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

{"title":"What's the optimal duration of neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer: a real-world study.","authors":"Zhoujunyi Tian, Haoshuai Yang, Jin Zhang, Derou Liu, Chaoyang Liang, Zhenrong Zhang","doi":"10.1093/ejcts/ezaf218","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf218","url":null,"abstract":"<p><strong>Objectives: </strong>The optimal duration of neoadjuvant chemoimmunotherapy for resectable non-small cell lung cancer remains unknown. This study aimed to assess whether the number of cycles of neoadjuvant therapy affects oncologic efficacy and surgical safety in a real-world setting.</p><p><strong>Methods: </strong>Patients with resectable non-small cell lung cancer who received neoadjuvant chemoimmunotherapy and subsequent surgery were included. Patients were divided into two groups: ≤ 2 or > 2 cycles. Oncology outcomes such as pathological complete response (pCR), and surgical outcomes were compared. Binary logistic regression analyses were conducted to identify independent factors for pCR. Kaplan-Meier analysis was used to compare long-term survival between groups. Cox regression analyses were conducted to identify independent predictors for recurrence.</p><p><strong>Results: </strong>A total of 140 patients with clinical stage IB-IIIB disease were included; 68 received ≤ 2 cycles, and 72 received > 2 cycles of neoadjuvant chemoimmunotherapy. No significant difference was observed in pCR rates, surgery difficulty, and postoperative complications between groups. Multivariate binary logistic regression analysis indicated that adenocarcinoma (odds ratio [OR] 0.14, 95% confidence interval [CI] 0.04-0.50, P = 0.003) and clinical T3 stage (OR 0.18, 95% CI 0.05-0.72, P = 0.015) were unfavourable factors for pCR. Kaplan-Meier survival analysis revealed no significant difference in recurrence-free survival (RFS) or overall survival (OS) between groups. Multivariate Cox regression analysis revealed that number of neoadjuvant cycles was not a predictor of recurrence (HR 0.87, 95% CI 0.31-2.44, P = 0.8).</p><p><strong>Conclusions: </strong>Compared with 3 or more cycles, two cycles of neoadjuvant chemoimmunotherapy might achieve similar perioperative outcomes and long-term survival in selected patients. Prospective studies and extended follow-up are needed to verify the conclusions.</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":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577575","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":"Renal failure post cardiac surgery, a complicated subject with still many unresolved issues.","authors":"Guillermo Lema","doi":"10.1093/ejcts/ezaf150","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf150","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":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577574","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":"Incidence and resource burden for the management of computed tomography-detected ground glass opacities at a tertiary lung cancer service in the United Kingdom.","authors":"Abdullah AlShammari, Muhammad Ashraf, Paulo De Sousa, Vinci Naruka, Laura Tincknell, Anant Patel, Asonitis Athanasios, Sarah Booth, Jessica Wallen, Chiara Proli, Catherine Docherty, Eric Lim","doi":"10.1093/ejcts/ezaf223","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf223","url":null,"abstract":"<p><strong>Objectives: </strong>The increased use of computed tomography (CT) for lung cancer screening has significantly raised awareness of pure ground glass opacity (pGGO) lesions. GGOs pose diagnostic challenges, ranging from benign findings to invasive adenocarcinomas. We aim to evaluate the incidence of pGGOs identified on CT at a tertiary UK lung cancer service and quantify their impact on time and healthcare resources.</p><p><strong>Methods: </strong>We conducted a retrospective review of patients with pGGOs discussed at multidisciplinary team (MDT) meetings between 2017 and 2019 at the Royal Free and Royal Brompton Hospitals. Demographics were recorded, and annual incidence along with management data was analyzed.</p><p><strong>Results: </strong>A total of 3,731 patients were discussed at MDTs during the specified timeframe. On initial review 401 cases (11%) discussed were identified on CT as exhibiting areas of ground glass change, with the annual incidence increasing from 8% in 2017 to 13% in 2019. Following a second stage detailed assessment of the cases and application of exclusion criteria-such as the presence of a part solid component-259 patients were confirmed to have pure GGOs and were included for subsequent analysis in this study. The median number of MDT meetings per GGO was 2 (range: 1-3), with 3 CT scans (range: 2-4) over a median follow-up of 8.7 months (range: 2.0-24.1). PET scans were performed in 74 (27%) patients, 40 (15%) underwent biopsies (62.5% confirming malignancy), and 24 (9%) proceeded to surgery.</p><p><strong>Conclusions: </strong>The rising incidence of GGOs presents a growing resource burden, with repeated MDT discussions, imaging, and interventions. Revised guidelines with improved risk stratification models are essential to optimize management, reduce unnecessary follow-up, and improve resource utilization in lung cancer services.</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":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562632","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":"Lobectomy versus sub-lobectomy for clinical stage IA (≤2cm) lung squamous cell carcinoma with tumor spread through air spaces: A multi-center retrospective study.","authors":"Hanbo Pan, Hang Chen, Zhen Ge, Yu Tian, Weicheng Kong, Wanyu Li, Junwei Ning, Zhiyuan Bao, Zhizhuo Dai, Zhongjie Chen, Difan Zhang, Liang Fang, Min Zheng, Guomo Ruan, Hui Wang, Ming Zhang, Hui Yin, Jia Huang, Chengwei Zhou, Guodong Xu, Qingquan Luo","doi":"10.1093/ejcts/ezaf224","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf224","url":null,"abstract":"<p><strong>Objectives: </strong>The efficacy of sub-lobectomy for clinical IA (tumors ≤2cm) lung squamous cell carcinoma with tumor spread through air spaces remains unknown. This study compares long-term survival outcomes between sub-lobectomy and lobectomy, aiming to offer pivotal evidence for optimizing resection strategies for clinical IA spread through air spaces-positive squamous cell carcinoma patients.</p><p><strong>Methods: </strong>Consecutive clinical IA spread through air spaces-positive squamous cell carcinoma patients undergoing surgery between 2010 and 2020 at seven high-volume institutions across five Chinese cities were retrospectively reviewed. The primary endpoint was overall survival, and the secondary endpoint was recurrence-free survival. Propensity-score matching was employed to mitigate selection bias.</p><p><strong>Results: </strong>A total of 870 patients were included, and propensity-score matching yielded 476 and 238 cases in the Lobe and Sub-lobe groups, respectively. Over an estimated median follow-up of 6.51 years, lobectomy significantly improved overall survival [hazard ratio[95% confidence interval]=0.598[0.447-0.761],P<0.001)] and recurrence-free survival (hazard ratio[95% confidence interval]=0.572[0.449-0.733],P<0.001), and reduced postoperative mortality (30.7% vs. 40.3%,P=0.010) and recurrence (39.3% vs. 55.0%,P<0.001) incidences compared to sub-lobectomy. Further subgroup analysis revealed that lobectomy improved survival outcomes over sub-lobectomy in younger (age <70 years) and clinical IA2 sub-cohorts, while the two approaches yielded comparable survival outcomes for elderly (age ≥70 years) and clinical IA1 sub-cohorts.</p><p><strong>Conclusions: </strong>Lobectomy improved survival outcomes over sub-lobectomy for clinical IA spread through air spaces-positive squamous cell carcinoma and thus might be preferred for clinical IA squamous cell carcinoma patients with highly suspected spread through air spaces. The prognostic benefits of lobectomy may be discriminated by age and clinical stage.</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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562605","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":"Wild wild west.","authors":"Bastien Devet, Soline Devos, Vincent Fraipont, Benjamin Laboulle","doi":"10.1093/ejcts/ezaf222","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf222","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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562608","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":"Gender-based outcomes following surgical aortic valve replacement: a multicentre propensity score matching analysis.","authors":"Ruggero De Paulis, Farhad Bakhtiary, Ali El-Sayed Ahmad, Martin Andreas, Rüdiger Autschbach, Peter Benedikt, Konrad Binder, Nikolaos Bonaros, Michael Borger, Thierry Bourguignon, Sergio Canovas, Enrico Coscioni, Francois Dagenais, Philippe Demers, Oliver Dewald, Nicolas Doll, Richard Feyrer, Hans-Joachim Geißler, Martin Grabenwöger, Jürg Grünenfelder, Sami Kueri, Ka Yan Lam, Thierry Langanay, Günther Laufer, Wouter Van Leeuwen, Seymur Karimli, Andreas Liebold, Giovanni Mariscalco, Parwis Massoudy, Arash Mehdiani, Renzo Pessotto, Francesco Pollari, Jochen Pöling, Gianluca Polvani, Alessandro Ricci, Jean-Christian Roussel, Saad Salamate, Matthias Siepe, Pierluigi Stefano, Justus Strauch, Alexis Theron, Andreas Vötsch, Alberto Weber, Olaf Wendler, Matthias Thielmann, Matthias Eden, Beate Botta, Peter Bramlage, Bart Meuris, Andreas Zierer","doi":"10.1093/ejcts/ezaf099","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf099","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the Gender-based difference in 3-year clinical outcomes, left ventricular (LV) regression, and Quality-of-life (QoL) following surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).</p><p><strong>Methods: </strong>A prospective multicentre study on combined data from two prospective registries, INDURE and IMPACT, resulted in 993 patients (735 males and 258 females). PSM yielded 689 patients: 442 males and 247 females undergoing first-time SAVR using Edwards INSPIRIS RESILIA.</p><p><strong>Results: </strong>In the PSM cohort, females had lower body mass index (median 27.9 vs 28.6 kg/m2; p = 0.004), higher EuroSCORE II (2.4 ± 3.0% vs 1.8 ± 1.9%; p < 0.001), STS score (1.8 ± 1.7% vs 1.3 ± 2.0%; p < 0.001) and were most often in NewYork Heart Association class III/IV (45.7% vs 37.6%; p < 0.021), angina CCS class III/IV (6.1% vs 2.9%; p < 0.001) than male. Post-SAVR clinical outcomes up to 3 years were similar between both genders. Significant differences existed for LV regression after surgery between genders at up to three years (p < 0.001) with better haemodynamic performance. Hypertension slowed the LV mass regression, mildly affecting LV restoration in females for up to 3 years. In both genders, NYHA status was restored within one year (p < 0.001) and maintained for up to 3 years (p < 0.001). At 3-years, QoL significantly improved.</p><p><strong>Conclusions: </strong>Despite females presenting with a significantly higher surgical risk profile, 3-year outcomes following SAVR were comparable between genders with significant improvement in functional status. However, the degree of QoL improvement differed between genders.</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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562631","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":"Surgical implications of the 2023 ESC endocarditis guidelines endorsed by EACTS: Bridging guidelines and practice.","authors":"Manuela de la Cuesta, Mateo Marin-Cuartas, Suzanne de Waha, Milan Milojevic, Patrick O Myers, Martin Misfeld, Eduard Quintana, Nikolaos Bonaros, Carlos A Mestres, Torsten Doenst, Alexey Dashkevich, Philipp Kiefer, David Holzhey, Michael A Borger","doi":"10.1093/ejcts/ezaf225","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf225","url":null,"abstract":"<p><p>Infective endocarditis (IE) remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations with regard to surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes. The multidisciplinary Endocarditis Team approach is highlighted as a key factor in improving patient prognosis by optimizing diagnosis and treatment strategies. Advanced imaging techniques, such as positron emission tomography-computed tomography, have enhanced diagnostic accuracy, particularly for prosthetic valve endocarditis. Despite the clear survival benefits associated with surgery, only a minority of eligible patients undergo surgical treatment, underscoring the need for better patient selection and timely intervention. Furthermore, the worse prognosis is found in patients with indications for surgery who do not undergo surgical intervention. The updated IE guidelines provide detailed timing recommendations for surgery based on the clinical scenario, including new considerations for patients with stroke. Additionally, novel recommendations regarding partial oral antibiotic therapy following surgery have been introduced. Finally, important measures for the prevention of IE recurrence are discussed. In conclusion, timely surgical intervention, based on defined recommendations guided by multidisciplinary collaboration and enhanced diagnostic tools, is crucial in improving outcomes for IE patients.</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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562607","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":"Robotic approach is useful for cervico-superior mediastinal tumor.","authors":"Ryusuke Sumiya, Shinsuke Uchida, Mariko Fukui, Takeshi Matsunaga, Yukio Watanabe, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki","doi":"10.1093/ejcts/ezaf129","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf129","url":null,"abstract":"<p><p>Surgical resection of a cervico-superior mediastinal tumour is challenging. We present two cases of robotic tumour resection. Because the hybrid robotic or robotic portal approach has several advantages over open thoracotomy or the conventional thoracoscopic approach, these approaches are options for cervico-superior mediastinal resection, allowing us to avoid a median sternotomy or transmanubrial approach.</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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562606","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":"Only randomized trials should be used for comparative effectiveness evaluation. Let the music play and the rock stars rock.","authors":"Mario Gaudino, Michael A Borger","doi":"10.1093/ejcts/ezaf221","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf221","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":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556495","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":"Percutaneous cannulation for minimally-invasive heart valve surgery: results from a multicenter registry.","authors":"Jonas Pausch, Jessica Weimann, Miriam Silaschi, Eissa Alaj, Vahid Seidiramool, Markus Kofler, Jörg Kempfert, Hendrik Treede, Ahmed Ghazy, Thilo Noack, Ibrahim Gadelkarim, Sabine Bleiziffer, Julia Götte, Hermann Reichenspurner, Lenard Conradi","doi":"10.1093/ejcts/ezaf219","DOIUrl":"https://doi.org/10.1093/ejcts/ezaf219","url":null,"abstract":"<p><strong>Objectives: </strong>To avoid potential groin incision associated complications and further streamline surgery percutaneous femoral cannulation using different vascular closure devices (VCD) has emerged to establish cardiopulmonary bypass during minimally-invasive heart valve surgery (HVS).</p><p><strong>Methods: </strong>The Percutaneous peRipheral cannulatiOn for Minimally-InvaSive heart valve surgEry (PROMISE) multicenter registry included patients, receiving percutaneous vascular access site (VAS) closure during minimally-invasive HVS. Retrospective analyses were performed to evaluate major and minor VAS-related complications of plug- (group 1) vs suture-based (group 2) systems according to modified Valve Academic Research Consortium (VARC) 3 criteria (ie retrograde dissection, vascular injury, conversion to surgical cut-down or vascular intervention).</p><p><strong>Results: </strong>In total 755 patients (66.1% (499/755) male; median age 61.9years) were included and treated using a plug- (n = 450) or suture-based (n = 305) VCD. Most prevalent comorbidities were hypertension (53.8%; 335/755) and atrial fibrillation (29.4%; 222/755), resulting in a median STS Prom Score of 0.5%. Prevalence of peripheral artery disease was 4.4% (33/450). Immediate hemostasis was significantly higher in the plug-based group (99.8 (445/450 vs 77.7% (237/305); p < 0.001). Accordingly, application of a second VCD (0.0 (0/450) vs 34.8% (106/305); p < 0.001) as well as conversion rates to surgical cut-down (1.3 (6/450) vs 3.9% (12/305); p = 0.04) were significantly lower. Prevalence of VAS-related complications (ie, arteriovenous (AV) fistula (0.2 (1/450) vs 0% (0/305); p > 0.99), pseudoaneurysm (0.4 (2/450) vs 0% (0/305); p = 0.66) or postoperative VAS-bleeding (1.6 (7/450) vs 0.7% (2/305); p = 0.26)) was low in both groups (2.9 (13/450) vs 5.2% (16/305); p = 0.14).</p><p><strong>Conclusion: </strong>VAS-related complications were favorably low in both groups. Plug-based VCD are potentially associated with significantly higher rates of immediate hemostasis and lower incidence for additional VCD or surgical cut-down. Usage of dedicated VCD (plug- and suture-based) for VAS closure after percutaneous cannulation is feasible, safe and further decreases invasiveness in minimally-invasive HVS.</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":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546846","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}