Editorial. Research Topic: Case Reports in Heart Surgery 2024

Giuseppe Gatti^*

• Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy

For the second consecutive year, I had the pleasure and honor of coordinating the (fourth) collection of 9 "Cases Reports in Heart Surgery" by Frontiers in Cardiovascular Medicine and Frontiers in Surgery. I am 10 sincerely grateful to the Editors-in-Chief for their renewed trust. 11 As for the previous edition, also for the 2024 collection the objective was to feature unique cases of 12 patients that present with an unexpected diagnosis, treatment outcome, or clinical course. This time too, 13 only original Case Reports that significantly will advance the cardiac surgical field – at least in my opinion 14 and that of the Reviewers who collaborated step by step with me in the manuscript review process – have 15 been considered. Rare cases with typical features, frequent cases with atypical features, as well as cases 16 with a convincing response to new treatments, were included in the present Research Topic. 17 The (undeclared) goal was also to match the excellent results achieved by the 2023 edition of collection, 18 which has reached over 26,000 views to date. I am confident! In fact, also the contributions selected in 19 this 2024 edition are rare and original clinical cases that could really offer many points of interest and 20 reflection for the readers of Frontiers, at least in my opinion. 21 The collection consists of 15 articles written by a total of 80 Authors from seven countries (China, 22 Colombia, Russia, Singapore, Switzerland, Türkiye and United States) on four different continents. To 23 date there have already been over 17,000 views. 24 The following are the main issues that were addressed in the present collection: 25 - The growing importance of minimally invasive surgery and interventional techniques and technologies 26 [1,5,7-10,13,14], and inevitably of their complications [1,5,7]. Obviously, the "minimally invasive" concept 27 should be understood in a broad sense, including minimal, mechanical and/or biological (humoral and cellular) invasiveness; - The essential need for multimodal imaging for complex cardiovascular lesions [1, 3-5,7,9,10,12-15]; - The essential need for multidisciplinary approach for diseases involving more organs or systems, including the heart [2,3,5-12,14,15]. To improve patient outcomes, in addition to the cardiologist and cardiac surgeon, other healthcare professionals, each within their own area of expertise, should also be involved in the management of complex cardiac patients and/or diseases. This according to the Latin maxim, "Unicuique suum" (To each his/her own); - The significant role of sometimes neglected (albeit life-threatening) complications such as sternal wound infections [2,7,11] and pericardial effusion [7]; An interesting report about two unresolved cases of late aortic endograft infection complicated by periaortic abscess [5] was (perhaps improperly) included in the present collection of case reports in heart surgery to familiarize cardiac surgeons with endovascular repair of the thoracic aorta and its rare but catastrophic complications involving the mediastinum. I synthesized the main message of each contribution to the present collection in Table 1. In 2023 Editorial [16] I stated: "Personally, I am particularly fond of the Case Reports sections of surgical Journals because they often include interesting and innovative contributions. The clinical presentation, diagnostic process and effective surgical treatment of rare conditions offer the reader stimulating food for thought. Sometimes there are reported cases of failure but of great educational value. However, Case Reports sections are increasingly rare nowadays in scientific Journals where more value is placed on large-scale studies such as multicenter studies, randomized controlled trials or meta-analyses. (...) Both for Heart Surgery and Interventional Cardiology, the most advanced frontiers of the disciplines are often glimpsed by analyzing Case Reports!". Today, after reviewing dozens of Case Reports for Frontiers, I could not agree with myself more. To conclude, I would like to sincerely thank all the valuable Reviewers and Co-editors who helped me in my task. I have certainly learned a lot from them throughout this experience. In addition, I would like to thank all the members of the Editorial Offices of the two valuable scientific Journals for having supported me at every moment of this experience. Thank you very much to all again! 4 Table 1: Case Reports in Heart Surgery 2024* First author Title Publication date DOI Total views† Main message Key words 1. Yunfei Tian Case Report: Minimally invasive management of suspected active bleeding from intercostal vessel after axillary thoracotomy ventricular septal defect repair: an application of Foley catheter May 27, 2025 doi.org/10.3389/fcvm.2025.1511221 640 Injury to the intercostal vessels during axillary thoracotomy can be a serious complication of minimally invasive cardiac surgery. The Authors reported a case of major bleeding following right axillary thoracotomy that was successfully treated using a Foley catheter inserted through the chest wall. Axillary thoracotomy; Foley catheter; Minimally invasive surgery 2. Zhaohui Wang Case Report: Deep sternal wound infection caused by Mycoplasma May 12, 2025 doi.org/10.3389/fcvm.2025.1538389 759 The Authors reported about a case of DSWI post-DSWI; Mycoplasma hominis hominis after cardiac surgery cardiac surgery caused by Mycoplasma hominis. Chunshui Liang Successful treatment of massive biventricular thrombi associated with myocarditis: a case report Apr 28, 2025 doi.org/10.3389/fcvm.2025.1530548 797 In a young man with stroke, massive bi-ventricular thrombosis associated with myocarditis was successfully treated with drugs alone, according to a multidisciplinary approach. Massive bi-ventricular thrombosis; Multidisciplinary approach; Myocarditis Jianggui Shan Case Report: "Dumbbell" giant right coronary artery ectasia with right atrial fistula Feb 28, 2025 doi.org/10.3389/fcvm.2025.1498359 943 Type IV giant ectasia of the right coronary artery, right atrial fistula, epicardial muscle bridge, as well as functional mitral regurgitation, were all successfully repaired in a middle-aged woman. The Authors discussed the origin and developing Cardiac fistula; Giant coronary aneurysm 6 stages of this complex cardiac lesion. 5. Danping Peng Aortic endograft infection after thoracic endovascular aortic repair: two case reports and literature review Feb 25, 2025 doi.org/10.3389/fcvm.2025.1549613 919 Two unresolved cases of late aortic endograft infection complicated by peri-aortic abscess involving the posterior mediastinum were presented by the Authors, who emphasized the role of strict follow-up after TEVAR to prevent late life-threatening complications. A literature review about the topic was also reported. Mediastinitis; Periaortic abscess; TEVAR 6. Nicolas Nunez-Ordonez Case Report: A usual procedure in an unusual situation: a patient with a rare Ehlers Danlos/ Feb 24, 2025 doi.org/10.3389/fcvm.2025.1480363 1,071 A case of Ehlers Danlos/Osteogenesis Imperfecta Overlap Syndrome undergoing aortic valve replacement for Ehlers-Danlos syndrome; Multidisciplinary approach; Osteogenesis 7 osteogenesis imperfecta overlap undergoing aortic valve replacement aortic regurgitation was presented. The Authors emphasized the role of the multidisciplinary approach in managing patients with rare genetic disorders. imperfecta; Overlap syndrome 7. Muhammad Idu Case Report: Late presentation of post-coronary artery bypass surgery pericardial effusion heralding mediastinitis with tracheocutaneous fistula Feb 13, 2025 doi.org/10.3389/fcvm.2025.1483395 1,023 A case of late post-CABG pericardial effusion, complicated by mediastinitis and tracheocutaneous fistula, was illustrated. Mediastinitis; Pericardial effusion; Tracheocutaneous fistula 8. Özge Çetinarslan Case Report: Staged surgical management in ESRD: off-pump CABG followed by renal transplantation to enhance graft survival Feb 7, 2025 doi.org/10.3389/fcvm.2025.1486771 798 Two patients scheduled for renal transplantation because of end-stage renal failure underwent uneventful off-pump CABG without blood transfusion. Blood transfusion; Graft rejection; Off-pump CABG; Minimally invasive surgery 8 The Authors stigmatized the role of off-pump, compared to on-pump surgery, to minimize blood transfusions, which could eventually increase the risk of graft rejection. bicuspid aortic valve patient followed by reoperation for ascending aorta rupture: a case report atrial fistula occurred after a prior replacement of stenotic BAV combined with ascending aortoplasty for mild (43 mm) aortic dilation. Replacement of the ascending aorta was finally performed. Given the increased risk of future, severe complications, the Authors would like sensibilize the readers about the need to consider a resolution strategy of ascending aortic replacement in the presence of diseased BAV, even for cut-offs of aortic dilation lower than 45 mm (as fixed by the most recent Ascending aortic rupture; Ascending aortoplasty; BAV; Guidelines 12 role of preoperative three-dimensional imaging and intraoperative transesophageal echocardiography. 15 Hongjia Ma Case Report: Surgical management of traumatic giant coronary artery pseudoaneurysm with pericardial patch repair and ostium isolation Nov 8, 2024 doi.org/10.3389/fcvm.2024.1462557 633 A complex surgical repair of a giant coronary artery pseudoaneurysm caused by trauma was reported. The correct anatomical reconstruction was confirmed with transthoracic echocardiography at one month after surgery. Cardiac trauma; Giant coronary pseudoaneurysm