Journal of Thoracic and Cardiovascular Surgery最新文献

{"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 G 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":"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}

{"title":"Reply: Moonlight and Sunlight are the same","authors":"Marc W. Gerdisch MD","doi":"10.1016/j.jtcvs.2025.02.005","DOIUrl":"10.1016/j.jtcvs.2025.02.005","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 5","pages":"Pages e52-e53"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544253","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":"Mitral valve repair in the United States: Single-center versus multicenter surgeons' risk-adjusted outcomes.","authors":"Thomas Bilfinger, Anne Bennett, Thomas A Bogue, Samuel Greenberg, Joshua Zhu, Joseph Pizzuti, Lee Ann Santore, Samantha Novotny, Jonathan D Price, Henry J Tannous, Lichun He, Jie Yang, A Laurie Shroyer","doi":"10.1016/j.jtcvs.2025.01.033","DOIUrl":"10.1016/j.jtcvs.2025.01.033","url":null,"abstract":"<p><strong>Objectives: </strong>Health care consolidation may force cardiac surgeons to operate at multiple centers. Few data exist as to this phenomenon's effect upon patients' quality of care as measured by risk-adjusted outcome (RAO) rates. We sought to compare mitral valve repair (MVr) RAO rates between surgeons operating at multiple centers (MC) versus single-centers (SC); and for MC surgeons, to compare MVr RAO rates between their primary and secondary centers.</p><p><strong>Methods: </strong>The 2011-2019 Society of Thoracic Surgeons Adult Cardiac Surgery Database's MVr records were analyzed. MC surgeons performed MVr procedures at ≥2 centers within a year; each MC surgeon's greatest MVr volume (\"primary\") center was identified. Applying the Society of Thoracic Surgeons-approved 2018 isolated-MVr risk models, study end points included risk-adjusted 30-day major morbidity or mortality (MMM; determined by operative death, dialysis, stroke, prolonged ventilation, mediastinitis, or repeat procedure) and risk-adjusted prolonged length of stay (pLOS). The impacts of surgeon's and hospital's MVr and total cardiac surgery volumes were evaluated.</p><p><strong>Results: </strong>Compared with MC surgeons, SC surgeons had lower risk-adjusted MMM (odds ratio [OR], 1.170; P < .001). After adjusting for surgeon and center volumes, this finding persisted (OR, 1.141; P = .0155). MC surgeons experienced lower risk-adjusted MMM at their primary versus secondary centers (OR, 1.269; P < .001); this finding was partially attributable to center-based volume variations (OR, 1.130; P = .098). No SC versus MC surgeon risk-adjusted pLOS differences were found; however, regional risk-adjusted pLOS differences persisted.</p><p><strong>Conclusions: </strong>Compared with SC surgeons, reallocating surgeons' caseload across multiple centers has a statistically significant, negative impact on their MVr RAO rates.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537950","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: Looking to the future: Revisiting the volume-outcome relationship in mitral valve repair.","authors":"Amit Iyengar, Cindy Song, Pavan Atluri","doi":"10.1016/j.jtcvs.2025.02.020","DOIUrl":"10.1016/j.jtcvs.2025.02.020","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537945","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":"An evaluation of lymph node harvest in sublobar resections in a statewide quality collaborative.","authors":"Jenny Bui, Stanley Kalata, Rishindra M Reddy, Melissa Clark, Mary Hollenbeck, Nathan Mollberg, Shelly Lall, Andrew M Popoff","doi":"10.1016/j.jtcvs.2025.02.016","DOIUrl":"10.1016/j.jtcvs.2025.02.016","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effectiveness of nodal harvest in sublobar resections for peripheral non-small cell lung cancer.</p><p><strong>Methods: </strong>Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for non-small cell lung cancer from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥10 LNs, ≥5 LN stations (LNSs), or 3 mediastinal LNSs and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted, or robot-assisted).</p><p><strong>Results: </strong>A total of 1398 patients receiving sublobar resections were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNSs harvested. Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥10 LNs (P < .001) or harvesting ≥5 LNSs or 3/1 LNS (P < .001) compared with video-assisted thoracoscopic surgery for WR. Compared with open procedures and video-assisted thoracic surgery, Robot-assisted thoracic surgery was associated with higher rates of harvesting ≥5 LNSs or 3/1 LNS for SG (P = .002 and P = .003, respectively).</p><p><strong>Conclusions: </strong>WR and SG have low rates of adequate LN harvesting. Robot-assisted surgery was associated with improved LN harvesting rates. Given the increase interest in sublobar resections, continued focus on improving and increasing LN harvesting are needed.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537942","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: Saving hearts: Utilizing cardiac catheterization after coronary artery bypass grafting.","authors":"Anthony V Norman, Irving L Kron","doi":"10.1016/j.jtcvs.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.024","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477025","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: Standing on the shoulders of giants to slide down the learning curve.","authors":"Ali Hage, Eugene A Grossi","doi":"10.1016/j.jtcvs.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.019","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477008","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":"Exploring the impact of fenestration closure on long-term outcomes in the modified Fontan operation.","authors":"Yunpeng Liu, Mengxia Qi, YanBo Wang","doi":"10.1016/j.jtcvs.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.018","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477010","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}