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

{"title":"Gender disparities in authorship in European cardio-thoracic journals.","authors":"Antonella Galeone, Julie Cleuziou, Fabiola Perrone, Irene Maffei, Giorgia Fiorinelli, Chiara Di Padua, Paula Duarte, Mariateresa Denora, Jolanda Kluin, Cecilia Pompili","doi":"10.1093/ejcts/ezaf205","DOIUrl":"10.1093/ejcts/ezaf205","url":null,"abstract":"<p><strong>Objectives: </strong>The goal was to evaluate gender authorship in 2 cardio-thoracic surgical journals.</p><p><strong>Methods: </strong>We performed a bibliometric analysis of all articles published from 2017 to 2022 in the European Journal of Cardio-Thoracic Surgery and the Interdisciplinary Cardiovascular and Thoracic Surgery. For each article, the gender and academic rank of the first, senior and corresponding authors were verified by Internet search, email contact or use of the application Genderize.io. Articles were categorized based on topic, type and country of origin. The Cochran-Armitage test was used to evaluate gender authorship trend over time.</p><p><strong>Results: </strong>A total of 5243 articles were included in the analysis. Women represented 18% of first authors, 7% of senior authors and 13% of corresponding authors; no trend was seen over time. Women represented 16% of first authors and 7% of senior authors in adult cardiac surgery, 23% of first authors and 9% of senior authors in congenital cardiac surgery and 19% of first authors and 8% of senior authors in thoracic surgery. Male first authors were more frequently full professors (17% vs 5%) and associate professors (16% vs 8%), and male senior authors were more frequently full professors (48% vs 31%) and associate professors (16% vs 8%) compared to female senior authors.</p><p><strong>Conclusions: </strong>The proportion of female authors is significantly lower than that of male authors in highest-impact European cardio-thoracic surgery journals, and no significant increase in female authorship has been demonstrated in recent years. Increasing awareness of gender disparities is essential to facilitate equal career opportunities and academic advancement for women in cardio-thoracic surgery.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532787","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":"Anatomic predictors of distal landing zone failure after endovascular repair of thoracic aortic aneurysm†.","authors":"Nicholas J Goel, Andrew M Peev, Peter Auteri, Grace J Wang, Kendall M Lawrence, Alexandra E Sperry, Mikolaj Berezowski, Murat Yildiz, Waseem Lutfi, John DePaolo, Yu Zhao, Alexander S Fairman, Wilson Y Szeto, Darren B Schneider, Nimesh D Desai","doi":"10.1093/ejcts/ezaf198","DOIUrl":"10.1093/ejcts/ezaf198","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse anatomic factors of the distal landing zone (dLZ) associated with the durability of endovascular repair of thoracic aortic aneurysm (TAA).</p><p><strong>Methods: </strong>Consecutive patients undergoing thoracic endovascular aortic repair (TEVAR) for undissected TAA were queried from a single centre from 2004 to 2022. Patient and operative factors were considered as well as detailed anatomic factors at the dLZ assessed by 3D reconstruction of pre-TEVAR imaging. The outcome of interest was the long-term risk of TEVAR failure at the dLZ.</p><p><strong>Results: </strong>A total of 101 patients undergoing TEVAR repair of TAA were considered, of whom 17 suffered distal TEVAR failure over a median follow-up period of 2.7 years. Two anatomic factors showed outsized influence on long-term outcomes: dLZ diameter and dLZ length (the length of non-dilated aortic tissue above the coeliac artery). Patients who progressed to distal TEVAR failure had larger dLZ diameter (34.2 mm vs 30.7 mm, P = 0.034) and far shorter dLZ length (3.8 cm vs 7.5 cm, P = 0.008). Patients with dLZ diameter greater than 35 mm had much greater risk of mortality or distal TEVAR failure within 2 years (34% vs 5%, P = 0.012), as did those with dLZ length less than 4 cm (27% vs 6%, P = 0.006).</p><p><strong>Conclusions: </strong>In this study, mild dilation at the dLZ beyond 35 mm and short length at the dLZ less than 4 cm are both clear anatomic risk factors for poor long-term outcome after supraceliac TEVAR. It may be appropriate to consider repair via branched endografts landing beyond the coeliac artery in patients with these risk factors.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Similar Trend in Benefit of Adjuvant Platinum in Lung Cancer Patients Irrespective of Epidermal Growth Factor Receptor Mutation Status.","authors":"Kenichi Suda, Kosuke Fujino, Mao Yoshikawa, Kazuhiko Shien, Ken Suzawa, Kotaro Nomura, Shota Fukuda, Shuta Ohara, Akira Hamada, Fumihiko Kinoshita, Kazuki Hayasaka, Hirotsugu Notsuda, Shinkichi Takamori, Satoshi Muto, Shinya Katsumata, Mototsugu Shimokawa, Junichi Soh, Yasuhiro Tsutani","doi":"10.1093/ejcts/ezaf239","DOIUrl":"10.1093/ejcts/ezaf239","url":null,"abstract":"<p><strong>Objectives: </strong>Adjuvant osimertinib is currently the standard of care after pulmonary resection in patients with non-small cell lung cancer (NSCLC) harbouring an activating epidermal growth factor receptor (EGFR) mutation. Several guidelines recommended up to 4 cycles of adjuvant platinum-doublet before adjuvant osimertinib treatment. However, whether adjuvant platinum-doublet prolongs the overall survival (OS) of patients with EGFR-mutated NSCLC as it did in the unselected LACE meta-analysis cohort is unclear.</p><p><strong>Methods: </strong>A multicentre retrospective observational study was conducted at 21 centres in Japan, enrolling 4181 patients with lung adenocarcinoma who received pulmonary resection between 2015 through 2018. In this study, we compared the efficacy of adjuvant platinum-doublet between EGFR mutated and EGFR wild-type cohort focusing on 706 patients with pathological stage II-III disease. Propensity score matching (1:1 ratio, caliper = 0.2) was used to balance patient characteristics (age, sex, smoking, preoperative performance status, pathological stage, and EGFR status) between patients who received adjuvant treatment and those who did not.</p><p><strong>Results: </strong>Among the 706 patients, 391 (55%) received adjuvant platinum-doublet. After 1:1 propensity score matching, patient characteristics were well balanced in the 2 groups (201 patients each). In subgroup analysis of overall and recurrence-free survival, the hazard ratios of adjuvant treatment were similar in the EGFR-mutated and EGFR wild-type groups (eg, OS, 0.56 [95% CI, 0.29-1.10] and 0.52 [95% CI, 0.33-0.82] in EGFR-mutated and EGFR wild-type subgroup, respectively).</p><p><strong>Conclusions: </strong>Adjuvant platinum-doublet chemotherapy showed similar trends of benefit in the EGFR-mutated and EGFR wild-type subgroups.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684029","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":"Online risk scores to predict operative mortality rate for acute type A aortic dissection surgery.","authors":"Dusko Nezic","doi":"10.1093/ejcts/ezaf188","DOIUrl":"10.1093/ejcts/ezaf188","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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532788","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 (≤2 cm) Lung Squamous Cell Carcinoma with Tumour Spread through Air Spaces: A Multi-Centre 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":"10.1093/ejcts/ezaf224","url":null,"abstract":"<p><strong>Objectives: </strong>The efficacy of sub-lobectomy for clinical IA (tumours ≤2 cm) lung squamous cell carcinoma with tumour spread through air spaces (STAS) 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 STAS-positive squamous cell carcinoma patients.</p><p><strong>Methods: </strong>Consecutive clinical IA STAS-positive squamous cell carcinoma patients undergoing surgery between 2010 and 2020 at 7 high-volume institutions across 5 Chinese cities were retrospectively reviewed. The primary end-point was overall survival, and the secondary end-point 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 < .001) and recurrence-free survival (hazard ratio [95% confidence interval] = 0.572 [0.449-0.733], P < .001), and reduced postoperative mortality (30.7% vs 40.3%, P = .010) and recurrence (39.3% vs 55.0%, P < .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 2 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 STAS-positive squamous cell carcinoma and thus might be preferred for clinical IA squamous cell carcinoma patients with highly suspected STAS. 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":"2025-07-01","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":"Avoiding damage to the atrioventricular conduction axis during surgical closure of ventricular septal defects.","authors":"Robert H Anderson, Damián Sánchez-Quintana, Andrew C Cook","doi":"10.1093/ejcts/ezaf154","DOIUrl":"10.1093/ejcts/ezaf154","url":null,"abstract":"<p><p>The commentary points to the multiple mistakes made in the article with which the commentary is associated.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532772","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":"An Analysis of Trainees' Operative Experiences Over the Past 16 Years Based on the Requirements of the New 2021 Cardiothoracic Surgery Curriculum in the United Kingdom and Ireland.","authors":"Jeremy Chan, Daniel P Fudulu, Tim Dong, Hunaid A Vohra, Gianni D Angelini","doi":"10.1093/ejcts/ezaf228","DOIUrl":"10.1093/ejcts/ezaf228","url":null,"abstract":"<p><strong>Objective: </strong>Before introducing the new 7-year curriculum in 2021, cardiothoracic surgery trainees were required to complete a 2-year basic surgical training programme followed by 6 years of higher speciality training. The new curriculum eliminates the need for basic surgical training. It is outcome-based, requiring a minimum of 250 major cases performed as the first operator. We assess trainees' operative experiences over the past 16 years based on the requirements of the new curriculum. The impact of the COVID-19 pandemic on training was also investigated.</p><p><strong>Participants: </strong>All trainees who commenced higher cardiothoracic surgical training from 2007 and graduated were included. Operative volumes were categorised into 13 major procedures (6 cardiac and 7 thoracic). The total number of major cases logged and the time required to achieve 250 cases were evaluated.</p><p><strong>Results: </strong>A total of 290 trainees were included, of whom 145 (50%) had completed training with validated eLogbooks. The median number of cases logged was 378 (interquartile range [IQR]: 309, 474) for all trainees across their training period. Cardiac-themed trainees logged 378 (IQR: 312.5, 474.5) cases, of which 202 (IQR: 166.5, 257.0) were coronary artery bypass grafting, followed by aortic valve surgery (n = 39, 14%, IQR: 15, 54.5). Thoracic-themed trainees logged 383.5 (IQR: 304.5, 469.75) cases, of which 345 (IQR: 270.25, 457.75) were anatomical lung resections followed by surgery for secondary pneumothorax (n = 124, 35%, IQR: 100.25, 165.0). The median time required to achieve 250 cases was 6.25 and 5.25 years for cardiac and thoracic trainees, respectively. There was an increase in time for trainees to complete higher surgical training before and during/after the COVID-19 pandemic (median 6 [IQR: 5, 8] vs 7 [IQR: 6, 10] years, P = 0.01).</p><p><strong>Conclusion: </strong>The new 2021 curriculum's target of 250 major cases appears feasible. However, post-COVID-19 reductions in surgical volume and the removal of basic surgical training require integration and reform to ensure trainees can complete the programme in the 7-year timeframe.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral malperfusion resolution after repair of acute DeBakey type I dissection with a novel hybrid prosthesis: early results of the PERSEVERE Study†.","authors":"William Brinkman, John J Squiers, Arminder Jassar, Shinichi Fukuhara, Fernando Fleischman, Hiroo Takayama, Ibrahim Sultan, George Arnaoutakis, Michael C Moon, Wilson Y Szeto","doi":"10.1093/ejcts/ezaf199","DOIUrl":"10.1093/ejcts/ezaf199","url":null,"abstract":"<p><strong>Objectives: </strong>Patients undergoing hemiarch repair for acute DeBakey type I dissection (ADTI) are high risk for postoperative stroke, especially if cerebral malperfusion is present preoperatively. We sought to evaluate whether the AMDS Hybrid Prosthesis (AMDS), a bare metal stent designed to promote positive aortic remodelling and prevent distal anastomotic new entry tears, may improve neurological outcomes of patients with ADTI presenting with cerebral malperfusion.</p><p><strong>Methods: </strong>PERSEVERE enrolled patients presenting with ADTI and malperfusion at 26 sites in North America. Among 93 enrolled patients, 30 (32.3%) presented with cerebral malperfusion. We evaluated for resolution of clinical and/or radiological cerebral malperfusion after hemiarch repair with AMDS.</p><p><strong>Results: </strong>Cerebral malperfusion was diagnosed clinically in 19 (63.3%) patients and radiographically in 23 (76.7%) patients. Among the patients with clinical cerebral malperfusion, 18 survived the perioperative period; of these, 11 (61%) experienced complete resolution of preoperative symptoms, 5 (28%) had no worsening of preoperative symptoms, and 2 (11%) had a new disabling stroke postoperatively. At follow-up, the mean true lumen to total arterial diameter ratio (measured by computed tomography angiography) improved from 30.9% to 64.4% (P = 0.002) in the innominate artery and 33.8% to 60.6% (P = 0.005) in the left common carotid artery from preoperative baseline in patients with radiographic cerebral malperfusion.</p><p><strong>Conclusions: </strong>Among patients presenting with ADTI and cerebral malperfusion, the majority had resolution or stability of neurological symptoms after hemiarch repair using the AMDS. Radiographic indicators of malperfusion also improved.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT05174767.</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of ultrasound-guided alveolar recruitment in thoracic surgery with one-lung ventilation: a randomized-controlled trial.","authors":"Bo Rim Kim, Leerang Lim, Jiwon You, Susie Yoon, Jung-Bin Park, Jae-Hyon Bahk, Jeong-Hwa Seo","doi":"10.1093/ejcts/ezaf204","DOIUrl":"10.1093/ejcts/ezaf204","url":null,"abstract":"<p><strong>Objectives: </strong>Although alveolar recruitment strategy (ARS) before one-lung ventilation (OLV) is beneficial in intraoperative oxygenation, the optimal protocol remains unestablished. As lung ultrasound (LUS) has been used recently, we designed a randomized controlled trial to compare preemptive LUS-guided ARS with conventional ARS in thoracic surgery.</p><p><strong>Methods: </strong>Patients aged 20-80 years scheduled to undergo lung resection surgery with OLV were randomized into 2 groups: (i) control group receiving conventional ARS and (ii) LUS group receiving LUS-guided ARS. ARS and modified LUS scoring were performed 5 min after intubation and before emergence. Arterial blood samples and respiratory parameters were collected every 30 min during OLV. The primary outcome was the incidence of intraoperative hypoxaemia (SpO2 < 95%).</p><p><strong>Results: </strong>In total, 166 patients were included. The incidence of intraoperative hypoxaemia was 1.2% in the LUS group and 14.3% in the control group [risk ratio (95% CI) 0.09 (0.01-0.64), P = 0.002]. However, the incidence of intraoperative severe hypoxaemia (SpO2 < 90%) was not significantly different [1.2% vs 6.0%, risk ratio (95% CI) 0.20 (00.02-1.72), P = 0.213]. In the LUS before emergence, higher atelectasis score (P = 0.005) and more significant atelectasis (P = 0.031) was observed in the control group. Postoperative adverse outcomes were comparable between both groups.</p><p><strong>Conclusions: </strong>LUS-guided ARS before OLV was more effective than conventional ARS in preventing intraoperative hypoxaemia during thoracic surgery.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov (NCT03770793, 10 December 2018).</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":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532777","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":"10.1093/ejcts/ezaf099","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the gnder-based difference in three-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 European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (2.4 ± 3.0 % vs 1.8 ± 1.9 %; P < 0.001), Society of Thoracic Surgeons (STS) score (1.8 ± 1.7 % vs 1.3 ± 2.0 %; P < 0.001) and were most often in New York 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 males. Post-SAVR clinical outcomes up to three 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 three years. In both genders, New York Heart Association status was restored within one year (P < 0.001) and maintained for up to three years (P < 0.001). At three years, QoL significantly improved.</p><p><strong>Conclusions: </strong>Despite females presenting with a significantly higher surgical risk profile, three-year outcomes following SAVR were comparable between genders with significant improvement in functional status. However, the degree of QoL improvement differed between genders.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov NCT04053088/-NCT03666741.</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":"2025-07-01","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}