Journal of Thoracic and Cardiovascular Surgery最新文献

Lung Transplantation After Ex Vivo Lung Perfusion in High-Risk Recipients: A Propensity Matched Analysis of a National Database. 高风险受者体内肺灌注后的肺移植：全国数据库倾向匹配分析》。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.10.041

Ernest G Chan, Rachel L Deitz, Jack K Donohue, John P Ryan, Yota Suzuki, Masashi Furukawa, Kentaro Noda, Pablo G Sanchez

{"title":"Lung Transplantation After Ex Vivo Lung Perfusion in High-Risk Recipients: A Propensity Matched Analysis of a National Database.","authors":"Ernest G Chan, Rachel L Deitz, Jack K Donohue, John P Ryan, Yota Suzuki, Masashi Furukawa, Kentaro Noda, Pablo G Sanchez","doi":"10.1016/j.jtcvs.2024.10.041","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.10.041","url":null,"abstract":"Purpose: We report outcomes associated with EVLP lungs in high-risk lung transplant recipients utilizing a national database.Methods: We performed a retrospective analysis of the UNOS Database (1/1/2018-3/31/2024). High-risk status was defined as mean pulmonary arterial pressure > 35 mmHg, lung retransplantation, or bridge to transplant. In addition to univariable analysis, propensity score matched analysis was performed on predictors of donor and recipient characteristics.Results: Risk of dying on the waitlist was significantly higher for high-risk candidates (HR: 1.69 [1.51 - 1.89], p < 0.001). Following matching, 203 EVLP cases were matched to 609 standard procurement recipients. The EVLP group was associated with higher rates of postoperative acute kidney injury requiring renal replacement therapy (27% vs 16%, p < 0.001), higher mortality on index admission (13% vs. 8%, p = 0.04), and longer length of stay (29 vs 25 days, p = 0.006). EVLP modality was associated with survival time (p < 0.001) with portable EVLP having significantly shorter survival (2.7 years) relative to standard cases (4.7 years, p < 0.02). A subgroup analysis found that this survival effect was limited to bridge and retransplant recipients.Conclusions: EVLP lungs were associated with higher rates of postoperative AKI and portable EVLP was associated with shorter survival in high-risk lung transplant recipients. However, given the high waitlist mortality in this candidate population, EVLP lungs should still be considered an alternative.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569551","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}

引用次数: 0

Donor and Recipient Factors Associated with Primary Graft Dysfunction Following Lung Transplantation: A DMG Registry Analysis. 与肺移植后原发性移植物功能障碍相关的供体和受体因素：DMG 登记分析。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-11-01 DOI: 10.1016/j.jtcvs.2024.10.045

Isaac S Alderete, Cathlyn K Medina, Arya Pontula, Samantha E Halpern, Alexandria L Soto, Kunal J Patel, Jacob A Klapper, Matthew G Hartwig

{"title":"Donor and Recipient Factors Associated with Primary Graft Dysfunction Following Lung Transplantation: A DMG Registry Analysis.","authors":"Isaac S Alderete, Cathlyn K Medina, Arya Pontula, Samantha E Halpern, Alexandria L Soto, Kunal J Patel, Jacob A Klapper, Matthew G Hartwig","doi":"10.1016/j.jtcvs.2024.10.045","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.10.045","url":null,"abstract":"Objective: Current risk-adjusted models to predict primary graft dysfunction (PGD) following lung transplantation (LTx) do not include bedside donor critical care data. Donor management goals (DMG) represent predefined critical care endpoints aimed at optimizing multi-organ donor management. Here, we sought to identify novel predictors to better understand the relationship between donor management and PGD following LTx.Methods: We used the national DMG registry to identify a cohort of LTx recipients linked to their respective donors between January 1st, 2015 and March 1st, 2023. Grade 3 PGD (PGD3) was defined according to modified ISHLT criteria. Multivariable modeling was performed to identify risk factors for the development of PGD3.Results: A total of 2704 eligible patients were identified of which 643 (23.8%) developed PGD3. After multivariable modeling, the likelihood of PGD3 was greater with increased donor age (OR 1.06 [1.02, 1.10] per 5 year change, p=0.003), increased donor serum pH at the time of authorization (OR 1.14 [1.02, 1.25] per 0.1 increase, p=0.016), donor history of cocaine use (OR 1.34 [1.05, 1.71], p=0.020), and increased recipient central venous pressure (1.03 [1.01, 1.06], p=0.005). Recipients who received donor lungs in which the DMG for PF ratio was met had a lower likelihood of developing PGD3 (OR 0.63 [0.46, 0.86], p=0.006).Conclusion: This study leverages a novel detailed donor management database to identify factors associated with the development of PGD3. These factors may be used to recognize donors and recipients that may benefit from early interventions to improve short-term outcomes.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569586","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}

引用次数: 0

Commentary: Epiaortic Ultrasound: Better Habit than Haphazard. 评论：主动脉超声：习惯胜于随意

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-30 DOI: 10.1016/j.jtcvs.2024.10.039

Mimi Xiaoming Deng, Abdulaziz M Alhothali, Terrence M Yau

引用次数: 0

Also, long live the joint general surgery/thoracic surgery (4+3) pathway! 此外，普外科/胸外科（4+3）联合路径万岁！

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-30 DOI: 10.1016/j.jtcvs.2024.10.002

John J Squiers, Emily Shih, Robert M Goldstein, J Michael DiMaio

引用次数: 0

Commentator Discussion: Cardiac Surgical Unit-Advanced Life Support-certified centers are associated with improved failure to rescue after cardiac arrest: A propensity score-matched analysis. 评论员讨论：心脏外科-高级生命支持认证中心与改善心脏骤停后抢救失败率有关：倾向得分匹配分析。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-30 DOI: 10.1016/j.jtcvs.2024.10.001

引用次数: 0

Commentator Discussion: Personalizing patient risk of a life-altering event: An application of machine learning to hemiarch surgery. 评论员讨论：个性化病人面临改变生命事件的风险：机器学习在半弓手术中的应用。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-30 DOI: 10.1016/j.jtcvs.2024.07.003

引用次数: 0

Commentary: Blood Biomarkers: Barriers and Benefits. 评论：血液生物标志物：障碍与益处。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-30 DOI: 10.1016/j.jtcvs.2024.10.040

Rebecca Bellis, Victoria Cranwell, Prasad S Adusumilli

引用次数: 0

The long-term impact of lesion set in the surgical ablation of atrial fibrillation during mitral valve surgery: multi-center propensity-score weighted study. 二尖瓣手术中心房颤动手术消融病灶设置的长期影响：多中心倾向分数加权研究。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-29 DOI: 10.1016/j.jtcvs.2024.10.036

Won Kyung Pyo, Joon Bum Kim, Yang Hyun Cho, Hyung Gon Je, Hee-Jung Kim, Seung Hyun Lee

{"title":"The long-term impact of lesion set in the surgical ablation of atrial fibrillation during mitral valve surgery: multi-center propensity-score weighted study.","authors":"Won Kyung Pyo, Joon Bum Kim, Yang Hyun Cho, Hyung Gon Je, Hee-Jung Kim, Seung Hyun Lee","doi":"10.1016/j.jtcvs.2024.10.036","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.10.036","url":null,"abstract":"Objective: This study aimed to assess the effect of the lesion sets for surgical ablation (SA) of atrial fibrillation (AF) on long-term outcomes and identify the optimal lesion set.Methods: Between 2005 and 2017, 1825 patients underwent SA concomitant to mitral valve (MV) surgery in the participating institutions. Of these, 529 underwent left atrial (LA) ablation, whereas the remainder had biatrial (BA) ablation. The clinical and rhythm outcomes were compared, considering death as a competing event. Inverse probability treatment weighting (IPTW) was used to mitigate the selection bias.Results: The patients undergoing LA ablation were younger and less frequently had long-standing AF with a shorter duration or required concomitant tricuspid valve surgery. Adjusted analysis showed that LA ablation was associated with a lower risk of early pacemaker implantation (odds ratio, 0.16; 95% confidence interval [CI], 0.07-0.38; p<0.001) than BA ablation. Over a median follow-up of 70.4 months (interquartile 44.1-111.2 months), the LA ablation group presented a higher risk of AF recurrence (subdistribution hazard ratio [SHR]1.26; 95% CI 1.12-1.41; p<0.001), with a 5-year cumulative incidence of 34.2% compared to 28.6% in the BA group. The risk of late mortality (SHR, 1.17; 95% CI, 0.74-1.86; p=0.507) and stroke (SHR, 1.21; 95% CI, 0.82-1.79; p=0.345) did not differ between the groups CONCLUSION: In patients undergoing SA concomitant to MV surgery, both lesion sets provided comparable incidence of mortality and stroke. However, BA ablation was associated with a superior rhythm outcome at the expense of a higher risk of early pacemaker implantation.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559258","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}

引用次数: 0

Operation for acute type A aortic dissection with internal carotid artery occlusion: Is it justified? 急性 A 型主动脉夹层伴颈内动脉闭塞的手术：手术合理吗？

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-28 DOI: 10.1016/j.jtcvs.2024.10.003

Hiroshi Nagamine, Hiroshi Nagano, Mitsuru Asano

引用次数: 0

The Role of Cardiac Surgeons in Transcatheter Structural Heart Disease Interventions. 心脏外科医生在经导管结构性心脏病介入治疗中的作用。

IF 4.9 1区医学

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2024-10-26 DOI: 10.1016/j.jtcvs.2024.10.037

Luigi Pirelli, Kendra J Grubb, Isaac George, Andrew M Goldsweig, Tamim M Nazif, Gry Dahle, Patrick O Myers, Maral Ouzounian, Wilson Y Szeto, Francesco Maisano, Arnar Geirsson, Torsten P Vahl, Susheel K Kodali, Tsuyoshi Kaneko, Gilbert H L Tang

{"title":"The Role of Cardiac Surgeons in Transcatheter Structural Heart Disease Interventions.","authors":"Luigi Pirelli, Kendra J Grubb, Isaac George, Andrew M Goldsweig, Tamim M Nazif, Gry Dahle, Patrick O Myers, Maral Ouzounian, Wilson Y Szeto, Francesco Maisano, Arnar Geirsson, Torsten P Vahl, Susheel K Kodali, Tsuyoshi Kaneko, Gilbert H L Tang","doi":"10.1016/j.jtcvs.2024.10.037","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.10.037","url":null,"abstract":"Background: With the rapid growth and evolution of transcatheter valve therapies, surgeons are foreseeing a crucial change in their practice. Their role is rapidly evolving and the concept of a structured heart valve team is becoming central in every established SHD program. The knowledge and expertise of surgeons is adapting to a novel and revolutionized field of transcatheter valve therapies, where a multidisciplinary approach is crucial for optimal outcomes and patient satisfaction. This manuscript aims to discuss the evolving role of surgeons in structural heart interventions METHODS: We depict the importance of the heart valve team and outline the challenges surgeons are facing to establish themselves as structural heart operators.Results: The switch in clinical practice surgeons are experiencing is extremely important for the future of cardiac surgery. The results of a globally conducted real-world survey shows that despite 97% of surgeons are active members of the heart team, 80% take part to TAVR procedures, and the percentage drops significantly in mitral and tricuspid interventions.Conclusions: Surgeons need to evolve, adapt and embrace this new patient-centered paradigm and broaden their skills and competences maintaining a primary role in the treatment of valvular heat pathologies.","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569557","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}

引用次数: 0