact of gender on early and long-term mortality after CABG using data from the KROK Registry. Methods: All 133,973 adult patients who underwent CABG in Poland between 1 January 2009 and 31 December 2019 were included in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry). The study enrolled 90,541 patients: 68,401 men (75.55%) and 22,140 women (24.45%) who met the inclusion criteria. Then, 30-day mortality, 1-year mortality, and long-term mortality rates were compared. Results: Advanced age, higher Canadian Cardiovascular Society (CCS) and New York Heart Association (NYHA) grade, diabetes, hypercholesterolemia, arterial hypertension, body mass index BMI > 35 kg/m2, and renal failure, before the propensity matching, were more frequently observed in women. Women more frequently underwent urgent surgery, including single and double graft surgery, and off-pump CABG (OPCAB) (p < 0.001). In propensity-matched groups, early mortality (30 days) was significantly higher in women (3.4% versus 2.8%, p < 0.001). The annual mortality remained higher in this group (6.6% versus 6.0%, p = 0.025). However, long-term mortality differed significantly between the groups and was higher in the male group (33.0% men versus 28.8% women, p < 0.001). Conclusions: There are no apparent differences in long-term mortality between the two sexes in the entire population. In propensity-matched patients, early mortality was lower for men, but the long-term survival was found to be better in women. Full article
(This article belongs to the Special Issue Clinical Outcomes of Cardiac Surgery)
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Review

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24 pages, 1404 KiB  
Review
Pushing the Survival Bar Higher: Two Decades of Innovation in Lung Transplantation
by Khalil Aburahma, Nunzio Davide de Manna, Christian Kuehn, Jawad Salman, Mark Greer and Fabio Ius
J. Clin. Med. 2024, 13(18), 5516; https://doi.org/10.3390/jcm13185516 - 18 Sep 2024
Viewed by 1532
Abstract
Survival after lung transplantation has significantly improved during the last two decades. The refinement of the already existing extracorporeal life support (ECLS) systems, such as extracorporeal membrane oxygenation (ECMO), and the introduction of new techniques for donor lung optimization, such as ex vivo [...] Read more.
Survival after lung transplantation has significantly improved during the last two decades. The refinement of the already existing extracorporeal life support (ECLS) systems, such as extracorporeal membrane oxygenation (ECMO), and the introduction of new techniques for donor lung optimization, such as ex vivo lung perfusion (EVLP), have allowed the extension of transplant indication to patients with end-stage lung failure after acute respiratory distress syndrome (ARDS) and the expansion of the donor organ pool, due to the better evaluation and optimization of extended-criteria donor (ECD) lungs and of donors after circulatory death (DCD). The close monitoring of anti-HLA donor-specific antibodies (DSAs) has allowed the early recognition of pulmonary antibody-mediated rejection (AMR), which requires a completely different treatment and has a worse prognosis than acute cellular rejection (ACR). As such, the standardization of patient selection and post-transplant management has significantly contributed to this positive trend, especially at high-volume centers. This review focuses on lung transplantation after ARDS, on the role of EVLP in lung donor expansion, on ECMO as a principal cardiopulmonary support system in lung transplantation, and on the diagnosis and therapy of pulmonary AMR. Full article
(This article belongs to the Special Issue Clinical Outcomes of Cardiac Surgery)
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