Seminars in Thoracic and Cardiovascular Surgery最新文献

{"title":"Non-traditional Inflow, Outflow, and Biventricular Configurations of Durable Ventricular Assist Devices.","authors":"Aaron M Williams, Swaroop Bommareddi, John M Trahanas, Brian Lima, Awab Ahmad, Aniket S Rali, Sandip K Zalawadiya, Ashish S Shah","doi":"10.1053/j.semtcvs.2025.08.006","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.08.006","url":null,"abstract":"<p><p>Ventricular assist device (VAD) technologies have advanced in recent years from large, pulsatile devices to smaller continuous flow (CF) pumps. As such, their design has allowed surgeons to pioneer less invasive methods of implantation with alternative configurations to treat a larger number of patients with varied types of cardiomyopathies who are often sick with high-risk clinical scenarios. In recent years, these patients appear to have a higher degree of vascular disease and have had multiple prior cardiac surgeries. In this review, we highlight both standard as well as alternative VAD configurations including additional inflow and outflow cannulation techniques along with considerations for biventricular support for both durable biventricular VADs and as a total artificial heart configuration.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Clinicopathological and Inflammatory Markers in Surgically Treated Pulmonary Invasive Mucinous Adenocarcinoma.","authors":"Esra Zeynelgil, Serkan Gülcü, Dilek Çağlayan, Nesrin Gürcay, Abdulkadir Koçanoğlu, Serdar Karakaya","doi":"10.1053/j.semtcvs.2025.08.007","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.08.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Invasive mucinous lung adenocarcinoma (IMA) is a rare histological subtype representing 2-10% of lung adenocarcinomas and exhibits unique molecular and clinicopathological features. Due to its rarity and the limited number of published studies, prospective studies are not possible. Therefore, prognostic markers in patients with IMA who underwent surgery are still unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;Data from patients with histopathologically confirmed pure IMA who underwent surgery between May 2020 and December 2024 were retrospectively analyzed. Demographic data, tumor size, localization, lymph node status, visceral pleural invasion [VPI], airspace spread [STAS], adjuvant therapy, and hematological indices thought to be prognostic in other cancer types were calculated. Estimated DFS and OS were calculated by the Kaplan-Meier method, and prognostic factors were investigated by Cox regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 53 patients with surgically resected mucinous adenocarcinoma were included in the study. The median age was 66 years (range: 36-88). Of the patients, 54.7% were male (n = 29) and 45.3% were female (n = 24). Nineteen patients (35.8%) received adjuvant chemotherapy, and 7 patients (13.2%) received adjuvant radiotherapy. Postoperative pathological examination revealed that 24 patients (45.3%) had tumors ≥4 cm in diameter, 6 patients (11.3%) had lymph node metastasis, and 10 patients (18.9%) were STAS-positive. The estimated median disease-free survival (mDFS) for the overall population was 98.9 months. In patients with lymph node metastasis, mDFS was 4.5 months, while the median was not reached in patients without nodal involvement (log-rank, p &lt; 0.001). In the presence of pleural invasion, mDFS was 42.7 months, while it was not reached in patients without invasion (log-rank, p = 0.008). In STAS-positive patients, mDFS was 18.6 months, compared to not reached in STAS-negative patients (log-rank, p = 0.039). For tumors ≥4 cm, mDFS was 47.1 months, while it was not reached for tumors &lt;4 cm (log-rank, p = 0.021). Patients with right lung tumors had an mDFS of 52.8 months, whereas those with left lung tumors had a non-reached median (log-rank, p = 0.023). No significant differences in DFS were observed by age, sex, adjuvant chemotherapy, adjuvant radiotherapy, LVI, PNI and hematological indexes. The estimated median overall survival (mOS) for the entire cohort was 150.5 months. Patients with lymph node metastasis had a median OS of 10.2 months, while it was 150.5 months in patients without nodal involvement (p &lt; 0.001). In the presence of pleural invasion, the mOS was 76.5 months, compared to 150.5 months in its absence (p = 0.008). STAS-positive patients had a mOS of 24.6 months, whereas STAS-negative patients had a mOS of 150.5 months (p = 0.001). No statistically significant differences in OS were observed according to age, sex, adjuvant chemotherapy, adjuvant radiotherap","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Dischord to Dialogue: A Conflict Transformation Framework to Move Beyond DEI.","authors":"Ashley P Oliver","doi":"10.1053/j.semtcvs.2025.08.005","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.08.005","url":null,"abstract":"<p><p>Women, other underrepresented identities in cardiothoracic surgery and cardiothoracic anesthesia and their allies have made significant headway in improving the diversity, equity and inclusion (DEI) in cardiac surgery and cardiothoracic anesthesia. However, as successful as these efforts have been, they have also been met with resistance, which range in their etiologies and expression. Formal analysis of DEI resistance by professional societies, departments and divisions is lacking and yet may result in several important positive professional consequences. When conflict is left unengaged and unmanaged, it can have negative cultural effects including the erosion of trust and can amplify alienation of individuals and groups from one another. This weakens the power and efficacy of professional societies and weakens the goals of affinity and professional support. On the other hand, when professional groups explore challenged or contentious topics in structured or formal ways, this process can have the opposite effect. Formal dialogue can reduce toxic polarization: it can increase affinity, professional support, and strengthen organizations. Conflict transformation is a framework developed in an international peacekeeping context that can be useful to provide the rationale and the methodology for engaging in the conflict surrounding DEI, including more recent executive orders that ban work promoting inclusion or diversity. Specifically, conflict transformation -- a relational and context-focused framework -- can help professional societies reframe and navigate polarizing disagreements around DEI. The proposed strategies in this piece aim to use ideological conflict as an opportunity for growth. Improving discourse around these issues may improve engagement in professional societies and strengthen a culture of empathy and mutual respect. This may be the best path to ensuring excellence and equity medicine.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tempest Surrounding Lung Transplant for Lung Cancer, with Lung Cancer, or with Isolated Lung Metastases.","authors":"Nathan P Zwintscher, Marc de Perrot, Marcelo Cypel, Shaf Keshavjee","doi":"10.1053/j.semtcvs.2025.08.004","DOIUrl":"https://doi.org/10.1053/j.semtcvs.2025.08.004","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Opinion: Intensive Care Unit Resternotomy Should Be Practiced in All Facilities That Perform Cardiac Surgery.","authors":"S Jill Ley, Joel Dunning","doi":"10.1053/j.semtcvs.2025.08.003","DOIUrl":"10.1053/j.semtcvs.2025.08.003","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Artificial Heart vs Left Ventricular Assist Device and Biventricular Assist Device.","authors":"Tessa Watt, Ranjit John","doi":"10.1053/j.semtcvs.2025.08.002","DOIUrl":"10.1053/j.semtcvs.2025.08.002","url":null,"abstract":"<p><p>Biventricular heart failure remains a challenging issue in patients with end-stage cardiomyopathy requiring mechanical circulatory support options. Also, the Achilles heel of durable left ventricular assist devices (LVADs) remains right ventricular failure that significantly impacts morbidity and mortality. With recent changes in the heart transplant allocation system, there has been major shifts in practice patterns in the use of extracorporeal membranous oxygenation (ECMO), temporary VADs, and durable VADs in the treatment of biventricular failure and strategies for bridge to heart transplantation. Direct comparisons between devices are often difficult to make as there is a learning curve both at the provider level and institution level for each of these devices and strategies. The field continues to rapidly evolve, and the application of artificial intelligence may further hasten this growth.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Descending Aorta: Open or Thoracic Endovascular Aortic Repair for Patients with Hereditary Aortopathy.","authors":"James A Kelly, Jennifer C Y Chung, Joan Zalvidar, Thomas F Lindsay, Sean Crawford, Marcus Salvatori, Kongteng T Tan, Miranda Witheford, Maral Ouzounian","doi":"10.1053/j.semtcvs.2025.06.005","DOIUrl":"10.1053/j.semtcvs.2025.06.005","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Precision-Pathway to Preservation - Mastering Left S9,10 Segmentectomy in the Era of Lung-Sparing Surgery.","authors":"Chigozirim N Ekeke","doi":"10.1053/j.semtcvs.2025.08.001","DOIUrl":"10.1053/j.semtcvs.2025.08.001","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masthead (copyright and information page)","authors":"","doi":"10.1053/S1043-0679(25)00112-1","DOIUrl":"10.1053/S1043-0679(25)00112-1","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":"37 3","pages":"Page I"},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seventy Years Managing Hypoplastic Left Heart Syndrome - What has been Learned and What Remains to be Learned.","authors":"Samuel M Hoenig, Justin Robinson, Tara Karamlou","doi":"10.1053/j.semtcvs.2025.07.004","DOIUrl":"10.1053/j.semtcvs.2025.07.004","url":null,"abstract":"<p><p>In this review, we describe the evolution of the surgical management of Hypoplastic Left Heart Syndrome from its initial description through the development of contemporary interventional strategies. Through this account, we highlight lessons learned from prior comparisons and how these apply to the current debate, Norwood vs Hybrid palliations. The Congenital Heart Surgeons Society - Critical Left Ventricular Outflow Tract Obstruction Cohort has played an important role in defining outcomes and shows promise for future understanding.</p>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}