New Insights into Cardiovascular and Minimally Invasive 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 May 2025 | Viewed by 2008

Special Issue Editors


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Guest Editor
Department of Cardiac Surgery, Klinikum Passau, 94032 Passau, Germany
Interests: coronary artery bypass grafting; minimally invasive cardiac surgery; surgery of thoracic aorta; reconstructive valve surgery; future of cardiac surgery
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Guest Editor
Department of Cardiothoracic Surgery, Klinikum Fulda gAG, Pacelliallee 4, 36043 Fulda, Germany
Interests: coronary artery bypass grafting; valve surgery; minimally invasive cardiac surgery; aortic surgery; training in cardiac surgery

Special Issue Information

Dear Colleagues,

Cardiac surgery, on the one hand, has reached very respectable standards in established fields like coronary artery bypass grafting and valve surgery, while other fields, like aortic arch surgery, do profit from dynamic changes. Overall, cardiac surgery continues to offer very sustainable therapies to patients, which represents its most significant advantage over interventional therapies.

On the other hand, the further development of the Heart Team has led to very precise definitions of the most suitable therapy for individual patients.

We encourage our colleagues to contribute to this Special Issue, which is meant as a platform for displaying the latest developments and established strategies in cardiac surgery.

Prof. Dr. Parwis Massoudy
Prof. Dr. Hilmar C. Dörge
Guest Editors

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Keywords

  • coronary artery bypass grafting
  • aortic valve surgery
  • mitral valve surgery
  • aortic surgery
  • minimally invasive cardiac surgery

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Published Papers (2 papers)

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Research

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10 pages, 229 KiB  
Article
Renal Outcome in Patients Undergoing Minimally Invasive Total Coronary Revascularization via Anterior Minithoracotomy Compared to Full Median Sternotomy Coronary Artery Bypass Grafting
by Christian Sellin, Sarah Laube, Volodymyr Demianenko, Robert Balan, Hilmar Dörge and Peter Benoehr
J. Clin. Med. 2024, 13(18), 5418; https://doi.org/10.3390/jcm13185418 - 12 Sep 2024
Viewed by 951
Abstract
Objective: Renal dysfunction and acute renal failure after coronary artery bypass grafting (CABG) are among the main causes of increased mortality and morbidity. A sternum-sparing concept of minimally invasive total coronary revascularization via anterior minithoracotomy (TCRAT) was introduced with promising early and midterm [...] Read more.
Objective: Renal dysfunction and acute renal failure after coronary artery bypass grafting (CABG) are among the main causes of increased mortality and morbidity. A sternum-sparing concept of minimally invasive total coronary revascularization via anterior minithoracotomy (TCRAT) was introduced with promising early and midterm outcomes in multivessel coronary artery disease. There are limited data regarding renal complications in patients undergoing the TCRAT technique. The present study analyzed renal outcomes in TCRAT compared to CABG via full median sternotomy (FS). Methods: We analyzed the records of 227 consecutive TCRAT patients (from September 2021 to June 2023) and 228 consecutive FS patients (from January 2017 to December 2018) who underwent nonemergent CABG. Following propensity score matching, preoperative baseline characteristics—including age, sex, diabetes mellitus, arterial hypertension, left ventricular ejection fraction, EuroSCORE II, preoperative serum creatinine, estimated glomerular filtration rate (eGFR), serum urea, and pre-existing chronic renal insufficiency—were comparable between the TCRAT (n = 170) and the FS group (n = 170). The examined postoperative renal parameters and complications were serum creatinine, eGFR, and serum urea on the first postoperative day. Moreover, serum creatinine, eGFR and serum urea at the time of discharge, postoperative ARF, and hemodialysis were investigated. Additionally, the duration of operation, CPB time, aortic cross-clamp time, ICU and hospital stay, ECMO support, rethoracotomy and in-hospital mortality were analyzed. The parameters were compared between groups using a Student’s t-test or Mann–Whitney U test. Results: The duration of operation (332 ± 66 vs. 257 ± 61 min; p < 0.05), CPB time (161 ± 40 vs. 116 ± 38 min; p < 0.05), and aortic cross-clamp time (100 ± 31 vs. 76 ± 26; p < 0.05) were longer in the TCRAT group. ICU (1.8 ± 2.2 vs. 2.9 ± 3.6 days; p < 0.05) and hospital (10.4 ± 7.6 vs. 12.4 ± 7.5 days; p < 0.05) stays were shorter in the TCRAT group. There were no differences between groups with regard to the renal parameters examined. Conclusions: Despite a prolonged duration of operation, CPB time, and aortic cross-clamp time when using the TCRAT technique, no increase in renal complications were found. In addition, ICU and hospital stays in the TCRAT group were shorter compared to CABG via full median sternotomy. Full article

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12 pages, 1951 KiB  
Case Report
Successful Treatment of Unilateral Pulmonary Edema as Minimally Invasive Mitral Valve Surgery Complication—Case Presentation
by Marius Mihai Harpa, Sânziana Flamind Oltean, Hussam Al Hussein, David Emanuel Anitei, Iulia Alexandra Puscas, Cosmin Marian Bănceu, Mihaly Veres, Diana Roxana Opriș, Radu Alexandru Balau and Horatiu Suciu
J. Clin. Med. 2024, 13(24), 7654; https://doi.org/10.3390/jcm13247654 - 16 Dec 2024
Viewed by 622
Abstract
Background/Objectives: In recent decades, the advantages of minimizing surgical trauma have led to the development of minimally invasive surgical procedures. While the benefits often outweigh the risks, several challenges are encountered that are not present in conventional surgical approaches. Unilateral pulmonary edema (UPE) [...] Read more.
Background/Objectives: In recent decades, the advantages of minimizing surgical trauma have led to the development of minimally invasive surgical procedures. While the benefits often outweigh the risks, several challenges are encountered that are not present in conventional surgical approaches. Unilateral pulmonary edema (UPE) after mitral interventions performed through a right-sided approach is a rare but potentially life-threatening event. Methods: We present the case of a 49-year-old patient who underwent endoscopic mitral valve repair. Immediately following ICU admission, the patient’s oxygen saturation suddenly dropped, and serous discharge was exteriorized from the endotracheal tube, with a thoracic X-ray revealing right-sided unilateral pulmonary edema. Results: The therapeutical course was complex. The patient developed hemodynamic instability, leading to cardiac arrest, which required cardiopulmonary resuscitation and the initiation of peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The endotracheal cannula was replaced with a right-sided double-lumen cannula, and the patient was placed on two ventilators operating independently. The patient was weaned off extracorporeal membrane oxygenation (ECMO) on the fifth day and extubated on the sixth postoperative day. Conclusions: We successfully treated this patient using ECMO and independent lung ventilation. Several cases have been described in the literature, but the pathogenesis and risk factors of UPE remain unclear. Management depends on the severity of UPE, but a deeper understanding of its underlying mechanisms could provide cardiac surgeons with enhanced strategies for preventing UPE and implementing timely interventions. Full article
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