Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Commentator Discussion: Time to surgery in early-stage non-small cell lung cancer (NSCLC): Defining the optimal diagnosis-to-resection interval to reduce mortality.","authors":"","doi":"10.1016/j.jtcvs.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.001","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587791","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":"A cohort evaluation of surgical pathways reported to a national audit of children undergoing treatment for congenital heart disease in England and Wales.","authors":"Katherine L Brown, Qi Huang, Ferran Espuny-Pujol, Carin Van Doorn, Serban Stoica, Victor Tsang, Christina Pagel, Rodney C G Franklin, Sonya Crowe","doi":"10.1016/j.jtcvs.2025.02.029","DOIUrl":"10.1016/j.jtcvs.2025.02.029","url":null,"abstract":"<p><strong>Objectives: </strong>To ascertain rates of completion of essential cardiac procedures and their overall contribution to longer-term mortality in children with congenital heart disease (CHD).</p><p><strong>Methods: </strong>In this cohort study using the United Kingdom National CHD Audit, we described the pathway operations required for treatment for 9 sentinel CHDs-hypoplastic left heart syndrome (HLHS), non-HLHS functionally univentricular heart, ventricular septal defect, tetralogy of Fallot, coarctation, aortic stenosis, atrioventricular septal defect, transposition of the great arteries, and pulmonary atresia-that were undertaken at the population level and report the mortality associated with these pathway operations by age 5 years.</p><p><strong>Results: </strong>Among 28,806 patients, over a median follow-up of 9.8 years (interquartile range, 4.2-15.4 years), 839 (2.9%) had undergone pre-pathway procedures only, 1135 (3.9%) had undergone initial palliation only (inclusive of functionally univentricular and biventricular reparative pathways), 2001 (6.9%) had undergone stage 2 palliation and/or total cavopulmonary connection (TCPC), 2254 (7.8%) had undergone staged biventricular repair after palliation, and 22,572 (78.3%) had undergone primary biventricular repair. Of the 23,239 children with 5 years of follow-up, 1794 (7.7%) had died by age 5 years, consisting of 409 (1.8%) who died following an initial palliative procedure, 43 (0.2%) who died following a stage 2 palliation or TCPC, 379 (1.6%) who died following a biventricular reparative procedure, and 963 (4.1%) who died in other circumstances, such as interstage or following reinterventions.</p><p><strong>Conclusions: </strong>The outcome metrics of surgical pathway completion (biventricular repair or TCPC) and overall mortality at age 5 years can be evaluated using registry data and could contribute to future assessment of overall CHD service quality.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587773","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":"Commentator Discussion: Evolving concern: Late outcomes after repair of transposition of the great arteries.","authors":"","doi":"10.1016/j.jtcvs.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.002","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587788","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":"Primary repair versus pulmonary artery banding in complete atrioventricular canal defects in the modern surgical era.","authors":"Mariana Chávez, M Mujeeb Zubair, Steven J Staffa, Sitaram M Emani, Luis G Quinonez, Aditya Kaza, David M Hoganson, Christopher W Baird","doi":"10.1016/j.jtcvs.2025.02.025","DOIUrl":"10.1016/j.jtcvs.2025.02.025","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The impact of early age on outcomes for repair of complete atrioventricular canal defects (CAVCs) remains poorly defined. We evaluated young infants with CAVC, comparing those who underwent primary repair versus primary pulmonary artery banding (PAB) and results related to left atrioventricular valve (AVV) reintervention and survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients (age &lt;60 days) with CAVC were evaluated (January 2005 to April 2022) at a single institution. Patients were categorized as having primary CAVC repair or PAB. Patients with complex unbalanced CAVC and severely hypoplastic ventricles and those not undergoing CAVC repair after PAB were excluded. Outcome measures included total number of operations, reoperation on the left AVV, hospital length of stay, and mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;CAVC was identified in 135 patients, mean age 33 ± 19 days and weight 3.4 ± 0.7 kg at primary operation. Additional diagnosis included transposition of the great arteries (n = 4), tetralogy of Fallot (n = 9), transposition of the great arteries (n = 13), and total and partial anomalous pulmonary venous return (n = 7). Thirty-three patients required preoperative respiratory support. Primary CAVC repair was performed in 101 patients at 38 ± 16.6 days and 3.5 ± 0.7 kg, and primary PAB was performed in 34 patients at 16 ± 15 days and 3.2 ± 0.7 kg, of whom 62% (n = 21) underwent subsequent CAVC repair at 6.9 ± 4.7 months and 6.6 ± 2.3 kg. When we compared patients undergoing primary CAVC versus PAB; 55% versus 48% had preoperative mild and 39% versus 29% mild-moderate or greater atrioventricular valve regurgitation (AVVR). In patients who underwent CAVC repair, a 2-patch repair was used in 66% of cases and posterior left AVV annuloplasty in 34%. Predischarge reoperation for left AVVR was required in 13% (n = 14/101) patients whereas in patients who underwent PAB, it was required in 14% (n = 3/21). Hospital length of stay was shorter for primary CAVC (25 vs 41 days). Overall, median follow-up was 4.5 years. Patients undergoing primary CAVC had fewer total number of operations (1.3 vs 2.5, P &lt; .001) and fewer reoperations on the left AVV (18% vs 24%, P = .56). Overall, freedom from reoperation in primary CAVC for left AVVR at 1 and 5 years was 85% and 82% compared with patients who underwent PAB (89% and 69%). At follow-up, 88% of patients undergoing primary CAVC repair had mild or less left AVVR, whereas 82% undergoing initial PAB had mild or less left AVVR. There were 10 deaths; overall mortality was 6% in patients who underwent primary CAVC and 19% in patients who underwent PAB. Similarly, follow-up rates of significant AVVR and mortality did not differ significantly between groups (P &gt; .05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Definitive CAVC repair at ≤60 days can be performed with acceptable midterm survival. Primary CAVC repair versus primary PAB for young patients undergoing CAVC has a trend toward fewer","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587803","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":"Strengthening support for cardiothoracic surgery trainees in the face of reproductive rights challenges.","authors":"Rajika Jindani, Cecilia Pompili","doi":"10.1016/j.jtcvs.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.004","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544322","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":"The effect of multimodal prehabilitation on postoperative outcomes in lung cancer surgery.","authors":"Ah-Reum Cho, Tahereh Najafi, Agnihotram V Ramanakumar, Lorenzo Ferri, Jonathan Spicer, Sara Najmeh, Jonathan Cools-Lartigue, Christian Sirois, Sonya Soh, Do Jun Kim, Franco Carli","doi":"10.1016/j.jtcvs.2025.02.013","DOIUrl":"10.1016/j.jtcvs.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>Patients with lung cancer are often elderly, frail, and smokers with poor functional reserve, making them excellent candidates for multimodal prehabilitation to improve postoperative outcomes. Patients referred to the prehabilitation clinic are at an even higher surgical risk. This retrospective observational study aimed to compare the postoperative 30-day outcomes in lung cancer surgery among the propensity score-matched patients.</p><p><strong>Methods: </strong>Patients who underwent lung cancer surgery between August 2018 and January 2024 were accessed for eligibility. After exclusion, a 1:1 propensity score-matching analysis was performed based on the following baseline characteristics: respiratory disease, predicted length of stay based on American College of Surgeons National Surgical Quality Improvement Program, Duke Activity Status Index less than 34, tumor stage, and neoadjuvant therapy. Baseline characteristics, preoperative and intraoperative data, and postoperative outcomes were compared between the matched patients.</p><p><strong>Results: </strong>Among 1242 patients, 555 were selected for propensity score matching, resulting in 147 matched pairs in each group. The control group exhibited significantly higher rates of overall (65.3% vs 46.3%, P = .001) and major complications (27.9% vs 13.6%, P = .003). Patients who underwent multimodal prehabilitation had a significantly lower Comprehensive Complication Index (12.2 [0-26.2] vs 0 [0-20.9], P < .0001), reduced intensive care unit admission rates (8.2% vs 2.7%, P = .040), and lower readmission rates (14.3% vs 6.1%, P = .021).</p><p><strong>Conclusions: </strong>Multimodal prehabilitation significantly reduced overall and major postoperative 30-day complications in lung cancer surgery. It also contributed to reducing the severity of complications. These findings suggest that multimodal prehabilitation may improve postoperative outcomes for patients with lung cancer.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568694","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":"Targeted immunotherapy with sphingosine-1-phosphate improves myocardial contractility and mitochondrial function in a novel murine ex vivo perfusion and transplantation model.","authors":"John Iguidbashian, Jack Zakrzewski, Li Lu, Anastacia M Garcia, Ludmila Khailova, Xinsheng Deng, Robert Plenter, Francisco La Rosa, Stephanie Nakano, Kevin Lynch, James Jaggers, Jesse Davidson, Matthew L Stone","doi":"10.1016/j.jtcvs.2025.02.021","DOIUrl":"10.1016/j.jtcvs.2025.02.021","url":null,"abstract":"<p><strong>Objective: </strong>To develop a reproducible ex vivo heart perfusion (EVHP) and murine heart transplantation model and to evaluate the efficacy of hypothermic, acellular ex vivo perfusion with sphingosine-1-phosphate (S1P) as a strategy to mitigate transplantation-associated ischemia-reperfusion injury (IRI).</p><p><strong>Methods: </strong>Donor hearts from wild-type mice were stratified by preservation technique. Group 1 hearts (n = 4) served as nontransplanted controls. Group 2 hearts (n = 10) underwent 90 minutes of cold static preservation (CSP) following cardioplegic arrest in donor mice. Group 3 to 5 hearts (n = 10/group) underwent EVHP with hypothermic acellular solution (Krebs-Henseleit buffer [KH]) alone (group 3), with KH plus S1P (FTY-720) (group 4), or with KH plus S1P plus S1P receptor subtype 2 antagonist (JTE-013) (group 5). Group 2 to 5 hearts were then transplanted into recipient mice with 120 minutes of reperfusion. Hearts were evaluated for function by echocardiography, for histopathologic injury by neutrophil infiltration, and for mitochondrial bioenergetics by Seahorse bioanalysis.</p><p><strong>Results: </strong>Functional assessment demonstrated comparable post-transplantation allograft function as defined by fractional shortening (FS) and fractional area change (FAC) for CSP and KH-only EVHP mice (P > .05). EVHP with S1P improved post-transplantation function by both FS and FAC (P < .05). Coadministration of S1P with S1PR2 antagonist abrogated the functional improvement of S1P alone (P < .05). EVHP with S1P also reduced injury severity scores based on neutrophil infiltration (P < .05). Finally, EVHP with S1P transplanted hearts demonstrated improved mitochondrial function compared to hearts transplanted after standard CSP (P < .05).</p><p><strong>Conclusions: </strong>Donor hearts perfused with hypothermic acellular perfusate and S1P demonstrated improved post-transplantation heart function, decreased histologic injury, and increased mitochondrial performance compared to hearts preserved with cold-static CSP, representing a potential strategy to mitigate IRI occurring in heart transplantation.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568691","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":"Assessing the role of induction Therapy and resection in esophageal cancer.","authors":"Xichen Fan, Yuxiang Zhao, Xin Zhao","doi":"10.1016/j.jtcvs.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.006","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568616","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":"Esophageal cancer invading adjacent organs: Esophagectomy combined organ resection may be a good approach.","authors":"Rirong Qu, Xiangning Fu","doi":"10.1016/j.jtcvs.2025.01.032","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.032","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544249","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":"Discussion to: Twenty-five years of Ross operation in adults: The inclusion technique keeps up the expectations.","authors":"","doi":"10.1016/j.jtcvs.2025.01.028","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.028","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568619","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}