Annals of Thoracic Surgery最新文献

{"title":"Avoiding a Permanent Pacemaker with Tricuspid Valve Surgery.","authors":"J Hunter Mehaffey, Vinay Badhwar","doi":"10.1016/j.athoracsur.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.10.006","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512380","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":"Harmonizing Guidelines and Other Clinical Practice Documents: A Joint Comprehensive Methodology Manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS).","authors":"Milan Milojevic, Nick Freemantle, J W Awori Hayanga, Rosemary F Kelly, Patrick O Myers, René Horsleben Petersen, Isabelle Opitz, Joseph F Sabik, Faisal G Bakaeen","doi":"10.1016/j.athoracsur.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.09.023","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512384","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":"Characteristics of long-term survivors with malignant pleural mesothelioma.","authors":"Isabelle Opitz, Olivia Lauk, Raphael Werner, Alessandra Matter, Monika Hebeisen, Bianca Battilana, Hasan Batirel, Harvey Pass, Raja Flores, Andrea Wolf, Marc de Perrot, Mir Alireza Hoda, Walter Klepetko, Thomas Klikovits, Masaki Hashimoto, Seiki Hasegawa, William G Richards, Raphael Bueno","doi":"10.1016/j.athoracsur.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>Pleural mesothelioma (PM) is a cancer with usually a dismal prognosis. However, long-term survivors do exist. Herein, we analyzed long-term survivors (>5 years after surgery) from high-volume centres around the world.</p><p><strong>Methods: </strong>This is a multicenter retrospective descriptive analysis of long-term survivors (overall survival ≥ 5 years from surgery) treated within a multimodality therapy approach including macroscopic complete resection. Overall survival was calculated with Kaplan Meier analysis and cases were matched by center and surgery year and compared with a control group of short-term survivors (<2 years) in a conditional logistic regression analysis.</p><p><strong>Results: </strong>There were 276 long-term survivors, most were male (n=166, 63%) with a median age of 59 (range 21-83) years at time of diagnosis. The histology for 246 was epithelioid and non-epithelioid for 30 patients. The disease was on the right side in 58% of the patients. As of this analysis, 148 patients were dead, 104 were alive and 10 were lost to follow-up. Pathological tumor stages were: pT1 (n=50), pT2 (n=63), pT3 (n=90) or pT4 (n=16), pN0 (n=150), pN1 (n=20) and pN2 (n=39). The matched control dataset included 333 patients, 95 cases and 238 controls. Comparing short- with long-term survivors, there was moderate evidence that a low white blood cell (WBC) count before surgery was more often observed in long-term survivors.</p><p><strong>Conclusions: </strong>The data show that long-term survival in PM is possible in a subgroup of surgically treated patients; histological subtype and WBC count seem to be prognosticators for longer survival.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512383","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 Way to Successful Aortic Root Replacement.","authors":"Rintaro Kinjo, Corazon De la Pena, Suguru Ohira","doi":"10.1016/j.athoracsur.2024.09.052","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.09.052","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512389","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":"Carinal Reconstruction for Lung Cancer and Airway Tumors: Long-term Results.","authors":"Antonio D'Andrilli, Beatrice Trabalza Marinucci, Anna Maria Ciccone, Mohsen Ibrahim, Claudio Andreetti, Fabiana Messa, Giorgia Piccioni, Ilaria De Benedictis, Federico Venuta, Giulio Maurizi, Erino A Rendina","doi":"10.1016/j.athoracsur.2024.10.005","DOIUrl":"10.1016/j.athoracsur.2024.10.005","url":null,"abstract":"<p><strong>Background: </strong>Resection and reconstruction of the carina infiltrated by non-small cell lung cancer (NSCLC) or an airway tumor is a technically demanding operation allowing oncologic radical treatment. Hereby we report the results of a 20-year experience from a high-volume center.</p><p><strong>Methods: </strong>Carinal resection was performed in 41 patients for NSCLC (n = 32) or primary airway tumor (n = 9). Right tracheal-sleeve pneumonectomy was performed in 19 patients, left tracheal-sleeve pneumonectomy in 6, isolated carinal resection in 4, and right tracheal-sleeve upper lobectomy in 12. Superior vena cava replacement was required in 8 patients. Extracorporeal membrane oxygenation was used in 4 patients undergoing isolated carinal reconstruction. Nine patients received neoadjuvant chemotherapy.</p><p><strong>Results: </strong>Complete resection (R0) was achieved in 97.5% of patients. Postoperative 30-day mortality was 7.3% (n = 3). The major complication rate was 24.3% (n = 10). There were 7 airway complications, consisting of 2 anastomotic fistulas and 5 anastomotic stenoses requiring dilatation and stenting; other major complications included 1 esophageal-pleural fistula, 1 pneumonia, and 1 pulmonary edema. Among the 32 NSCLC patients, 26 were pathologic stage III, and 6 were pathologic stage II. The recurrence rate was 34.2% (n = 13) and was 41.3% (n = 12) in NSCLC and 11.1% (n = 1) in airway tumors. The 3- and 5-year overall survival (Kaplan-Meier) was 56.1% (NSCLC, 50.8%; airway, 76.2%) and 50.5% (NSCLC, 44.5%; airway, 76.2%), respectively. Disease-free survival was 61.7% (NSCLC, 55.2%; airway, 85.7%) at 3 years and 55.5% (NSCLC, 48.3%; airway, 85.7%) at 5 years.</p><p><strong>Conclusions: </strong>Carinal reconstruction for lung and airway tumors resection is a complex, oncologically reliable procedure allowing good long-term results in adequately selected patients. Wherever possible, these operations should include parenchymal-sparing techniques allowing healthy lung tissue being spared without compromising the radicality of the resection.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512382","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":"Avoiding the Things That Can Go Bump in the Night After Cardiac Surgery.","authors":"Michael C Grant, Rakesh C Arora","doi":"10.1016/j.athoracsur.2024.09.050","DOIUrl":"10.1016/j.athoracsur.2024.09.050","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512381","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":"Intraoperative Molecular Imaging with Pafolacianine in Resection of Occult Pulmonary Malignancy in the ELUCIDATE trial.","authors":"David Rice, Sunil Singhal, Emma Niemeyer, Inderpal Sarkaria, Linda W Martin, Michael I Ebright, Brian E Louie, Tommy Lee, Jarrod D Predina","doi":"10.1016/j.athoracsur.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>Clinical studies have demonstrated that intraoperative molecular imaging (IMI) with pafolacianine identifies occult pulmonary lesions that are not identified by preoperative CT or by intraoperative inspection techniques in ∼20% of patients. In this study we provide a description of occult lesion clinical data and evaluate characteristics so that surgeons can better incorporate this emerging technology into clinical decision making.</p><p><strong>Methods: </strong>Participants (n=100) enrolled in a Phase 3 trial of IMI with pafolacianine during pulmonary resection (ELUCIDATE, NCT04241315) were identified. Participants underwent preoperative computed tomography (CT)with 1.25mm slices. Variables and lesion characteristics were analyzed. Positive predictive value and false positive rates were tabulated for IMI fluorescent lesions with predictors of malignant versus benign occult lesions described.</p><p><strong>Results: </strong>IMI identified 29 occult lesions in 23 (23%) participants. Seventeen of 29 (58%) lesions were identified within the same lobe as known lesions; 12 of 29 (42%) identified in a different lobe from the suspicious nodule known by preoperative assessment. Twenty-three of 29 (79%) of occult lesions found by IMI were resected with an additional wedge resection. Ten of 29 (34%) lesions identified by IMI were malignant. There was no additional morbidity in participants with lesions resected. With pafolacianine, 7 participants had a synchronous primary stage I lung cancer identified and one subject had additional metastases identified. .</p><p><strong>Conclusions: </strong>IMI with pafolacianine identifies occult malignant lesions during pulmonary resection despite thorough preoperative imaging and intraoperative assessment by experienced surgeons.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512385","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":"Long-Term Impact of Regionalization of Thoracic Oncology Surgery.","authors":"Jordan Crosina, Frances Wright, Jonathan Irish, Mohammed Rashid, Tharsiya Martin, Dhruvin H Hirpara, Amber Hunter, Sudhir Sundaresan","doi":"10.1016/j.athoracsur.2024.10.002","DOIUrl":"10.1016/j.athoracsur.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>In 2007, Cancer Care Ontario created Thoracic Surgical Oncology Standards for the delivery of surgery, including lobectomy, esophagectomy, and pneumonectomy. These standards regionalized thoracic surgery into designated centers and mandated physical and human resources. This analysis sought to identify the impact of these standards, hereafter referred to as \"regionalization,\" on outcomes after thoracic oncology surgery in Ontario, Canada.</p><p><strong>Methods: </strong>This study was a population-level analysis of patients undergoing lobectomy, esophagectomy, or pneumonectomy, and it used multilevel regression models to compare 30- and 90-day mortality and length of stay before, during, and after regionalization. Interrupted time series models were used to assess for an impact of regionalization while controlling for ongoing trends.</p><p><strong>Results: </strong>A total of 22,195 surgical procedures (14,902 lobectomies, 4958 esophagectomies, and 2408 pneumonectomies) were performed within the study period. A total of >99% of cases were performed at a designated center after regionalization. Mean annual volumes per designated center increased after regionalization for lobectomy and esophagectomy and decreased for pneumonectomy. The 30- and 90-day mortality and length of stay improved for lobectomy and esophagectomy over the study period, as did 90-day mortality for pneumonectomy. However, the interrupted time series analysis did not demonstrate any statistically significant effect of regionalization on these outcomes, separate from preexisting trends.</p><p><strong>Conclusions: </strong>Consistent improvements in mortality and length of stay in thoracic surgical oncology occurred on a provincial level between 2003 and 2020, although this analysis does not attribute these improvements to implementation of Thoracic Surgical Oncology Standards including regionalization.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512386","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":"STS Policy for Respectful Scholarly Discourse: Providing a Framework for Professional Behavior at Academic Conferences.","authors":"Mara B Antonoff, Jessica Donington, S Adil Husain, Tsuyoshi Kaneko, Ahmet Kilic, Sara J Pereira","doi":"10.1016/j.athoracsur.2024.09.051","DOIUrl":"10.1016/j.athoracsur.2024.09.051","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512387","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 Society of Thoracic Surgeons Intermacs 2024 Annual Report: Focus on Outcomes in Younger Patients.","authors":"Dan M Meyer, Aditi Nayak, Katherine L Wood, Vanessa Blumer, Sarah Schettle, Chris Salerno, Devin Koehl, Ryan Cantor, James K Kirklin, Jeffrey P Jacobs, Thomas Cascino, Francis D Pagani, Manreet K Kanwar","doi":"10.1016/j.athoracsur.2024.10.003","DOIUrl":"10.1016/j.athoracsur.2024.10.003","url":null,"abstract":"<p><p>The 15th Annual Report from The Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support includes 29,634 continuous-flow left ventricular assist devices from the 10-year period between 2014 and 2024. The outcomes reported here demonstrate continued improved survival in the current era of fully magnetically levitated devices, with a significantly higher 1-year (85.7% vs 78.4%) and 5-year (59.7% vs 43.7%) survival than those receiving non-magnetically levitated devices. Magnetically levitated device recipients are experiencing a lower incidence of adverse events, including freedom from gastrointestinal bleeding (72.6%), device malfunction (82.9%), and stroke (86.7%) at 5 years. Additionally, a focus on a subgroup of patients younger than 50 years of age has demonstrated both superior outcomes in survival (91.6% survival at 1 year and 72.6% survival at 5 years) and decreased incidence of adverse events compared with older recipients. This younger cohort also demonstrated more tolerance to the characteristics of sex, race, ethnicity, and psychosocial indicators that are associated with worse outcomes after heart transplantation. Based upon these data, a potential net prolongation of life may be realized by considering prolonged left ventricular assist device support prior to heart transplantation in this population. These analyses provide preliminary data that could positively influence adoption of left ventricular assist device technology in groups previously not seen as candidates for this therapy, while providing a more responsible donor allocation strategy for advanced heart failure patients.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512388","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}