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Innovations and Challenges in Cardiovascular Surgery
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Innovations and Challenges in Cardiovascular Surgery

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

Deadline for manuscript submissions: 30 December 2025 | Viewed by 647

Special Issue Editor

Dr. Marc Leon

E-Mail Website
Guest Editor
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford University, 870 Quarry Road, Palo Alto, CA 94304, USA
Interests: cardiovascular surgery; minimally invasive surgery; robotic surgery; hybrid; 3D printing; artificial intelligence; mechanical circulatory support; heart transplantation; valve disease; aortic dissection; ischemic heart disease; heart failure

Special Issue Information

Dear Colleagues,

Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. Since Dr. John Gibbon's pioneering use of the heart-lung machine for open-heart surgery in 1953, cardiovascular surgery has served as a primary approach in the treatment. However, traditional open-surgical approaches are increasingly challenged by catheter-based endovascular techniques. This challenge has driven cardiovascular surgery toward minimally invasive approaches, including small-incision, off-pump, robotic, and hybrid surgeries, all designed to improve patient outcomes and speed recovery times. At the same time, rapid technological advancements, such as 3D printing, artificial intelligence, and advanced real-time imaging, are reshaping cardiovascular surgery, from planning and implementation to monitoring and perioperative care. Alongside these innovations, the evolving disease spectrum presents new demands: conditions such as age-related degenerative valve diseases, aortic dissections, ischemic heart disease, heart failure, and cases requiring repeated surgeries are becoming increasingly common. Addressing these complex cases requires more highly refined surgical and organ protective techniques. All these challenges mentioned above highlight the need for continuous innovation and collaboration between cardiovascular surgery and other disciplines.

This Special Issue welcomes contributions to these cutting-edge developments, including novel clinical research findings, explorations of new technologies, reviews of current and emerging therapeutic approaches, and educational case reports. We also encourage submissions of meaningful studies with negative results, acknowledging the importance of such findings in advancing the field. Through this collection, we aim to provide a robust platform for advancing knowledge in cardiovascular surgery, addressing current challenges, and showcasing innovations that will shape future practices and improve patient outcomes.

Dr. Marc Leon (also known as Hongliang Liang)
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 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

  • cardiovascular surgery
  • minimally invasive surgery
  • robotic surgery
  • hybrid
  • 3D printing
  • artificial intelligence
  • mechanical circulatory support
  • heart transplantation
  • valve disease
  • aortic dissection
  • ischemic heart disease
  • heart failure

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Published Papers (1 paper)

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Research

13 pages, 475 KB  
Article
Minimally Invasive Mitral Valve Replacement in the Gray Zone: Bioprosthetic vs. Mechanical Valves in Patients Aged 50–69 Years
by Alexander Weymann, Sadeq Ali-Hasan-Al-Saegh, Sho Takemoto, Nunzio Davide De Manna, Jan Beneke, Lukman Amanov, Fabio Ius, Ruemke Stefan, Bastian Schmack, Alina Zubarevich, Aburahma Khalil, Arjang Ruhparwar and Jawad Salman
J. Clin. Med. 2025, 14(18), 6666; https://doi.org/10.3390/jcm14186666 - 22 Sep 2025
Viewed by 157
Abstract
Background: Mitral valve replacement presents considerable challenges in the field of cardiothoracic surgery, particularly in patients aged 50 to 69, where the decision between bioprosthetic and mechanical valves is critical. Nevertheless, the optimal selection of prosthetic valves for candidates within this age-related [...] Read more.
Background: Mitral valve replacement presents considerable challenges in the field of cardiothoracic surgery, particularly in patients aged 50 to 69, where the decision between bioprosthetic and mechanical valves is critical. Nevertheless, the optimal selection of prosthetic valves for candidates within this age-related gray zone remains inadequately defined, necessitating a thorough evaluation of long-term outcomes and associated risks. Objective: This study aims to assess mid-term outcomes of MIMVR in patients aged 50 to 69, comparing reoperation rates, prosthesis-related morbidity, and overall survival between bioprosthetic and mechanical valves. While many prior studies on valve choice in patients aged 50 to 69 years are derived from sternotomy cohorts, the novelty of our work lies in the exclusive focus on patients undergoing minimally invasive techniques. Methods: A retrospective analysis was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, including 172 patients aged 50–69 years who underwent minimally invasive mitral valve replacement via right minithoracotomy at a high-volume center in Germany between 2011 and 2023. Of the 172 patients, 95 underwent MIMVR using biological prostheses, while 77 received mechanical prostheses. Comprehensive data on demographics, surgical procedures, and postoperative complications, as well as long-term outcomes, were analyzed. Results: With a mean follow-up of 7.1 years, early outcomes revealed no significant differences in 30-day mortality (7.4% for bioprosthetic vs. 2.6% for mechanical; p = 0.06). There was no significant differences in all-cause mortality at 1 year (8.4% vs. 3.9%; p = 0.22), 3-year (9.5% vs. 7.8%; p = 0.69), and 5-year (13.7% vs. 10.4%; p = 0.19), or at the longest follow-up (13.7% vs. 10.4%; p = 0.51). Kaplan–Meier analysis showed no significant difference in long-term survival between the groups (p = 0.5427). Postoperative arrhythmia occurred significantly more frequently in the biologic group compared to the mechanical group (18.9% vs. 6.5%; p = 0.01). Conclusions: For patients aged 50–69 undergoing MIMVR using a bioprosthetic or mechanical valve, the mid-term survival and incidence of reoperation and re-hospitalization were comparable up to 7 years. This provides evidence supporting the safe application of the MICS approach with either valve type in this gray-zone age group. Full article
(This article belongs to the Special Issue Innovations and Challenges in Cardiovascular Surgery)
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