Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Outcomes following multivalve reoperation in adults with congenital heart disease: A 30-year, single-center study.","authors":"Ahmed A Abdelrehim, Elizabeth H Stephens, Kimberly A Holst, William R Miranda, Heidi M Connolly, Luke J Burchill, Austin L Todd, Juan A Crestanello, Alberto Pochettino, Hartzell V Schaff, Joseph A Dearani","doi":"10.1016/j.jtcvs.2024.07.025","DOIUrl":"10.1016/j.jtcvs.2024.07.025","url":null,"abstract":"<p><strong>Objective: </strong>As patients with congenital heart disease increasingly live into adulthood, reoperative surgery is frequently required. Although half of these are valve-related procedures, little is known regarding early and late outcomes, and factors associated with adverse outcomes.</p><p><strong>Methods: </strong>From 1993 to 2022, a total of 1960 adult patients with congenital heart disease underwent repeat median sternotomy at our institution. Of these, 502 patients (26%) underwent intervention on 2 or more valves and constituted the study cohort.</p><p><strong>Results: </strong>The median age was 39 (27-51) years, and 275 patients (55%) were female. A second sternotomy was performed in 265 patients (53%), a third sternotomy was performed in 135 patients (27%), a fourth sternotomy was performed in 75 patients (15%), and a fifth or more sternotomy was performed in 27 patients (5%). Interventions were performed on 2 valves in 436 patients (87%), 3 valves in 62 patients (12%), and 4 valves in 4 patients (1%). The most common combinations were pulmonary and tricuspid in 241 patients (48%), followed by mitral and tricuspid in 85 patients (17%), aortic and pulmonary in 42 patients (8%), and aortic and mitral in 41 patients (8%). Early mortality was 4.2% overall and 2.7% for elective operations. Nonelective operations and congenital heart disease of major complexity were independently associated with early mortality. Median follow-up was 14 years. One, 5-, and 10-year survivals were 93.6%, 89.3%, and 79.5%, respectively. Factors independently associated with overall mortality were age, ventricular dysfunction, coronary artery disease, renal failure, double valve replacement, nonelective operations, and bypass time.</p><p><strong>Conclusions: </strong>Multiple valve interventions are common and confer low early mortality in the elective setting. Referral before ventricular dysfunction and in an elective setting optimizes outcomes.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":"208-216.e2"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749536","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: The pulmonary sulcus phenomenon in lung cancer invading the chest wall.","authors":"Marc de Perrot","doi":"10.1016/j.jtcvs.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.11.022","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883639","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":"Delivering the News of an Intraoperative Death; Literature Based Guidance from the AATS Wellness Committee.","authors":"James R Edgerton, Ann Marie Warren, Andrea S Wolf, Ross Ungerleider, Jamie Dickey Ungerleider, Cherie P Erkmen, Michael Maddaus, Michael S Firstenberg, Anna Hollembeak Olds, Robert J Cerfolio, Ari Mennander, Noboru Motomura, Ross M Bremner","doi":"10.1016/j.jtcvs.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.017","url":null,"abstract":"<p><strong>Objectives: </strong>Fortunately, operating room deaths and unexpected deaths are infrequent occurrences. However, when they occur, the surgeon is called upon to deliver this news to family and loved ones. There is a paucity of literature on this topic and little guidance preparing cardiothoracic surgeons for this important but difficult situation. Further, the surgeon may very well lack prior experience with this challenging situation. Having contemplated this in advance and having a script in mind will likely benefit both the surgeon and family.</p><p><strong>Methods: </strong>The American Association for Thoracic Surgery Wellness Committee called upon the available published literature, consultation with experts, and upon their collective experience and cumulative wisdom to address this topic.</p><p><strong>Results: </strong>The result of this process is a narrative discussion of delivering news of an unexpected death and a bullet point guide to speaking with the bereaved family.</p><p><strong>Conclusions: </strong>In this stressful situation, precontemplation of the surgeon's duties and being armed with a bullet point guide may benefit the surgeon, family and heath care team. The lessons learned may be applicable to other situations requiring the delivery of distressing information.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878441","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 outcomes of intrathoracic vs. cervical anastomosis post-esophagectomy: a large-scale propensity score matching analysis.","authors":"Kexun Li, Simiao Lu, Longlin Jiang, Changding Li, Jie Mao, Wenwu He, Chenghao Wang, Kangning Wang, Guangyuan Liu, Yunchao Huang, Yongtao Han, Xuefeng Leng, Lin Peng","doi":"10.1016/j.jtcvs.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.015","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) is a prevalent and aggressive gastrointestinal tumor, particularly in East Asia. However, there is a lack of consensus on the long-term survival outcomes of intrathoracic anastomosis and cervical anastomosis following esophagectomy. This study aims to provide a comprehensive summary of the long-term survival outcomes of these two anastomosis techniques.</p><p><strong>Methods: </strong>We employed data drawn from the Sichuan Cancer Hospital and Institute Esophageal Cancer Case Management Database from January 2010 to December 2017. Patients were stratified into two distinct groups according to the anatomical location of anastomosis following esophagectomy: those who underwent intrathoracic anastomosis (IA Group) and those who underwent cervical anastomosis (CA Group). To account for potential confounding factors and baseline imbalances between the two groups, propensity score matching (PSM) was employed.</p><p><strong>Results: </strong>The CA Group exhibited longer OS compared to the IA Group, with a median OS of 49.10 months versus 35.87 months (HR,1.118; 95% CI: 1.118-1.412; P < 0.001) . Additionally, survival rates at 1-, 3-, and 5-years were higher in the CA Group (87%, 59%, and 48% respectively) compared to the IA Group (86%, 50%, and 39% respectively). The significance persisted even after propensity score matching (PSM) (HR: 1.164; 95% CI: 1.013-1.336; P < 0.001), inverse probability of treatment weighting (IPTW), and overlap weighting (OW) were applied. The survival difference between CA and IA was attributed to varying extents of lymph node dissection, particularly in the upper mediastinal zone (P < 0.001).</p><p><strong>Conclusions: </strong>In conclusion, our study suggests that there could be the potential survival advantage of CA over IA in patients undergoing esophagectomy for ESCC.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878446","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: Soluble mesothelin-related peptide as a prognosticator in pleural mesothelioma patients receiving checkpoint immunotherapy.","authors":"","doi":"10.1016/j.jtcvs.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.11.007","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873293","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":"Corrigendum to: Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance)\" [The Journal of Thoracic and Cardiovascular Surgery Volume 167, Issue 1, January 2024, Pages 338-347.e1].","authors":"Nasser Altorki, Xiaofei Wang, Bryce Damman, Jennifer Mentlick, Rodney Landreneau, Dennis Wigle, David R Jones, Massimo Conti, Ahmad S Ashrafi, Moishe Liberman, Marc de Perrot, John D Mitchell, Robert Keenan, Thomas Bauer, Daniel Miller, Thomas E Stinchcombe","doi":"10.1016/j.jtcvs.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.011","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873294","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: Going small should not, and does not compromise quality.","authors":"Luke J Rogers, Piroze M Davierwala","doi":"10.1016/j.jtcvs.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.014","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873292","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":"Truncal valve repair in neonates.","authors":"Igor E Konstantinov","doi":"10.1016/j.jtcvs.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.009","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873295","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: \"In Search of a Magic Bullet for CS-AKI Prevention and Treatment\".","authors":"Daniel L Landry, Daniel T Engelman","doi":"10.1016/j.jtcvs.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.012","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873291","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: Pulmonary vasodilation in the Fontan circulation: are we searching in the wrong place to significantly improve the circulation?","authors":"Jack Rychik","doi":"10.1016/j.jtcvs.2024.10.059","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.10.059","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856525","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}