Annals of Thoracic Surgery最新文献

{"title":"Omitting Lymph Node Dissection for Small Ground-Glass Opacity–Dominant Tumors","authors":"Takahiro Mimae MD, PhD ,&nbsp;Yoshihiro Miyata MD, PhD ,&nbsp;Norifumi Tsubokawa MD, PhD ,&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.athoracsur.2024.03.013","DOIUrl":"10.1016/j.athoracsur.2024.03.013","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to determine the optimal extent of lymph node dissection required in patients with small (≤3 cm) radiologically ground-glass opacity–dominant, peripheral, non-small cell lung cancer tumors.</div></div><div><h3>Methods</h3><div>The study analyzed the clinicopathologic findings and surgical outcomes of 988 patients with radiologic, ground-glass opacity–dominant non-small cell lung cancer without lymph node involvement who underwent complete resection of the primary tumor between 2010 and 2020. Patients were followed up for 54.5 months (median). Kaplan-Meier curves and the log-rank test were used in statistical analyses of the prognosis.</div></div><div><h3>Results</h3><div><span><span>Median age, whole tumor size, solid tumor<span><span> size, and maximum standardized uptake values were 68 years, 1.7 cm, 0.4 cm, and 0.9, respectively. Sixty percent of the cohort was female (n = 590). </span>Wedge resection, </span></span>segmentectomy, and </span>lobectomy<span> were performed in 206, 372, and 410 patients, respectively. A total of 982 of 988 (99%) tumors were adenocarcinomas. One patient had hilar lymph node involvement; however, no mediastinal lymph node metastasis or hilar or mediastinal lymph node recurrence was detected. The 5-year overall survival rate was 96.5% (95% CI, 94.8%-97.7%). Excellent survival outcomes were achieved regardless of procedure (wedge resection, 94.7% [95% CI, 89.1%-97.5%]; segmentectomy, 96.9% [95% CI, 93.7%-98.5%]; and lobectomy, 97.1% [95% CI, 94.4%-98.5%]).</span></div></div><div><h3>Conclusions</h3><div>Omitting lymph node dissection may be acceptable with curative intent for small tumors with radiologic ground-glass opacity dominance. Appropriate surgical procedures such as wedge resection, segmentectomy, or lobectomy can provide satisfactory outcomes in patients with indolent tumors if surgical margins are secured.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 192-198"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What’s the Game Plan, Coach? Preparation and Triage Are Key for HLHS Management","authors":"Neel K. Prabhu MD,&nbsp;Douglas M. Overbey MD,&nbsp;Joseph W. Turek MD, PhD","doi":"10.1016/j.athoracsur.2024.06.007","DOIUrl":"10.1016/j.athoracsur.2024.06.007","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 178-179"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiarterial vs Single Arterial Revascularization: Persistent Uncertainties in Long-term Outcomes After CABG","authors":"Wei-Zhen Tang MD,&nbsp;Zhi-mou Li MD,&nbsp;Tai-Hang Liu PhD","doi":"10.1016/j.athoracsur.2024.08.007","DOIUrl":"10.1016/j.athoracsur.2024.08.007","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Page 247"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Breath of Canned Air: Avoiding Home Oxygen After Pulmonary Resection","authors":"Natalia Roa-Vidal MD,&nbsp;Kathryn E. Engelhardt MD, MS","doi":"10.1016/j.athoracsur.2024.09.032","DOIUrl":"10.1016/j.athoracsur.2024.09.032","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 190-191"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Implantation of Transcatheter Valve in Mitral Annular Calcification: A Multicenter Study","authors":"Ali Fatehi Hassanabad MD, MS ,&nbsp;Mohamad Rabbani MD, MS ,&nbsp;Derrick Y. Tam MD, PhD ,&nbsp;Gianluigi Bisleri MD ,&nbsp;David Latter MD ,&nbsp;Ray Guo MD ,&nbsp;Michael W.A. Chu MD, MS ,&nbsp;William D.T. Kent MD, MS ,&nbsp;Corey Adams MD, MS","doi":"10.1016/j.athoracsur.2024.09.036","DOIUrl":"10.1016/j.athoracsur.2024.09.036","url":null,"abstract":"<div><h3>Background</h3><div>Mitral valve replacement in the setting of severe annular calcification (MAC) is associated with high morbidity and mortality. Direct surgical implantation of a transcatheter heart valve (THV) through a transatrial approach is a strategy to mitigate surgical risk. This study reports the perioperative and 1-year outcomes of mitral valve replacement using a THV in patients with severe circumferential MAC at 3 Canadian centers.</div></div><div><h3>Methods</h3><div>Charts were reviewed between January 1, 2018 and September 30, 2023 to identify patients with severe circumferential MAC who had undergone direct implantation of a THV. Primary outcomes were 30-day mortality, debilitating stroke, and 1-year mortality. Secondary outcomes included left ventricular outflow tract obstruction, degree of paravalvular leak (PVL), transvalvular mean pressure gradient, and length of stay.</div></div><div><h3>Results</h3><div>Twenty-two patients at the 3 centers underwent direct implantation of a THV. Nineteen patients were female, with mean age of 70.41 ± 9.33 years. A THV was successfully implanted in all patients. There were 2 deaths at 30 days. Four patients died of noncardiac causes at 1 year, and 1 patient had a postoperative stroke. Seventeen (77%) patients had no PVL or trace PVL, 4 had mild PVL, and 1 patient had mild-moderate PVL. The mean transvalvular gradient was 4.42 ± 4.40 mm Hg. There were no cases of left ventricular outflow tract obstruction.</div></div><div><h3>Conclusions</h3><div>Direct deployment of a THV in patients with severe MAC may be a reasonable option. Thirty-day and 1-year mortality rates of 9% and 18%, respectively, suggest that this approach should be reserved for high-risk patients who are not able to undergo conventional strategies.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 129-136"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve-Sparing Aortic Root Replacement in ATAAD: A Superior Long-term Solution","authors":"Robbin G. Cohen MD, MMM","doi":"10.1016/j.athoracsur.2024.10.009","DOIUrl":"10.1016/j.athoracsur.2024.10.009","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 107-108"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifetime Management of Adolescents and Young Adults with Congenital Aortic Valve Disease","authors":"William C. Frankel MD ,&nbsp;Justin A. Robinson MD ,&nbsp;Eric E. Roselli MD ,&nbsp;Shinya Unai MD ,&nbsp;Justin T. Tretter MD ,&nbsp;Stephanie Fuller MD ,&nbsp;Jennifer S. Nelson MD ,&nbsp;Joanna Ghobrial MD, MSc ,&nbsp;Lars G. Svensson MD ,&nbsp;Gösta B. Pettersson MD, PhD ,&nbsp;Hani K. Najm MD, MSc ,&nbsp;Tara Karamlou MD, MSc","doi":"10.1016/j.athoracsur.2024.04.038","DOIUrl":"10.1016/j.athoracsur.2024.04.038","url":null,"abstract":"<div><div>In this invited expert review, we focus on evolving lifetime management strategies for adolescents and young adults with congenital aortic valve disease, acknowledging that these patients often require multiple interventions during their lifetime. Our goal is to preserve the native aortic valve when feasible. Leveraging advanced multimodality imaging, a detailed assessment of the aortic valve and root complex can be obtained, and a surgically approach tailored to an individual patient’s anatomy and pathology can be used. In turn, aortic valve repair and reconstruction can be offered to a greater number of patients, either as a definitive strategy or as a component of a staged strategy to delay the need for aortic valve replacement until later in life when more options are available.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 59-69"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Surgical Interrupted Aortic Arch Repair in 181 Patients With Biventricular Circulation","authors":"Takeaki Harada MD, PhD ,&nbsp;Yusuke Ando MD, PhD ,&nbsp;Toshihide Nakano MD, PhD","doi":"10.1016/j.athoracsur.2024.07.007","DOIUrl":"10.1016/j.athoracsur.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>This study compared the outcomes of primary and staged surgery for interrupted aortic arch (IAA) with biventricular circulation.</div></div><div><h3>Methods</h3><div>A search of our surgical database identified 181 patients with biventricular anatomy who underwent surgical repair of IAA between 1982 and 2022. The patients were divided according to whether they underwent surgery in 1982 to 2001 or 2002 to 2022 and were categorized according to their anomalies into a simple group and a complex group. Repair was 1-stage in 130 patients (71.8%) and 2-stage in 51 (28.2%).</div></div><div><h3>Results</h3><div>There were 6 early deaths (3.3%) and 9 (5.0%) late deaths. The 20-year actuarial survival rate was 91.7%. The 20-year survival rate was 94.7% in the simple group and 82.9% in the complex group (<em>P</em> = .007); the respective rates were 91.7% and 96.8% in 1982 to 2001 (<em>P</em> = .63) and 68.4% and 90.1% in 2002 to 2022 (<em>P</em> = .012). Multivariate analysis identified a complex anomaly and surgery performed in 1982 to 2001 to be risk factors for mortality. Aortic arch reintervention was required in 26 patients (balloon dilation, n = 15; surgical, n = 11). The 15-year freedom from reintervention rate improved from 67.8% in 1982 to 2001 to 89.8% in 2002 to 2022 (<em>P</em> = .041). Multivariate analysis identified type of surgical approach and emergent surgery to be risk factors for reintervention on the aortic arch.</div></div><div><h3>Conclusions</h3><div>The results of IAA surgery have improved in recent years, especially for complex cases. Development of surgical techniques and individualized treatment strategies could reduce postoperative mortality and morbidity. However, follow-up for recurrence of aortic arch obstruction is necessary.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 152-159"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Annals of Thoracic Surgery","authors":"","doi":"10.1016/j.athoracsur.2024.11.001","DOIUrl":"10.1016/j.athoracsur.2024.11.001","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 1-7"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guest Reviewers for The Annals of Thoracic Surgery","authors":"","doi":"10.1016/j.athoracsur.2024.11.002","DOIUrl":"10.1016/j.athoracsur.2024.11.002","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 1","pages":"Pages 8-10"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}