European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery最新文献

{"title":"Electrosurgical septotomy across the full spectrum of aortic dissection.","authors":"Gabriel Weiss, Hubert Trnka, Sebastian Tauber, Emely Manville, Zsuzsanna Arnold, Bernhard Winkler, Sandra Folkmann, Martin Grabenwöger","doi":"10.1093/ejcts/ezag246","DOIUrl":"https://doi.org/10.1093/ejcts/ezag246","url":null,"abstract":"<p><strong>Objectives: </strong>Transcatheter electrosurgical septotomy divides the dissection membrane to reconstitute a single aortic lumen. Reported experience is largely confined to chronic post-dissection aneurysms. We assessed the technique across the full spectrum of descending aortic dissection, including stand-alone treatment of malperfusion.</p><p><strong>Methods: </strong>Retrospective intention-to-treat analysis of 21 consecutive patients scheduled for septotomy between June 2022 and May 2026. The membrane was crossed by needle re-entry and divided with an electrified through-and-through guidewire at 40-60 W under fluoroscopy, without routine intravascular ultrasound or image fusion. A perfused-lumen index (perfused lumen divided by total aortic diameter) was measured before and after the procedure.</p><p><strong>Results: </strong>Septotomy was performed in 20 of 21 patients (technical success 95% on an intention-to-treat basis). Indications were landing-zone preparation (57%), malperfusion (33%), preparation for open repair and true-lumen collapse. Malperfusion resolved in all 7 patients treated for that indication, and the perfused-lumen index rose from a median of 0.16 to 0.98 (18 patients, P < 0.001). There was no stroke, spinal cord ischaemia or retrograde type A dissection. Thirty-day, in-hospital and overall mortality were 10%, 14% and 19%, with one fatal delayed aortic rupture and no intraprocedural death. Three unplanned reinterventions occurred; median follow-up was 5.1 months.</p><p><strong>Conclusions: </strong>Electrosurgical septotomy was feasible across the full spectrum of aortic dissection and, in selected patients, as stand-alone treatment for malperfusion, using standard electrosurgical equipment. Given the small heterogeneous cohort and short follow-up, these findings demonstrate feasibility rather than durability.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinventing coronary bypass surgery: A journey.","authors":"John Puskas","doi":"10.1093/ejcts/ezag202","DOIUrl":"https://doi.org/10.1093/ejcts/ezag202","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid regurgitation: choosing the right treatment for the right patient at the right time.","authors":"Benedetto Del Forno, Francesco Maisano, Ottavio Alfieri","doi":"10.1093/ejcts/ezag244","DOIUrl":"https://doi.org/10.1093/ejcts/ezag244","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung volume reduction surgery in emphysema with severely impaired 6-minute walk distance.","authors":"Jacopo Saccomanno, Aron Elsner, Thomas Sgarbossa, Stefan Welter, Marc Hinterthaner, Stephan Eisenmann, Bernd Schmidt, Wolfgang Gesierich, Nicolas Dickgreber, Christian Geltner, Joachim H Ficker, Angelique Holland, Björn Schwick, Stephan Eggeling, Klaus-Dieter Diemel, Christian Grah, Christoph Hünermann, Urte Sommerwerck, Andreas Fertl, Sylke Kurz, Peter Schramm, Joanna Krist, Martin Witzenrath, Jens-C Rückert, Ralf-Harto Hübner","doi":"10.1093/ejcts/ezag242","DOIUrl":"https://doi.org/10.1093/ejcts/ezag242","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung volume reduction surgery for severe emphysema-no place for heroes?","authors":"David Waller","doi":"10.1093/ejcts/ezag239","DOIUrl":"https://doi.org/10.1093/ejcts/ezag239","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Segmentectomy versus Lobectomy for cT1N0M0 NSCLC Upstaged to pT2aN0M0 by Occult Visceral Pleural Invasion: a multicenter cohort study.","authors":"Alessio Campisi, Wentao Fang, Andrea Dell'Amore, Yang Chen, Alessandro Bonis, Alessandro Rebusso, Filippo Lococo, Dania Nachira, Stefano Margaritora, Tiziano Conti, Francesco Londero, Andrea Zuin, Andrea Billè, Rebecca Weedle, Micayla Pather, Chiara Catelli, Nicola Sarnicola, Luca Luzzi, Nicola Tamburini, Francesco Dolcetti, Giampiero Dolci, Riccardo Giovannetti, Corrado Pedrazzani, Tommaso Valigi, Alfonso Fiorelli, Beatrice Leonardi, Stefano Bongiolatti, Giovanni Mugnaini, Luca Voltolini, Martin Eichhorn, Hauke Winter","doi":"10.1093/ejcts/ezag241","DOIUrl":"https://doi.org/10.1093/ejcts/ezag241","url":null,"abstract":"<p><strong>Objectives: </strong>Occult visceral pleural invasion (VPI) may upstage cT1N0M0 non-small cell lung cancer (NSCLC) to pT2aN0M0. We compared perioperative and oncological outcomes after segmentectomy and lobectomy in this setting.</p><p><strong>Methods: </strong>This multicenter retrospective study included cT1N0M0 NSCLC patients treated with minimally invasive segmentectomy or lobectomy who were subsequently upstaged to pT2aN0M0 because of VPI. Propensity score matching (PSM) (1:1) was performed. Perioperative and oncological outcomes were compared. Exploratory and sensitivity analyses evaluated tumors ≤20 mm and patients who did not receive adjuvant therapy.</p><p><strong>Results: </strong>Among 448 patients, 104 underwent segmentectomy and 344 lobectomy. After PSM, 87 matched pairs were analyzed. Segmentectomy was associated with shorter operative time, lower postoperative morbidity, and shorter hospital stay. No significant differences were observed in DFS (p = 0.387), OS (p = 0.075), or CSS (p = 0.388). Multivariable analysis identified adjuvant therapy and age as independent predictors of DFS and OS, respectively, whereas the extent of resection was not independently associated with survival. In patients with a preoperative CT total tumor diameter ≤20 mm, segmentectomy was associated with a higher rate of local recurrence (13.8vs2.0%, p = 0.037) and worse adjusted DFS and OS, despite no significant differences in Kaplan-Meier survival.</p><p><strong>Conclusions: </strong>In patients with cT1N0M0 NSCLC upstaged to pT2aN0M0 because of occult VPI, segmentectomy was associated with lower postoperative morbidity, with no significant differences in oncological outcomes in the overall matched cohort. Exploratory findings in patients with a preoperative CT total tumor diameter ≤20 mm suggest a higher risk of local recurrence and worse adjusted DFS and OS after segmentectomy, warranting further validation.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EACTS Expert Consensus Document on Robotic Cardiac Surgery Minimum Standards for Programme Implementation, Training and Quality Assurance, developed in collaboration with EACTAIC and EBCP.","authors":"Wouter Oosterlinck, Meindert Palmen, Monica Gianoli, Milan Milojevic, Jan Bekaert, Friedhelm Beyersdorf, Filip P A Casselman, Karlien Degezelle, Volkmar Falk, Thierry Folliguet, Ulrich Franke, Pavel Hedvicak, Danny F Hoogma, Jörg Kempfert, Bonnie Kyle, Tom Melvin, Daniel Pereda, Paola Quattroni, Ricard Navarro-Ripoll, Emmanuel Vander Poorten, Johannes O Bonatti, Stepan Cerny","doi":"10.1093/ejcts/ezag187","DOIUrl":"10.1093/ejcts/ezag187","url":null,"abstract":"<p><p>Robotic cardiac surgery is entering a renewed phase of adoption, supported by growing clinical experience, evolving robotic platforms, and rising demand for less invasive procedures and faster recovery. However, implementation remains technically demanding and resource-intensive and can expose patients to avoidable harm when initiated without a structured training programme, clear technical standards, and rigorous outcome monitoring. This expert consensus document summarizes the current state of robotic cardiac surgery and defines requirements for the safe, effective, and sustainable development of robotic cardiac programmes. It addresses the current regulatory environment for surgical robots and accessories and proposes minimum requirements for hardware, software, and instruments for reconstructive intracardiac and coronary cardiac procedures. Furthermore, it outlines prerequisites for starting and developing training centres, including surgeon experience, multidisciplinary team composition, patient selection, and institutional infrastructure and volume considerations. A stepwise, competency-based training pathway is presented that integrates video and live case observation, virtual and simulation-based skills acquisition, wet/dry laboratory training, and proctored clinical implementation, ideally supported by dual-console systems. The document emphasises the need for transparent documentation and outcome benchmarking via a society-driven database to support quality assurance, learning-curve oversight, and continuous improvement. Finally, it highlights priorities for further research, including harmonized reporting standards, long-term and procedure-specific outcome evaluation, and prospective studies assessing training models, cost-effectiveness, and the incremental value of emerging technologies.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":"68 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Maze Procedure for Atrial Fibrillation.","authors":"James L Cox","doi":"10.1093/ejcts/ezag132","DOIUrl":"10.1093/ejcts/ezag132","url":null,"abstract":"","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EACTS Expert Consensus Document on aortic valve repair and valve-sparing aortic root replacement procedures.","authors":"Ruggero De Paulis, Giulio Folino, Alain Berrebi, Filip P A Casselman, Rui J Cerqueira, Alessandro Della Corte, Laurent De Kerchove, Yves d'Udekem, Alberto Forteza, Vadim P Irimie, Marjan Jahangiri, Marek Jasinski, Emmanuel Lansac, Hector I Michelena, Milan Milojevic, Hans-Joachim Schäfers, David Vancraeynest, Carlos A Villa Hincapie, Jan Vojacek","doi":"10.1093/ejcts/ezag182","DOIUrl":"10.1093/ejcts/ezag182","url":null,"abstract":"<p><p>Aortic valve repair is a complex and evolving field that requires multidisciplinary teamwork among heart specialists to diagnose and treat various causes and mechanisms of aortic regurgitation and proximal thoracic aortic aneurysms across all age groups. From a surgical standpoint, aortic valve repair includes all procedures aimed at restoring or maintaining native valve function. This European Association for Cardio-Thoracic Surgery (EACTS) Expert Consensus Document critically evaluates the current evidence on the common causes and mechanisms of aortic regurgitation, the use of echocardiographic parameters in patient selection, intraoperative assessment, and prognostic evaluation as well as the surgical techniques in practice. It outlines fundamental surgical principles shared across different repair methods and provides consensus statements to guide clinical practice. These statements are intended for a broad audience, including paediatric and adult cardiologists, echocardiographers, cardiovascular imaging specialists, and cardiac surgeons. Where high-quality evidence is unavailable, the guidance relies on the collective experience and expert judgement of the multidisciplinary author team. This document presents the official stance of the EACTS and aims to promote standardized, evidence-based decision-making in the management of patients undergoing aortic valve repair.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":"68 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of contemporary durable left ventricular assist device support in younger patients: a European registry for patients with mechanical circulatory support (EUROMACS) analysis.","authors":"Guglielmo Gallone, Kevin M Veen, Alexander M Bernhardt, Kadir Caliskan, Emil Najjar, Ivan Netuka, Anna Mara Scandroglio, Antonio Spitaleri, Diego Sangiorgi, Peter Ivak, Arnt Fiane, Feras Khaliel, Mustafa Özbaran, Yuri Pya, Daniel Zimpfer, Gloria Färber, Jan Gummert, Bart Meyns, Paola Quattroni, Felix Schoenrath, Gaetano Maria De Ferrari, Mauro Rinaldi, Evgenij Potapov, Antonio Loforte","doi":"10.1093/ejcts/ezag234","DOIUrl":"https://doi.org/10.1093/ejcts/ezag234","url":null,"abstract":"<p><strong>Objectives: </strong>Superior survival outcomes have been reported for younger patients receiving durable left ventricular assist devices (LVADs) in INTERMACS. We explored whether these findings extend to contemporary European practice leveraging on EUROMACS (European Registry for Patients with Mechanical Circulatory Support).</p><p><strong>Methods: </strong>Adult patients undergoing implantation of current-generation magnetically levitated LVADs in EUROMACS were stratified according to age groups. The primary outcome was 5-year on-device survival, censoring at heart transplantation (HT) or LVAD explantation. Secondary outcomes included LVAD explant for myocardial recovery, and survival free from major adverse events (bleeding, stroke, device-related infection, or device malfunction). Death incidence accounting for HT and support cessation as competing risks was also calculated.</p><p><strong>Results: </strong>A total of 2,850 patients undergoing HeartMate 3 implantation were included (<50 years: 23.5%; 50-59 years: 29.7%; 60-69 years: 38.0%; ≥70 years: 8.8%). Younger patients had fewer comorbidities, a higher prevalence of non-ischemic cardiomyopathy, and INTERMACS profile ≤3.Younger patients had superior on-device 5-yr survival (<50 years: 74.7%; 50-59 years: 65.5%; 60-69 years: 53.9%; ≥70 years: 48.8%; p < 0.001) and LVAD explantation for myocardial recovery (<50 years: 4.3%; 50-59 years: 1.8%; 60-69 years: 2.3%; ≥70 years: 0.4%; p = 0.031). Accounting for competing outcomes, the 5-year cumulative incidence of death was lowest among younger patients (<50 years: 20.8%; 50-59 years: 29.1%; 60-69 years: 40.8%; ≥70 years: 49.5%; p < 0.001), driven by higher HT rates. Survival free from bleeding was significantly higher in younger patients (p < 0.001). In contrast, 5-year freedom from stroke, device-related infection, and device malfunction was similar across age groups.</p><p><strong>Conclusions: </strong>In contemporary European practice, patients <50 yrs undergoing LVAD implant had high 5-yr survival approaching that reported in cohorts of patients listed for HT. These findings support further investigation of prolonged LVAD support before HT as a potential strategy to maximize lifetime benefit in selected motivated younger candidates.</p>","PeriodicalId":520617,"journal":{"name":"European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}