Journal of Cardiothoracic Surgery最新文献

{"title":"Prognostic nutritional index is associated with severe postoperative complications after neoadjuvant immunochemotherapy for esophageal squamous cell carcinoma: a retrospective cohort study with threshold effect analysis.","authors":"Qiang Zhang, Qiuxia Liu, Zongxiang Lin, Pengfei Chen","doi":"10.1186/s13019-026-04511-0","DOIUrl":"10.1186/s13019-026-04511-0","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant immunochemotherapy (nICT) followed by esophagectomy has become the standard treatment for locally advanced esophageal squamous cell carcinoma (LA-ESCC). However, severe postoperative complications remain a significant clinical concern. The prognostic nutritional index (PNI), reflecting both nutritional and inflammatory status, may identify patients at elevated risk for complications. This study aimed to investigate the dose-response relationship between preoperative PNI and severe postoperative complications, identify potential thresholds for risk stratification, and explore heterogeneity by pathological response.</p><p><strong>Methods: </strong>This retrospective cohort study included 134 consecutive patients with LA-ESCC who received nICT followed by radical esophagectomy. Preoperative PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count (×10⁹/L). The primary outcome was severe postoperative complications (SPCs). Multivariable logistic regression, restricted cubic spline analysis, threshold effect analysis, and subgroup analyses were performed to evaluate the independent association of PNI and explore nonlinear relationships.</p><p><strong>Results: </strong>SPCs occurred in 29 patients (21.6%). Multivariable analysis demonstrated that preoperative PNI was independently associated with SPCs (adjusted OR from the primary parsimonious model = 0.86, 95%CI: 0.78-0.96, P = 0.006). When PNI was categorized into quartiles, compared with Q1, the adjusted ORs for Q2, Q3, and Q4 were 0.22 (95% CI: 0.06-0.75, P = 0.016), 0.11 (95% CI: 0.03-0.46, P = 0.003), and 0.29 (95% CI: 0.08-1.06, P = 0.061), respectively, with a significant trend across quartiles (P for trend = 0.016). Restricted cubic spline analysis revealed a nonlinear \"L-shaped\" relationship between PNI and SPCs (P for non-linearity = 0.045). Threshold effect analysis identified 50.00 as the inflection point: below this threshold, each unit increase in PNI was associated with a 25% reduction in SPC risk (OR = 0.75, 95% CI: 0.594-0.936, P = 0.011); above this threshold, no significant association was observed (OR = 1.09, 95% CI: 0.872-1.372, P = 0.438). Subgroup analysis revealed significant heterogeneity by pathological response (P for interaction = 0.011): the protective effect of higher PNI was pronounced in non-pCR patients (OR = 0.80, 95% CI: 0.69-0.92) but absent in patients achieving pCR (OR = 1.06, 95% CI: 0.88-1.28).</p><p><strong>Conclusions: </strong>Preoperative PNI is independently associated with severe postoperative complications in LA-ESCC patients receiving nICT, exhibiting a nonlinear \"L-shaped\" relationship with a threshold of 50.00. The observed interaction with pCR status is exploratory and hypothesis-generating. Future prospective studies are needed to confirm these findings before clinical implementation.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic evidence for a potential role of cytoskeleton-associated protein 2 in lung squamous cell carcinoma: a bidirectional mendelian randomization study.","authors":"Qiang Xie, Yuzuo Lin, Qingtong Wu, Ziyan Lin, Yanhong Cheng, Guodong Zhong, Lei Wang","doi":"10.1186/s13019-026-04634-4","DOIUrl":"10.1186/s13019-026-04634-4","url":null,"abstract":"<p><strong>Background: </strong>Cytoskeleton-associated protein 2 (CKAP2) plays a role in tumor proliferation, but its causal relationship with lung cancer remains unclear. This study employed a bidirectional two-sample Mendelian randomization (MR) analysis to investigate this association.</p><p><strong>Methods: </strong>Using genome-wide association and FinnGen data, we assessed the potential causal relationship between genetically predicted plasma CKAP2 levels and lung cancer risk, including its subtypes. The inverse-variance weighted (IVW) method served as the primary analysis, supplemented by MR-Egger and weighted median. Sensitivity analyses included leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO. To assess generalizability, we replicated the forward MR analysis using an independent deCODE pQTL dataset.</p><p><strong>Results: </strong>Forward MR showed a nominal association between elevated CKAP2 and lung squamous cell carcinoma (LUSC) risk (IVW: OR = 1.18; 95% CI = 1.01-1.38; P = 0.033). However, this did not survive Bonferroni correction (α = 0.0125) and was not replicated in an independent deCODE dataset (OR = 0.875; P = 0.493). No significant associations were found for overall lung cancer, lung adenocarcinoma, or small cell lung cancer. Sensitivity analyses revealed no heterogeneity or horizontal pleiotropy. Reverse MR found no causal effect of lung cancer on CKAP2 levels.</p><p><strong>Conclusions: </strong>This study provides nominally significant genetic evidence for an association between elevated CKAP2 levels and LUSC risk, but the finding does not survive multiple-testing correction and was not replicated in an independent dataset. Further validation in larger cohorts with harmonized proteomic platforms is required before CKAP2 can be considered a therapeutic target.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomic model with SHAP-based interpretability for predicting invasiveness of pure ground-glass nodules: a retrospective study based on high-resolution computed tomography (HRCT) volumetric datasets.","authors":"Hui Sheng, Rui Wang, Guowei Zhang, Ning Dong, Yunpeng Zhou, Ping Wang, Kexin Li, Guojie Bai","doi":"10.1186/s13019-026-04560-5","DOIUrl":"10.1186/s13019-026-04560-5","url":null,"abstract":"<p><strong>Background: </strong>Radiomics holds promise for lung cancer diagnosis. This study developed an interpretable radiomics-clinical model to predict the invasiveness of pure ground-glass nodules (pGGNs) on high-resolution computed tomography (HRCT). To address the model's \"black box\" nature, we applied the SHapley Additive exPlanations (SHAP) framework.</p><p><strong>Methods: </strong>We retrospectively analyzed 235 surgically resected, histopathologically confirmed pGGNs, classified as non-invasive (AAH/AIS/MIA) or invasive (IAC) according to the 2015 WHO classification of lung tumors. We developed three prediction models: clinical, radiomic, and combined. Feature selection for the radiomic and combined models employed LASSO regression. Model performance was assessed using AUC, calibration curves, and decision curve analysis (DCA). Additionally, SHAP was used to quantify feature importance and to generate individualized explanations.</p><p><strong>Results: </strong>Two clinico-radiological features (mean CT value, VolumePercent₋₃₀₀) and eight radiomic features were retained. The combined model yielded AUCs of 0.923 (training) and 0.832 (testing), outperforming the clinical model (0.799/0.733) and the radiomic model (0.917/0.827). Decision curve analysis (DCA) confirmed the superior clinical utility of the combined model. SHAP analysis ranked log_sigma_2_0mm_3D_firstorder_Range as the single most important predictive feature.</p><p><strong>Conclusions: </strong>The SHAP-augmented radiomics-clinical model offers an accurate and interpretable preoperative assessment of pGGN invasiveness. This tool can help clinicians choose the optimal surgical strategy and support individualized decision-making.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum long non-coding RNA SNHG9 as a diagnostic biomarker for acute coronary syndrome and a predictor of prognosis following percutaneous coronary intervention: a clinical evaluation.","authors":"Jinhe Chen, Yujuan Gao, Fan Liu, Yuan Li, Li Liu, Xiaona Jia","doi":"10.1186/s13019-026-04493-z","DOIUrl":"10.1186/s13019-026-04493-z","url":null,"abstract":"<p><strong>Background: </strong>With the change of lifestyle and the aging of the population, the incidence of Acute coronary syndrome (ACS) is increasing and showing a trend of younger patients. Therefore, the study of risk factors for ACS has important clinical implications for the diagnosis and prognosis of patients. The purpose of this study was to explore the role of long non-coding RNA (lncRNA) SNHG9 in the diagnosis and prognosis of ACS, with a view to developing new biomarkers for the diagnosis and prognosis of ACS.</p><p><strong>Methods: </strong>A total of 130 ACS patients and 99 healthy subjects were included in this study, and their serum SNHG9 levels were measured by RT-qPCR. The diagnostic value of SNHG9 in ACS was evaluated by ROC curve and binary Logistic analysis. Risk factors for major adverse cardiovascular events (MACE) in patients with ACS were analyzed using Kaplan-Meier curves and multivariate Cox regression. Correlation of SNHG9 levels with clinical indicators was analyzed using Pearson and Spearman methods.</p><p><strong>Results: </strong>SNHG9 was highly expressed in ACS patients compared to healthy subjects. Logistic analysis and ROC results showed high diagnostic accuracy of SNHG9 in ACS patients (OR = 7.106, P < 0.001; AUC = 0.929). Furthermore, SNHG9 expression was upregulated in the MACE events group compared to the group without MACE events. Kaplan-Meier curves indicated lower survival in ACS patients with high SNHG9 expression (P = 0.002). Cox results showed that SNHG9 is a risk factor for MACE events in ACS patients after treatment. Besides, SNHG9 was positively and significantly correlated with cTnI, NT-proBNP, hs-CRP, Gensini score, and the number of diseased vessels.</p><p><strong>Conclusions: </strong>SNHG9 has high predictive value for the diagnosis and prognosis of ACS patients, which may become a biomarker for clinical diagnosis and prediction of survival outcome in ACS patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of preoperative hematologic inflammation indices (NLR, PLR, SII) and clinical risk factors in predicting postoperative pulmonary complications after elective isolated on-pump coronary artery bypass grafting: a retrospective cohort study of 1034 patients.","authors":"Özden Vezir, Esra Ertürk Tekin","doi":"10.1186/s13019-026-04541-8","DOIUrl":"10.1186/s13019-026-04541-8","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary complications after coronary artery bypass surgery continue to be a significant problem, affecting 5-20% of patients, prolonging hospital stays and increasing costs. In this study, we investigated whether simple blood tests that measure inflammation, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), could help identify patients at risk before surgery.</p><p><strong>Methods: </strong>The records of 1034 patients who underwent elective coronary artery bypass grafting with heart-lung machine support between 2023 and 2024 were retrospectively reviewed. NLR, PLR, and SII values were calculated from routine blood tests performed the day before surgery. Patients who developed pulmonary complications were defined according to the European Perioperative Clinical Outcome (EPCO) definitions.</p><p><strong>Results: </strong>114 patients (11%) developed PPC. Preoperative inflammatory markers were significantly higher in patients with complications (NLR: 3.55 ± 1.07 vs. 1.79 ± 0.54, PLR: 156 ± 47 vs. 120 ± 36, SII: 825 ± 248 vs. 548 ± 164; all p < 0.001). ROC analysis demonstrated excellent discrimination for NLR (AUC 0.939), good for SII (AUC 0.818), and fair-to-good for PLR (AUC 0.724). In multivariate analysis, NLR was by far the strongest independent predictor of PPC, together with COPD, diabetes, active smoking, CPB and ACC durations. PLR and SII also reached statistical significance, but with effect sizes very close to unity (adjusted OR 1.02 and 1.01 respectively), indicating that they offered minimal additional discriminatory value once NLR was taken into account.</p><p><strong>Conclusions: </strong>In this single-center retrospective cohort, preoperative NLR, PLR and SII were associated with PPC, with NLR accounting for most of the predictive signal. Because they are measured at a single preoperative timepoint, these indices reflect baseline inflammatory tone and cannot capture the acute, surgery-induced inflammatory response that drives postoperative pulmonary complications. In view of the single-center retrospective design, the absence of external validation, and the lack of comparison with validated risk scores such as EuroSCORE II or the STS score, these indices are not yet suitable to guide clinical decision-making on their own. Given their simplicity and ready availability, however, they appear to be promising candidate markers that merit further evaluation in prospective, multicenter studies also incorporating specific inflammatory mediators measured dynamically throughout the perioperative period.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A visualization analysis of research hotspots and trends in enhanced recovery after surgery (ERAS) for elderly patients based on web of science and scopus.","authors":"Chang Xiao, Yiting Wang, Yanfeng Sun, Shengqiang Zou, Xihu Yang","doi":"10.1186/s13019-026-04635-3","DOIUrl":"10.1186/s13019-026-04635-3","url":null,"abstract":"<p><strong>Aims: </strong>To analyze the research landscape and thematic evolution of enhanced recovery after surgery (ERAS) in elderly patients from 2009 to 2025 using bibliometric methods.</p><p><strong>Methods: </strong>Publications were retrieved from the Web of Science Core Collection and Scopus databases, limited to English articles and reviews. CiteSpace and VOSviewer were used to analyze annual publication trends, international and institutional collaboration networks, keyword co-occurrence, clustering, and burst detection.</p><p><strong>Results: </strong>A total of 773 publications were included. Annual publication output increased markedly after 2017. China (183 publications, 23.7%) and the United States (152 publications, 19.7%) were the leading contributors. Keyword clustering identified nine major thematic clusters (Q = 0.4617,S = 0.7527),with \"lung neoplasms\" and \"esophagus resection\" emerging as independent clusters. A sub-analysis revealed that 37 publications (4.8%) specifically addressed thoracic surgery, indicating that thoracic ERAS represents an emerging but still underdeveloped subfield within the overall ERAS research landscape. Among the top 20 high-frequency keywords, \"aged\" (519 occurrences, 67.1%) and \"enhanced recovery after surgery\" (504 occurrences, 65.2%) were the most prominent. Burst detection revealed 25 keywords with significant citation surges. Recent high-intensity bursts included \"functional status\" (strength = 7.18), \"preoperative exercise\" (strength = 6.28), and \"physiotherapy\" (strength = 5.38), indicating a shift toward functional recovery and prehabilitation. Major research themes focused on frail older populations, colorectal and oncologic surgical applications, perioperative analgesia, and prehabilitation strategies. Temporal overlay and burst analyses indicated sustained prominence of terms such as \"functional status\", \"frailty\", and \"preoperative exercise\".</p><p><strong>Conclusions: </strong>Research on ERAS in elderly patients has evolved into a multi-thematic knowledge structure with an increasing emphasis on functional outcomes and personalized perioperative management.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cartilage oligomeric matrix protein in pulmonary arterial hypertension associated with lung adenocarcinoma.","authors":"Dongqing Yan, Bangxian Hu, Shan Jiang, Junhang Zhang, Yun Li","doi":"10.1186/s13019-026-04514-x","DOIUrl":"10.1186/s13019-026-04514-x","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary arterial hypertension (PAH) associated with lung adenocarcinoma (LUAD) is a pathological condition that arises during LUAD progression. Cartilage oligomeric matrix protein (COMP) is an important extracellular matrix (ECM) glycoprotein and may mediate the relationship between PAH and LUAD.</p><p><strong>Methods: </strong>We collected chest-enhanced CT scans from clinical LUAD patients and screened for PAH using the Pulmonary Artery(PA)/ Aortic(A) ratio. By analyzing the TCGA-LUAD, GSE140797, and VSMCPRG gene sets, we identified gene signatures associated with PAH in LUAD. Additionally, we analyzed pathological samples, serum samples, EdU cell proliferation assays, and measurements of pulmonary artery vascular contractile function.</p><p><strong>Results: </strong>Our study retrospectively collected relevant data from 421 patients in our department between 2020 and 2025. In the LUAD group, the PA/A ratio ≥ 1 was significantly higher than in both the adenocarcinoma in situ (AIS) group and the Benign nodules group. Immunohistochemical(IHC) analysis of 17 pathological samples revealed significant upregulation of COMP in the LUAD group compared with normal lung tissue. Serum COMP optical density (OD) values were significantly higher in LUAD groups than in control groups, in both humans and mice.EdU assays demonstrated that human pulmonary artery smooth muscle cells (HPASMCs) co-cultured with COMP showed significantly higher proliferation rates than the control group. To assess the effect of COMP on pulmonary artery vasculature, rat and human experiments showed that the contractile force in the COMP group was significantly greater than that in the control group.</p><p><strong>Conclusions: </strong>These findings suggest that LUAD may be associated with PAH, and that COMP may promote PAH development by enhancing pulmonary artery smooth muscle cell proliferation and vascular contractility.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-stage surgical repair of congenital aortopulmonary window associated with interrupted aortic arch in two toddlers: a case report.","authors":"Junxiang Pan, Mengqi Zhao, Xiaoya Zhang, Enrui Zhang, Yongqiang Jin","doi":"10.1186/s13019-026-04612-w","DOIUrl":"10.1186/s13019-026-04612-w","url":null,"abstract":"<p><p>Congenital aortopulmonary window (APW) associated with interrupted aortic arch (IAA) is a rare and severe form of congenital heart disease. The optimal surgical timing and strategy remain challenging, particularly beyond infancy. We report two toddlers diagnosed with APW and IAA who underwent one-stage surgical repair. At the time of surgery, the children were 17 and 22 months old, with body weights of 6.6 kg and 8.0 kg, respectively. Both patients survived and experienced no perioperative complications. During postoperative follow-up of 12 and 19 months, respectively, the children demonstrated New York Heart Association (NYHA) class I cardiac function, with normal intracardiac anatomy and no evidence of residual shunting, vascular stenosis, or pulmonary hypertension. These cases indicate that delayed one-stage repair beyond infancy can be performed safely and effectively in selected patients with preoperative evaluation and individualized surgical planning.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary cryptococcosis showing a solitary nodule in patients with previous malignancy.","authors":"Keita Tobari, Atsushi Sano","doi":"10.1186/s13019-026-04618-4","DOIUrl":"10.1186/s13019-026-04618-4","url":null,"abstract":"<p><p>Pulmonary cryptococcosis is one of the pulmonary fungal infections caused by the inhalation of Cryptococcus neoformans. Pulmonary cryptococcosis shows various radiological findings and sometimes a pulmonary nodule on CT. We experienced three cases of pulmonary cryptococcosis showing a solitary nodule in patients with previous malignancy. All three cases show a newly emerging or growing nodule. Two cases whom FDG-PET was tested showed accumulation of FDG. All three cases underwent pulmonary resection and were pathologically diagnosed with pulmonary cryptococcosis. It is difficult to distinguish a pulmonary nodule due to cryptococcosis from pulmonary malignancy such as a primary lung cancer and a pulmonary metastasis. Especially, it is important to distinguish a pulmonary metastasis from a nodule due to infection in patients with previous malignancy. Surgical resection for diagnosis is often necessary for such cases.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside patent ductus arteriosus ligation via anterior mini-thoracotomy in preterm infants weighing ≤ 1500 g: a retrospective cohort study.","authors":"Serkan Secici, Seyyit Bahaettin Oncu, Serkan Terkanlıoglu","doi":"10.1186/s13019-026-04581-0","DOIUrl":"10.1186/s13019-026-04581-0","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamically significant patent ductus arteriosus (hsPDA) remains a major clinical challenge in preterm infants. Surgical ligation remains necessary in selected patients when medical treatment fails or is contraindicated, or when transcatheter closure is not feasible. Left anterior mini-thoracotomy (LAMT) has been proposed as a less invasive alternative, and bedside ligation in the neonatal intensive care unit (NICU) may avoid transport-related risks in critically ill neonates.</p><p><strong>Methods: </strong>This retrospective cohort study included preterm infants weighing ≤ 1500 g who underwent surgical PDA ligation between August 2020 and May 2025. Patients were grouped according to the location of surgery: bedside ligation in the NICU or ligation in the operating room (OR). All procedures were performed by a single surgeon using a standardized LAMT. Demographic characteristics, perioperative variables, postoperative outcomes, and mortality were compared between groups. Continuous variables were analyzed using the Mann-Whitney U test, and categorical variables using Fisher's exact test.</p><p><strong>Results: </strong>Sixty-eight preterm infants were included (NICU group, n = 25; OR group, n = 43). Baseline demographic characteristics and preoperative comorbidities were largely comparable between groups. All procedures were completed without conversion to sternotomy, intraoperative mortality, major bleeding, or vascular injury. The duration of postoperative mechanical ventilation, postoperative NICU stay, and postmenstrual age at NICU discharge did not differ significantly between groups. Two deaths occurred in the NICU group from progressive multiorgan failure on postoperative days 11 and 15. Both weighed less than 1000 g, had preoperative acute renal dysfunction, and required vasoactive support before surgery. Neither death was associated with an intraoperative complication. No surgical site infection or postoperative sepsis was documented in either group within the first 7 postoperative days.</p><p><strong>Conclusions: </strong>Bedside PDA ligation via LAMT was technically feasible in selected preterm infants weighing ≤ 1500 g, and all procedures were completed as planned. However, the small sample size and differences in referral status between groups limit definitive conclusions regarding comparative safety.</p><p><strong>Trial registration: </strong>Not applicable. This study is a retrospective observational study and did not require trial registration.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}