Seminars in Thoracic and Cardiovascular Surgery最新文献

{"title":"Predictors of Intervention in Acute Type B Aortic Penetrating Ulcer and Intramural Hematoma","authors":"Michele Piazza MD ,&nbsp;Francesco Squizzato MD ,&nbsp;Luca Porcellato MD,&nbsp;Eugenia Casali MD,&nbsp;Franco Grego MD,&nbsp;Michele Antonello PhD","doi":"10.1053/j.semtcvs.2022.07.009","DOIUrl":"10.1053/j.semtcvs.2022.07.009","url":null,"abstract":"<div><p>We aimed to investigate predictors of intervention of acute type B aortic penetrating ulcer (PAU) and intramural hematoma (IMH). We conducted a retrospective chart review of all patients admitted for acute type B PAU or IMH in a tertiary referral hospital. Indications to intervention were “complicated” (rupture, impending rupture, malperfusion) or “high risk for unfavorable outcome” (refractory hypertension and/or pain despite best medical treatment, morphologic aortic evolution, transition to a new aortic syndrome, or increase in IMH/PAU depth &gt;5 mm) during the acute/subacute phase. The primary outcomes were overall mortality, aortic-related mortality, and freedom from intervention. Time-dependent outcomes were estimated with Kaplan-Meier curves. Cox proportional hazards models<span><span> were used to identify predictors of intervention and mortality. There were 54 acute aortic syndromes, 37 PAUs and 17 IMHs. Mean age was 69 ± 14 years and 33 patients (62.2%) were male. Six (11.5%) patients had complicated aortic syndromes and underwent urgent repair. Two (3.7%) additional patients developed an impending rupture during the acute phase. Eleven (21.1%) patients were classified as at “high risk” during the initial hospitalization. Overall, 22 (40.7%) patients required an aortic intervention during the initial admission (n = 16, 72.7% during the acute phase; n = 6, 27.3% during the subacute phase). In-hospital mortality was 5.5% (1 PAU and 2 IMH), and was aorta-related in all cases. For IMH, disease extension in &gt;3 aortic zones (HR 1.94, 95%CI 1.17–32.6; p = 0.038) and presence of ulcer-like projections (ULPs) (HR 1.23, 95%CI 1.02–9.41; p = 0.042) were associated with the need for intervention. There were no aortic-related deaths or intervention during the chronic phase. PAU width &gt;20 mm (HR 1.68, 95%CI 1.07–16.08; p = 0.014), PAU depth &gt;15 mm (HR 6.74, 95%CI 1.31–34.18; p = 021), PAU depth/total aortic diameter &gt;0.3 (HR 4.31, 95%CI 1.17–20.32; p = 0.043), and location at the level of the paravisceral aorta (HR 2.24, 95%CI 1.23–4.70; p = 0.035) were significantly associated with need for intervention. Six additional (16.2%) PAUs required intervention during the chronic phase owing to PAU growth. Maximum aortic diameter &gt;35 mm was significantly associated with intervention (HR 1.45, 95%CI 1.00–2.32; p = 0.037). Acute symptomatic type B IMHs and PAUs are characterized by a high risk of complications during the first month from presentation. Morphologic features associated with intervention were IMH with ULPs or extension in more than 3 aortic zones, as well as PAUs with depth&gt;15 mm, width &gt;20 mm, or depth/aortic diameter ratio&gt;0.3. A strict follow-up protocol or consideration for early intervention within 30 days from presentation should be taken into account for these high-risk patients. During the chronic phase imaging follow-up is particularly important for PAUs in order to identify progression to </span>saccular","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40587811","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 Retrospective Evaluation of Endo-Aortic Balloon Occlusion Compared to External Clamping in Minimally Invasive Mitral Valve Surgery","authors":"Husam H. Balkhy MD ,&nbsp;Eugene A. Grossi MD ,&nbsp;Bob Kiaii MD ,&nbsp;Douglas Murphy MD ,&nbsp;Arnar Geirsson MD ,&nbsp;Sloane Guy MD ,&nbsp;Clifton Lewis MD","doi":"10.1053/j.semtcvs.2022.11.016","DOIUrl":"10.1053/j.semtcvs.2022.11.016","url":null,"abstract":"<div><p><span><span><span><span><span>We compare outcomes of endo-aortic balloon occlusion (EABO) vs external </span>aortic clamping (EAC) </span>in patients<span> undergoing minimally invasive mitral valve surgery (MIMVS) in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database. Adults undergoing mitral valve surgery (July 2017–December 2018) were identified within the STS database (N = 60,607). Total 7,978 patients underwent a minimally invasive approach (including robotically assisted). About 1,163 EABO patients were 1:1 propensity-matched to EAC patients using exact matching on age, sex, and type of mitral procedure, and propensity score average matching for 16 other risk indicators. Early outcomes were compared. Categorical variables were compared using </span></span>logistic regression; hospital and </span>intensive care unit<span> length of stay were compared using negative binomial regression. In the matched cohort, mean age was 62 years; 35.9% were female, and 86% underwent mitral valve repair<span>. Cardiopulmonary bypass time was shorter for EABO vs EAC group (125.0 ± 53.0 vs 134.0 ± 67.0 minutes, </span></span></span><em>P</em><span> = 0.0009). There was one aortic dissection in the EAC group and none in the EABO group (</span><em>P</em><span> value &gt; 0.31), and no statistically significant differences in cross-clamp time, major intraoperative bleeding, perioperative mortality, stroke, new onset of atrial fibrillation, postoperative acute kidney injury, success of repair. Median hospital LOS was shorter for EABO vs EAC procedures (4 vs 5 days, </span><em>P</em> &lt; 0.0001). In this large, retrospective, STS database propensity-matched analysis ofpatients undergoing MIMVS, we observed similar safety outcomes for EABO and EAC, including no aortic dissections in the EABO group. The EABO group showed slightly shorter CPB times and hospital LOS.</p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9222167","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":"Recent Articles in AATS Journals","authors":"","doi":"10.1053/j.semtcvs.2024.02.001","DOIUrl":"10.1053/j.semtcvs.2024.02.001","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1043067924000017/pdfft?md5=6decfc849910eae63db73de7f0f8dafa&pid=1-s2.0-S1043067924000017-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139922170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Sustained Reduction of Functional Mitral Regurgitation Impact Survival?","authors":"Tessa M.F. Watt MD, MSc ,&nbsp;Alexander A. Brescia MD, MSc ,&nbsp;Shannon L. Murray MSH ,&nbsp;Liza M. Rosenbloom BA ,&nbsp;Alexander Wisnielwski BS ,&nbsp;David Burn PhD ,&nbsp;Matthew A. Romano MD ,&nbsp;Steven F. Bolling MD","doi":"10.1053/j.semtcvs.2023.04.003","DOIUrl":"10.1053/j.semtcvs.2023.04.003","url":null,"abstract":"<div><p>Functional mitral regurgitation (FMR) is associated with increased mortality and has been considered a marker for advanced heart disease, yet the value of mitral valve repair (MVr) in this population remains unclear. This study aims to evaluate the impact of reducing FMR burden through surgical MVr on survival. Patients with severe FMR who underwent MVr with an undersized, complete, rigid, annuloplasty between 2004 and 2017 were assessed (n = 201). Patients were categorized based on grade of recurrent FMR (0-4). Time-to-event Kaplan-Meier estimations of freedom from death or reoperation were performed using the log-rank test. Cox proportional hazards models evaluated all-cause mortality and reported in hazards ratios (HR) and 95% confidence intervals (CI). Patients were categorized by postoperative recurrent FMR: 45% (91/201) of patients had grade 0, 29% (58/201) grade 1, 20% (40/201) grade 2, 2% (4/201) grade 3%, and 4% (8/201) grade 4. The cumulative incidence of reoperation with death as a competing risk was higher in patients with grades ≥3 recurrent FMR compared to grades ≤2 (44.6% vs 14.6%, subhazard ratio 3.69 [95% CI, 1.17-11.6]; <em>P</em> = 0.026). Overall freedom from death or reoperation was superior for recurrent FMR grades ≤2 compared to grades ≥3 (log-rank <em>P</em> &lt; 0.001). Increasing recurrent FMR grade was independently associated with mortality (HR 1.30 [95% CI, 1.07-1.59] <em>P</em> = 0.009). Reduced postoperative FMR grade resulted in an incrementally lower risk of death or reoperation after MVr. These results suggest that achieving a durable reduction in FMR burden improves long-term survival.</p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1043067923000874/pdfft?md5=706cec2afa2a6cc3d0e8caef22049958&pid=1-s2.0-S1043067923000874-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: How Far Will We Go?","authors":"S. Ram Kumar MD, PhD, FACS","doi":"10.1053/j.semtcvs.2022.11.005","DOIUrl":"10.1053/j.semtcvs.2022.11.005","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10344486","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":"Early Experience With Reverse Double Switch Operation for the Borderline Left Heart","authors":"Brandi Braud Scully MD, MS ,&nbsp;Eric N. Feins MD ,&nbsp;Wayne Tworetzky MD ,&nbsp;Sunil Ghelani MD ,&nbsp;Rebecca Beroukhim MD ,&nbsp;Pedro J. del Nido MD ,&nbsp;Sitaram M. Emani MD","doi":"10.1053/j.semtcvs.2022.09.009","DOIUrl":"10.1053/j.semtcvs.2022.09.009","url":null,"abstract":"<div><p><span><span><span>This study reviews our early experience with the “reverse” double switch operation (R-DSO) for borderline left hearts. A retrospective review of children with borderline left hearts who underwent R-DSO between 2017 and 2021 was conducted. Patient characteristics<span> and early hemodynamic<span> and clinical outcomes were collected. R-DSO was performed in 8 patients with no operative or postoperative deaths; 5 underwent decompressing bidirectional Glenn. Left ventricular (LV) poor-compliance was the dominant pathophysiology<span>. Four patients had undergone staged LV recruitment but were not candidates for anatomical biventricular circulation due to LV hypoplasia<span><span> and/or diastolic dysfunction. 7/8 patients had risk factors for Fontan circulation including </span>pulmonary vein stenosis<span><span>, pulmonary hypertension, and pulmonary artery stenosis. Median age at R-DSO was 3.7 years (19 months-12 years). All patients were in </span>sinus rhythm at discharge. At median follow-up of 15 months (57 days-4.1 years) no mortalities, </span></span></span></span></span></span>reoperations<span><span> or heart transplants had occurred. All patients had normal morphologic LV </span>systolic function. In one patient, pre-existing pulmonary hypertension (HTN) resolved after R-DSO. Reinterventions included transcatheter </span></span>mitral valve replacement<span> for residual mitral stenosis<span> and neo-pulmonary balloon valvuloplasty<span>. In 4 patients follow-up catheterization done at a median of 519 days (320 days-4 years) demonstrated median cardiac index of 3.2 L/min/m</span></span></span></span>²<span> (2.2-4); median sub-pulmonary left ventricular end diastolic pressure<span><span><span> was 9 mm Hg (7-15); median inferior vena cava/baffle pressure was 8 mm Hg (7-13). R-DSO is an alternative to anatomical biventricular repair or single ventricle </span>palliation </span>in patients<span> with borderline left hearts and can result in low inferior vena cava pressures and favorable early results. This approach can also relieve pulmonary HTN and allow future transplant candidacy.</span></span></span></p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386500","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":"Commentary: Tears for TEER Failure","authors":"Craig R. Smith MD","doi":"10.1053/j.semtcvs.2023.02.005","DOIUrl":"10.1053/j.semtcvs.2023.02.005","url":null,"abstract":"","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9232429","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":"Making a Painless Drain: Proof of Concept","authors":"Anna K. Gergen MD ,&nbsp;Helen J. Madsen MD ,&nbsp;Adam J. Rocker PhD ,&nbsp;Allana M. White MD ,&nbsp;Kendra Jones BS ,&nbsp;Daniel T. Merrick MD ,&nbsp;Daewon Park PhD ,&nbsp;Jessica Y. Rove MD","doi":"10.1053/j.semtcvs.2022.08.017","DOIUrl":"10.1053/j.semtcvs.2022.08.017","url":null,"abstract":"<div><p><span><span>Chest tubes account for a large proportion of postoperative pain after </span>cardiothoracic<span> operations. The objective of this study was to develop a novel, cost-effective, easy-to-use, lidocaine-eluting coating to reduce pain associated with postoperative chest tubes. A lidocaine-eluting hydrogel was developed by dispersing lidocaine-loaded nanoparticles<span> in an aqueous solution containing gelatin (5%). Glutaraldehyde (1%) was added to crosslink the gelatin into a hydrogel. The hydrogel was dehydrated, resulting in a thin, stable polymer. Sterile lidocaine hydrogel-coated silicone discs and control discs were prepared and surgically implanted in the subcutaneous space of C57B6 mice. Using von Frey filaments, mice underwent preoperative baseline pain testing, followed by pain testing on post-procedure day 1 and 3. On post-procedure day 1, mice implanted with control discs demonstrated no change in pain tolerance compared to baseline, while mice implanted with 20 mg and 80 mg lidocaine-loaded discs demonstrated a 2.4-fold (</span></span></span><em>P</em> = 0.36) and 4.7-fold (<em>P</em> = 0.01) increase in pain tolerance, respectively. On post-procedure day 3, mice implanted with control discs demonstrated a 0.7-fold decrease in pain tolerance compared to baseline, while mice implanted with 20 mg and 80 mg lidocaine-loaded discs demonstrated a 1.8-fold (<em>P</em> = 0.88) and 8.4-fold (<em>P</em> = 0.02) increase in pain tolerance, respectively. Our results demonstrate successful development of a lidocaine-eluting chest tube with hydrogel coating, leading to improved pain tolerance <em>in vivo</em>. The concept of a drug-eluting drain coating has significant importance due to its potential universal application in a variety of drain types and insertion locations.</p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33512974","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":"Impact of Tricuspid Regurgitation on Outcomes of Mitral Valve Surgery after Transcatheter Edge-to-Edge Repair","authors":"Syed Zaid MD ,&nbsp;Paolo Denti MD ,&nbsp;Gilbert H.L. Tang MD, MSc, MBA ,&nbsp;Tamim N. Nazif MD ,&nbsp;Vinayak N. Bapat MD ,&nbsp;Tsuyoshi Kaneko MD ,&nbsp;Thomas Modine MD, PhD, MBA ,&nbsp;CUTTING-EDGE Investigators","doi":"10.1053/j.semtcvs.2022.06.021","DOIUrl":"10.1053/j.semtcvs.2022.06.021","url":null,"abstract":"<div><p><span>Tricuspid regurgitation<span> (TR) severity after mitral transcatheter edge-to-edge repair (TEER) has been shown to impact outcomes but unknown in patients requiring mitral valve (MV) surgery after TEER. We sought to determine the impact of preoperative TR severity and right ventricular (RV) dysfunction on MV surgery after TEER. From 7/2009 to 7/2020, 260/332 patients in the CUTTING-EDGE registry who underwent MV surgery after TEER had paired echocardiographic evaluation on TR severity, and ≥moderate (2+) vs &lt;2+ TR at the time of index TEER were compared. Median follow-up post-MV surgery was 9.1 months, 96.5% complete at 30 days and 81.9% complete at 1 year. Mean age was 73.8 ± 10.3; with primary/mixed and secondary MR present in 65.6% and 32.0%, respectively. Proportion of ≥2+ TR increased from TEER to MV surgery (40% vs 57%, </span></span><em>P</em><span> &lt; 0.001). Compared to &lt;2+ TR group, ≥2+ pre-TEER TR patients were older, had higher STS risk score at TEER, higher RVSP, more RV dysfunction, more MR post-TEER, and a shorter median interval from TEER to MV surgery (1.9 vs 4.9 months, </span><em>P</em> = 0.023). Mortality was higher in the ≥2+ pre-TEER TR group at 30 days(24.2% vs 13.8%, <em>P</em> = 0.043) and 1 year (45.3% vs 22.3%, <em>P</em> = 0.003). On Kaplan-Meier analysis, cumulative mortality was 23.8% at 1 year and 31.6% at 3 years after MV surgery overall, and was associated with preoperative RV dysfunction (<em>P</em> = 0.023), ≥2+ TR at pre-TEER (<em>P</em> = 0.001) and presurgery (<em>P</em> = 0.004), but not concomitant tricuspid surgery. Moderate or greater pre-TEER TR was associated with worse outcomes, and pre-TEER TR worsened significantly at MV surgery. Concomitant tricuspid surgery did not increase overall mortality.</p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40587809","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":"Well-being of Cardiothoracic Surgeons in the Time of COVID-19: A Survey by the Wellness Committee of the American Association for Thoracic Surgery","authors":"Ross M. Bremner MD, PhD ,&nbsp;Ross M. Ungerleider MD ,&nbsp;Jamie Ungerleider MSW-LCSW, PhD ,&nbsp;Andrea S. Wolf MD ,&nbsp;Cherie P. Erkmen MD ,&nbsp;Jessica G.Y. Luc MD ,&nbsp;Virginia R. Litle MD ,&nbsp;Robert J. Cerfolio MD ,&nbsp;David T. Cooke MD ,&nbsp;the Wellness Committee of the American Association for Thoracic Surgery","doi":"10.1053/j.semtcvs.2022.10.002","DOIUrl":"10.1053/j.semtcvs.2022.10.002","url":null,"abstract":"<div><p>The prevalence of burnout among physicians has been increasing over the last decade, but data on burnout in the specialty of cardiothoracic surgery are lacking. We aimed to study this topic through a well-being survey. A 54-question well-being survey was developed by the Wellness Committee of the American Association for Thoracic Surgery (AATS) and sent by email from January through March of 2021 to AATS members and participants of the 2021 annual meeting. The 5-item Likert-scale survey questions were dichotomized, and associations were determined by Chi-square tests or independent samples t-tests, as appropriate. The results from 871 respondents (17% women) were analyzed. Many respondents reported at least moderately experiencing: 1) a sense of dread coming to work (50%), 2) physical exhaustion at work (58%), 3) a lack of enthusiasm at work (46%), and 4) emotional exhaustion at work (50%). Most respondents (70%) felt that burnout affected their personal relationships at least “some of the time,” and many (43%) experienced a great deal of work-related stress. Importantly, most respondents (62%) reported little to no access to workplace resources for emotional support, but those who reported access reported less burnout. Most respondents (57%) felt that the COVID-19 pandemic has negatively affected their well-being. On a positive note, 80% felt their career was fulfilling and enjoyed their day-to-day job at least “most of the time.” Cardiothoracic surgeons experience high levels of burnout, similar to that of other medical professionals. Interventions aimed at mitigating burnout in this profession are discussed.</p></div>","PeriodicalId":48592,"journal":{"name":"Seminars in Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}