Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Nanosecond Pulsed Field Ablation: Feasibility of Creating the Cox-Maze Lesion Set on the Beating Heart.","authors":"Jack Yi, Jakraphan Yu, Samantha Procasky, Ruth Obiarinze, Mehran Rahimi, Batool Arif, Leslie D Wilson, Jonathan K Zoller, Matthew R Schill, Ralph J Damiano, Christian Zemlin","doi":"10.1016/j.jtcvs.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.027","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the feasibility of creating Cox-Maze IV lesions, including the ablation of the left posterior wall (box) and the isthmus lines, using nanosecond pulsed field ablation (nsPFA) in a beating heart porcine model.</p><p><strong>Methods: </strong>Nine pigs underwent surgical nsPFA. Lesions included right atrial appendage, left atrial appendage, left atrial posterior wall (the box), and isthmus lines, as replicated by ablating across the mitral and tricuspid annuli. Each ablation lasted 2.5 - 5 s. At 30 days, the cardiac tissue was examined histologically. Ablation lines were sectioned at 5-mm intervals and stained with 10% triphenyl tetrazolium chloride and Gomori trichrome. Exit block testing and echocardiography were performed before, after, and 30-days post-ablation. Valvular and coronary tissues were assessed by a blinded pathologist.</p><p><strong>Results: </strong>Seven pigs were survived for an average of 26 ± 8 days. Two pigs died acutely from refractory ventricular fibrillation immediately after transvalvular ablations. Transmurality was confirmed for 99.6% (251/252) of histological cross-sections and 97% (32/33) of lesions. The mean ablated tissue thickness was 6.7 ± 3.3 mm. At 30 days, exit block was confirmed at 94% of available testing sites (16/17). There was no evidence of progression of baseline valvular regurgitation. Histological assessment did not find significant differences between ablated and non-ablated valves or coronary arteries.</p><p><strong>Conclusion: </strong>An nsPFA clamp device effectively created transmural lesions, including the box and isthmus lesions. This non-thermal energy source may shorten procedural time and enable surgical ablation in the beating heart. However, the relationship between nsPFA and ventricular arrhythmias warrants additional study.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180314","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: When Rescue Fails Beyond the Core Four: The Case for STS+5.","authors":"Jonathan Chinea, Daniel T Engelman","doi":"10.1016/j.jtcvs.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.023","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151504","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: Heart Healthy after Procurement.","authors":"Joseph C Cleveland, David A Fullerton","doi":"10.1016/j.jtcvs.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.022","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151512","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: Balancing rhythm and risk with prophylactic left atrial appendage closure.","authors":"Aminah Sallam, Derrick Y Tam, Joanna Chikwe","doi":"10.1016/j.jtcvs.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.06.013","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126429","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: Discrete subaortic membrane-simple in appearance, complex in reality.","authors":"Jie Dong, Keming Yang, Shuo Dong","doi":"10.1016/j.jtcvs.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.08.026","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114975","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":"Surgical judgment in the age of artificial intelligence.","authors":"Dimitrios E Magouliotis, Serge Sicouri, Andrew Xanthopoulos, Basel Ramlawi","doi":"10.1016/j.jtcvs.2025.08.029","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.08.029","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088055","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":"Broadening the evidence base for same-day discharge after video-assisted thoracoscopic surgery lung resection: Methodological considerations from the VALUE trial.","authors":"Luca Bertolaccini, Monica Casiraghi, Antonio Mazzella, Claudia Bardoni, Lorenzo Spaggiari","doi":"10.1016/j.jtcvs.2025.08.020","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.08.020","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088029","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":"Do Patients with Severe Aortic Stenosis and Progressive LVEF Decline to <50-59% Remain Asymptomatic?","authors":"Muhammad Etiwy, Adam N Berman, Michael H Picard, Chiara Fraccaro, Nicole Karam, Meagan M Wasfy, Cynthia Taub, John Hsu, James L Januzzi, Jason H Wasfy","doi":"10.1016/j.jtcvs.2025.09.019","DOIUrl":"10.1016/j.jtcvs.2025.09.019","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TROPION-Lung12: A phase 3 study of adjuvant datopotamab deruxtecan and rilvegostomig in ctDNA-positive or high-risk pathology stage I NSCLC.","authors":"David R Jones, Isabelle Opitz, David Harpole, Jane Yanagawa, Eric Lim, Yasuhiro Tsutani, Daniel S W Tan, Sanja Dacic, Apar Kishor Ganti, Shankar Bodla, Anastasiya Batig, Pavlo Lyfar, Alessandra Forcina, Enriqueta Felip","doi":"10.1016/j.jtcvs.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.017","url":null,"abstract":"<p><strong>Objective: </strong>Five-year disease recurrence rates for patients with stage I non-small cell lung cancer (NSCLC) post-surgery are variable (15%-40%). There is an urgent need for novel biomarker strategies to identify high-risk patients who may benefit from adjuvant treatment. High-risk pathological features, including high-grade histology and lymphovascular or visceral pleural invasion, serve as independent risk factors for worse outcomes. Pre-operative circulating tumor DNA (ctDNA) detection is also correlated with poorer outcomes in stage I NSCLC. Datopotamab deruxtecan (Dato-DXd), an antibody-drug conjugate composed of a humanized anti-TROP2 antibody conjugated to a potent topoisomerase I inhibitor via a plasma-stable linker, and rilvegostomig, an Fc-reduced, monovalent, bispecific, humanized IgG1 antibody targeting both PD-1 and TIGIT receptors, have shown promise in NSCLC studies. Combining Dato-DXd with rilvegostomig may improve treatment outcomes in select patients with stage I NSCLC.</p><p><strong>Methods: </strong>TROPION-Lung12 (NCT06564844) is a phase 3, randomized study enrolling approximately 660 patients with stage I adenocarcinoma without actionable genomic alterations who have undergone complete surgical resection. Eligible patients must have pre-operative ctDNA-positive status or ≥1 high-risk pathological feature(s). Patients will be randomized 2:1:2 to receive Dato-DXd (6 mg/kg IV Q3W) plus rilvegostomig (750 mg IV Q3W) for 4 cycles followed by rilvegostomig (up to 12 months/18 cycles total); rilvegostomig alone (up to 12 months/18 cycles total); or standard of care (SoC) for up to 12 months. The primary endpoint is disease-free survival assessed using blinded independent central review per RECIST v1.1, with key secondary endpoints including overall survival, for Dato-DXd plus rilvegostomig vs SoC arms.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114971","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":"Long-Term Survival and Operative Outcomes of the Bentall Procedure for Aortic Root Aneurysm, Aortic Dissection, and Endocarditis.","authors":"Christopher Lau, Alexander Gregg, Eilon Ram, Charles Mack, Katherine Krieger, Mohamed Rahouma, Ivancarmine Gambardella, Giovanni Soletti, Mario Gaudino, Leonard N Girardi","doi":"10.1016/j.jtcvs.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.09.018","url":null,"abstract":"<p><strong>Objective: </strong>To assess outcomes after aortic root replacement with Bentall procedure for aortic aneurysm, dissection and endocarditis.</p><p><strong>Methods: </strong>We identified consecutive patients undergoing Bentall from 1997-2023, with stratification based on the primary diagnosis. Operative outcomes and long-term survival were compared.</p><p><strong>Results: </strong>Of 1493 patients, 1378(92.3%) had surgery for aneurysms, 75(5%) dissections and 40(2.7%) endocarditis. The aneurysm group was older (61[50,70] vs 57[47,66.5] vs 56[49,64]; p=0.024). Patients with dissection or endocarditis had more preoperative myocardial infarctions (7.4% vs 12% vs 17.5%; p=0.026), cerebrovascular accidents (9.6% vs 18.7% vs 45%; p<0.001), renal dysfunction (8.3% vs 22.7% vs 45%; p<0.001), shock (0.1% vs 10.7% vs 15%; p<0.001) and ruptures (0.4% vs 10.7% vs 10%; p<0.001). Regarding outcomes, acute renal failure (0.6% vs 1.3% vs 7.5%; p<0.001) and operative mortality (0.4% vs 1.3% vs 7.5%; p=0.001) were higher for endocarditis. Re-exploration for bleeding was highest for dissections (4.1% vs 12% vs 2.5%; p=0.004). Ten-year survival was similar between groups (71.8% vs 67% vs 83.7%; p=0.94), with mean follow-up 68.2 ± 2.08 months. Multivariable analysis found age (HR 1.04 (1.03, 1.05); p<0.001), chronic obstructive pulmonary disease (HR 2.12 (1.44, 3.11); p<0.001), renal dysfunction (HR 1.97 (1.4, 2.78); p<0.001) and ejection fraction (HR 0.97 (0.95, 0.98); p<0.001) were associated with late mortality but primary diagnosis was not.</p><p><strong>Conclusions: </strong>The Bentall procedure can be performed with low operative risk for aneurysms and selected dissections. Endocarditis is associated with higher but acceptable operative mortality. Excellent long-term survival can be expected after surviving initial operative risk.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115000","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}