Annals of thoracic surgery short reports最新文献

{"title":"Surgical Approaches to Left Ventricular Assist Device Deactivation: Lessons From Remission From Stage D Heart Failure","authors":"Ian Nickel MD,&nbsp;Emma Birks MD, PhD,&nbsp;Hui Li MD, MSTAT,&nbsp;Mark S. Slaughter MD,&nbsp;Eduardo Rame MD,&nbsp;Brian Lowes MD, PhD,&nbsp;Snehal Patel MD,&nbsp;Daniel Goldstein MD,&nbsp;Simon Maybaum MD,&nbsp;John Um MD,&nbsp;Christopher Cunningham PhD,&nbsp;Jaimin Trivedi MD,&nbsp;Pavan Atluri MD,&nbsp;Randall Starling MD, MPH,&nbsp;Josef Stehlik MD, MPH,&nbsp;Stavros Drakos MD, PhD,&nbsp;Craig H. Selzman MD","doi":"10.1016/j.atssr.2026.02.001","DOIUrl":"10.1016/j.atssr.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Remission From Stage D Heart Failure (RESTAGE-HF) was a multicenter study demonstrating that a selected patient population with left ventricular assist devices (LVADs) could achieve functional recovery and subsequent durable pump explantation. The purpose of our study was to describe the impact of surgical approach to deactivation in this study cohort.</div></div><div><h3>Methods</h3><div>The study prospectively enrolled 40 patients with HeartMate II LVAD. Overall, 19 (52.8%) of 36 evaluable patients reached the predefined criteria and underwent LVAD deactivation. Three approaches were used: complete explantation (n = 8), partial explantation (n = 10), and percutaneous decommissioning (n = 1). The primary outcome was survival free from transplantation or LVAD reimplantation.</div></div><div><h3>Results</h3><div>Patients with partial explantation had a longer duration of heart failure and a larger posterior wall thickness before ventricular assist device implantation. There were no differences in other preimplantation parameters. Median follow-up was 7.9 years. Median time to deactivation was similar between approaches. Post-LVAD survival free from LVAD reimplantation or transplantation was 90% at 1 year and remained stable after 4 years at 74% for the entire cohort. No significant intergroup differences in 7-year survival were observed (87.5% vs 40%; <em>P</em> = .06).</div></div><div><h3>Conclusions</h3><div>This analysis represents the longest follow-up of post-LVAD patients stratified by surgical approach and suggests that select patients can achieve sustained myocardial recovery after LVAD deactivation.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1023-1026"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871041","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":"The Contemporary Utility of the Eloesser Flap for Management of Complex Pleural Space Infections","authors":"Ioana B. Florea MD, MPHS,&nbsp;Johanna Lou MD,&nbsp;Keshav Kooragayala MD,&nbsp;Erin Crable BFA,&nbsp;Christopher Derivaux MD,&nbsp;John Aversa MD,&nbsp;Kenji Minakata MD,&nbsp;David D. Shersher MD","doi":"10.1016/j.atssr.2026.03.015","DOIUrl":"10.1016/j.atssr.2026.03.015","url":null,"abstract":"<div><div>A 27-year-old man with hyperimmunoglobulin E syndrome and remote left upper lobectomy for refractory hemoptysis presented with recurrent hemoptysis and a defunctionalized left lung. He underwent a reoperative thoracotomy and completion pneumonectomy complicated by a bronchopleural fistula. A 45-year-old man with a prior left upper lobectomy for adenocarcinoma presented with progressive cavitary <em>Mycobacterium avium</em> refractory to third-line antibiotics. These cases of chronic pleural space pathology in the immunosuppressed, reoperative setting were successfully addressed through a staged operative intervention with Eloesser thoracoplasty, demonstrating its ongoing utility in the armamentarium of the modern thoracic surgeon.</div></div><div>A 27-year-old man with hyperimmunoglobulin E syndrome and remote left upper lobectomy for refractory hemoptysis presented with recurrent hemoptysis and a defunctionalized left lung. He underwent a reoperative thoracotomy and completion pneumonectomy complicated by a bronchopleural fistula. A 45-year-old man with a prior left upper lobectomy for adenocarcinoma presented with progressive cavitary <em>Mycobacterium avium</em> refractory to third-line antibiotics. These cases of chronic pleural space pathology in the immunosuppressed, reoperative setting were successfully addressed through a staged operative intervention with Eloesser thoracoplasty, demonstrating its ongoing utility in the armamentarium of the modern thoracic surgeon.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 961-965"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870990","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":"Negative Pressure Wound Therapy for Residual Cavity Reduction After Open-Window Thoracostomy Following Pneumonectomy","authors":"Machiko Nishii MD,&nbsp;Satoru Okada MD, PhD,&nbsp;Takumi Nakagawa MD,&nbsp;Shunta Ishihara MD, PhD,&nbsp;Ryosuke Tokuda MD,&nbsp;Taiyo Kawamura MD,&nbsp;Masanori Shimomura MD, PhD,&nbsp;Tatsuo Furuya MD, PhD,&nbsp;Ayako Kawarazaki MD, PhD,&nbsp;Masayoshi Inoue MD, PhD","doi":"10.1016/j.atssr.2026.02.010","DOIUrl":"10.1016/j.atssr.2026.02.010","url":null,"abstract":"<div><div>Postpneumonectomy empyema with a bronchopleural fistula (BPF) usually requires open-window thoracostomy, which can leave a large difficult-to-close residual cavity when muscle or omental flaps are unavailable. An 81-year-old man who developed empyema with a BPF after completion left pneumonectomy underwent open-window thoracostomy. The BPF closed with granulation, and the large pleural cavity remained. Negative-pressure wound therapy (−50 to −75 mm Hg) achieved &gt;50% cavity reduction within 10 days, enabling definitive thoracoplasty. Negative-pressure wound therapy appears a safe and effective option for reducing postpneumonectomy cavities and facilitating chest closure when conventional filling procedures are not feasible.</div></div><div>Postpneumonectomy empyema with a bronchopleural fistula (BPF) usually requires open-window thoracostomy, which can leave a large difficult-to-close residual cavity when muscle or omental flaps are unavailable. An 81-year-old man who developed empyema with a BPF after completion left pneumonectomy underwent open-window thoracostomy. The BPF closed with granulation, and the large pleural cavity remained. Negative-pressure wound therapy (−50 to −75 mm Hg) achieved &gt;50% cavity reduction within 10 days, enabling definitive thoracoplasty. Negative-pressure wound therapy appears a safe and effective option for reducing postpneumonectomy cavities and facilitating chest closure when conventional filling procedures are not feasible.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 952-956"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870996","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":"Symmetrical Bicuspidization Minimizing Use of Pericardium for Unicuspid Aortic Valve With Aortic Regurgitation","authors":"Yutaka Okita MD,&nbsp;Ryo Kawabata MD","doi":"10.1016/j.atssr.2026.04.027","DOIUrl":"10.1016/j.atssr.2026.04.027","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Page 856"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870888","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":"Beating the Odds: Finding Fulfillment and Success as an International Medical Graduate in Cardiothoracic Surgery","authors":"Andrew R. Brownlee MD","doi":"10.1016/j.atssr.2026.05.001","DOIUrl":"10.1016/j.atssr.2026.05.001","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Page 1092"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148871035","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":"Successful Repair of a Blunt Injury to the Donor's Pulmonary Artery and Subsequent Use of the Lungs","authors":"Eugene Golts MD, MBA,&nbsp;Samvel Gaboyan MS,&nbsp;Alejandro Bribriesco MD,&nbsp;Travis Pollema DO,&nbsp;Ian Glenn MD,&nbsp;Rebecca Golts,&nbsp;Aideen Afshar,&nbsp;Aiden Walters,&nbsp;Kamyar Afshar DO","doi":"10.1016/j.atssr.2026.02.014","DOIUrl":"10.1016/j.atssr.2026.02.014","url":null,"abstract":"<div><div>A significant proportion of lungs accepted for lung transplantation are not transplanted due to chest trauma. We present a successful repair of a blunt injury to the pulmonary artery of the donor during lung transplantation. Lungs with this type of injury can be transplanted safely after repair, potentially expanding the donor pool without compromising the postoperative course.</div></div><div>A significant proportion of lungs accepted for lung transplantation are not transplanted due to chest trauma. We present a successful repair of a blunt injury to the pulmonary artery of the donor during lung transplantation. Lungs with this type of injury can be transplanted safely after repair, potentially expanding the donor pool without compromising the postoperative course.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1039-1041"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870542","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":"A Predictive Tool Using The Society of Thoracic Surgeons Risk Calculator for Safe Operating Room Extubation After Coronary Bypass Surgery","authors":"John G. Byrne MD,&nbsp;Farhaan Chaugle BS,&nbsp;Thomas W. Kessinger MD,&nbsp;Curtis S. Dickey DO,&nbsp;Ali Asghar MD,&nbsp;Prince Thommen MD,&nbsp;Shahistha Hyder MD,&nbsp;Hannaan Chaugle MD","doi":"10.1016/j.atssr.2026.02.036","DOIUrl":"10.1016/j.atssr.2026.02.036","url":null,"abstract":"<div><h3>Background</h3><div>Operating room extubation (ORE) after coronary artery bypass grafting (CABG) has proven benefit. However, predicting which patients should undergo ORE is difficult. We hypothesized that The Society of Thoracic Surgeons (STS) risk scores could be used as a predictive tool for ORE.</div></div><div><h3>Methods</h3><div>Between January 1, 2023 and November 30, 2025, the STS risk scores of 687 consecutive patients who underwent on-pump CABG were calculated. Risk scores for death (in-hospital or 30-day mortality), stroke (cerebrovascular accident), acute kidney injury (AKI), reoperation, prolonged ventilation, deep sternal wound infection, prolonged length of stay, and blood transfusions were used to generate the predictive model for ORE. Multivariate logistic regression analysis was used to determine which STS scores were independent predictors of ORE. A composite score, along with a receiver operating characteristic curve with area under the curve, were also generated.</div></div><div><h3>Results</h3><div>Among the 687 patients, 289 (42%) underwent ORE, and 1 of 289 (0.3%) required reintubation. Multivariate analysis determined that the risk of prolonged ventilation &lt;3% (odds ratio [OR], 1.62; <em>P</em> = .03; 95% CI, 1.06-2.46), the risk of in-hospital or 30-day mortality &lt;0.5% (OR, 2.58; <em>P</em> &lt; .01; 95% CI, 1.39-4.80), and the risk of AKI &lt;2% (OR, 1.67; <em>P</em> = .05; 95% CI, 0.99--2.84) were all independently associated with successful ORE. The receiver operating characteristic and area under the curve documented that the model’s performance was accurate 65% of the time. A composite score &lt;7% favored ORE, whereas a composite score &gt;25% favored FTE.</div></div><div><h3>Conclusions</h3><div>ORE is safe in selected patients undergoing CABG, particularly if ORE is practiced with high frequency and in patients with an STS calculator risk of prolonged ventilation &lt;3%, in-hospital or 30-day mortality &lt;0.5%, and AKI &lt;2%.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 1042-1046"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870689","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":"Selective Sinus Replacement for a Patient With an Unruptured Sinus of Valsalva Aneurysm","authors":"Takuya Matsushiro MD,&nbsp;Ryotaro Kitadai MD,&nbsp;Naoki Edo MD,&nbsp;Ren Saito MD,&nbsp;Shinichi Imai MD, PhD,&nbsp;Yujiro Miura MD","doi":"10.1016/j.atssr.2025.12.020","DOIUrl":"10.1016/j.atssr.2025.12.020","url":null,"abstract":"<div><div>This report describes the case of an 82-year-old man incidentally diagnosed with an unruptured saccular aneurysm of the left coronary sinus, a condition that occurs infrequently. Computed tomography and echocardiography revealed a 10-mm aneurysm. The aneurysm and the surrounding left sinus wall were resected and reconstructed using a polyester graft with a selective sinus replacement technique. This case supports the feasibility and safety of elective surgical treatment for an unruptured sinus of Valsalva aneurysm in high-risk anatomical locations, particularly using a selective sinus replacement approach to preserve valve function and coronary flow while minimizing the risk of recurrence.</div></div><div>This report describes the case of an 82-year-old man incidentally diagnosed with an unruptured saccular aneurysm of the left coronary sinus, a condition that occurs infrequently. Computed tomography and echocardiography revealed a 10-mm aneurysm. The aneurysm and the surrounding left sinus wall were resected and reconstructed using a polyester graft with a selective sinus replacement technique. This case supports the feasibility and safety of elective surgical treatment for an unruptured sinus of Valsalva aneurysm in high-risk anatomical locations, particularly using a selective sinus replacement approach to preserve valve function and coronary flow while minimizing the risk of recurrence.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 766-769"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870832","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":"Subcoronary Implantation of Decellularized Aortic Allografts—An Ex Vivo and In Vivo Feasibility Study","authors":"Murat Avsar MD, PhD,&nbsp;Tomislav Cvitkovic MD,&nbsp;Alexander Weymann MD, PhD,&nbsp;Klaus Hoeffler,&nbsp;Dmitry Bobylev MD, PhD,&nbsp;Dietmar Boethig MD, PhD,&nbsp;Arjang Ruhparwar MD, PhD,&nbsp;Samir Sarikouch MD, PhD,&nbsp;Alexander Horke MD, PhD","doi":"10.1016/j.atssr.2026.01.006","DOIUrl":"10.1016/j.atssr.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Decellularized aortic homografts were introduced in 2008 as a further option for pediatric aortic valve replacement. Subcoronary decellularized aortic homograft implantation may eliminate the need for aortic root replacement and coronary artery reimplantation in patients with sufficient left ventricular outflow tract dimensions.</div></div><div><h3>Methods</h3><div>Ovine aortic xenografts were harvested from the slaughterhouse and decellularized using an approved detergent-based decellularization protocol. Two cardiac surgeons performed subcoronary implantation in explanted ovine hearts, and results were compared regarding procedure time and procedural success. After these ex vivo experiments, 4 adult black-headed sheep were operated on in acute experiments.</div></div><div><h3>Results</h3><div>The 2 surgeons were able to perform the ex vivo subcoronary implantation of the decellularized ovine aortic allografts (DOAA) without technical problems within 1 hour. Mechanical strength of the processed ovine DOAA appeared comparable to that of native aortic tissue. Both surgeons stated that there were no differences with respect to appearance, haptics, trimability, and sewability. The initial 2 sheep operated on showed significant valvular incompetence. After modification of the surgical protocol to a single-line suture technique, the next 2 sheep showed fully competent aortic valves with laminar flow across the subcoronary implanted DOAA.</div></div><div><h3>Conclusions</h3><div>We have developed a technique for subcoronary implantation of decellularized aortic homografts including acute large animal experiments. Long-term animal experiments will provide further insight into durability and recellularization.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 824-829"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870942","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":"Patient-Prosthesis Mismatch After Mitral Valve Replacement Using Bileaflet Preservation Technique for Mitral Regurgitation","authors":"Abel Cherian BS,&nbsp;Chidiebere Peter Echieh FRCS,&nbsp;Rintaro Kinjo MD,&nbsp;Ayah Ibrahim BS,&nbsp;Alexander Ryan BS,&nbsp;Tawanda Zvavamwe BS,&nbsp;Yash Rohilla,&nbsp;Mohammed Hamidi MD,&nbsp;Dina Al Rameni MD,&nbsp;Toshinobu Kazui MD, PhD","doi":"10.1016/j.atssr.2026.02.006","DOIUrl":"10.1016/j.atssr.2026.02.006","url":null,"abstract":"<div><div>Patient-prosthesis mismatch (PPM) in the mitral valve position is underreported but may occur when both anterior and posterior leaflets are preserved during mitral valve replacement (MVR), a technique that can reduce the area to place an appropriate-size valve. Therefore, balancing the risks and benefits of leaflet preservation is critical, given that certain degrees of left ventricular dysfunction or valvular disease causes may favor bileaflet or partial-leaflet preservation while minimizing the risk for PPM. We report a case of PPM 1 year after MVR with bileaflet preservation in a patient with normal left ventricular size and function who required redo MVR with a larger valve for symptom resolution.</div></div><div>Patient-prosthesis mismatch (PPM) in the mitral valve position is underreported but may occur when both anterior and posterior leaflets are preserved during mitral valve replacement (MVR), a technique that can reduce the area to place an appropriate-size valve. Therefore, balancing the risks and benefits of leaflet preservation is critical, given that certain degrees of left ventricular dysfunction or valvular disease causes may favor bileaflet or partial-leaflet preservation while minimizing the risk for PPM. We report a case of PPM 1 year after MVR with bileaflet preservation in a patient with normal left ventricular size and function who required redo MVR with a larger valve for symptom resolution.</div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"4 3","pages":"Pages 837-840"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870882","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}