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Open research questions in Cardiac and Coronary Surgery Techniques

130 gap statements mined from Cardiac and Coronary Surgery Techniques papers in our 4.5M-paper local library, which holds 578 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • It highlights the need for dedicated risk instruments for certain procedures. The authors also discuss the challenge of selecting patients for surgery, particularly in cases where guideline-indicated surgery is withheld from eligible patients.

    Beyond Thirty Days: Risk, Reintervention, and Recovery in Contemporary Cardiovascular Surgery · 2026 · DOI

  • The relationship between sex-specific patterns of coronary artery disease and valvular heart disease and ABO blood groups is unclear. The impact of these patterns on renal function is not well understood.

    Add-Ons of Heart Disease from the Cardiosurgical Perspective: Gender, Blood Groups and Renal Function · 2026 · DOI

  • The relationship between EASIX and angiographic coronary collateral development in CTO remains limited. There is a need to identify factors associated with poorly developed CCC. The study aims to fill this gap by evaluating the association between EASIX and CCC grades in patients with CTO.

    Endothelial Activation and Stress Index Predicts Poor Coronary Collateral Development in Chronic Total Occlusion · 2026 · DOI

  • The need to balance the benefits of improved cosmesis with the potential risks and challenges of the alternative approach.

    Vertical Right Axillary Thoracotomy for Repair of Ventricular Septal Defects in Infants and Children: Experience with 50 Consecutive Cases · 2026 · DOI

  • The lack of MR-compatible perfusion systems has limited real-time assessment of cerebral perfusion. Current methods for monitoring cerebral blood flow have limitations.

    Establishment of an MR-Conditional Porcine Model for Real-Time Assessment of Cerebral Blood Flow During Extracorporeal Circulation · 2026 · DOI

  • The retrospective design limited the ability to control for certain factors. The lack of centralized core laboratory adjudication and blinding of echocardiographers may have introduced variability in the measurements.

    Left Ventricular Remodeling After Total Coronary Revascularization via Anterior Thoracotomy Versus Conventional Coronary Artery Bypass Grafting · 2026 · DOI

  • The impact of TCRAT on postoperative left ventricular systolic function and ventricular remodeling is not well defined. There is a lack of direct comparison between TCRAT and MS-CABG in terms of left ventricular functional outcomes. The clinical significance of the difference in left ventricular end-diastolic diameter between TCRAT and MS-CABG is uncertain.

    Left Ventricular Remodeling After Total Coronary Revascularization via Anterior Thoracotomy Versus Conventional Coronary Artery Bypass Grafting · 2026 · DOI

  • The study faced challenges in terms of treatment-selection bias, which was addressed using propensity score matching. The study also faced challenges in terms of the limited number of patients at risk over time, resulting in wider confidence intervals and reduced statistical reliability.

    Does Total Arterial Revascularisation Confer a Survival Advantage in Moderate Left Ventricular Dysfunction? A Retrospective Cohort Study of 1866 Patients · 2026 · DOI

  • The need for early identification and optimization of vulnerable patients. The lack of comprehensive narrative reviews on the role of frailty.

    Contemporary Cardiac Surgery—Towards Granular Precision in Surgical Care · 2026 · DOI

  • Minimally invasive robotic approaches have been limited to a narrow patient population due to resource limitations, a steep learning curve, and patient selection. There is a need to extend the boundaries of robotic-assisted minimally invasive direct coronary artery bypass to encompass more patients with complex multivessel disease.

    Extending the Indications for Full Revascularization with Robotic-Assisted Coronary Artery Bypass · 2026 · DOI

  • The study notes that the incidence and impact of postoperative vasoplegia in patients undergoing durable continuous flow left ventricular assist device implantation is a challenge that needs to be addressed.

    Incidence, Predictors and Outcome of Vasoplegia After Left Ventricular Assist Device Implantation · 2026 · DOI

  • Further studies are needed to evaluate the long-term effects of CPB on retinal parameters. Research on the effects of CPB on other ocular structures is necessary. Investigation of the relationship between CPB and retinal changes in patients with systemic diseases is required.

    Alterations in retinal microcirculation following cardiac surgery: a prospective observational study using optical coherence tomography angiography · 2026 · DOI

  • The effect of cardiopulmonary bypass on the structural and vascular parameters of the retina is not well understood. There is a lack of studies investigating the correlation between retinal parameters and the duration of surgery, CPB, and ACC time.

    Alterations in retinal microcirculation following cardiac surgery: a prospective observational study using optical coherence tomography angiography · 2026 · DOI

  • There was a 15-year period without scientific publications on the topic of endoscopic IMA harvest. The paper aims to fill this gap by providing an overview of the technique from its inception to the present. The gap in the literature is the lack of recent studies on the non-robotic endoscopic harvest of the internal mammary artery.

    Non-Robotic Endoscopic-Assisted Internal Mammary Artery Harvest—A Historical Review and Recent Advancements · 2025 · DOI

  • There is a lack of data on the safety and outcomes of TCRAT in octogenarians. The role of TCRAT in the treatment of multivessel coronary artery disease in elderly patients remains uncertain. The study aims to fill this gap by investigating the in-hospital and midterm outcomes of TCRAT in octogenarians.

    Minimally Invasive Multivessel Coronary Artery Bypass Grafting Using Total Coronary Revascularization via Left Anterior Minithoracotomy in Octogenarians · 2025 · DOI

  • The influence of prior myocardial infarction (MI) on outcomes following MAG remains uncertain.

    Impact of Prior Myocardial Infarction on Outcomes Following Multiple Arterial Coronary Bypass Grafting: A Propensity-Matched Analysis · 2026 · DOI

  • This perspective may support earlier recognition, phenotype-based management and the development of more targeted therapeutic strategies in a clinically significant yet underexplored area of cardiovascular critical care.

    Vasoplegia in Cardiac Surgery and Mechanical Circulatory Support: From Cardiopulmonary Bypass to Advanced Circulatory Support Devices · 2026 · DOI

  • Importance: No-touch saphenous vein harvesting preserves perivascular tissue and may improve graft patency after coronary artery bypass grafting (CABG), but whether it reduces long-term clinical events remains uncertain.

    No-Touch vs Conventional Vein Grafts in Coronary Surgery · 2026 · DOI

  • Women also have increased morbidity and mortality compared with men after coronary revascularization; however, outcomes for female patients with kidney failure undergoing dialysis remain understudied, particularly with multiarterial grafting (MAG) during CABG.

    Sex Differences in Arterial Grafting in Patients Undergoing Dialysis and Coronary Artery Bypass Grafting · 2026 · DOI

  • Adenosine, has been investigated as an adjunctive therapy to limit this injury; However, evidence supporting its intraoperative evidence, remains controversial.

    Evaluating direct intra-aortic adenosine administration for myocardial protection in cardiac surgery: A prospective pilot study · 2026 · DOI

  • Suture-based LAA closure has been shown to be unreliable, with incomplete closure rates as high as 36-60%. Mechanical exclusion of the LAA at the time of cardiac surgery has emerged as an important strategy for long-term stroke risk reduction, but achieving reliable and complete LAA exclusion during minimally invasive mitral valve surgery via right minithoracotomy remains technically challenging.

    Left Atrial Appendage Exclusion via Right Minithoracotomy Using an Epicardial Clip Device During Minimally Invasive Mitral Valve Surgery · 2026 · DOI

  • Survival estimates at 20 and 25 years are based on a limited subset of the original matched cohort.

    Does Total Arterial Revascularisation Confer a Survival Advantage in Moderate Left Ventricular Dysfunction? A Retrospective Cohort Study of 1866 Patients · 2026 · DOI

  • Data in younger patients remain the outstanding requirement, - The need for new risk models and techniques that account for long-term outcomes, - Further research on the predictors of failure for fast-track…

    Beyond Thirty Days: Risk, Reintervention, and Recovery in Contemporary Cardiovascular Surgery · 2026 · DOI

  • Future refinements are expected to include combined procedures, - Integration of robotic or endoscopic assistance is expected, - Long-term results are needed to confirm…

    The TCRAT Technique (Total Coronary Revascularization via Left Anterior Thoracotomy): Renaissance in Minimally Invasive On-Pump Multivessel Coronary Artery Bypass Grafting? · 2026 · DOI

  • Non-systematic search strategy, - Heterogeneity of surgical techniques and reported outcomes, - Limited generalizability due to evidence from experienced high-volume centers, - Lack of direct quantitative comparisons, - Qualitative…

    Beyond Surgical Access: Evidence Supporting a Multidimensional Concept of Surgical Invasiveness in Contemporary Cardiac Surgery · 2026 · DOI

Most-cited papers in Cardiac and Coronary Surgery Techniques

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Open questions raised by papers listed on this page include: (1) The relationship between sex-specific patterns of coronary artery disease and valvular heart disease and ABO blood groups is unclear (“Add-Ons of Heart Disease from the Cardiosurgical Perspective: Gender, Blood…”, 2026); (2) The relationship between EASIX and angiographic coronary collateral development in CTO remains limited (“Endothelial Activation and Stress Index Predicts Poor Coronary Collateral…”, 2026); (3) The lack of MR-compatible perfusion systems has limited real-time assessment of cerebral perfusion (“Establishment of an MR-Conditional Porcine Model for Real-Time Assessment of…”, 2026); (4) The lack of centralized core laboratory adjudication and blinding of echocardiographers may have introduced variability in the measurements (“Left Ventricular Remodeling After Total Coronary Revascularization via Anterior…”, 2026); (5) The lack of comprehensive narrative reviews on the role of frailty (“Contemporary Cardiac Surgery—Towards Granular Precision in Surgical Care”, 2026). 130 gap statements have been mined from Cardiac and Coronary Surgery Techniques papers in our 4.5M-paper local library, which holds 578 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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