Annals of Thoracic Surgery最新文献

{"title":"Valve-Sparing vs Bio-Bentall Aortic Root Replacement in Patients Aged 60 to 75 Years: Survival, Reintervention, and Aortic Regurgitation.","authors":"Alessandra Sala, Michele Di Mauro, Edoardo Zancanaro, Marta Bargagna, Francesco Grimaldi, Veronica D'Oria, Lorenzo Menicanti, Ottavio Alfieri, Michele De Bonis, Carlo de Vincentiis","doi":"10.1016/j.athoracsur.2024.12.028","DOIUrl":"10.1016/j.athoracsur.2024.12.028","url":null,"abstract":"<p><strong>Background: </strong>Valve-sparing root replacement (VSRR) with the David technique is an established therapy for aortic root pathology in young patients. This study evaluated short- and long-term outcomes between VSRR and aortic root replacement (ARR) with a biological-valved conduit in sexagenarians.</p><p><strong>Methods: </strong>A multicenter retrospective review from 2002 to 2022 identified 299 sexagenarians undergoing aortic root surgery, among whom 82 (27.4%) underwent VSRR and 217 (72.6%) underwent bio-Bentall. Inverse probability of treatment weighting (IPTW) was applied to balance clinical variables. Median follow-up was 15 years (interquartile range, 12-18 years). Study end points were in-hospital mortality, long-term survival, freedom from reintervention, and recurrence of at least moderate aortic regurgitation (AR).</p><p><strong>Results: </strong>There were no major differences in baseline characteristics. The incidence of bicuspid valves (VSRR, 4.9%; ARR, 19%), severe AR (42% vs 51%), type A aortic dissection (1.2% vs 6.9%), and reoperation (4% vs 23%) were higher in ARR. After IPTW, there was no difference in in-hospital mortality (VSRR, 1.2%; ARR, 4.6%; P = .3). The incidence of neurologic complications (P = .003) and permanent pacemaker implantation (P = .022) were significantly higher in the bio-Bentall group. After IPTW, 10-year survival did not differ between VSRR (87%) and ARR (80%; P = .176). However, cardiac survival was significantly higher in VSRR patients (98% vs 92%, P = .018), with deaths mainly due to infective endocarditis and end-stage heart failure. No difference was reported in reoperation/recurrence of at least moderate AR among the groups at 10 years, with only 1 patient undergoing reintervention after bio-Bentall (P = .117).</p><p><strong>Conclusions: </strong>David and bio-Bentall procedures have low in-hospital mortality and good long-term survival in sexagenarians. VSRR is associated with improved long-term cardiac survival, lower rates of infective endocarditis, permanent pacemaker implantation, and heart failure episodes, with similar rates of reintervention/recurrence of moderate AR.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015781","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":"Eighth Annual Society of Thoracic Surgeons Pedimacs Report.","authors":"Eric R Griffiths, Michael P Profsky, Deepa Mokshagundam, Katerina Boucek, Shahnawaz Amdani, Ryan R Davies, Michael C Monge, David Ls Morales, Joseph W Rossano, Jeffrey P Jacobs, James K Kirklin, Devin Koehl, Ryan Cantor, David M Peng","doi":"10.1016/j.athoracsur.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.12.020","url":null,"abstract":"<p><strong>Background: </strong>The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), supported by The Society of Thoracic Surgeons, provides detailed information on pediatric patients supported with ventricular assist devices (VADs).</p><p><strong>Methods: </strong>From September 19, 2012, to December 31, 2023, there were 1648 devices in 1349 patients (<19 years) from 39 North American Hospitals with 100 patients enrolled in 2023.</p><p><strong>Results: </strong>Cardiomyopathy was the most common underlying etiology (59%), followed by congenital heart disease (26%) and myocarditis (8%). Regarding device type, implantable continuous VADs were most common at 37%, followed by paracorporeal continuous (28%) and paracorporeal pulsatile (28%) and percutaneous (7%). Baseline demographics differed, with the paracorporeal continuous cohort being younger, smaller, more complex (ie, congenital heart disease), and sicker at implantation (p< .0001). At 6 months after VAD implantation, a favorable outcome (transplantation, recovery, or alive on device) was achieved in 84% of patients, which was greatest among those on intracorporeal VADs (92%) and least for paracorporeal continuous VADs (71%). Survival for single ventricle patients is similar to other congenital heart disease patients but inferior to those with cardiomyopathy. Survival for single ventricles varies by stage of palliation.</p><p><strong>Conclusions: </strong>This Eighth Pedimacs Report demonstrates the important role in VAD support in the care of children with end stage heart disease. The complexity of cardiac physiologies and anatomic constraint mandates the need for multiple types of devices used. The pre-implantation characteristics and different patient populations likely account for some of the differences in outcomes amongst the different device types.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015633","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":"Too little, too late? Extra anatomic aortic bypass for aortic coarctation in adults.","authors":"A Cozette Killian, Robert J Dabal","doi":"10.1016/j.athoracsur.2024.12.025","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.12.025","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980614","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":"Hematocrit, Acute Kidney Injury, and Cardiopulmonary Bypass.","authors":"Guillermo Lema, Eduardo Turner, Marcela Rodríguez","doi":"10.1016/j.athoracsur.2024.12.021","DOIUrl":"10.1016/j.athoracsur.2024.12.021","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980611","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":"Refining Conduit Choices in CABG: Insights and Challenges from the CORONARY Analysis.","authors":"Vasileios Leivaditis, Manfred Dahm, Nikolaos G Baikoussis","doi":"10.1016/j.athoracsur.2024.12.023","DOIUrl":"10.1016/j.athoracsur.2024.12.023","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980613","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 Can be Done to Prevent Acute Renal Failure after Type A Aortic Dissection Repair?","authors":"Raymond J Strobel, J Hunter Mehaffey","doi":"10.1016/j.athoracsur.2024.12.024","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.12.024","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980615","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 Tale of Two Cohorts: Differences in PARTNER 3 Populations.","authors":"Stanley B Wolfe, J Hunter Mehaffey","doi":"10.1016/j.athoracsur.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.12.018","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980609","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":"Considerations Regarding Intervention Threshold in Neonates and Infants with Coarctation.","authors":"Elizabeth H Stephens","doi":"10.1016/j.athoracsur.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.12.022","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980610","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":"Multisociety Endorsement of the 2024 European Guideline Recommendations on Coronary Revascularization.","authors":"Victor Dayan, Joseph F Sabik, Minoru Ono, Marc Ruel, Song Wan, Lars G Svensson, Leonard N Girardi, Y Joseph Woo, Vinay Badhwar, Marc R Moon, Wilson Y Szeto, Vinod H Thourani, Rui M S Almeida, Zhe Zheng, Walter J Gomes, Dawn S Hui, Rosemary F Kelly, Miguel Sousa Uva, Joanna Chikwe, Faisal G Bakaeen","doi":"10.1016/j.athoracsur.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2024.11.011","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980612","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 (STS) Clinical Practice Guideline on Surgical Management of Oligometastatic Non-small Cell Lung Cancer.","authors":"Mara B Antonoff, Kyle G Mitchell, Samuel S Kim, Hai V Salfity, Svetlana Kotova, Robert Taylor Ripley, Alfonso L Neri, Pallavi Sood, Saumil G Gandhi, Yasir Y Elamin, Jessica S Donington, David R Jones, Elizabeth A David, Stephen G Swisher, Isabelle Opitz, J W Awori Hayanga, Gaetano Rocco","doi":"10.1016/j.athoracsur.2024.11.010","DOIUrl":"10.1016/j.athoracsur.2024.11.010","url":null,"abstract":"<p><strong>Background: </strong>The use of local consolidative therapy (LCT) in patients with oligometastatic non-small cell lung cancer (NSCLC) is rapidly evolving, with a preponderance of data supporting the benefits of such therapeutic approaches incorporating pulmonary resection for appropriately selected candidates. However, practices vary widely institutionally and regionally, and evidence-based guidelines are lacking.</p><p><strong>Methods: </strong>The Society of Thoracic Surgeons assembled a panel of thoracic surgical oncologists to evaluate and synthesize the available evidence regarding the role of pulmonary resection as LCT. Clinical and research questions of interest were identified, and a complete literature review was conducted. Best practice guidelines were developed accordingly.</p><p><strong>Results: </strong>The panel identified 7 areas of controversy, and data were assimilated to support the best recommended practices related to these clinical issues. Ultimately, a number of issues in this realm were found to have a high level of evidence to support the role for surgical therapy in patients with stage IV lung cancer. However, the nuances of how these operations are conducted remain in equipoise, without ample evidence to support the extent of resection or nodal dissection.</p><p><strong>Conclusions: </strong>Clear data exist to support the use of surgical resection of the primary lung tumor as LCT in stage IV lung cancer. Evidence-based recommendations have been provided to guide multidisciplinary teams on the implementation of treatment plans as well as to guide researchers on areas of ongoing need for further investigation.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967249","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}