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The large incisions and long recovery periods that accompany traditional cardiac surgery procedures along with the constant patient demand for minimally invasive procedures have motivated cardiac surgeons to implement the robotic technologies in their armamentarium. The robotic systems have been utilized successfully in various cardiac procedures including atrial septal defect repair, left atrial myxoma resection, MAZE procedure and left ventricular lead placement, yet coronary artery bypass and mitral valve repair still comprise the vast majority of them. This review analyzes the development of the robot-assisted cardiac surgery in recent years, its outcomes, advantages, disadvantages, its patient selection criteria as well as its economic feasibility. Robotic endovascular surgery, albeit its limited applications, is presently considered an attractive alternative to conventional endovascular approaches. The increased flexibility and precision along with the wider range of accessible anatomy provided by the endovascular robotic systems, have increased the pool of patients that can be offered minimally invasive treatment options and have helped to overcome many limitations of the traditional endovascular procedures. With this review we aimed to summarize the applications of the commercially available endovascular robotic devices, as well as the limitations and the future perspectives in the field of endovascular robotic surgery., (Copyright © 2022. Published by Elsevier Inc.)

Introduction: The aim of this paper is to systematically review the existing literature reporting on patients recruited during the past twenty years regarding the role of left ventricular (LV) reconstruction in ischemic cardiomyopathy in terms of efficacy and mortality and provide an updated overview of the current evidence., Evidence Acquisition: The PubMed and Cochrane bibliographical databases were thoroughly searched for the following MeSH terms: "ventricular reconstruction" OR ventriculoplasty OR "ventricular aneurysm" OR "ventricular restoration." Original studies -recruiting patients during the past twenty years- on LV reconstruction surgery in more than five cases and reporting on the associated peri- or postoperative mortality were deemed eligible., Evidence Synthesis: Twenty-seven studies were included and provided data for 3220 patients with a mean age of 61 years. Angina was present in 66.6% (510/766) of the patients, while nine out of ten (635/699) had a history of myocardial infarction. Average preoperative ejection fraction was 29.9% and end-systolic volume index was 93.6 mL/m2. With respect to complications, low cardiac output syndrome and the need for intra-aortic balloon pump were prevalent in 9.3% (79/850) and 18.8% (334/1773), respectively. Thirty-day mortality was 7.1% (230/3220) and late-mortality (mean follow-up of 36.9 months) was 19.6% (548/2791), while the rate of MACCE was 40.1% (367/915). Five-year mortality was 29% (340/1171)., Conclusions: Our findings provide a current perspective of the role of LV reconstruction in the treatment of ischemic cardiomyopathy suggesting its benefit in survival. Taking into consideration the existing debate, further studies are required so that a solid conclusion to be made.

The application of robotic technologies in cardiac surgery has provided the possibility for minimally invasive access inside the thorax and avoidance of a median sternotomy. Given that current evidence seems promising, we sought to systematically review the existing literature regarding the efficacy, feasibility and mortality rate associated with robotic cardiac surgery. The PubMed and Cochrane bibliographical databases were thoroughly searched for the following MeSH terms: "robotic", "cardiac surgery" and "heart surgery". Original studies on robotic cardiac surgery in more than ten cases and reporting on the associated peri- or post-operative mortality were deemed eligible. Twenty-eight studies were included and provided data for 5993 patients with a mean age of 59.8 years. Approximately, one out of two patients (49.2%) underwent robotic CABG, while the other half (49.9%) underwent robotic MVR. Robotic atrial septal defect repair and atrial tumor resection were performed in a small proportion (0.9%) of the patients. Mean 30-day mortality was 0.7% ranging from 0 to 0.8% among the different types of surgery, while late mortality was 0.8% ranging from 0 to 1% with a mean follow-up period of 40.1 months. Our findings demonstrate that the application of robotics in cardiac surgery has provided a safe and efficacious alternative to the traditional techniques. However, more trials are necessary to elucidate all of its aspects.

Objectives: Proteomic analysis of patients with advanced cardiovascular disease was conducted to identify possible biomarkers for atrial fibrillation (AF)., Methods: A total of 123 patients undergoing cardiac surgery (22 with AF and 101 without AF) and 20 healthy subjects were recruited. Demographic data, patient history and blood samples were collected. Growth/differentiation factor 15, resistin, intracellular adhesion molecule-1, galectin-3, trefoil factor 3, tissue inhibitor of metalloproteinases 1, matrix metallopeptidase 9, high-sensitive troponin T, interleukins 6, 1α, 3, 4, 8, 20 and 22, tumour necrosis factor alpha, C-X-C motif chemokines 10 and 11, S100A6 and Type III procollagen were measured in blood serum. Differential expression between any 2 groups for any of the measured proteins was identified by fitting linear models, whereas Matthews Correlation Coefficient was used to evaluate their predictive capacity. Combined markers using more than 1 protein were attained via weighted Support Vector Machines., Results: Although serum levels of the markers were higher in patients with cardiovascular disease than in healthy subjects, only growth/differentiation factor 15 and resistin were significantly higher in patients with AF among the subpopulation who underwent heart surgery (P = 0.029 and P = 0.007, respectively). Specific pairs of several biomarkers had mediocre predictive capacity for AF., Conclusions: Growth/differentiation factor 15 and resistin are 2 markers that could be helpful in stratifying risk for AF in patients with cardiovascular disease. Yet, more research in terms of proteomics and investigation of possible molecular pathways implicated is required.

This systematic review sought to investigate the current evidence regarding surgical management of primary cardiac tumors in children and adolescents. Twenty-eight studies were deemed eligible, reporting on 745 pediatric patients. Rhabdomyoma was the most prevalent histologic type and echocardiography was the most common diagnostic tool. Cumulative 30-day mortality rate was 6.7%. Rhabdomyomas and teratomas had the highest 30-day mortality. The higher percentage of tumor relapse was noted for myxoma and teratoma. Although cardiac tumors are rare, their atypical clinical presentation, potential for recurrence, and the poor prognosis associated with recurrence elucidate the need for reliable diagnostic and therapeutic management.