Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Reply: Cardiac magnetic resonance for patients with Ebstein anomaly-limitations to overcome.","authors":"M Yasir Qureshi, Paul Chai","doi":"10.1016/j.jtcvs.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.026","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-dependent survival benefit of concomitant tricuspid valve surgery in recipients of left ventricular assist devices.","authors":"Xingyue Feng, Xinyu Nie, Can Xu","doi":"10.1016/j.jtcvs.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.025","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing critical gaps in RFA prognostic stratification for high-risk stage I Non - small cell lung cancer.","authors":"Qiang Wu, Ting Lei, Hongcan Shi","doi":"10.1016/j.jtcvs.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.020","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary valve repair at the time of the Ross procedure: a safe and durable strategy to address post-implantation aortic regurgitation.","authors":"Vincent Chauvette, Ismail Bouhout, Charles Laurin, Elbert E Williams, Raymond Cartier, Nancy Poirier, Philippe Demers, Ismail El-Hamamsy","doi":"10.1016/j.jtcvs.2025.09.054","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.054","url":null,"abstract":"<p><strong>Background: </strong>Contemporary evidence supports use of the Ross procedure (pulmonary autograft) to treat patients with aortic valve disease. No studies have evaluated the impact of autograft repair to correct residual aortic regurgitation (AR) at index Ross on late outcomes.</p><p><strong>Methods: </strong>This study includes patients undergoing a Ross procedure followed by concomitant autograft valve repair at two institutions. Autograft repair was defined as correction of residual AR during the same admission for the Ross procedure.</p><p><strong>Results: </strong>Between 2011 and 2024, 675 patients underwent a Ross procedure in 2 large volume institutions. Of them, 22 (3%) underwent autograft repair for post-procedural AR (mean age: 52 yo, 23% female). Fourteen patients had a bicuspid valve (64%) and 5 had a unicuspid aortic valve (23%). One patient had a bicuspid autograft. Residual AR was eccentric in 8 patients (36%), commissural in 9 (41%) and combined in 5 (23%). AR was corrected using central plication sutures in 13 patients (59%) and commissuroplasty in 14 patients (63%). There were no perioperative deaths. One patient required reintervention and conversion to a Bentall procedure 6 days after the index Ross procedure. All but one (5%; mild AR) had none/trivial AR on discharge. At a median echocardiographic follow-up of 3 years (Q1-Q3: 2-8), seven patients have mild AR (32%), and one patient developed mild-to-moderate AR after 7 years. All other patients have no/trivial AR. At 5 years, the cumulative incidence of AR>2 is 6±6%.</p><p><strong>Conclusions: </strong>Addressing post-procedural AR after autograft implantation is safe and associated with durable outcomes in the first decade. These findings support correction of post-procedural commissural and/or eccentric jets at the time of index operation.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying the prognostic implications of high Deauville scores in stage I Non - Small cell lung cancer.","authors":"Yuanpu Wei, Hancheng Yin, Zhang Yang","doi":"10.1016/j.jtcvs.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.021","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Evaluation of Mistreatment and Well-being in Cardiothoracic Surgery Trainees.","authors":"Ammara A Watkins, Dena G Shehata, Emma Holler, Edilin Lopez, Jennifer Megan Pan, Thomas K Varghese, Adam A Doty, Cherie P Erkmen, David T Cooke, David D Odell, Kirsten Freeman, Elliot L Servais, Yue-Yung Hu, Karl Y Bilimoria, DuyKhanh P Ceppa","doi":"10.1016/j.jtcvs.2025.10.011","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.10.011","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes the prevalence of mistreatment among cardiothoracic (CT) surgery trainees and its association with burnout, suicidal ideation, and program attrition.</p><p><strong>Methods: </strong>A cross-sectional national volunteer survey was conducted immediately following the 2024 Thoracic Surgery Directors Association In-Training Exam. The questionnaire consisted of multiple-choice and Likert-scale questions on trainee experiences with mistreatment (e.g., identity discrimination, verbal/emotional abuse, sexual harassment). Multivariable regression was used to evaluate the association between mistreatment and a composite outcome of \"trainee distress\" encompassing burnout, suicidal thoughts, or program attrition.</p><p><strong>Results: </strong>A total of 440 trainees participated from 74 programs (74.3% response rate). Overall, 31% identified as female, 64% male, and 5.0% did not disclose gender. Respondents were 51% White, 23% Asian, 7% Hispanic/Latino, and 5% Black/African American (5.0%). Female trainees reported higher rates of identity discrimination (56% vs. 14%, p < 0.001), verbal/emotional abuse (46% vs. 36%, p = 0.009), sexual harassment (14% vs. 3%, p < 0.001), and burnout (51% vs. 39%, p = 0.006) compared to male trainees. Sources of mistreatment included faculty ,patients and their families, and other healthcare staff . Approximately 50% of trainees reported experiencing the composite measure of trainee distress. Trainees who experienced any form of mistreatment had an increased risk of experiencing the composite distress measure (69.0% vs. 31.0%, Risk Ratio 1.19 [95% CI: 1.11-1.28]).</p><p><strong>Conclusion: </strong>There is a high prevalence of perceived mistreatment among CT surgery trainees, with female trainees reporting significantly more burnout and perceived discrimination, and abuse, than male trainees. Perceived mistreatment is associated with trainee distress.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Underscoring the importance of surgical judgment.","authors":"Adrienne Kline, Parisa Rashidi, Arman Kilic, Robert M Sade","doi":"10.1016/j.jtcvs.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.016","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined inflation and cooling method improves lung function in uncontrolled donation after circulatory death.","authors":"Ali Karim, Shubham Makkar, Ajay Malviya, Syed Khooshal Fareeduddin, Parkash Kumar, Manaish Kumar","doi":"10.1016/j.jtcvs.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.012","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume-Outcome Relationship of Mortality Following Surgical Explant of Transcatheter Aortic Valve Replacements.","authors":"Maxwell C Braasch, Mehran Rahimi, June He, Ryan Mikami, Harold G Roberts, Alexander A Brescia, Puja Kachroo, Ralph J Damiano, Nicholas Kouchoukos, Tsuyoshi Kaneko","doi":"10.1016/j.jtcvs.2025.09.053","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.053","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the relationship between hospital volume of transcatheter aortic valve replacement (TAVR) Explants and post-operative mortality.</p><p><strong>Methods: </strong>The Center for Medicare & Medicaid Services was queried from 2016-2024 for patients who underwent TAVR Explant. The study period was divided into two eras: early (2016-2021) and recent (2022-2024). Hospitals were grouped as low- or high-volume. Both 30-day and 1-year mortality were compared and multivariable analysis was performed.</p><p><strong>Results: </strong>We identified 1,238 TAVR Explants. Of the 375 hospitals that performed a TAVR Explant, 235 (63%) performed fewer than three. Post-operative mortality at 30-days and 1-year was 13.3% and 18.3%, respectively. In the early era, 30-day mortality was higher in low-volume compared to high-volume hospitals (17% vs 9.68%, p=0.029), but not in the recent era (11.0% vs 13.4%, p=0.409). At low-volume hospitals, both 30-day and 1-year mortality were higher following concomitant TAVR Explant compared to isolated TAVR Explant (19.9% vs 9.3%, p<0.001; 25.4% vs 13.6%, p<0.001), but not in high-volume hospitals (14% vs 8.78%, p=0.148; 18.3% vs 15.5%, p=0.518). On multivariable analysis, high-volume hospital status was associated with lower mortality for the early era (OR 0.48 [CI 0.25-0.95]), but not for the recent era (OR 1.30 [CI 0.71-2.38]) or the overall cohort (OR 0.80 [CI 0.51-1.24]).</p><p><strong>Conclusions: </strong>While hospital volume-outcome relationship to TAVR Explant mortality existed in the early era, recent data suggests no volume-outcome relationship. With the lack of a volume-outcome relationship, TAVR Explant will become a fundamental cardiac surgery. High-risk concomitant surgery may benefit from high-volume hospital management.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary outcomes and healthcare costs associated with single-ventricle heart failure admissions in adults in the United States.","authors":"Michael A Catalano, Jonathan B Edelson, Omar Toubat, Halil Beqaj, Benjamin Smood, Sumeet Vaikunth, Juan M Ortega, Joseph Rossano, Constantine D Mavroudis","doi":"10.1016/j.jtcvs.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.10.008","url":null,"abstract":"<p><strong>Objective: </strong>Advances in surgical and medical therapies have enabled patients with single-ventricle physiology to survive into adulthood, leading to a growing population of adults with single-ventricle congenital heart disease (SV-ACHD). This study aims to characterize contemporary SV-ACHD healthcare utilization and outcomes, in comparison to acquired heart failure (HF).</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) was queried for the years 2016-2021 to identify all non-elective hospital admissions for HF or cardiogenic shock in patients aged ≥18. Patients with a diagnosis of common ventricle, double-inlet ventricle, tricuspid atresia, or hypoplastic left heart syndrome were identified as SV-ACHD. Patients with two-ventricle congenital diagnoses were excluded, leaving a control group of acquired HF. Demographics, comorbidities, procedure utilization, in-hospital mortality, and total hospital costs were assessed.</p><p><strong>Results: </strong>There were 28,402,843 HF admissions identified, of which 3,375 (0.01%) were SV-ACHD. SV-ACHD admissions were younger and had differing comorbidities. Patients with SV-ACHD had prolonged length of stay, increased rates of advanced heart failure therapy, and increased hospital cost. There was no absolute difference in in-hospital mortality (5.8 vs. 5.7%, p=0.908); mortality rates decreased over time in SV-ACHD patients (OR 0.79 [0.66-0.96], p = 0.017). However, in multivariable analysis, SV-ACHD was associated with increased risk of mortality (OR 1.876, 95% confidence interval 1.210-2.907, p=0.005).</p><p><strong>Conclusions: </strong>SV-ACHD represents a small proportion of adult HF admissions, though they have increased rates of procedure utilization and increased total costs. Risk of in-hospital mortality has improved over time in SV-ACHD patients, but there remains an increased risk of mortality relative to patients with acquired HF.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}