UCMC CT Surgery

08/05/2025

08/02/2025

“Mechanical valves over bioprosthesis for AVR
?! “
While this might be the reaction of a Cardiac surgeon or an Interventional cardiologist given the current norms in clinical practice, the following study from Bowdish and collegues using real-world 12-year data from STS database comparing bioprosthetic vs mechanical SAVR in >100,000 patients aged 40-75 years may seriously make you consider this question:
- After risk adjustment, mechanical SAVR was independently associated with lower all-cause mortality in patients less than or equal to 60 years of age.
- These findings persisted with sensitivity analyses
after excluding the potential influence of pure aortic insufficiency, intermediate/ high surgical risk, and discontinued prosthetesis.

Interestingly, this study also reported a 10% decrease in utilization of mechanical valves over the 12-year study period pre-dominantly owing to the anticoagulation liability with these devices.

One might ask:
“But won’t anticoagulants affect the active lifestyle of a young patient?”🧐

The counter evidence to this fear of anticoagulant use in young patients in current clinical practice has been quoted by Dearani and collegues in their editorial as follows:

“With the current lower INR range (2-2.5) for aortic prostheses and advancements in home monitoring, the complications associated with anticoagulation are much less than generally perceived. Studies have shown that the risk of severe complications, such as fatal intracranial hemorrhage, can be reduced to levels comparable to those seen in the general population.”
“Patients who receive the On-X mechanical aortic valve have the option of using a lower INR target of 1.5 to 2.0 with the addition of aspirin, provided at least 3 months have passed since surgery”

Although given the retrospective nature of the study and lack of comparisons with TAVR bioprosthesis, these findings might not be enough to affect our clinical practice right away, they are enough to reconsider how we perceive mechanical valves usage in younger patients.

Find out more in the full texts of these articles:

https://www.sciencedirect.com/science/article/abs/pii/S0735109725001585?via%3Dihub

https://www.annalsthoracicsurgery.org/article/S0003-4975(25)00175-4/abstract

The study by Bowdish and colleagues1 confirms what has been known but largely ignored by our specialty about prosthetic valve choice for aortic valve replacement (AVR), and the findings are a wake-up call for clinicians, patients, and industry partners. For more than 2 decades, studies from large in...

07/31/2025

Robotic Resection of a Posterior Mediastinal Nerve Sheath Tumor

This unique video presents a case of a patient with a benign posterior mediastinal nerve sheath tumor with concurrent neurosurgical and thoracic resection, showcasing the robotic thoracic resection of the tumor.

🔗https://ow.ly/sOSy50Vtmo7

07/29/2025

Aorto-Left Ventricular Tunnel With Intraoperative Right Coronary Artery Occlusion: A Surgical Perspective

This outstanding video demonstrates the surgical management of an aorto-left ventricular tunnel in an 11-month-old infant.

🔗https://ow.ly/Ira250WwmlC

07/28/2025

Does duration of ECMO bridge-to-transplant affect posttransplant outcomes? 🧐
In adjusted analysis, ECMO bridge for a period of 9 days or more effects 6 months post-transplant survival but this effect seems to disappear at 1 year follow-up.
More in the following:

07/26/2025

Anomalous Aortic Origin of the Right Coronary Artery From the Wrong Sinus of Valsalva (AAORCA): Two Surgical Strategies

This remarkable video demonstrates two different surgical techniques for repairing anomalous aortic origin of the right coronary artery: translocation and unroofing.

🔗https://ow.ly/F5vS50Wvouy

07/25/2025

✨Can radiotherapy have anticancer immunostimulatory response? 🧐

✨ John Hopkins researchers found following when comparing systemic immunomodulatory effects of stereotactic body radiation therapy (SBRT)+pembrolizumab vs pembrolizumab monotherapy in patients with immunologically cold(unresponsive) non-small cell lung cancer.

🔎Patients in the SBRT had longer progression-free survival
🔎Patients in the SBRT arm had higher induction of tumor stimulatory gene sets in non-irradiated tumor sites
🔎 Significant new and pre-existing antitumor T-cell growth in both the local and systemic compartments was noted in participants with long-term survival after radio immunotherapy.

🧐For more information visit the following:

Huang et al. analyzed serial samples from participants with metastatic non-small cell lung cancer treated with radiotherapy followed by immunotherapy and report improved clinical outcomes and enhanced antitumor responses in immunologically cold tumors.

07/23/2025

Uniportal VATS Decortication for Late-Stage TB Empyema

This incredible video demonstrates a minimally invasive step-by-step approach to performing uniportal thoracoscopic decortication for late-stage tuberculous empyema, which is often considered suitable only for open surgery.

🔗https://ow.ly/6mkl50Wty5G

07/22/2025

07/17/2025

UC Health cardiac surgeons Dr. Cristiano Spadaccio and Dr. Antonio Panza have successfully implanted Ohio’s first fully tissue-engineered tricuspid valve in an adult patient. This breakthrough helps restore healthy blood flow through the right side of the heart. Using the patient’s own tissue means lower risk of complications, no need for lifelong blood thinners and longer-lasting results.

UC Health is one of 14 hospitals in the country to offer this device. We’re proud to bring this advanced care to our community.