{"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":"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}
Adrienne Kline, Parisa Rashidi, Arman Kilic, Robert M Sade
{"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}
Maxwell C Braasch, Mehran Rahimi, June He, Ryan Mikami, Harold G Roberts, Alexander A Brescia, Puja Kachroo, Ralph J Damiano, Nicholas Kouchoukos, Tsuyoshi Kaneko
{"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}
Michael A Catalano, Jonathan B Edelson, Omar Toubat, Halil Beqaj, Benjamin Smood, Sumeet Vaikunth, Juan M Ortega, Joseph Rossano, Constantine D Mavroudis
{"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}
Keertana Yalamanchili, Christopher Stone, Kelsey C Muir, Dwight D Harris, Meghamsh Kanuparthy, Frank W Sellke
{"title":"Metformin's Effects Beyond Ischemia: Evaluating Cardioprotection in Non-Ischemic Myocardium in a Large Animal Model of Coronary and Metabolic Disease.","authors":"Keertana Yalamanchili, Christopher Stone, Kelsey C Muir, Dwight D Harris, Meghamsh Kanuparthy, Frank W Sellke","doi":"10.1016/j.jtcvs.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.10.004","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effects of metformin (MET) on non-ischemic myocardium in a large animal model of coronary artery disease (CAD) and metabolic syndrome (MS). While prior work has shown MET improves perfusion and function in ischemic tissue, this study assessed whether its cardioprotective effects extend to non-ischemic regions.</p><p><strong>Methods: </strong>Yorkshire swine (n = 12) were fed a high-fat diet to induce MS, and then underwent ameroid constrictor placement around the left circumflex artery to simulate CAD. Animals received either oral MET (1000 mg/day) or placebo for 7 weeks. Regional myocardial perfusion was assessed via microsphere injections at rest and during pacing. Non-ischemic myocardial tissue was identified using gold microsphere distribution and analyzed using immunoblotting, immunofluorescence, and hemodynamic assessment. Statistical significance was evaluated using Student's t-test or the Mann Whitney U test.</p><p><strong>Results: </strong>Despite no significant changes in perfusion, MET-treated animals demonstrated significantly reduced apoptotic markers (caspase 9, cleaved caspase 9, AIF, BAD; p < 0.05) and increased pBAD/BAD ratios. Pro-survival signaling was enhanced with elevated pAKT/AKT, pmTOR/mTOR, and pAMPK/AMPK ratios (p < 0.05). TUNEL staining confirmed decreased apoptosis histologically. Functionally, MET improved cardiac output, stroke volume, and dV/dt Max in the myocardium (p < 0.05), correlating with reductions in apoptotic signaling.</p><p><strong>Conclusions: </strong>MET was associated with significantly reduced apoptosis and promoted pro-survival signaling in non-ischemic myocardium without altering perfusion. These findings suggest that MET's cardioprotective effects are not limited to ischemic tissue, highlighting its potential role as a systemic therapy for CAD and MS, including as an adjunct in cardiac surgery.</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":"145304287","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":"Re-evaluating cardiac surgery and long-term cancer risk-Key gaps and clinical implications.","authors":"Fan Yang","doi":"10.1016/j.jtcvs.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.011","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276382","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":"Commentary: Will TROPION be a CHAMPION in stage I lung cancer?","authors":"Gavitt A Woodard, Brendon M Stiles","doi":"10.1016/j.jtcvs.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.10.009","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287569","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}