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Clinical Advances in Ischemic Heart Disease
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Clinical Advances in Ischemic Heart Disease

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

Deadline for manuscript submissions: 15 September 2024 | Viewed by 793

Special Issue Editors

Dr. Stefano Schena

E-Mail Website
Guest Editor
Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
Interests: complex myocardial revascularization; multi-arterial grafting; atrial fibrillation; aorta; minimally invasive cardiac surgery
Dr. Andrea Amabile

E-Mail Website
Guest Editor Assistant
Division of Cardiac Surgery, Yale University, New Haven, CT 06520, USA
Interests: minimally invasive cardiac surgery; robotic cardiac surgery; mitral valve surgery; cardiac surgery outcomes; robot-assisted cardiac surgery; outcomes-based research

Special Issue Information

Dear Colleagues,

Coronary artery disease (CAD) remains one of the leading causes of death worldwide; however, the past two decades have witnessed tremendous progress in the diagnosis and clinical and surgical treatment of severe CAD and ischemic cardiomyopathy. Computed tomography and magnetic resonance angiography are now established modalities for both anatomic and functional evaluation, alongside traditional testing such as echocardiography and left heart catheterization. The integration of modern imaging techniques with artificial intelligence appears imminent. Moreover, recent guidelines have more clearly defined the roles of both percutaneous therapies (PCI) and coronary artery bypass surgery (CABG) in the treatment of coronary artery disease. Even so, the increasing complexity of severe CAD cases nowadays demands a multidisciplinary approach and, as such, patients may require proper medical or mechanical optimization soon after diagnosis.

Additionally, ischemic heart disease has a significant impact on valvular function, with ischemic mitral and tricuspid regurgitation being a frequent complication of ventricular pathologic remodeling. Thankfully, significant advancements have been made in this field as well, with new evidence on repair versus replacement techniques, as well as transcatheter strategies to restore proper valvular function.

We are therefore pleased to introduce this fascinating editorial initiative titled “Clinical Advances in Ischemic Heart Diseases”, and invite you to submit your original contributions or critical reviews of the existing literature to this Special Issue.

Our goal is to provide our readers with access to rigorously, peer-reviewed content on several aspects of coronary artery disease, including modern imaging, mechanical support of complex ischemic cardiomyopathy, modern revascularization techniques (hybrid, minimally invasive, and robotic), and treatment of ischemic valvulopathies, with ongoing advancements emerging in the foreseeable future.

Dr. Stefano Schena
Guest Editor

Dr. Andrea Amabile
Guest Editor Assistant

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

  • multidisciplinary approach
  • modern imaging
  • myocardial pre-habilitation
  • revascularization in severe ischemic cardiomyopathy
  • guidelines
  • complex PCI
  • hybrid treatment
  • minimally invasive surgery

Published Papers (2 papers)

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13 pages, 966 KiB  
Article
Functional Mitral Valve Regurgitation: Mitral Valve Repair or Replacement? Our “Road Map” for the Appropriate Strategy
by Konstantinos Sideris, Melchior Burri, Antonia Mayr, Stephanie Voss, Keti Vitanova, Anatol Prinzing, Bernhard Voss, Andrea Amabile, Arnar Geirsson, Markus Krane and Ralf Guenzinger
J. Clin. Med. 2024, 13(11), 3264; https://doi.org/10.3390/jcm13113264 - 31 May 2024
Abstract
Objectives: The optimal surgical approach for the treatment of functional mitral regurgitation (FMR) remains controversial. Current guidelines suggest that the surgical approach has to be tailored to the individual patient. The aim of the present study was to clarify further aspects of this [...] Read more.
Objectives: The optimal surgical approach for the treatment of functional mitral regurgitation (FMR) remains controversial. Current guidelines suggest that the surgical approach has to be tailored to the individual patient. The aim of the present study was to clarify further aspects of this tailored treatment. Methods: From 01/2006 to 12/2015, 390 patients underwent mitral valve (MV) surgery for FMR (ischemic n = 241, non-ischemic n = 149) at our institution. A regression analysis was used to determine the effect of MV repair or replacement on survival. The patients were analyzed according to the etiology of the MR (ischemic or non-ischemic), different age groups (<65 years, 65–75 years, and >75 years), LV function, and LV dimensions, as well as the underlying heart rhythm. Results: The overall survival rates for the repair group at 1, 5, and 8 years were 86.1 ± 1.9%, 70.6 ± 2.6%, and 55.1 ± 3.1%, respectively. For the same intervals, the survival rates in patients who underwent MV replacement were 75.9 ± 4.5%, 58.6 ± 5.4%, and 40.9 ± 6.4%, respectively (p = 0.003). Patients younger than 65 years, with an ischemic etiology of FMR, poor ejection fraction (<30%), severe dilatation of left ventricle (LVEDD > 60mm), and presence of atrial fibrillation had significantly higher mortality rates after MV replacement (HR, 3.0; CI, 1.3–6.9; p = 0.007). Patients between 65 and 75 years of age had a higher risk of death when undergoing mitral valve replacement (HR, 1.7; CI, 1.0–2.8; p = 0.04). In patients older than 75 years, the surgical approach (MV repair or replacement) had no effect on postoperative survival (HR, 0.8; CI, 0.4–1.3; p = 0.003). Conclusions: Our data demonstrate that, in patients younger than 65 years, the treatment of choice for FMR should be MV repair. This advantage was even more evident in patients with an ischemic origin of MR, a poor ejection fraction, a severe LV dilatation, and atrial fibrillation. Full article
(This article belongs to the Special Issue Clinical Advances in Ischemic Heart Disease)

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10 pages, 2880 KiB  
Technical Note
Robotic-Assisted Minimally Invasive Direct Coronary Artery Bypass Grafting: A Surgical Technique
by Laura Giroletti, Ascanio Graniero and Alfonso Agnino
J. Clin. Med. 2024, 13(8), 2435; https://doi.org/10.3390/jcm13082435 - 22 Apr 2024
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Abstract
In recent years, there has been a growing interest in robotic-assisted coronary artery revascularization in Europe. Two different types of surgery can be performed using a robotic platform: RA-MIDCAB, in which the mammary artery is harvested endoscopically with robotic assistance and off-pump bypass [...] Read more.
In recent years, there has been a growing interest in robotic-assisted coronary artery revascularization in Europe. Two different types of surgery can be performed using a robotic platform: RA-MIDCAB, in which the mammary artery is harvested endoscopically with robotic assistance and off-pump bypass graft is achieved under direct vision through mini thoracotomy, and TE-CAB, completely robotically performed. We started the robotic cardiac surgery program for mitral valve disease in our hospital, Humanitas Gavazzeni (Bergamo, Italy), in 2019; and in 2021, we addressed our experience with RA-MIDCAB. After a learning curve period, we have developed our technique to optimize the benefits offered by the robotic platform, tailoring strategy to individual patients, based on preoperative radiological images. Full article
(This article belongs to the Special Issue Clinical Advances in Ischemic Heart Disease)
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