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Article History

Received: 15 April 2025

Accepted: 7 August 2025

First Online: 30 August 2025

Declarations

:

: The authors declare that they have no conflict of interest.

: Details of the informed consent process for all participants who were enrolled in this research are provided in a separate section of the manuscript. The study was approved by the institutional committee on human research (approval number: B24-028), and the research protocol was considered acceptable by the committee.

: As this was an observational study utilizing existing medical records and biological samples, neither written nor verbal consent was obtained from the participants. However, to provide the participants (or their legal guardians) with the opportunity to opt out, information about the study was made publicly available on the websites of the Department of Cardiovascular Surgery, Kitasato University School of Medicine, and the Ethics Committee. If a participant requested excluded, the relevant data and samples were removed or destroyed and not included in the analysis.