Annals of Thoracic Surgery最新文献

{"title":"Editor's Choice","authors":"","doi":"10.1016/S0003-4975(24)01050-6","DOIUrl":"10.1016/S0003-4975(24)01050-6","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348593","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":"Neurocognitive Dysfunction After Short (<20 Minutes) Duration Hypothermic Circulatory Arrest","authors":"G. Chad Hughes MD ,&nbsp;Edward P. Chen MD ,&nbsp;Jeffrey N. Browndyke PhD ,&nbsp;Wilson Y. Szeto MD ,&nbsp;J. Michael DiMaio MD ,&nbsp;William T. Brinkman MD ,&nbsp;Jeffrey G. Gaca MD ,&nbsp;James A. Blumenthal PhD ,&nbsp;Jorn A. Karhausen MD ,&nbsp;Michael L. James MD ,&nbsp;David Yanez PhD ,&nbsp;Yi-Ju Li PhD ,&nbsp;Joseph P. Mathew MD, MHS","doi":"10.1016/j.athoracsur.2024.09.015","DOIUrl":"10.1016/j.athoracsur.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>It has long been held that the safe duration of hypothermic circulatory arrest (HCA) is at least 25 to 30 minutes. However, this belief is based primarily on clinical outcomes research and has not been systematically investigated using more sensitive brain imaging and neurocognitive assessments.</div></div><div><h3>Methods</h3><div>This exploratory substudy of the randomized Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest (GOT ICE) trial, which compared outcomes for deep vs moderate hypothermia during aortic arch surgery, investigated the frequency of neurocognitive and structural and functional magnetic resonance imaging (MRI) deficits with HCA of short (&lt;20 minutes) duration. Neurocognitive deficit was defined as ≥1 SD decline in ≥1 of 5 cognitive domains on neurocognitive testing.</div></div><div><h3>Results</h3><div>Of 228 GOT ICE participants with complete 4-week cognitive data, 74.6% (n = 170 of 228) had HCA durations &lt;20 minutes, including 59 patients randomized to deep hypothermia (&lt;20.0 °C), 55 patients randomized to low-moderate (20.1-24.0 °C) hypothermia, and 56 randomized to high-moderate (24.1-28.0 °C) hypothermia. Of these participants, cognitive deficit was detected 4 weeks postoperatively in ∼40% of patients in all 3 groups (deep hypothermia, 22 of 59 [37.3%]; low-moderate hypothermia, 23 of 55 [41.8%]; and high-moderate hypothermia, 24 of 56 [42.9%]). Furthermore, in a subset of patients with complete MRI data (n = 43), baseline to 4-week postoperative right frontal lobe functional connectivity change was inversely associated with HCA duration (range, 8-17 minutes; <em>P</em> for familywise error rate &lt; .01).</div></div><div><h3>Conclusions</h3><div>Even short durations of HCA result in cognitive deficits in ∼40% of patients, independent of systemic hypothermia temperature. HCA duration was inversely associated with frontal lobe functional MRI connectivity, a finding suggesting that this brain region may be preferentially sensitive to HCA. Surgeons should be aware that even short durations of HCA may not provide complete neuroprotection after aortic arch surgery.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 343-350"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331876","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":"Tophaceous Gout Presenting as a Fluorodeoxyglucose-Avid Anterior Mediastinal Mass","authors":"Matthew Aizpuru MD ,&nbsp;Casey M. Briggs MD ,&nbsp;Rafael E. Jimenez MD, MHA ,&nbsp;Chi Wan Koo MD ,&nbsp;Trenton R. Foster MD ,&nbsp;Sahar A. Saddoughi MD, PhD","doi":"10.1016/j.athoracsur.2024.09.024","DOIUrl":"10.1016/j.athoracsur.2024.09.024","url":null,"abstract":"<div><div>In this case report, we describe an unusual presentation of gout, manifesting as a fluorodeoxyglucose-avid anterior mediastinal mass mimicking a malignant neoplasm on positron emission tomography/computed tomography. The unusual observation of tophaceous gout in the anterior mediastinum is of relevance to chest physicians and surgeons as well as to radiologists and pathologists evaluating patients with lesions in the mediastinum.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 472-475"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373520","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 for Aortic Stenosis: Strategy and Decision-Making in the Current Era","authors":"Shmuel Chen MD, PhD ,&nbsp;Andrei Pop MD ,&nbsp;Lakshmi Prasad Dasi PhD ,&nbsp;Isaac George MD","doi":"10.1016/j.athoracsur.2024.05.047","DOIUrl":"10.1016/j.athoracsur.2024.05.047","url":null,"abstract":"<div><div>Aortic stenosis, the most common valvular disease in the Western world, has traditionally been treated with surgical aortic valve replacement (SAVR) but is increasingly treated by transcatheter aortic valve replacement (TAVR). Whereas patients older than 65 years are preferably treated with bioprosthetic tissue valves, there is considerable uncertainty in the choice between TAVR and SAVR. We present various considerations for optimizing the lifelong management of patients receiving bioprosthetic valves (SAVR or TAVR). To maximize life expectancy and to minimize cumulative lifetime risk, we suggest decision-making individualized for patient anatomy and overall (current and future) risk.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 296-307"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114521","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":"Blurring of the Lines for Better Outcomes","authors":"Russell Seth Martins MD,&nbsp;Faiz Y. Bhora MD, FACS","doi":"10.1016/j.athoracsur.2024.10.018","DOIUrl":"10.1016/j.athoracsur.2024.10.018","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Page 491"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631897","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":"Metrics for Benchmarking Lung Cancer Surgery Quality: Not Waiting for Godot!","authors":"Sora Ely MD ,&nbsp;Raymond U. Osarogiagbon MBBS","doi":"10.1016/j.athoracsur.2024.10.016","DOIUrl":"10.1016/j.athoracsur.2024.10.016","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 253-256"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559347","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":"Commission on Cancer Standards for Lymph Node Sampling and Oncologic Outcomes After Lung Resection","authors":"Benjamin J. Resio MD ,&nbsp;Kay See Tan PhD ,&nbsp;Matthew Skovgard MD ,&nbsp;Joe Dycoco MS ,&nbsp;Prasad S. Adusumilli MD ,&nbsp;Manjit S. Bains MD ,&nbsp;Matthew J. Bott MD ,&nbsp;Robert J. Downey MD ,&nbsp;Katherine D. Gray MD ,&nbsp;James Huang MD ,&nbsp;Daniela Molena MD ,&nbsp;Bernard J. Park MD ,&nbsp;Valerie W. Rusch MD ,&nbsp;Smita Sihag MD ,&nbsp;Gaetano Rocco MD ,&nbsp;David R. Jones MD ,&nbsp;James M. Isbell MD","doi":"10.1016/j.athoracsur.2024.09.009","DOIUrl":"10.1016/j.athoracsur.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>The newest Commission on Cancer standards recommend sampling 3 mediastinal and 1 hilar lymph node stations, 3 (N2) 1 (N1), for lung cancer resections. However, the relationship between the Commission on Cancer standards and outcomes has not been thoroughly investigated.</div></div><div><h3>Methods</h3><div>A prospective institutional database was queried for clinical stage I-III lung resections before the implementation of the new standards. The relationship between the 3 (N2) 1 (N1) standard (“guideline concordant”) and outcomes (upstaging, complications, receipt of adjuvant therapy, locoregional/distant recurrence, and survival) was assessed with multivariable models and stratified by stage.</div></div><div><h3>Results</h3><div>Of 9289 pulmonary resections, 3048 (33%) were guideline concordant and 6241 (67%) were not. Compared with nonconcordant, those that were guideline concordant had higher rates of nodal upstaging (21% vs 13%; odds ratio [OR], 1.32 [95% CI, 1.14-1.51]; <em>P</em> &lt; .001) and in-hospital complications (34% vs 27%; OR, 1.17 [95% CI, 1.05-1.30]; <em>P</em> = .004) but similar adjuvant systemic therapy administration (19% vs 13%; OR, 1.09 [95% CI, 0.95-1.24]; <em>P</em> = .2; 98% chemotherapy). Locoregional and distant recurrences were not significantly improved with guideline concordance across clinical stage I, II, and III subsets. Overall survival was similar in clinical stages I and II, but improved survival was observed for guideline concordant clinical stage III patients (hazard ratio, 0.85 [95% CI, 0.74-0.97]; <em>P</em> = .02).</div></div><div><h3>Conclusions</h3><div>Sampling 3 (N2) 1 (N1) was associated with increased upstaging and complications but not with decreased recurrence or mortality in clinical stage I or II patients. Survival was improved for concordant, clinical stage III patients. Further study is indicated to determine the ideal lymph node sampling strategy across heterogeneous lung cancer patients.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 308-315"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300167","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":"Is It Time for Lung Transplantation to Step Fully Into the Light?","authors":"Nathaniel B. Langer MD, MSc","doi":"10.1016/j.athoracsur.2024.10.011","DOIUrl":"10.1016/j.athoracsur.2024.10.011","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 431-432"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569871","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":"Harvey W. Bender Jr: Son of Texas, Gifted Surgeon, Inspiring Teacher, STSA and ACS President","authors":"Walter H. Merrill MD ,&nbsp;Richard L. Prager MD","doi":"10.1016/j.athoracsur.2024.09.049","DOIUrl":"10.1016/j.athoracsur.2024.09.049","url":null,"abstract":"<div><div>Harvey W. Bender Jr spent his early years in Humble, Texas. After attending Baylor University College of Medicine, he trained in surgery at the Johns Hopkins Hospital. In 1971 he was recruited to Vanderbilt University to reinvigorate the residency training program and significantly expand the clinical services. He became Chair of the Residency Review Committee for Thoracic Surgery and of the American Board of Thoracic Surgery. He was also Chair of the Board of Regents, President of the American College of Surgeons, and President of the Southern Thoracic Surgical Association. He was a unique person whose influence will last for generations.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"119 2","pages":"Pages 485-490"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631969","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":"Taking the Back Seat on the Innovation Trip: Not as Much Fun as Being Up Front.","authors":"Pirooz Eghtesady","doi":"10.1016/j.athoracsur.2025.01.017","DOIUrl":"10.1016/j.athoracsur.2025.01.017","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076458","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}