Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Today. Today, I'm Invincible: Setting Process-Oriented Goals By Andrea S. Wolf","authors":"","doi":"10.1016/S0022-5223(24)01001-8","DOIUrl":"10.1016/S0022-5223(24)01001-8","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1755-1756"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745744","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":"Adult Articles in AATS Journals","authors":"","doi":"10.1016/S0022-5223(24)00977-2","DOIUrl":"10.1016/S0022-5223(24)00977-2","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Page e208"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745831","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":"Concomitant ablation of atrial fibrillation: New pacemakers and early rhythm recovery","authors":"Andrei Churyla MD ,&nbsp;Patrick M. McCarthy MD ,&nbsp;Jane Kruse BSN ,&nbsp;Adin-Cristian Andrei PhD ,&nbsp;Rachel Kaplan MD ,&nbsp;Rod S. Passman MD ,&nbsp;James L. Cox MD","doi":"10.1016/j.jtcvs.2023.10.030","DOIUrl":"10.1016/j.jtcvs.2023.10.030","url":null,"abstract":"<div><h3>Objective</h3><div><span>New permanent pacemaker (PPM) implantation after concomitant atrial fibrillation (AF) ablation has been associated with </span>surgical ablation (SA). We sought to determine factors for PPM use as well as early rhythm recovery.</div></div><div><h3>Methods</h3><div>From 2004 through 2019, 6135 patients underwent valve surgery and were grouped: No AF (n = 4584), AF no SA (n = 346), and AF with SA (n = 1205) to evaluate predischarge PPM and 3-month rhythm recovery (intrinsic heart rate &gt;40 beats per minute).</div></div><div><h3>Results</h3><div><span><span>Overall, 282 (4.6%) patients required a predischarge PPM: atrioventricular node dysfunction in 75.3%, </span>sick sinus syndrome in 19.1%, both (5%), and indeterminate (0.7%). Patients with AF had more PPMs: AF with SA (7.9%) versus AF no SA (6.9%) versus No AF (3.6%) (</span><em>P</em> &lt; .001). For patients with AF, PPM rates were not significantly higher for ablation patients (7.6% SA vs 6.9% AF no SA; <em>P</em><span> = .56). There were differences in PPM by SA lesion set (biatrial 12.8%; left atrial only 6.1%; pulmonary vein isolation 3.0%; </span><em>P</em> &lt; .001). Among patients with AF treated with 3-month PPM follow-up, rhythm recovery was common (35 out of 62 [56.5%]) and did not differ by lesion set. Rhythm recovery was seen in 63 out of 141 (44.7%) in the atrioventricular node dysfunction group versus 24 out of 35 (68.6%) in the sick sinus syndrome group (<em>P</em> = .011). In propensity score-matched groups, late survival was similar (<em>P</em> = .63) for new PPM patients.</div></div><div><h3>Conclusions</h3><div>Avoiding conduction system trauma and delaying implantation reduces the need for postoperative PPM. Rhythm recovery within 3 months is frequent, especially for patients with sick sinus syndrome. A conservative approach to the implantation of a new PPMs is warranted.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1677-1685.e1"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693470","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: Pacemakers after heart valve operations","authors":"James S. Gammie MD","doi":"10.1016/j.jtcvs.2023.11.050","DOIUrl":"10.1016/j.jtcvs.2023.11.050","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Page 1686"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500016","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":"ABTS Announcement for Continuing Certification","authors":"","doi":"10.1016/S0022-5223(24)00998-X","DOIUrl":"10.1016/S0022-5223(24)00998-X","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1756-1757"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745741","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 severity of chronic obstructive pulmonary disease is associated with adverse outcomes after open thoracoabdominal aortic aneurysm repair","authors":"Vicente Orozco-Sevilla MD ,&nbsp;Christopher T. Ryan MD ,&nbsp;Kimberly R. Rebello MD, MSc ,&nbsp;Lynna H. Nguyen MS ,&nbsp;Ian O. Cook MD ,&nbsp;Ginger M. Etheridge BBA ,&nbsp;Susan Y. Green MPH ,&nbsp;Thomas Bini BS ,&nbsp;Subhasis Chatterjee MD ,&nbsp;Marc R. Moon MD ,&nbsp;Scott A. LeMaire MD ,&nbsp;Joseph S. Coselli MD","doi":"10.1016/j.jtcvs.2023.09.067","DOIUrl":"10.1016/j.jtcvs.2023.09.067","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed associations between outcomes after open thoracoabdominal aortic aneurysm (TAAA) repair and preoperative airflow limitation stratified by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric classification of chronic obstructive pulmonary disease (COPD) severity.</div></div><div><h3>Methods</h3><div>Among 2368 open elective TAAA repairs in patients with spirometric data, 1735 patients had COPD and 633 did not. Those with COPD were stratified by preoperative respiratory dysfunction as GOLD 1 (forced expiratory volume in the first second of expiration [FEV₁] ≥80% of predicted; n = 228), GOLD 2 (50% ≤ FEV₁ &lt; 80% of predicted; n = 1215), GOLD 3 (30% ≤ FEV₁ &lt; 50% of predicted; n = 260), or GOLD 4 (FEV₁ &lt; 30% of predicted; n = 32). Early outcomes included operative mortality and adverse events (operative death or persistent stroke, spinal cord deficit, or renal failure requiring dialysis); associations of outcomes were determined using logistic regression models. Kaplan–Meier analysis compared late survival by the log-rank test.</div></div><div><h3>Results</h3><div>Pulmonary complications occurred in 38.4% of patients with COPD versus 30.0% without COPD (<em>P</em> &lt; .001). Operative mortality and adverse events were more frequent in patients with COPD than without COPD (7.9% vs 3.8% [<em>P</em> &lt; .001] and 14.9% vs 9.8% [<em>P</em> = .001], respectively). Worsening GOLD severity was independently associated with operative death and adverse event. Survival was poorer in patients with COPD than in those without (61.9% ± 1.2% vs 73.6% ± 1.8% at 5 years; <em>P</em> &lt; .001), particularly in patients with increasing GOLD severity (68.7% ± 3.2% vs 63.7% ± 1.4% vs 51.4% ± 3.2% vs 31.3% ± 8.2% at 5 years; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Patients with COPD are at elevated risk for operative death and adverse events. Staging by GOLD severity aids preoperative risk stratification. Patients with airflow limitations may benefit from optimization before TAAA repair.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1603-1613.e4"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177381","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":"Multifocal disease progression and subsequent intervention in patients with actin alpha-2 variants: A single-center experience","authors":"Jean-Luc A. Maigrot BS ,&nbsp;Patrick R. Vargo MD ,&nbsp;Benjamin Kramer DO, MS ,&nbsp;Christina Rigelsky MS ,&nbsp;Joanna Ghobrial MD ,&nbsp;Kenneth Zahka MD ,&nbsp;Hani Najm MD ,&nbsp;Eric E. Roselli MD","doi":"10.1016/j.jtcvs.2023.11.052","DOIUrl":"10.1016/j.jtcvs.2023.11.052","url":null,"abstract":"<div><h3>Objectives</h3><div><span>To describe patient characteristics and indications for surgical intervention, </span>reoperation, and outcomes in patients with actin alpha-2 (ACTA2) variants.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study with prospective follow-up was performed for 38 patients with an ACTA2 variant.</div></div><div><h3>Results</h3><div><span><span>From 1999 to 2020, 26 (70%) patients underwent surgery; 11 remain under surveillance (mean follow-up, 7.5 ± 5 years). Median age at index operation was 42 (range, 10-69) years, with 4 pediatric<span> cases. Thoracic aortic aneurysm<span> was present in 19 (73%) patients (mean adult max diameter, 5.2 ± 0.8 cm; pediatric z score, 10.7 ± 5.4). Aortic dissection<span> was present in 13 (50%) patients, with 4 (15%) having type A dissection. Operations included replacement of the aortic root in 16 (17%), </span></span></span></span>ascending aorta<span><span> in 20 (77%), and aortic arch in 14 (54%) patients. Four (15%) patients had </span>coronary artery disease, and 2 (7.7%) underwent concomitant </span></span>coronary artery bypass grafting<span>. There was no operative mortality, stroke, reoperation for bleeding, or dialysis-dependent renal failure; One (3.8%) patient developed acute on chronic kidney injury. Three patients (12%) required prolonged ventilation. Eleven (42%) patients underwent 26 reoperations, median time 45 (range, 4-147) months, including 5 open thoracoabdominal aneurysm repairs.</span></div></div><div><h3>Conclusions</h3><div>Patients with ACTA2 variants frequently develop aortic aneurysm and are at risk of aortic dissection and coronary artery disease. However, age at diagnosis and symptoms at presentation are highly variable. Multiple operations are often required for disease management, particularly after dissection. Close monitoring and timely intervention are important in mitigating disease progression and improving outcomes.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1618-1627.e3"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138548616","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":"Prognostic value of KRAS G12V mutation in lung adenocarcinoma stratified by stages and radiological features","authors":"Wangyang Zhu MD ,&nbsp;Han Han MD, PhD ,&nbsp;Zelin Ma MD ,&nbsp;Hang Cao MD ,&nbsp;Yueren Yan MD, PhD ,&nbsp;Yue Zhao MD, PhD ,&nbsp;Chaoqiang Deng MD ,&nbsp;Haomiao Xu BS ,&nbsp;Fangqiu Fu MD ,&nbsp;Fanfan Fan MD ,&nbsp;Yang Zhang MD ,&nbsp;Haiquan Chen MD, PhD","doi":"10.1016/j.jtcvs.2024.03.025","DOIUrl":"10.1016/j.jtcvs.2024.03.025","url":null,"abstract":"<div><h3>Objective</h3><div>KRAS G12V is one of the most common KRAS mutation variants in lung adenocarcinoma (LUAD), and yet its prognostic value is still unrevealed. In this study, we investigated the clinicopathologic characteristics and prognostic value of the KRAS G12V mutation in LUAD.</div></div><div><h3>Methods</h3><div>Data of 3829 patients who underwent LUAD resection between 2008 and 2020 were collected. Mutations were classified as wild-type, G12V, or non-G12V. The clinicopathologic characteristics, postoperative outcomes, and recurrence pattern were analyzed among groups.</div></div><div><h3>Results</h3><div><span>In total, 3554 patients were wild-type and 275 patients harbored a KRAS mutation: 60 patients with G12V (22.2%) and 215 patients with non-G12V (77.8%). The KRAS G12V mutation was more frequent in male patients, older patients (≥60 years), former/current smokers, those patients with radiologic solid nodules, and those with highly invasive histologic subtypes. Tumors carrying KRAS G12V mutation exhibited elevated programmed death-ligand 1 expression in comparison with wild-type tumors. KRAS G12V was more prevalent in older patients and had less lymphovascular invasion compared with other mutation types. </span><span><em>FGF3</em></span>, <em>RET</em>, and <em>KDR</em> co-mutations occurred more frequently in the KRAS G12V group. Multivariate analysis demonstrated that the KRAS G12V mutation was an independent prognostic factor in stage Ⅰ tumors, whereas the KRAS non-G12V mutation was not. KRAS G12V was associated with early recurrence and locoregional recurrence.</div></div><div><h3>Conclusions</h3><div>The KRAS G12V mutation was associated with aggressive clinical-pathologic phenotype and early recurrence. To note, this mutation exhibited a significantly worse prognosis in patients with part-solid and stage Ⅰ lung adenocarcinoma. Meanwhile, the prognostic significance of KRAS G12C and G12V variants was comparable.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1525-1537.e6"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289396","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: Long-term outcomes following the Ross procedure in neonates and infants: A multi-institutional analysis","authors":"","doi":"10.1016/j.jtcvs.2024.07.014","DOIUrl":"10.1016/j.jtcvs.2024.07.014","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Page 1731"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914391","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":"Longitudinal versus circumferential biomechanical behavior of the aneurysmal ascending aorta","authors":"Benjamin Kramer DO, MS ,&nbsp;Matthew A. Thompson BS, BA ,&nbsp;Samar A. Tarraf MSc ,&nbsp;Emily Vianna MD ,&nbsp;Callan Gillespie MS ,&nbsp;Emidio Germano MD ,&nbsp;Brett Gentle DO ,&nbsp;Frank Cikach MD ,&nbsp;Ashley M. Lowry MS ,&nbsp;Amol Pande PhD ,&nbsp;Eugene Blackstone MD ,&nbsp;Jennifer Hargrave DO ,&nbsp;Robb Colbrunn PhD ,&nbsp;Chiara Bellini PhD ,&nbsp;Eric E. Roselli MD","doi":"10.1016/j.jtcvs.2023.09.016","DOIUrl":"10.1016/j.jtcvs.2023.09.016","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluate the independent effects of patient and aortic tissue<span> characteristics on biaxial physiologic mechanical metrics in aneurysmal and nonaneurysmal tissues, and uniaxial failure metrics in aneurysmal tissue, comparing longitudinal and circumferential behavior.</span></div></div><div><h3>Methods</h3><div>From February 2017 to October 2022, 382 aortic specimens were collected from 134 patients; 268 specimens underwent biaxial testing, and 114 specimens underwent uniaxial testing. Biaxial testing evaluated Green-Lagrange transition strain and low and high tangent moduli. Uniaxial testing evaluated failure stretch, Cauchy stress, and low and high tangent moduli. Longitudinal gradient boosting models were implemented to estimate mechanical metrics and covariates of importance.</div></div><div><h3>Results</h3><div>On biaxial testing, nonaneurysmal tissue was less deformable and exhibited a lower transition strain than aneurysmal tissue in the longitudinal (0.18 vs 0.30, <em>P</em> &lt; .001) and circumferential (0.25 vs 0.30, <em>P</em><span> = .01) directions. Older age and increasing ascending aortic length contributed most to predicting transition strain. On uniaxial testing, longitudinal specimens failed at lower stretch (1.4 vs 1.5, </span><em>P</em> = .003) and Cauchy stress (1.0 vs 1.9 kPa, <em>P</em> &lt; .001) than circumferential specimens. Failure stretch and Cauchy stress were most strongly associated with tissue orientation and decreased sharply with older age. Age, ascending aortic length, and tissue thickness were the most frequent covariates predicting mechanical metrics across 10 prediction models.</div></div><div><h3>Conclusions</h3><div>Age was the strongest predictor of mechanical behavior. After adjusting for age, nonaneurysmal tissue was less deformable than aneurysmal tissue. Differences in longitudinal and circumferential mechanics contribute to tissue dysfunction and failure in ascending aneurysms. This highlights the need to better understand the effects of age, ascending aortic length, and thickness on clinical aortic behavior.</div></div>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"168 6","pages":"Pages 1589-1600.e8"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10635730","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}