Right lateral mini-thoracotomy approach for infective endocarditis in the aortic valve
Kayo Sugiyama1*, Hirotaka Watanuki1, Masato Tochii1, Katsuhiko Matsuyama1
1Department of Cardiac Surgery, Aichi Medical University Hospital
1 - 1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan
Purpose: To evaluate the clinical background and postoperative outcomes of patients with infective endocarditis in the aortic valve position and discuss the appropriate approach in the era of minimum invasive cardiac surgery.
Methods: We evaluated the preoperative background, intraoperative procedure, and postoperative outcomes of infective endocarditis in the aortic valve including 13 patients at our hospital. The right lateral mini-thoracotomy approach was introduced in six patients with localized infectious changes in the aortic valve.
Results: All surgical treatment were performed successfully, and there were no mortality or cardiac events related to recurrent infection. The right lateral mini-thoracotomy approach was completed safely; however, ventricular diverticulum was detected in multidetector computed tomography after surgery.
Conclusions: Infective endocarditis in the aortic valve was appropriately treated, and the postoperative course was favorable. The right lateral mini-thoracotomy approach is feasible, but it should be selected carefully only for cases with localized infection in the aortic valve.
DOI: 10.29245/2578-3025/2025/1.1222 View / Download PdfAnticoagulation Strategies After Spontaneous Retroperitoneal Hemorrhage in Patients Requiring Long-Term Anticoagulation
Niti Dalal1, Aabha Divya2
1Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
2Division of Cardiothoracic Surgery, Department of Surgery, Tulane School of Medicine, New Orleans, LA
Patients undergoing pulmonary endarterectomy surgery require lifelong anticoagulation to prevent thromboembolic complications. However, spontaneous retroperitoneal hemorrhage (SRH) represents a rare but severe complication of long-term anticoagulation. There are controversies regarding the optimal timing and strategy for resuming anticoagulation. This review explores the current evidence on long-term anticoagulation management following spontaneous retroperitoneal hemorrhage. This review aims to analyze risks, diagnostic tests, therapeutic approaches, and clinical outcomes. We refer to a case report of SRH following pulmonary thromboembolectomy surgery, and we discuss conservative and interventional management strategies for the management of long-term anticoagulation after significant bleeding complications such as SRH.
DOI: 10.29245/2578-3025/2025/1.1220 View / Download PdfThe effect of low-dose statins on blood pressure in patients with prehypertension and borderline elevated blood lipids
Zhuang Lu1#, Jing Liu2#, Tangjia Cui1, Yehua Lu1, Zhongwei Bao1, Qiuming He3, Yaming Yan1*
1Kangqiao Community Health Center, Shanghai 201319, China
2Department of Microbiology and Immunity, The College of Medical Technology, Shanghai University of Medicine & Health Sciences, Shanghai 201318, P.R. China
3Ruzhou Renai Hospital, Henan 467500, China
#These authors contributed equally to this work
Objective: This study aimed to examine the effects of low-dose statins on blood pressure in individuals diagnosed with prehypertension and borderline elevated blood lipids.
Methods: From January 2020 to June 2021, a cohort of 150 patients with prehypertension and borderline elevated blood lipids was recruited from the Kangqiao Community Health Service Center, Pudong New Area, Shanghai. Participants were randomly divided into an experimental group and a control group, each comprising 75 patients. Both groups received standard lifestyle interventions. Additionally, the experimental group was treated with low-dose statins, while the control group was given with placebo. The treatment duration was three months. Blood pressure (systolic blood pressure (SBP), diastolic blood pressure (DBP)), blood lipids (total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)), vascular endothelial function (nitric oxide (NO), endothelin-1 (ET-1), flow-mediated dilation (FMD)), and carotid intima-media thickness (IMT) were measured. These parameters were assessed at baseline, one month into treatment, and at the end of the three-month treatment period. Subsequently, patients were followed for two years to evaluate the incidence of hypertension.
Results: Both SBP and DBP showed a progressive decrease from baseline to three months in both the experimental group and control group, with the experimental group experiencing a more significant reduction. Statistically significant differences were observed between the two groups, over time, and in group-by-time interactions (P < 0.05). Similarly, reductions in TC, TG, and LDL-C were more pronounced in the experimental group, with significant differences between the two groups, time points, and group-by-time interactions (P < 0.05). Improvements in NO and FMD levels and reductions in ET-1 levels were more marked in the experimental group, with statistically significant differences (P < 0.05). IMT reduction was also more notable in the experimental group, with significant differences between groups, over time, and in group-by-time interactions (P < 0.05). After two years of follow-up, the experimental group had a lower prevalence of hypertension compared to the control group (P <0.05).
Conclusion: Low-dose statin therapy could effectively lower blood pressure and blood lipid levels, enhance vascular endothelial function, delay arteriosclerosis progression, and reduce the incidence of hypertension in patients with prehypertension and borderline elevated blood lipids.
DOI: 10.29245/2578-3025/2025/1.1217 View / Download PdfSingle-Pill Combination for Treatment of Hypertension: Only Better Adherence or Best Cardiovascular Prevention?
DOI: 10.29245/2578-3025/2025/1.1218 View / Download PdfAntonio Coca
School of Health and Life Sciences, Universitat Abat Oliba CEU, CEU Universities, Barcelona, Spain