Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Outcomes of aortic surgery in patients with Takayasu arteritis","authors":"Defne Gunes Ergi MD ,&nbsp;Hartzell V. Schaff MD ,&nbsp;Alberto Pochettino MD ,&nbsp;Philip D. Hurst MD ,&nbsp;Kevin L. Greason MD ,&nbsp;Richard C. Daly MD ,&nbsp;Juan A. Crestanello MD ,&nbsp;Joseph A. Dearani MD ,&nbsp;Austin Todd MS ,&nbsp;Nishant Saran MD, MBBS","doi":"10.1016/j.jtcvs.2024.01.041","DOIUrl":"10.1016/j.jtcvs.2024.01.041","url":null,"abstract":"<div><h3>Objective</h3><div><span>To investigate the presentation, aortic involvement, and surgical outcomes in patients with Takayasu arteritis undergoing </span>aortic surgery.</div></div><div><h3>Methods</h3><div>We queried our surgical database for patients with Takayasu arteritis who underwent aortic surgery from 1994 to 2022.</div></div><div><h3>Results</h3><div><span>There were a total of 31 patients with Takayasu arteritis who underwent aortic surgery. Patients' median age at the time of diagnosis was 35.0 years (interquartile range, 25.0-42.0). The majority were female (n = 27, 87.0%). Most patients (n = 28, 90.3%) were diagnosed before surgery, and 3 patients (9.6%) were diagnosed perioperatively. The median time interval from diagnosis to surgery was 2.8 years (interquartile range, 0.5-13.9). The most common presentation was ascending aorta<span><span> aneurysm (n = 22, 70.9%), and severe aortic regurgitation was the most common valve insufficiency (n = 17, 54.8%). The most common operation was </span>ascending aorta replacement (n = 20, 64.5%), and </span></span>aortic valve<span> replacement was the most common valve intervention (n = 17, 54.8%). Active vasculitis was identified in 2 (11.7%) aortic valve specimens. Early mortality was 6.5% (n = 2). A total of 6 deaths occurred over a median follow-up of 13.1 years (interquartile range, 6.1-25.2). Survival at 10 years was 86.7% (95% CI, 75.4-99.7). A total of 5 patients (16.1%) required a subsequent operation in a median of 1.9 years (interquartile range, 0.2-7.4). Freedom from reoperation was 96.9% (95% CI, 90.1-100) at 1 year, 89.4% (95% CI, 78.7-100.0) at 5 years, and 77.5% (95% CI, 61.2-98.1) at 10 and 15 years.</span></div></div><div><h3>Conclusions</h3><div>Ascending aorta aneurysm and aortic valve regurgitation are the most frequent presentations in patients with Takayasu arteritis requiring aortic surgery. Surgery in these individuals is safe, with acceptable short- and long-term results.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 576-583"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703845","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":"Utility of structured follow-up imaging after aortic surgery","authors":"Megan M. Chung BA ,&nbsp;Annie Yu ANP ,&nbsp;Yanling Zhao MS ,&nbsp;Elizabeth Wist MS, PA-C ,&nbsp;Yu Hohri MD, PhD ,&nbsp;Paul Kurlansky MD ,&nbsp;Jay Leb MD ,&nbsp;Thomas F.X. O’Donnell MD ,&nbsp;Virendra Patel MD, MPH ,&nbsp;Hiroo Takayama MD, PhD","doi":"10.1016/j.jtcvs.2024.02.007","DOIUrl":"10.1016/j.jtcvs.2024.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Although postoperative follow-up after aortic surgery is recommended by guidelines, its clinical utility is not well documented. We hypothesized that structured follow-up imaging by an aortic program would improve outcomes. We then documented radiologic findings on asymptomatic postoperative imaging.</div></div><div><h3>Methods</h3><div><span>All patients who survived to discharge after open thoracic aortic surgery<span> between January 2017 and July 2021 were included, excluding endocarditis. Patients who followed at our center and received scheduled imaging were compared with patients who did not. Survival was analyzed by the method of Kaplan–Meier, and reintervention was assessed using the Fine–Gray subhazard function. Routine imaging was reviewed for aortic growth, </span></span>pseudoaneurysm, and perigraft density.</div></div><div><h3>Results</h3><div>After aortic surgery, the cumulative incidence of follow-up was 38.6% at 3 years postoperatively. Patients with follow-up were more likely to have a dissection and fewer comorbidities but were similar in regards to socioeconomic factors and distance to hospital. After matching and accounting for immortal time bias, patients with follow-up had a greater reintervention rate (26.0% vs 9.0%) with similar survival (98.7% vs 95.2%, <em>P</em> = .110) at 4 years. The cumulative incidence of pseudoaneurysm, significant perigraft density, and growth ≥3 mm/year on routine imaging was 49.7% at 3 years.</div></div><div><h3>Conclusions</h3><div>Implementation of structured follow-up imaging by an aortic program resulted in low clinical compliance. Follow-up was associated with increased rates of aortic reintervention. Clinically relevant radiologic findings were common on asymptomatic imaging and increased throughout 5-year follow-up rather than plateauing in the early postoperative period.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 584-594.e5"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718023","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":"Influence of air quality on lung cancer in people who have never smoked","authors":"Hollis Hutchings MD ,&nbsp;Anqi Wang MS ,&nbsp;Sue Grady PhD, MPH ,&nbsp;Andrew Popoff MD ,&nbsp;Qiong Zhang PhD ,&nbsp;Ikenna Okereke MD","doi":"10.1016/j.jtcvs.2024.06.014","DOIUrl":"10.1016/j.jtcvs.2024.06.014","url":null,"abstract":"<div><h3>Objective</h3><div>Lung cancer is the leading cause of cancer-related death. The percentage of people who have never smoked with lung cancer has risen recently, but alternative risk factors require further study. Our goal was to determine the influence of air quality on incidence of lung cancer in people who have smoked or never smoked.</div></div><div><h3>Methods</h3><div>The cancer registry from a large urban medical center was queried to include every new diagnosis of lung cancer from 2013 to 2021. Air quality and pollution data for the county were obtained from the US Environmental Protection Agency from 1980 to 2018. Patient demographics, location of residence, smoking history, and tumor stage were recorded. Bivariate comparison analyses were conducted in R (R Foundation for Statistical Computing).</div></div><div><h3>Results</h3><div>A total of 2223 new cases of lung cancer were identified. Mean age was 69.2 years. There was a nonsmoking rate of 8.1%. A total of 37% of patients identified as a racial minority. People who have never smoked were more likely to be diagnosed at an advanced stage. When analyzing geographic distribution, incidence of lung cancer among people who have never smoked was more closely associated with highly polluted areas. People who have never smoked with lung cancer had significantly higher exposure levels of multiple pollutants.</div></div><div><h3>Conclusions</h3><div>Newly diagnosed lung cancer appears to be more related to poor air quality among people who have never smoked than people who have smoked. Future studies are needed to examine the associations of specific pollutants with lung cancer incidence.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 454-461.e2"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472074","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":"Late recurrence of completely resected stage I to IIIA lung adenocarcinoma","authors":"Cameron N. Fick MD ,&nbsp;Elizabeth G. Dunne MD ,&nbsp;Nicolas Toumbacaris MSPH ,&nbsp;Kay See Tan PhD ,&nbsp;Brooke Mastrogiacomo MS ,&nbsp;Bernard J. Park MD ,&nbsp;Prasad S. Adusumilli MD ,&nbsp;Daniela Molena MD ,&nbsp;Katherine D. Gray MD ,&nbsp;Smita Sihag MD ,&nbsp;James Huang MD ,&nbsp;Matthew J. Bott MD ,&nbsp;Gaetano Rocco MD ,&nbsp;James M. Isbell MD ,&nbsp;David R. Jones MD","doi":"10.1016/j.jtcvs.2024.06.026","DOIUrl":"10.1016/j.jtcvs.2024.06.026","url":null,"abstract":"<div><h3>Objective</h3><div>Research into the risk factors associated with late recurrence (&gt;2 years after surgery) of lung adenocarcinoma is limited. We investigated the incidence of and clinicopathologic and genomic features associated with late recurrence of resected stage I-IIIA lung adenocarcinoma.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of patients with completely resected pathologic stage I-IIIA lung adenocarcinoma (2010-2019). Patients with a history of lung cancer, neoadjuvant therapy, or mucinous or noninvasive lung adenocarcinoma, or with follow-up of less than 2 years were excluded. Cox and logistic regression modeling were used to compare clinicopathologic variables among patients with no, early (≤2 years), and late recurrence. Comparisons of genomic mutations were corrected for multiple testing.</div></div><div><h3>Results</h3><div>Of the 2349 patients included, 537 developed a recurrence during follow-up. Most recurrences (55% [297/537]) occurred early; 45% (240/537) occurred late. A larger proportion of late recurrences than early recurrences were locoregional (37% vs 29%; <em>P</em> = .047). Patients with late recurrence had more aggressive pathologic features (International Association for the Study of Lung Cancer grade 2 and 3, lymphovascular invasion, visceral pleural invasion) and higher stage than patients without recurrence. Pathologic features were similar between patients with early and late recurrence, except stage IIIA disease was more common in the early cohort. No genomic mutations were associated with late recurrence.</div></div><div><h3>Conclusions</h3><div>Late recurrence of lung adenocarcinoma after resection is more common than previously reported. Patients without disease more than 2 years after surgery who had aggressive pathologic features at the time of resection have an elevated risk of recurrence and may benefit from more aggressive follow-up.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 445-453.e3"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477829","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":"Information for readers","authors":"","doi":"10.1016/S0022-5223(24)01184-X","DOIUrl":"10.1016/S0022-5223(24)01184-X","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Page 684"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129847","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":"Impact of surgical strategy and postrepair transverse aortic arch size on late hypertension after coarctation repair during infancy","authors":"Sanam Safi MD ,&nbsp;David Hoganson MD ,&nbsp;Sitaram Emani MD ,&nbsp;Lynn Sleeper ScD ,&nbsp;Eleni Elia PhD ,&nbsp;Minmin Lu MS ,&nbsp;Tor Biering-Sørensen MD, MSc, MPH, PhD ,&nbsp;Ashwin Prakash MD","doi":"10.1016/j.jtcvs.2024.08.049","DOIUrl":"10.1016/j.jtcvs.2024.08.049","url":null,"abstract":"<div><h3>Background</h3><div>Late hypertension (HTN) after coarctation of the aorta (CoA) repair contributes to higher morbidity and mortality. An association between transverse aortic arch (TAA) hypoplasia and HTN has been found, but its relationship with surgical strategy is unclear. We studied the association between late HTN and initial surgical strategy pertaining to the TAA.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who underwent surgical repair of CoA during infancy with at least 10 years of follow-up, excluding those with atypical coarctation, major associated heart defects, and residual isthmic narrowing. TAA diameter <em>z</em>-score immediately postrepair was measured as a marker of surgical strategy. Systemic HTN at latest follow-up was assessed using standard criteria.</div></div><div><h3>Results</h3><div>A total of 130 patients underwent surgical repair of CoA (76% via thoracotomy, 24% via sternotomy) with resection and end-to-end anastomosis (62%), extended end-to-end anastomosis (30%), subclavian flap (5%), or arch repair with patch (4%), at a median age of 14 days (interquartile range [IQR], 7-62 days). The median postrepair TAA diameter <em>z</em>-score was −2.04 (IQR, −2.69 to 1.24). At a mean follow-up of 17.3 years, 43 of the 130 patients (33%) developed HTN. After controlling for age at repair, sex, and presence of a genetic syndrome, HTN was not associated with immediate postrepair TAA diameter <em>z</em>-score (<em>P</em> = .41), type of surgical incision (<em>P</em> = .99), or type of surgical repair (<em>P</em> = .66).</div></div><div><h3>Conclusions</h3><div>In patients undergoing surgical repair of CoA during infancy, late HTN was not associated with immediate postrepair TAA size or surgical strategy pertaining to the TAA. These results suggest that factors other than surgical strategy, such as differential growth of the TAA during childhood, may be important.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 345-352"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156492","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":"Predictive modeling of endocardial fibroelastosis recurrence in patients with congenital heart disease","authors":"Daniel Diaz-Gil MD ,&nbsp;Natalia Silva-Gomez cand. med. ,&nbsp;Sarah U. Morton MD, PhD ,&nbsp;Jonathan G. Seidman PhD ,&nbsp;Christine E. Seidman MD ,&nbsp;David Zurakowski MS, PhD ,&nbsp;Steven J. Staffa MS ,&nbsp;Gerald R. Marx MD ,&nbsp;Sitaram M. Emani MD ,&nbsp;Pedro J. del Nido MD ,&nbsp;Ingeborg Friehs MD","doi":"10.1016/j.jtcvs.2024.08.036","DOIUrl":"10.1016/j.jtcvs.2024.08.036","url":null,"abstract":"<div><h3>Background</h3><div>Endocardial fibroelastosis (EFE) is a major effector in the maldevelopment of the heart in patients with congenital heart disease. Despite successful surgical removal, EFE can redevelop, but the underlying cause of EFE recurrence remains unknown. This study aimed to identify hemodynamic predictors and genetic links to epithelial/endothelial-to-mesenchymal transition (EMT/EndMT) alterations for preoperative risk assessment.</div></div><div><h3>Methods</h3><div>We assessed the impact of preoperative hemodynamic parameters on EFE recurrence in a cohort of 92 patients with congenital heart disease who underwent left ventricular (LV) EFE resection between January 2010 and March 2021. Additionally, whole-exome sequencing in 18 patients was used to identify rare variants (minor allele frequency &lt;10⁻⁵) in high-expression heart (HHE) genes related to cardiac EMT/EndMT and congenital heart disease.</div></div><div><h3>Results</h3><div>EFE recurred in 55.4% of patients, within a median of 2.2 years postsurgery. Multivariable analysis revealed specific hemodynamic parameters (mitral valve inflow and area, LV filling pressure, and aortic valve gradient and diameter) as predictors, forming a predictive model with an area under the receiver operating characteristic curve of 0.782. Furthermore, 89% of the patients exhibited damaging variants in HHE genes, with 38% linked to cardiac EMT/EndMT Gene Ontology processes and 22% associated with known congenital heart disease genes. Notably, HHE genes associated with cardiac EMT/EndMT were significantly associated with faster EFE recurrence in a multivariate analysis (hazard ratio, 3.56; 95% confidence interval, 1.24-10.17; <em>P</em> = .018).</div></div><div><h3>Conclusions</h3><div>These findings established a predictive scoring system using preoperative hemodynamic parameters for EFE recurrence risk assessment. Alterations in HHE genes, particularly those linked to cardiac EMT/EndMT, exacerbate the risk of recurrence.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 366-374"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114229","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":"Appropriate sizing of the frozen elephant trunk: How to predict proximal descending aortic diameter prior to dissection?","authors":"Yuichiro Kitada MD ,&nbsp;Homare Okamura MD, PhD ,&nbsp;Taketo Yamauchi MD ,&nbsp;Satoshi Nishi MD, PhD ,&nbsp;Mamoru Arakawa MD, PhD ,&nbsp;Naoyuki Kimura MD, PhD ,&nbsp;Koji Kawahito MD, PhD ,&nbsp;Atsushi Yamaguchi MD, PhD","doi":"10.1016/j.jtcvs.2024.01.030","DOIUrl":"10.1016/j.jtcvs.2024.01.030","url":null,"abstract":"<div><h3>Objective</h3><div>The predissection aortic diameter is the best reference for determining the size of the frozen elephant trunk in aortic dissection. We aimed to develop a new prediction method to estimate the predissection diameter of proximal descending aorta. Furthermore, we evaluated the accuracy of the estimated predissection proximal descending aortic diameters calculated using 3 prediction methods.</div></div><div><h3>Methods</h3><div><span><span>A total of 39 patients with acute type A aortic dissection who underwent predissection </span>computed tomography were included in derivation sets. We measured the aortic dimensions at 3 levels of the proximal descending aorta: 5, 10, and 15 cm from zone 2. We developed a new prediction method—postdissection aortic diameter divided by 1.13 (AoD</span>_{New factor})—and estimated the predissection aortic diameter using the new and previously proposed methods by Rylski (AoD_Rylski) and Yamauchi (Equation_Yamauchi). Furthermore, we validated the new prediction method using a validation dataset with 24 patients.</div></div><div><h3>Results</h3><div>The rate of bias ≤2 mm was significantly greater with Equation_Yamauchi and AoD_{New factor} than with AoD_Rylski in the derivation group at each level of the proximal descending aorta (<em>P</em> &lt; .001). In the validation group, the rate of bias ≤2 mm was significantly greater with Equation_Yamauchi and AoD_{New factor} than with AoD_Rylski at 10 cm and 15 cm from zone 2 (10 cm: <em>P</em> = .014, 15 cm: <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>These results suggest that the new prediction method can be used as a simple and accurate estimation method for the predissection aortic diameter at the proximal descending aorta.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 542-551.e3"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571416","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":"Impact of dual thoracic recovery from circulatory death donors on heart and lung transplant outcomes","authors":"Alice L. Zhou MS ,&nbsp;Alexandra A. Rizaldi BA ,&nbsp;Jessica M. Ruck MD, PhD ,&nbsp;Armaan F. Akbar BS ,&nbsp;Andrew Kalra BS ,&nbsp;Alfred J. Casillan MD, PhD ,&nbsp;Jinny S. Ha MD ,&nbsp;Christian A. Merlo MD ,&nbsp;Ahmet Kilic MD ,&nbsp;Errol L. Bush MD","doi":"10.1016/j.jtcvs.2024.07.008","DOIUrl":"10.1016/j.jtcvs.2024.07.008","url":null,"abstract":"<div><h3>Objectives</h3><div>Concomitant heart and lung recovery can result in increased operative complexity, ischemic time, and competition for resources and anatomic territory. Dual thoracic recovery from circulatory death donors may have additional risks that are not fully understood. We investigated the effects of dual heart and lung recovery from circulatory death donors on thoracic transplant outcomes.</div></div><div><h3>Methods</h3><div>Using the United Network for Organ Sharing database, we categorized all adult thoracic circulatory death donor transplants from 2019 to 2023 by whether the donor heart, lung, or both (dual donors) were recovered. Heart and lung transplant outcomes were compared between dual recovery donors and heart-only or lung-only donors, respectively, using multivariable analyses.</div></div><div><h3>Results</h3><div>Of the 2513 donors included, 42.9% were heart-only, 45.0% were lung-only, and 12.0% were dual donors. Recipients of dual versus heart-only donors had similar likelihood of post-transplant dialysis (18.9% vs 18.3%, <em>P</em> = .84), likelihood of stroke (2.9% vs 4.7%, <em>P</em> = .34), and 2-year risk of mortality (adjusted hazard ratio, 1.15 [95% CI, 0.90-1.47], <em>P</em> = .26), but lower likelihood of acute rejection (10.2% vs 16.1%, <em>P</em> = .04). Recipients of dual and lung-only donors had similar likelihood of predischarge acute rejection (7.6% vs 8.5%, <em>P</em> = .70), intubation at 72 hours (38.9% vs 45.1%, <em>P</em> = .13), and extracorporeal membrane oxygenation at 72 hours (13.1% vs 18.1%, <em>P</em> = .11), as well as 2-year risk of mortality (adjusted hazard ratio, 1.16 [95% CI, 0.74-1.82], <em>P</em> = .52).</div></div><div><h3>Conclusions</h3><div>Recovering both the heart and lungs from a circulatory death donor does not negatively impact transplant outcomes. Outcomes in this population should continue to be investigated as more data and longer-term follow-up become available.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 505-515.e5"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617539","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":"105th AATS Annual Meeting","authors":"","doi":"10.1016/S0022-5223(24)01192-9","DOIUrl":"10.1016/S0022-5223(24)01192-9","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Page 683"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129849","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}