Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Congenital Articles in AATS Journals","authors":"","doi":"10.1016/S0022-5223(24)01146-2","DOIUrl":"10.1016/S0022-5223(24)01146-2","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Page e11"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143130100","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: Evaluation of sex differences in the receipt of concomitant atrial fibrillation procedures during nonmitral cardiac surgery","authors":"","doi":"10.1016/j.jtcvs.2024.07.034","DOIUrl":"10.1016/j.jtcvs.2024.07.034","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 635-636"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037580","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 cone repair allows right ventricle rehabilitation with excellent tricuspid valve function following the Starnes procedure","authors":"Syed Faaz Ashraf MD ,&nbsp;Jose Pedro Da Silva MD ,&nbsp;Mario Castro-Medina MD ,&nbsp;Melita Viegas MD ,&nbsp;Tarek Alsaied MD ,&nbsp;Laura Seese MD ,&nbsp;Victor O. Morell MD ,&nbsp;Luciana Da Fonseca Da Silva MD","doi":"10.1016/j.jtcvs.2024.08.024","DOIUrl":"10.1016/j.jtcvs.2024.08.024","url":null,"abstract":"<div><h3>Background</h3><div>We present a case series of right ventricle (RV) rehabilitation after the Starnes procedure in patients with Ebstein anomaly (EA), applying the Cone repair of the tricuspid valve (TV) to achieve 2-ventricle or 1.5-ventricle physiology.</div></div><div><h3>Methods</h3><div>This is a retrospective database analysis from 2 institutions in North America. We included all consecutive cases of Cone repair after the Starnes procedure. The data are expressed as median and interquartile range (IQR).</div></div><div><h3>Results</h3><div>Eleven patients underwent RV rehabilitation between 2019 and 2023 after initial Starnes palliation at a median age of 27 months (IQR, 20.5 months). All patients were critically ill before their Starnes procedure, and 4 were on extracorporeal membrane oxygenation. Before the Cone repair, the median preoperative regurgitant velocity at the Starnes patch was 1.65 m/s (IQR, 1.3 m/s). During the Cone procedure, 9 patients required a concomitant pulmonary valve repair, of whom 3 needed a transannular monocusp patch. Four patients were successfully rerouted to a 2-ventricle repair, and 7 patients with a previous Glenn achieved 1.5-ventricle circulation. There were no cases of heart block and no deaths. Seven patients had trivial, 3 patients had mild, and 1 patient had moderate tricuspid regurgitation (TR) at a median follow-up of 11 months (IQR, 21.5 months). There was no significant TV stenosis; all patients had good functional status at the last follow-up despite severe RV dysfunction in 1 patient.</div></div><div><h3>Conclusions</h3><div>After the Starnes procedure, the Cone repair allowed RV rehabilitation, resulting in trivial or mild TR at a midterm follow-up. The Starnes procedure is a reproducible technique that no longer commits patients to lifetime single-ventricle physiology.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 354-361.e3"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057029","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":"Commentary: Neonatal Starnes: When “cone” the conversion to a biventricular repair be done?","authors":"Joseph A. Dearani MD ,&nbsp;David M. Overman MD ,&nbsp;Elizabeth H. Stephens MD, PhD","doi":"10.1016/j.jtcvs.2024.09.008","DOIUrl":"10.1016/j.jtcvs.2024.09.008","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 364-365"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299691","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: What drives variability in postoperative transfusion rates?","authors":"","doi":"10.1016/j.jtcvs.2024.03.016","DOIUrl":"10.1016/j.jtcvs.2024.03.016","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 675-676"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773340","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: What matters more: Method of revascularization or completeness?","authors":"Robert B. Hawkins MD, MSc","doi":"10.1016/j.jtcvs.2024.04.014","DOIUrl":"10.1016/j.jtcvs.2024.04.014","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 648-649"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782972","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":"Feasibility and comparative prognosis of segmentectomy versus lobectomy in centrally located small and solid dominant cN0 non–small cell lung cancer","authors":"Norifumi Tsubokawa MD, PhD ,&nbsp;Takahiro Mimae MD, PhD ,&nbsp;Akira Saeki MD ,&nbsp;Yoshihiro Miyata MD, PhD ,&nbsp;Chiaki Kanno MD ,&nbsp;Yujin Kudo MD, PhD ,&nbsp;Takuya Nagashima MD, PhD ,&nbsp;Hiroyuki Ito MD, PhD ,&nbsp;Norihiko Ikeda MD, PhD ,&nbsp;Morihito Okada MD, PhD","doi":"10.1016/j.jtcvs.2024.06.016","DOIUrl":"10.1016/j.jtcvs.2024.06.016","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the feasibility of segmentectomy in patients with central, whole tumor size ≤2 cm and radiologically solid-dominant cN0 non–small cell lung cancer (NSCLC).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 1240 patients who underwent lobectomy or segmentectomy for small and radiologically solid-dominant cN0 NSCLC between January 2010 and December 2022. The inclusion criteria encompassed centrally located tumors, defined as tumors located in the inner two-thirds of the pulmonary parenchyma. Propensity score matching was applied to balance the baseline characteristics in the 2 study groups.</div></div><div><h3>Results</h3><div>Among the 299 eligible patients, no significant differences in recurrence-free survival (RFS) and overall survival (OS) were observed between the segmentectomy (n = 121) and lobectomy (n = 178) groups (<em>P</em> = .794 and .577, respectively). After propensity score matching, no significant differences in hilar and mediastinal lymph node upstaging were found among the 93 matched patients (<em>P</em> = 1.00), and locoregional recurrence was comparable in the segmentectomy (n = 4) and lobectomy (n = 4) groups. RFS and OS did not differ significantly between the 2 groups (<em>P</em> = .700 and .870, respectively). Propensity score–adjusted multivariable Cox analysis for RFS and OS indicated that segmentectomy was not an independent prognostic factor (RFS: hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.43-1.85; <em>P</em> = .755; OS: HR, 1.09; 95% CI, 0.38-3.14; <em>P</em> = .860).</div></div><div><h3>Conclusions</h3><div>Segmentectomy may be a viable treatment option, with local control and prognosis comparable to that of lobectomy in appropriately selected patients with central, small (≤2 cm), and radiologically solid-dominant NSCLC.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 2","pages":"Pages 427-435.e2"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538808","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":"Navigating the Future of Pediatric Cardiovascular surgery: Insights and Innovation powered by ChatGPT.","authors":"Rittal Mehta, Justus G Reitz, Alyssia Venna, Arif Selcuk, Bishakha Dhamala, Jennifer Klein, Christine Sawda, Mitchell Haverty, Can Yerebakan, Aybala Tongut, Manan Desai, Yves d'Udekem","doi":"10.1016/j.jtcvs.2025.01.022","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.022","url":null,"abstract":"<p><strong>Introduction: </strong>Interdisciplinary consultations are essential to decision-making for patients with congenital heart disease. The integration of artificial intelligence (AI) and natural language processing (NLP) into medical practice is rapidly accelerating, opening new avenues to diagnosis and treatment. The main objective of this study was to consult the AI trained model Chat Generative Pre-Trained Transformer (ChatGPT) regarding cases discussed during a cardiovascular surgery conference (CSC) at a single tertiary center and compare the ChatGPT suggestions with CSC expert consensus results.</p><p><strong>Methods: </strong>37 cases discussed at a single CSC were retrospectively identified. Clinical information comprised of de-identified data from the last ECG, echocardiogram, ICU progress note (or cardiology clinic note if outpatient) as well as a patient summary. Diagnosis was removed from the summary and possible treatment options were deleted from all notes. ChatGPT (v.4.0) was asked to summarize the case, identify diagnoses, and recommend surgical procedures and timing of surgery. The responses of ChatGPT were compared with the results of the CSC.</p><p><strong>Results: </strong>Of the 37 cases uploaded to ChatGPT, 45.9% (n=17) were considered to be less complex cases with only 1 treatment option, and 54.1% (n=20) were considered more complex with several treatment options. ChatGPT correctly provided a detailed and systematically written summary for each case within 10-15 seconds. ChatGPT correctly identified diagnoses for about 94.5% (n=35) cases. The surgical intervention plan matched the group decision for about 40.5% (n=15) cases; however, it differed in 27% cases. In 23 out of 37 cases, timing of surgery was the same between CSC group and ChatGPT. Overall, the match between ChatGPT responses and CSC decisions for diagnosis was 94.5%, surgical intervention was 40.5%, and timing of surgery was 62.2%. However, within complex cases, we have 25% agreement for surgical intervention and 67% for timing of surgery.</p><p><strong>Conclusion: </strong>ChatGPT can be used as an augmentative tool for surgical conferences to systematically summarize large amounts of patient data from electronic health records and clinical notes in seconds. In addition, our study points out the potential of ChatGPT as an AI-based decision support tool in surgery, particularly for less-complex cases. The discrepancy, particularly in complex cases, emphasizes on the need for caution when using ChatGPT in decision-making for the complex cases in pediatric cardiovascular surgery. There is little doubt that the public will soon use this comparative tool.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081765","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":"Low-dose warfarin and self-management anticoagulation Strategy: A combination to analyze and promote.","authors":"Giuseppe Santarpino, Alessandro Fiorentino","doi":"10.1016/j.jtcvs.2024.12.028","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2024.12.028","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076269","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":"Preoperative diabetic duration and long-term outcomes in acute myocardial infarction patients undergoing coronary artery bypass grafting.","authors":"Jun Ho Lee, Yun Jin Kim, Yang Hyun Cho, Joon Bum Kim, Hee Jung Kim","doi":"10.1016/j.jtcvs.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.020","url":null,"abstract":"<p><strong>Background: </strong>The association between preoperative diabetes mellitus (DM) duration and outcomes of coronary artery bypass grafting (CABG) remains unclear. This study aimed to investigate the relationship between DM duration at the time of CABG and long-term outcomes, particularly patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>Using data from South Korea's National Health Insurance Service database, the study included adult patients who underwent first-time isolated CABG with an AMI diagnosis between 2005 and 2021. DM patients were categorized based on whether their diagnosis occurred within 5 years before CABG. Patients with impaired fasting glucose were also classified. The primary outcome was all-cause overall mortality. The secondary outcome was repeat revascularization.</p><p><strong>Results: </strong>A total of 21,957 patients (median age, 65.0 years) were categorized into four groups: without DM, impaired fasting glucose, DM diagnosed within 5 years, and DM diagnosed more than 5 years before CABG. Patients with DM for less than 5 years had a higher overall mortality rate (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.08-1.24), and those with DM for more than 5 years had an even higher rate (HR, 1.36; 95% CI, 1.27-1.46) compared to those without DM. The incidence rate of repeat revascularization was significantly higher in those with DM for more than 5 years (HR, 2.07; 95% CI, 1.89-2.28).</p><p><strong>Conclusions: </strong>The duration of DM prior to CABG is correlated with worse clinical outcomes. A prolonged period of DM before CABG may be a significant risk factor for poorer long-term outcomes in AMI patients.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081766","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}