Carlin Lee MD , Sara Sakowitz MS MPH , Avital Zucker MD , Kelly Fairbairn DO , Ali Mahtabifard MD , Peyman Benharash MD , Hari B. Keshava MD
{"title":"Relationship Between Case Volume and Outcomes for Pulmonary Resection for Lung Cancer at Safety-Net Hospitals","authors":"Carlin Lee MD , Sara Sakowitz MS MPH , Avital Zucker MD , Kelly Fairbairn DO , Ali Mahtabifard MD , Peyman Benharash MD , Hari B. Keshava MD","doi":"10.1016/j.atssr.2025.11.015","DOIUrl":"10.1016/j.atssr.2025.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Safety-net hospital (SNH) status is associated with high perioperative morbidity in pulmonary resection. Multiple etiologies have been proposed, including delays in diagnosis and inefficient care pathways. In integrated health systems, surgical volume has been shown to improve outcomes in pulmonary resection. However, whether surgical volume can overcome the inherent challenges of SNHs is unclear. We hypothesize that surgical volume is associated with improved outcomes at SNHs.</div></div><div><h3>Methods</h3><div>The 2016 to 2021 Nationwide Readmissions Database was queried for all adult (≥18 years) patients undergoing elective lobectomy for lung cancer. Centers in the top quartile of Medicaid or self-pay/uninsured admissions were defined as SNHs. SNHs were further stratified by lobectomy caseload as a low-volume hospital (<10 cases/y), medium-volume hospital (10-33 cases/y), or high-volume hospital (>33 cases/y). Multivariable regressions were built to consider the independent association of hospital volume on acute clinical and financial outcomes among patients treated at SNHs.</div></div><div><h3>Results</h3><div>Care at high-volume centers remained associated with significantly reduced likelihood of overall major morbidity (adjusted odds ratio [AOR], 0.81; 95% CI, 0.68-0.97), respiratory complications (AOR, 0.79; 95% CI, 0.65-0.96), need for blood transfusion (AOR, 0.67; 95% CI, 0.48-0.93), and nonhome discharge (AOR, 0.66; 95% CI, 0.48-0.88). Care at high-volume centers was also associated with a decrease in duration of hospitalization (β = −1.02 days; 95% CI, −1.48 to −0.54 days) and overall expenditures (β = −$4360; 95% CI, −$7020 to −$1700).</div></div><div><h3>Conclusions</h3><div>Surgical volume is associated with improved outcomes in pulmonary resection at SNHs. Patients who are eligible for care only at SNHs can still benefit from undergoing pulmonary resection at a high-volume center.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 391-395"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103836","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}
Kaity Han-Yung Tung MD , Chancy Fontenelle BA , Max Ilecki HS , Nathaniel Ivanick MD, FCCP , Andrew Bain MD , Kenneth Patrick Seastedt MD, FACS
{"title":"Use of Injectable Carboxymethylcellulose Gel in the Treatment of Acquired Bronchoesophageal Fistula Secondary to Lung Cancer","authors":"Kaity Han-Yung Tung MD , Chancy Fontenelle BA , Max Ilecki HS , Nathaniel Ivanick MD, FCCP , Andrew Bain MD , Kenneth Patrick Seastedt MD, FACS","doi":"10.1016/j.atssr.2025.11.013","DOIUrl":"10.1016/j.atssr.2025.11.013","url":null,"abstract":"<div><div>Bronchoesophageal fistula (BEF) is a rare but serious complication of malignant neoplasia of the lung. Whereas endoscopic stenting has emerged as a less invasive alternative, persistent or complicated fistulas may require adjunctive therapies. We present a case of successful closure of a 4-mm BEF secondary to stage IIIB left lung squamous cell carcinoma in a 64-year-old man, refractory to stenting and endoscopic suturing, achieved without surgery. This case highlights the potential role of carboxymethylcellulose gel as a minimally invasive adjunct to stents in management of small yet persistent BEFs.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 428-431"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103902","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}
Constantine M. Poulos MD , Ryan Cassidy MD , Lana Schumacher MD, FACS
{"title":"Use of Cardiopulmonary Bypass for Complex Robotic Left Upper Lobectomy After Prior Mantle Irradiation","authors":"Constantine M. Poulos MD , Ryan Cassidy MD , Lana Schumacher MD, FACS","doi":"10.1016/j.atssr.2025.10.008","DOIUrl":"10.1016/j.atssr.2025.10.008","url":null,"abstract":"<div><div>We discuss the case of a 58-year-old woman with a history of mantle irradiation who presented later in life with a 3.7-cm left upper lobe squamous cell carcinoma. Because of the complexity of the case, all the necessary preoperative precautions were taken in case cardiopulmonary bypass (CPB) became necessary. The patient underwent a completely robotic left upper lobectomy under peripheral CPB. Here we highlight the utility of CPB to enable minimally invasive robotic resections of large, high-risk tumors.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 412-414"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103904","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}
Shazil Mahmood MD , Mohamed AbdalAziz MD , Zin Tarakji MD , Parvathy Sankar DO , Richard Bloomingdale MD , George Comas MD , Rakesh M. Suri MD, DPhil
{"title":"Port-Access Robotic Repair of Barlow Mitral Annular Disjunction and Severe Mitral Valve Regurgitation","authors":"Shazil Mahmood MD , Mohamed AbdalAziz MD , Zin Tarakji MD , Parvathy Sankar DO , Richard Bloomingdale MD , George Comas MD , Rakesh M. Suri MD, DPhil","doi":"10.1016/j.atssr.2025.11.024","DOIUrl":"10.1016/j.atssr.2025.11.024","url":null,"abstract":"<div><div>Mitral annular disjunction (MAD) is associated with malignant ventricular arrhythmias and progressive mitral regurgitation. We describe a 35-year-old man with a history of sudden cardiac death who presented with palpitations and recurrent ventricular arrhythmias. Remote transthoracic echocardiography showed no structural abnormality, with repeated transthoracic echocardiography demonstrating only mild mitral regurgitation. During this admission, transesophageal echocardiography revealed severe mitral regurgitation from Barlow disease with profound MAD. Port-access robotic mitral valve repair eliminated mitral regurgitation and corrected MAD. This case underscores that ventricular arrhythmias may precede valve disease, warranting high suspicion for MAD in young patients with arrhythmias and mild mitral regurgitation.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 651-653"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103998","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}
Geraud Galvaing MD, MSc , Mehdi Farhat MD , Jean-Baptiste Chadeyras MD , Nicolas d’Ostrevy MD, PhD , Marc Filaire MD
{"title":"Right Pulmonary Artery Bypass After Prior Left Pneumonectomy for Pulmonary Artery Sarcoma","authors":"Geraud Galvaing MD, MSc , Mehdi Farhat MD , Jean-Baptiste Chadeyras MD , Nicolas d’Ostrevy MD, PhD , Marc Filaire MD","doi":"10.1016/j.atssr.2025.11.023","DOIUrl":"10.1016/j.atssr.2025.11.023","url":null,"abstract":"<div><div>Primary pulmonary artery sarcoma is a rare and aggressive malignant neoplasm with poor prognosis and frequent local recurrence. Complete resection remains the treatment of choice, but repeated surgery is rarely described, especially after a pneumonectomy. Repeated radical resection of recurrent pulmonary artery sarcoma with prosthetic reconstruction is feasible and can be performed without additional lung loss. Three-dimensional modeling is a valuable adjunct for preoperative planning in complex pulmonary vascular surgery and may help preserve pulmonary function in selected patients.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 453-455"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103912","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}
Majed Tolah MD, MSc , Dragan Opacic MD, PhD , Mohammad Sharaf MD , Joanna Gilis-Januszewski MD , André Renner MD , Jan Gummert MD, PhD , Tomasz Gilis-Januszewski MD
{"title":"A Novel Technique for Simultaneous Double Annular Enlargement Using a Single Dacron Graft","authors":"Majed Tolah MD, MSc , Dragan Opacic MD, PhD , Mohammad Sharaf MD , Joanna Gilis-Januszewski MD , André Renner MD , Jan Gummert MD, PhD , Tomasz Gilis-Januszewski MD","doi":"10.1016/j.atssr.2025.12.001","DOIUrl":"10.1016/j.atssr.2025.12.001","url":null,"abstract":"<div><h3>Purpose</h3><div>We describe a novel surgical technique for simultaneous enlargement of both the aortic and mitral annuli using a single Dacron (DuPont) graft.</div></div><div><h3>Description</h3><div>The mitral prosthesis is first sutured within the graft, followed by trimming and fixation of the aortic prosthesis at a predetermined offset. The completed conduit is then implanted en bloc, allowing controlled, symmetric annular enlargement with precise geometric alignment.</div></div><div><h3>Evaluation</h3><div>The technique was applied in a redo case after prior aortic valve replacement with a Freestyle (Medtronic) prosthesis in a patient presenting with prosthetic stenosis and mitral valve endocarditis. The procedure simplified complex reconstruction, reduced operative steps, avoided multiple patches, and preserved the geometry of the annuli and left ventricular outflow tract. The patient recovered uneventfully with excellent postoperative hemodynamics.</div></div><div><h3>Conclusions</h3><div>This streamlined approach offers a practical and reproducible alternative for complex double-valve replacement with concomitant aortic root replacement involving the fibrous skeleton, particularly in patients with small annuli, heavy calcification, porcelain aorta, or prior surgery.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 625-629"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103982","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}
Haris Patail MD , Yasser Radwan MBBCh , Hasan Ahmad MD , Junichi Shimamura MD, PhD , Suguru Ohira MD , Syed Abbas Haidry MD , Joshua Goldberg MD , Daniel M. Spevack MD
{"title":"Recurrent Infective Endocarditis With Recurrent Intravenous Drug Use: Illustrating the High Complexity of Surgical Decision-Making","authors":"Haris Patail MD , Yasser Radwan MBBCh , Hasan Ahmad MD , Junichi Shimamura MD, PhD , Suguru Ohira MD , Syed Abbas Haidry MD , Joshua Goldberg MD , Daniel M. Spevack MD","doi":"10.1016/j.atssr.2025.11.032","DOIUrl":"10.1016/j.atssr.2025.11.032","url":null,"abstract":"<div><div>Management of infective endocarditis in patients who inject drugs is often a significant challenge. The decision to proceed with surgical management frequently occurs in patients experiencing a complex web of psychosocial, socioeconomic, medical, and legal issues that can be difficult for clinicians to address. The recent addition of percutaneous mechanical aspiration as a potential adjunctive tool adds further still to the complexity of picking a rational therapeutic strategy. We report a case of recurrent infective endocarditis in a patient who injects drugs that illustrates the many difficult dilemmas commonly presented in this population.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 630-634"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103983","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}
Eric Francis Macharia-Nimietz MD , Jan-Christoph Zeisel Dr med univ , Martin Thanh-Long Takes MD , Didier Lardinois MD
{"title":"Surgery After Microcoil Embolization in a Patient With Large Bilateral Intrathoracic Extramedullary Hematopoiesis and Thalassemia","authors":"Eric Francis Macharia-Nimietz MD , Jan-Christoph Zeisel Dr med univ , Martin Thanh-Long Takes MD , Didier Lardinois MD","doi":"10.1016/j.atssr.2025.11.031","DOIUrl":"10.1016/j.atssr.2025.11.031","url":null,"abstract":"<div><div>We report the case of a 54-year-old woman with thalassemia intermedia and large bilateral intrathoracic extramedullary hematopoiesis since childhood. The patient presented with severe dyspnea and a suspected left-sided hemothorax on a computed tomography scan accompanied by almost complete atelectasis of the left lower lobe 3 weeks after blunt trauma. Microcoil embolization of the affected intercostal arteries was performed before a challenging but successful surgical resection.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 499-501"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148103951","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":"Formula-Based Relocation of the Papillary Muscle in Patients With Ischemic Mitral Regurgitation","authors":"Takashi Kunihara MD, PhD , Tadashi Isomura MD, PhD , Hiroshi Tsuneyoshi MD, PhD , Tatsuhiko Komiya MD, PhD , Kenta Zaikokuji MD , Naoto Inoue MD , Fumihiro Sata MD, PhD","doi":"10.1016/j.atssr.2025.11.016","DOIUrl":"10.1016/j.atssr.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>We developed a formula to estimate the optimal distance between the posterior papillary muscle (PPM) and the midseptal fibrous annulus (D<sub>P-A</sub>) to facilitate PPM relocation in patients with ischemic mitral regurgitation (IMR) undergoing mitral valve repair.</div></div><div><h3>Methods</h3><div>D<sub>P-A</sub> was measured in 109 patients without valvular disease undergoing electrocardiogram-gated 3-dimensional computed tomography, and a predictive formula that best approximated this value was developed. This formula was evaluated in 10 patients (59.2 [SD, 10.7] years, 7 men) with moderate-severe IMR undergoing mitral valve repair using PPM relocation by 3 surgeons in 6 institutions from 2014 to 2023. Two arms of CV-3 suture fixed at the PPM were passed through the midseptal fibrous annulus to the annuloplasty ring and tied at the length estimated using the formula (35 [SD, 4] mm).</div></div><div><h3>Results</h3><div>Postoperative echocardiography demonstrated neither residual regurgitation nor leaflet tenting. Three patients died and 1 underwent mitral valve replacement during follow-up (71 [SD, 35] months), but IMR was well controlled, and left ventricular reverse remodeling and improved left ventricular function was observed in the other 6.</div></div><div><h3>Conclusions</h3><div>This formula facilitates mitral valve repair using PPM relocation in patients with IMR.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 590-595"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148104011","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}
Marianna V. Papageorge MD, MPH , Busra Cangut MD, MS , Tanisha Rajah BA , Sara Sakowitz MPH , Rebekah Boyd MD , Nicole Lin MD , Madigan Stanley MD , Shanda Blackmon MD, MPH , Daniela Molena MD , Ammara A. Watkins MD , Stephanie G. Worrell MD , Mara B. Antonoff MD
{"title":"“My Better Half”: Partner Experiences of Women Cardiothoracic Surgeons","authors":"Marianna V. Papageorge MD, MPH , Busra Cangut MD, MS , Tanisha Rajah BA , Sara Sakowitz MPH , Rebekah Boyd MD , Nicole Lin MD , Madigan Stanley MD , Shanda Blackmon MD, MPH , Daniela Molena MD , Ammara A. Watkins MD , Stephanie G. Worrell MD , Mara B. Antonoff MD","doi":"10.1016/j.atssr.2025.09.032","DOIUrl":"10.1016/j.atssr.2025.09.032","url":null,"abstract":"<div><h3>Background</h3><div>The demands of cardiothoracic surgery often affect personal relationships, with those of partners vulnerable to numerous challenges. We aimed to characterize the personal relationship experiences of women cardiothoracic surgeons.</div></div><div><h3>Methods</h3><div>We designed a survey gathering information on relationship dynamics from partners of women cardiothoracic surgeons. The survey was loaded into an internet-based platform, and links were disseminated to members of the Women in Thoracic Surgery, who subsequently distributed the survey to their partners and spouses. Questions explored avenues through which the women’s surgical careers had affected their partners and relationships.</div></div><div><h3>Results</h3><div>The survey was completed by 32 individuals, and relationship roles included 28 (87.5%) spouses and 4 (12.5%) nonmarital partners. Among respondents, 64.3% (17 of 27) reported that the cardiothoracic surgeon’s dedication to her job inspired the partner to be more understanding, whereas 55.6% (15 of 27) noted challenges in maintaining healthy work-life balance. Irregular and demanding work hours resulted in missed important events (44.4%; 12 of 27), reduced quality time together (55.6%; 15 of 27), and increased relationship tension (48.1%; 13 of 27). Notably, 66.7% (18 of 27) reported that their partners’ surgical careers did not affect their decision to have children. When comparing experiences across relationship durations, there were no meaningful differences in the distribution of the responses.</div></div><div><h3>Conclusions</h3><div>Our findings highlight challenges encountered by partners of women cardiothoracic surgeons across all stages of their careers and relationships. Elucidating these dynamics enables us to better support those interested in the field and within our community.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 2","pages":"Pages 721-726"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148104065","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}