Annals of Thoracic Surgery最新文献

{"title":"Simplifying academic writing for greater impact: the case of the double negative.","authors":"Stephanie Lee Teen Ch'ng, David Chu Yik Tang","doi":"10.1016/j.athoracsur.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.02.018","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626662","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 importance of being bicuspid.","authors":"Marco Moscarelli, Khalil Fattouch","doi":"10.1016/j.athoracsur.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.02.017","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626664","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":"Variation in Techniques of Selective Antegrade Cerebral Perfusion in Neonates Undergoing Aortic Arch Reconstruction: A Comprehensive Review.","authors":"Michael A Catalano, Omar Toubat, Lindsay J Nitsche, Danielle I Aronowitz, Halil Beqaj, Benjamin F Smood, Madison Grasty, Jennifer M Lynch, J William Gaynor, Constantine D Mavroudis","doi":"10.1016/j.athoracsur.2025.02.013","DOIUrl":"10.1016/j.athoracsur.2025.02.013","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread adoption of selective antegrade cerebral perfusion (SACP) for neonatal aortic arch reconstruction, significant variability in techniques persists across institutions, thus reflecting limited supporting data and lack of consensus on best practices. This review aimed to characterize the use of SACP in the extant literature comprehensively and highlight variations in practice to guide future research and standardization of care.</p><p><strong>Methods: </strong>A comprehensive search was conducted using Embase, Medline/OVID, and the National Center for Biotechnology Information/PubMed databases to identify studies published from 1999 to 2024 that contained the following terms: (\"neonatal\" OR \"neonate\" OR \"newborn\") AND (\"aortic arch\" OR \"Norwood\" OR \"stage one\") AND (\"circulatory arrest\" OR \"cerebral perfusion\"). Studies were included if they were human studies, with ≥10 patients, and with descriptions of SACP flow rates and at least 1 other variable of SACP technique.</p><p><strong>Results: </strong>On the basis of the specified search terms, after removal of duplicate studies, 845 manuscripts were reviewed. By using the described inclusion criteria, a total of 57 studies were identified and assessed. All studies were published between 2000 and 2023, and the overall median sample size was 47 patients (interquartile range, 24-70 patients). Across these studies, targeted flow rate ranged from 10 to 100 mL/kg/min, targeted temperature ranged from 18 °C to 34 °C, and there was significant variation in monitoring strategy and response to monitoring.</p><p><strong>Conclusions: </strong>Significant variability persists in SACP technique in neonatal patients, including flow rate, temperature, and monitoring strategies. Given the critical neurodevelopmental risks associated with this patient population, it is essential to evaluate and optimize SACP practices rigorously in neonates undergoing aortic arch reconstruction.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617782","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":"Blood Pressure and Heart Rate Management in Patients After Repair of Type A Aortic Dissection.","authors":"Chun-Hung Ho, Chia-Pin Lin, Feng-Cheng Chang, Chun-Yu Chen, Yu-Ting Cheng, Ying-Chang Tung, Yi-Hsin Chan, Victor Chien-Chia Wu, Pao-Hsien Chu, Shao-Wei Chen","doi":"10.1016/j.athoracsur.2025.02.012","DOIUrl":"10.1016/j.athoracsur.2025.02.012","url":null,"abstract":"<p><strong>Background: </strong>The long-term optimal targets for blood pressure and heart rate in patients after surgical repair of acute type A aortic dissection (TAAD) remain unclear. This study evaluated the long-term association of blood pressure and heart rate control on patients after TAAD surgical repair.</p><p><strong>Methods: </strong>We identified 839 patients who underwent TAAD surgical repair and survived to discharge between 2003 and 2018 from the Chang Gung Research Database. Primary outcomes included all-cause mortality, aortic progression, and aortic surgery events. Vital signs examined were systolic blood pressure (SBP), diastolic blood pressure, and heart rate (HR) at discharge and at 3 months of follow-up.</p><p><strong>Results: </strong>The patients were a mean age of 57.2 ± 13.6 years, and approximately two-thirds were men. The results showed that SBP >150 mm Hg at discharge was correlated with increased all-cause mortality (adjusted hazard ratio [aHR], 3.21; 95% CI, 1.61-6.37). Moreover, an HR between 81 and 100 beats/min was associated with a higher hazard of all-cause mortality (aHR, 2.59; 95% CI, 1.28-5.24) and an HR >100 beats/min was also associated with a higher hazard of aortic surgery events (aHR, 2.19; 95% CI 1.24-3.86) compared with an HR of ≤80 beats/min at discharge. During the 3-month follow-up, an HR >100 beats/min was associated with a higher hazard of all-cause mortality (aHR, 3.59; 95% CI, 1.19-10.78) relative to an HR ≤80.</p><p><strong>Conclusions: </strong>The careful management of blood pressure and HR contributes to favorable long-term outcomes in patients after surgical repair of TAAD.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587792","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":"From Enigma to Equity: Asian American and Pacific Islanders in Cardiothoracic Surgery.","authors":"Michael Lesgart, Alexander An Nguyen, Anastasiia K Tompkins, Kathleen S Berfield, Richard Kim, Douglas E Wood, David T Cooke, Cherie P Erkmen","doi":"10.1016/j.athoracsur.2025.01.036","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.01.036","url":null,"abstract":"<p><strong>Background: </strong>Promoting physician diversity is crucial for addressing healthcare disparities in the United States. Asian Americans and Pacific Islanders (AAPIs) constitute 5.7% of the US population and 20% of physicians. However, their experiences in cardiothoracic surgery remain underexplored. This work examines historical context, representation, salary data, and AAPIs' personal experiences elaborating on biases and misconceptions faced in academic cardiothoracic surgery.</p><p><strong>Methods: </strong>We conducted a literature review, analyzed representation from the Accreditation Council for Graduate Medical Education Data Resource Book (2022-2023) and salary data from the Association of American Medical Colleges Faculty Salary Reports (2021-2023).</p><p><strong>Results: </strong>AAPI trainees constitute 20.7% of thoracic surgery fellows and 25.7% of integrated thoracic surgery residents. AAPI faculty representation was 32.3% of assistant professors, 33.9% of associate professors, and 18.9% of professors. Salary analysis revealed disparities, with AAPI assistant professors earning significantly less than their White counterparts (90.2%; p = 0.018).</p><p><strong>Conclusions: </strong>Despite representation in the trainee and faculty cardiothoracic workforce, AAPIs face challenges in cultural biases and salary equity. Individual, institutional and national efforts valuing diversity and equity of career opportunities in cardiothoracic surgery are needed.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587801","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":"Lessons Learned From Various 3D-Printed Tracheal Grafts in an Extensive Porcine Model for De Novo Tracheal Regeneration.","authors":"Sen-Ei Shai, Yi-Ling Lai, Yi-Wen Hung, Chi-Wei Hsieh, Kuo-Chih Su, Chun-Hsiang Wang, Te-Hsin Chao, Yung-Tsung Chiu, Chia-Ching Wu, Shih-Chieh Hung","doi":"10.1016/j.athoracsur.2025.02.010","DOIUrl":"10.1016/j.athoracsur.2025.02.010","url":null,"abstract":"<p><strong>Background: </strong>Tracheal implants using tissue engineering and 3-dimensional printing are promising, but challenges remain, including graft composition, anastomosis methods, and tracheal tissue regeneration. This study examined the effectiveness of various tracheal graft materials in a large animal model.</p><p><strong>Methods: </strong>A total of 38 operations were performed on a porcine large animal model, involving a 2-cm circumferential tracheal excision with end-to-end anastomosis. The grafts used included translucent plastic material crystal (n = 16), silicone (n = 8), and polycaprolactone (PCL; n = 8). Nonabsorbable (n = 28) or absorbable (n = 4) sutures were applied, and 2 animals underwent modified distal trachea anchoring using the strap muscle. Bronchoscopy and laser ablation were used to assess granulation tissue and graft patency in select cases. Postoperative complications, survival rates, and tissue regeneration outcomes were tracked.</p><p><strong>Results: </strong>Operation times ranged from 91 to 126 minutes. Animals survived between 5 and 92 days, with 29 experiencing complications such as abdominal distress (n = 15) and granulation tissue formation (n = 18) after 7 days. Postoperative issues included wound infection (n = 16), graft infection (n = 7), and necrosis (n = 14). Histologic examination revealed regenerating tissue with chondrogenesis (n = 8), adipogenesis (n = 9), myogenesis (n = 9), angiogenesis (n = 6), glandogenesis (n = 2), and epithelialization (n = 2). Two PCL graft recipients with strap muscle reinforcement survived longer, gaining 101 kg, with 1 animal showing heterotopic ossification.</p><p><strong>Conclusions: </strong>This study highlights critical insights into graft material selection and integration with native tissue. PCL grafts demonstrated improved integration and tissue healing with biodegradable properties, findings supporting their potential for clinical use in tracheal implants.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574596","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":"Current Practices for Cohort Reporting and Statistical Adjustment in Studies From The Society of Thoracic Surgeons Adult Cardiac Surgery Database.","authors":"Polina Mantaj, Irbaz Hameed, Aina Hirofuji, Michele Dell'Aquila, Mohamed Rahouma, Shadi Abdalla, Moira Kennedy, Alexander Gregg, Camilla S Rossi, Giovanni Soletti, Giorgia Falco, Mary Charlson, Sigrid Sandner, Thomas A Schwann, Mario Gaudino","doi":"10.1016/j.athoracsur.2025.02.011","DOIUrl":"10.1016/j.athoracsur.2025.02.011","url":null,"abstract":"<p><strong>Background: </strong>Current reporting and statistical adjustment practices of studies based on The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD) have not been described.</p><p><strong>Methods: </strong>A review identified all published studies based on STS ACSD data from January 2016 to May 2024. Data were extracted by 2 authors and independently checked by the senior author.</p><p><strong>Results: </strong>A total of 134 studies were included. There were 46 (34.3%) studies on coronary artery bypass grafting, 22 (16.4%) on mitral valve surgery, 16 (11.9%) on aortic surgery, 14 (10.4%) on surgical aortic valve replacement, 3 (2.2%) on tricuspid valve surgery, 18 (13.4%) on combined procedures, and 15 (11.2%) on other interventions; 59 (44.0%) studies used the Participant User File (PUF) program, with a significant increase over time (P_trend = .005). Of the 1239 variables available in the STS ACSD (version 4.20.2), 136 (11.0%; median, 21 variables per study; interquartile range [IQR], 16-25) were used to describe the baseline characteristics of the patients and 191 (15.4%; median, 22 variables per study; IQR, 17-33) for statistical adjustment; 121 studies (90.3%) performed statistical adjustment, with multivariable regression used in most (80 [66.1%]). PUF manuscripts had significantly more junior first authors (20.3% vs 1.3%; P = .001) and were published in higher impact journals (median impact factor, 4.90 [IQR, 3.70-9.15] vs 3.90 [IQR, 3.60-4.70]; P = .002) compared with non-PUF manuscripts.</p><p><strong>Conclusions: </strong>Our analysis provides data that may inform efforts to standardize reporting and analytic practices in studies based on the STS ACSD.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574595","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 Clinical Outcomes and Health-Related Quality of Life After the Ross Procedure.","authors":"Miza Salim Hammoud, Lin Chen, Andrew J Toth, Jeevanantham Rajeswaran, Gosta B Pettersson, Eugene Blackstone, Hani K Najm, Shinya Unai, Rimsha Hussaini, Justin Robinson, Lars G Svensson, Tara Karamlou","doi":"10.1016/j.athoracsur.2025.02.009","DOIUrl":"10.1016/j.athoracsur.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>This study sought to evaluate long-term clinical outcomes and health-related quality of life (HR-QoL) in young adults after Ross procedures for aortic valve disease.</p><p><strong>Methods: </strong>From January 1990 to April 2021, 166 patients aged 14 to 63 years underwent the Ross procedure at Cleveland Clinic (Cleveland, OH). Outcomes included postoperative events, longitudinal autograft valve function, reinterventions, and survival. HR-QoL was assessed cross-sectionally using validated instruments, including the Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10) and MacNew. Associations between patient variables, including area deprivation indices (a socioeconomic metric), and HR-QoL measures were analyzed using random forest regression.</p><p><strong>Results: </strong>Median follow-up of 6 years showed stable postoperative autograft valve function. Reintervention was needed in 20 patients, with a 10-year freedom from reintervention of 89%. Increased economic hardship or inequality and lower education were associated with higher cardiac reintervention risk. The 25-year survival was 70%, with no deaths for operations performed after 2000. Significantly better mental HR-QoL PROMIS-10 scores were obtained compared with the general population norm (median [15th, 85th percentile]: 53 [43, 64] vs 50; P = .001), whereas physical HR-QoL scores showed no significant difference (48 [42, 55] vs 50; P = .2). All domains of the MacNew were significantly better compared with matched patients with heart disease (P < .0001). State-referenced area deprivation indices were not associated with HR-QoL PROMIS-10 or MacNew scores.</p><p><strong>Conclusions: </strong>The Ross procedure results in favorable long-term outcomes, including survival, autograft function, and enhanced HR-QoL, in young adults with aortic valve disease. Despite low mortality and stable valve function, reinterventions, especially among socioeconomically disadvantaged patients, pose concerns.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568366","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":"Sixty Is the New Fifty: Save More Living Valves","authors":"Eric E. Roselli MD","doi":"10.1016/j.athoracsur.2025.02.007","DOIUrl":"10.1016/j.athoracsur.2025.02.007","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 5","pages":"Pages 999-1000"},"PeriodicalIF":3.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537904","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":"Increased Prevalence of Stroke After Heart Transplant in the New Allocation System Era.","authors":"Allison Lin, Iris Feng, Yanling Zhao, Paul Kurlansky, Alice Vinogradsky, Chunhui Wang, Gabriel Sayer, Nir Uriel, Koji Takeda","doi":"10.1016/j.athoracsur.2025.02.006","DOIUrl":"10.1016/j.athoracsur.2025.02.006","url":null,"abstract":"<p><strong>Background: </strong>Temporary mechanical circulatory support (tMCS) use has increased after the 2018 United Network for Organ Sharing (UNOS) heart transplant allocation criteria change. However, tMCS is associated with increased stroke risk and may impact stroke rates after heart transplant. This study sought to determine the impact of the criteria change on posttransplant stroke rates.</p><p><strong>Methods: </strong>The study included 19,512 patients from the UNOS database who received a heart transplant between October 18, 2014, and October 17, 2022, divided into precriteria change (n = 9768) and postcriteria change (n = 9744) cohorts. The primary outcome was stroke, and secondary outcomes included mortality and adverse events.</p><p><strong>Results: </strong>At baseline, patients who received a transplant postcriteria change had higher rates of prior stroke (7.6% vs 6.0%, P < .001) and were more likely to be bridged from tMCS. The posttransplant stroke rate was significantly higher in patients who received a transplant after the criteria change compared with before (3.7% vs 3.0%, P = .009). Multivariable logistic regression found that receiving a transplant after the criteria change was an independent risk factor for posttransplant stroke (adjusted odds ratio, 1.208; 95% CI, 1.011-1.443; P = .038). Multivariable Cox analysis of patients in the postcriteria change era showed that posttransplant stroke was independently associated with nearly 6-times greater risk of mortality within 6 months after transplant (adjusted hazard ratio, 5.951; 95% CI, 4.091-8.658; P < .001).</p><p><strong>Conclusions: </strong>The 2018 donor heart allocation criteria change is associated with a higher risk of posttransplant stroke. Posttransplant stroke increased the risk of mortality by 6-fold during the early posttransplant period.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537882","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}