JTCVS open最新文献

{"title":"A foregone conclusion? The association between early hospital course and late outcomes in modern era heart transplant","authors":"Chen Chia Wang BSc ,&nbsp;Mark Petrovic MS ,&nbsp;Awab Ahmad MD ,&nbsp;Brian Lima MD ,&nbsp;Yuliya Tipograf MD ,&nbsp;John Trahanas MD ,&nbsp;Swaroop Bommareddi MD ,&nbsp;Duc Nguyen MD ,&nbsp;Hasan Siddiqi MD ,&nbsp;Christina Jelly MD ,&nbsp;Aditi Balakrishna MD ,&nbsp;Kelly H. Schlendorf MD ,&nbsp;Ashish S. Shah MD","doi":"10.1016/j.xjon.2025.03.009","DOIUrl":"10.1016/j.xjon.2025.03.009","url":null,"abstract":"<div><h3>Objectives</h3><div>The revised US donor heart allocation policy allows for transplantation in more critically ill patients with heart failure. This study examines the association between index hospitalization and 1-year functional outcomes in the modern era.</div></div><div><h3>Methods</h3><div>All adult, single-organ heart transplant recipients at a single institution from October 2018 to January 2023 were retrospectively reviewed. Multistate Cox regression identified predictors of death in hospital or prolonged length of stay. Length of stay was then associated with 1-year Karnofsky Performance score, chronic dialysis, readmission, and mortality.</div></div><div><h3>Results</h3><div>A total of 441 patients were stratified into a death in hospital group (n = 28) and short (≤30 days, n = 341), medium (30-60 days, n = 59), and long (≥60 days, n = 16) length of stay groups. Short index length of stay is associated with higher 1-year performance status scores and lower rates of chronic dialysis and readmissions compared with medium and long length of stay groups, as well as superior 1-year survival compared with the long length of stay group. Congenital and graft failure etiology, pretransplant left ventricular assist device, post-transplant extracorporeal membrane oxygenation, and post-transplant dialysis were independent predictors of death in hospital. Pretransplant left ventricular assist device, hypertension, poor baseline renal function, post-transplant extracorporeal membrane oxygenation, and post-transplant dialysis were risk factors for prolonged hospitalization.</div></div><div><h3>Conclusions</h3><div>Both preoperative recipient characteristics and early outcomes are predictive of in-hospital mortality or prolonged length of stay after heart transplant. Longer length of stay is associated with inferior 1-year functional outcomes and mortality. This study suggests the need for interventions targeted toward high-risk patients to improve early and late outcomes.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 227-240"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321656","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":"Physician specialty shapes hypothetical self-treatment choices for locally advanced non−small cell lung cancer: Is the “best” option subjective?","authors":"Mara B. Antonoff MD ,&nbsp;Corinne Faivre-Finn MD ,&nbsp;Patrick M. Forde MBBCh ,&nbsp;Sanjay Popat MBBS, PhD ,&nbsp;Brendon M. Stiles MD ,&nbsp;Alessandro Brunelli MD ,&nbsp;collaborators","doi":"10.1016/j.xjon.2025.03.026","DOIUrl":"10.1016/j.xjon.2025.03.026","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 424-434"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320932","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":"Celebrating the unseen benefits of surgical careers for mothers in cardiothoracic surgery","authors":"Busra Cangut MD, MS ,&nbsp;Sara Sakowitz MPH, MS ,&nbsp;Tanisha Rajah BSc ,&nbsp;Marianna Papageorge MD, MPH ,&nbsp;Rebekah Boyd MD ,&nbsp;Nicole Lin MD, MPH ,&nbsp;Madigan Stanley MD ,&nbsp;Shanda Blackmon MD, MPH ,&nbsp;Daniela Molena MD ,&nbsp;Ammara Watkins MD ,&nbsp;Stephanie G. Worrell MD ,&nbsp;Mara B. Antonoff MD","doi":"10.1016/j.xjon.2025.02.009","DOIUrl":"10.1016/j.xjon.2025.02.009","url":null,"abstract":"<div><h3>Background</h3><div>While careers in cardiothoracic (CT) surgery can enrich home life, emphasis is often placed on potential negative impacts on surgeons’ families, particularly when surgeons are mothers. We aimed to elucidate the beneficial impacts on family dynamics for female cardiothoracic surgeons.</div></div><div><h3>Methods</h3><div>A survey was designed and disseminated electronically to partners/spouses, coparents, and adult children of female cardiothoracic surgeons. Participants answered questions regarding the impacts of their career on their lives and relationships. Results were analyzed descriptively.</div></div><div><h3>Results</h3><div>A total of 71 participants completed the survey, comprising 43 spouse (60.6%), 12 partners (16.9%), 4 other co-parents (5.6%), and 12 adult children (16.9%). All 35 coparents (100%) felt that CT surgeon-mothers’ careers contributed to their children's development of essential life skills. Reported benefits included instilling discipline, time management, problem-solving abilities, independence, and grit and inspiring the children to consider their own careers in medicine. Partners/spouses noted other positive impacts on their family: 81% (26 of 32) felt pride, 89% (25 of 28) affirmed positive impacts on lifestyle related to income, and 92% (25 of 27) appreciated access to medical guidance. Adult children highlighted strong financial foundations and opportunities for personal growth. Notably, 88.8% of adult children (8 of 9) described relationships with their CT surgeon-mothers as supportive.</div></div><div><h3>Conclusions</h3><div>We identified underreported benefits to families of female CT surgeons, dispelling negative stereotypes associated with this specialty. These findings emphasize to future trainees that not only are they wanted and needed in this field, but also that their families and relationships stand to flourish from the numerous benefits afforded by this incredibly rewarding career.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 516-524"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321423","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":"Acute loss of mitral annular dynamics predicts development of functional mitral regurgitation after myocardial infarction in a swine model","authors":"Yuta Kikuchi MD, PhD ,&nbsp;Daisuke Onohara MD, PhD ,&nbsp;Michael Silverman MD ,&nbsp;Chase L. King MD ,&nbsp;Stephanie K. Tom MD ,&nbsp;Brooks A. Lane PhD ,&nbsp;Amanda Maddamma RVT ,&nbsp;Robert Guyton MD ,&nbsp;Muralidhar Padala PhD","doi":"10.1016/j.xjon.2025.01.016","DOIUrl":"10.1016/j.xjon.2025.01.016","url":null,"abstract":"<div><h3>Objective</h3><div>Functional mitral regurgitation is identified in approximately 40% of patients after myocardial infarction, adversely affecting their prognosis. Predicting functional mitral regurgitation development after the onset of myocardial infarction remains challenging, yet early intervention could potentially enhance patient outcomes. In this study, we developed porcine models with consistent lateral wall infarction to investigate the morphological and functional differences between animals with functional mitral regurgitation and those without.</div></div><div><h3>Methods</h3><div>Twenty-two Yorkshire pigs underwent myocardial infarction induction through occlusion of the left circumflex coronary artery. Epicardial echocardiography and pressure-volume loop analysis were performed before and after myocardial infarction induction. Three months after myocardial infarction, mitral regurgitation quantification was conducted with epicardial echocardiography via mini left thoracotomy, and the animals were classified into 2 groups based on mitral regurgitation severity: no/mild mitral regurgitation (lower mitral regurgitation, n = 11) and moderate/severe mitral regurgitation (greater mitral regurgitation, n = 11). The left ventricle and mitral valve geometry and function immediately after myocardial infarction were compared between the 2 groups.</div></div><div><h3>Results</h3><div>The infarction area was comparable between the groups, with no significant differences observed in invasive hemodynamic parameters after myocardial infarction. However, the change in the mitral annular anteroposterior diameter (diastolic anteroposterior minus systolic anteroposterior) immediately after myocardial infarction was significantly lower in the greater mitral regurgitation group (2.02 ± 1.19 vs 4.34 ± 0.93, <em>P</em> &lt; .01), and it was strongly correlated with effective regurgitant orifice area (r = −0.7873, <em>P</em> &lt; .01), regurgitant volume (r = −0.7585, <em>P</em> &lt; .01), and regurgitant fraction (r = −0.7290, <em>P</em> &lt; .01) at the 3-month follow-up after myocardial infarction.</div></div><div><h3>Conclusions</h3><div>Reduced anteroposterior diameter shortening from diastole to systole, indicative of impaired annular dynamics, immediately after myocardial infarction can serve as a new predictor for the subsequent development of mitral regurgitation.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 58-69"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320939","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":"Venovenous extracorporeal membrane oxygenation with mechanical chest compression for cardiopulmonary resuscitation: A porcine model study","authors":"Federico Sertic MD ,&nbsp;Paulo Gregorio MD ,&nbsp;Shampa Chatterjee PhD ,&nbsp;Asad Usman MD ,&nbsp;Gerald Broniec CCP ,&nbsp;Andres Bermudez BSE ,&nbsp;Thomas Richards PhD ,&nbsp;Jonathan Salas BS ,&nbsp;Kathryn Gray CCP, MHA ,&nbsp;Cory Tschabrunn PhD ,&nbsp;Christian Andres Bermudez MD","doi":"10.1016/j.xjon.2025.04.016","DOIUrl":"10.1016/j.xjon.2025.04.016","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of venovenous (VV) extracorporeal membrane oxygenation (ECMO) using a dual-lumen cannula coupled with continuous mechanical chest compressions (cMCC) for cardiopulmonary resuscitation and compare it with venoarterial (VA) ECMO or cMCC only, in a preclinical model.</div></div><div><h3>Methods</h3><div>Twenty-three pigs were allocated into 3 experimental groups: cMCC using a LUCAS 3 compression device, VA-ECMO, and cMCC + VV-ECMO. After cannulation, ventricular fibrillation was induced and circulatory support initiated per allocation. Defibrillation occurred after 30 minutes of support initiation. Hemodynamic, echocardiographic, and laboratory measurements were collected at different timepoints. The primary outcome was the rate of return of spontaneous circulation (ROSC).</div></div><div><h3>Results</h3><div>ROSC was achieved in 1 of 8 of animals with cMCC only (13%), 5 of 7 (71%) animals with cMCC + VV-ECMO, and 8 of 8 (100%) animals with VA-ECMO. cMCC + VV-ECMO was associated with a significantly greater ROSC rate as compared with compressions alone (<em>P</em> = .04). Arterial oxygen tension was significantly greater with cMCC + VV-ECMO as compared with cMCC alone at all time points. After defibrillation, lactate was lower in the VA-ECMO group as compared with cMCC alone (5.1 mmol/L vs 8.6 mmol/L; <em>P</em> &lt; .01) and in the VV-ECMO group (6.3 mmol/L vs 8.6 mmol/L; <em>P</em> = .06).</div></div><div><h3>Conclusions</h3><div>cMCC in association with VV-ECMO using a single dual-lumen femoral cannula may be a viable option of extracorporeal cardiopulmonary resuscitation, potentially leading to greater rates of ROSC when compared with cMCC alone. Additional studies are needed to determine whether this strategy could serve as an early alternative to VA-ECMO in the out-of-hospital cardiac arrest setting.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 215-224"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321654","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":"Characterizing the tumor immune environment in thymic epithelial tumors using T-cell receptor repertoire analysis and gene expression profiling","authors":"Hiroto Ishida MD ,&nbsp;So Takata MD, PhD ,&nbsp;Koichiro Aya PhD ,&nbsp;Yoichiro Nakatani PhD ,&nbsp;Masafumi Horie MD, PhD ,&nbsp;Daichi Maeda MD, PhD ,&nbsp;Soichiro Funaki MD, PhD ,&nbsp;Yasushi Shintani MD, PhD ,&nbsp;Shinichi Yachida MD, PhD","doi":"10.1016/j.xjon.2025.03.008","DOIUrl":"10.1016/j.xjon.2025.03.008","url":null,"abstract":"<div><h3>Objectives</h3><div>A thymoma is a functional thymic epithelial tumor wherein tumorigenic thymic epithelial cells possess T-cell differentiation and maturation potential. The tumor immune environment exhibits heterogeneous tumor immunity. The tumor immune environment of thymoma is characterized by its distinctive and complex immunological functions, requiring an analysis of the various factors involved. We aimed to evaluate the thymoma tumor immune environment and conduct a comprehensive immunogenomic profiling.</div></div><div><h3>Methods</h3><div>Ninety-seven patients undergoing surgery for primary thymoma were enrolled in the study. RNA was extracted from frozen tissue specimens, followed by analysis of T-cell receptor repertoire and RNA-seq. A clonality assessment of the T-cell receptor repertoire and shared clonotypes was also conducted. Gene expression profiling using digital cytometry (CIBERSORTx), T-cell inflammation signature, and Immunogram methodologies was performed.</div></div><div><h3>Results</h3><div>The analysis of T-cell receptor repertoire results indicated a higher level of clonality in B3 thymomas than in other histological types. The high-clonality group exhibited a worse prognosis than the low-clonality group. The results of digital cytometry revealed that type B3 thymomas were clustered and distinguished by a higher abundance of activated natural killer cells, macrophages, and resting mast cells than in other histological types. Additionally, the Immunogram gene signatures showed no correlation with the clonality of the T-cell receptor repertoire.</div></div><div><h3>Conclusions</h3><div>Multiple immunological approaches to evaluate the tumor immune environment and immunogenomic profile of thymoma reveal a diverse and complex immune environment. B3 thymomas, despite being T-cell depleted, exhibit increased T-cell receptor clonality and expanded T-cell clones. Given the poor prognosis and the elevated expression of T-cell inhibitory markers, particularly CTLA4, this subset of patients may represent a critical target population for future clinical trials investigating T-cell checkpoint inhibitors.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 435-465"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321638","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":"Impact of extracellular matrix scaffold on driveline infection rate in patients with left ventricular assist devices","authors":"Mehmet H. Akay MD,&nbsp;Mateja K. Jezovnik MD, PhD,&nbsp;Rajko Radovancevic MD,&nbsp;Ismael A. Salas de Armas MD,&nbsp;Maria Patarroyo Aponte MD,&nbsp;Marwan Jumean MD,&nbsp;Manish K. Patel MD,&nbsp;Jayeshkumar Patel MD,&nbsp;Biswajit Kar MD,&nbsp;Igor D. Gregoric MD","doi":"10.1016/j.xjon.2025.03.029","DOIUrl":"10.1016/j.xjon.2025.03.029","url":null,"abstract":"<div><h3>Objective</h3><div>Left ventricular assist device (LVAD) implantation is a life-saving procedure for patients with advanced heart failure. However, postimplantation complications such as driveline infections (DLIs) can significantly affect patient outcomes. We assessed whether placing an extracellular matrix (ECM) scaffold around the driveline during LVAD implantation reduces the incidence of DLIs in patients with LVADs.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 196 consecutive patients with LVADs between January 2018 and June 2022. We compared the data of patients who received ECM implantation during LVAD implantation (ECM group, n = 69) with those who did not (control group, n = 127).</div></div><div><h3>Results</h3><div>During the study period, 24 of 196 (12.2%) patients with LVADs developed a DLI. Patients who underwent ECM placement exhibited a significantly lower incidence of DLIs than those in the control group (ECM 3/69 vs control 21/127; <em>P</em> = .012).</div></div><div><h3>Conclusions</h3><div>Patients who received ECM implantation at the time of LVAD implantation had a significantly lower rate of DLIs than patients who did not receive ECM around the driveline. These results suggest that ECM may be a valuable adjunctive strategy to reduce the risk of DLIs in LVAD recipients.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 200-205"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321012","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":"Does retrograde autologous priming during coronary artery bypass grafting reduce blood transfusions?","authors":"Gabrielle Li BA ,&nbsp;Alex M. Wisniewski MD ,&nbsp;Raymond J. Strobel MD, MSc ,&nbsp;Evelynn Dallas CCP ,&nbsp;Kenan Yount MD, MBA ,&nbsp;Leora Yarboro MD ,&nbsp;Karen Singh MD ,&nbsp;John Kern MD ,&nbsp;Nicholas R. Teman MD ,&nbsp;Jared P. Beller MD","doi":"10.1016/j.xjon.2025.02.023","DOIUrl":"10.1016/j.xjon.2025.02.023","url":null,"abstract":"<div><h3>Objective</h3><div>Coronary artery bypass grafting is associated with a significant risk of blood transfusion. The clinical efficacy of retrograde autologous priming, a potential blood conservation strategy, lacks consensus. We aim to evaluate the effect of retrograde autologous priming on transfusion requirements and clinical outcomes in patients undergoing coronary artery bypass grafting.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on all patients undergoing on-pump, isolated coronary artery bypass grafting between October 2018 and March 2023 at a single institution. Those undergoing retrograde autologous priming were identified and compared with non–retrograde autologous priming cases. Wilcoxon rank-sum and chi-square analyses were used to analyze continuous and categorical outcomes, respectively. Risk-adjusted multivariable logistic regression was performed.</div></div><div><h3>Results</h3><div>A total of 1109 patients met inclusion criteria, with 332 (29.9%) receiving retrograde autologous priming. At baseline, patients in the retrograde autologous priming group had higher preoperative hemoglobin (14.0 g/dL vs 13.7 g/dL, <em>P =</em> .03), higher nadir intraoperative hemoglobin (10.2 g/dL vs 9.7 g/dL, <em>P &lt;</em> .0), and less total crystalloid use (900 mL vs 110 0 mL, <em>P &lt;</em> .01) in the operating room. On risk-adjusted analysis, including adjustment for preoperative hemoglobin levels, retrograde autologous priming was found to significantly reduce the risk of postoperative blood transfusion (odds ratio, 0.54, <em>P &lt;</em> .01) and postoperative prolonged ventilation (odds ratio, 0.47, <em>P =</em> .02).</div></div><div><h3>Conclusions</h3><div>Use of retrograde autologous priming may result in fewer transfusions and thus potentially prevent transfusion-associated risks such as prolonged ventilation. Potential mechanisms include avoidance of volume overload and transfusion-related acute lung injury. Retrograde autologous priming should be considered in appropriately selected patients undergoing cardiac surgery.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 126-133"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of donor distance on post-transplant mortality in the modern era","authors":"David Rekhtman BS ,&nbsp;Sharon Lee BS ,&nbsp;Amit Iyengar MD, MSE ,&nbsp;Cindy Song BA ,&nbsp;Noah Weingarten MD ,&nbsp;Max Shin MD ,&nbsp;Michaela Asher MPhil ,&nbsp;Joyce Jiang BS ,&nbsp;Marisa Cevasco MD, MPH ,&nbsp;Pavan Atluri MD","doi":"10.1016/j.xjon.2025.02.019","DOIUrl":"10.1016/j.xjon.2025.02.019","url":null,"abstract":"<div><h3>Objective</h3><div>In the new US heart transplant allocation system, eligible patients can receive hearts from donors beyond a 250-mile radius. The safety of extended travel and its impact on ischemic time are poorly understood. This study examines post-transplantation mortality based on distance between donor and transplant centers.</div></div><div><h3>Methods</h3><div>Adult patients listed as status 1 or 2 for isolated heart transplantation between October 18, 2018, and September 30, 2023, who subsequently received an organ were identified in the United Network for Organ Sharing database. Patients were stratified by donor distance (≤250 or &gt;250 miles). Linear and logistic models analyzed the relationships among 1-year survival, distance, and ischemic time. The 1-year mortality was further characterized by Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Of the 5315 patients included in this cohort, 45% received hearts within a 250-mile radius, and 55% received hearts from distances beyond 250 miles. The majority of patients were male and White, and had dilated cardiomyopathy. Assessment of the relationship between distance and ischemic time showed an 18-minute increase for every additional 100 miles of travel. Multivariable logistic regression indicated increased mortality with longer ischemic times, but no difference in survival with increasing distances. Further, on multivariable time-dependent analysis, increasing ischemic time was a predictor of mortality (odds ratio, 1.19 [1.01-1.21]), whereas increased donor distance was not (odds ratio, 0.84 [0.68-1.04]).</div></div><div><h3>Conclusions</h3><div>Distance between donor and transplant center minimally affected ischemic time and showed no impact on post-transplant 1-year survival. Therefore, ischemic time limitations rather than distance cutoffs may be more appropriate for policies regarding heart procurement.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 241-252"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320954","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":"Requirements for biventricular repair after bilateral pulmonary artery banding for patients with borderline left ventricle","authors":"Dai Asada MD, PhD ,&nbsp;Yoichiro Ishii MD, PhD ,&nbsp;Takuya Fujisaki MD ,&nbsp;Masayoshi Mori MD ,&nbsp;Kumiyo Matsuo MD ,&nbsp;Hisaaki Aoki MD, PhD ,&nbsp;Sanae Tsumura MD, PhD ,&nbsp;Futoshi Kayatani MD","doi":"10.1016/j.xjon.2025.03.019","DOIUrl":"10.1016/j.xjon.2025.03.019","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to examine factors associated with the decision to perform biventricular repair or univentricular repair in patients with left heart obstructive diseases after bilateral pulmonary artery banding.</div></div><div><h3>Methods</h3><div>In this retrospective study, we used data from an institutional database. In total, 12 patients who underwent univentricular repair (group U) and 18 patients who underwent biventricular repair (group B) were included in the analysis. Left heart obstructive diseases included critical aortic stenosis, coarctation complex, interruption of aortic arch, and hypoplastic left heart complex. The Z-scores of the mitral, aortic, tricuspid, and pulmonary valve diameters, along with other parameters, were compared before and after bilateral pulmonary artery banding. Three months after the initial bilateral pulmonary artery banding, a cardiac catheter examination was performed in all patients to determine whether univentricular repair or biventricular repair should be performed.</div></div><div><h3>Results</h3><div>Mitral valve size in group B was significantly larger than in group U both before (−0.27 ± 1.04 vs −2.25 ± 1.83, <em>P &lt;</em> .01) and after bilateral pulmonary artery banding (0.05 ± 1.58 vs −1.86 ± 1.91, <em>P &lt;</em> .01). In group U, mitral and aortic valve sizes showed no significant increase after bilateral pulmonary artery banding. In group B, mitral valve size showed no significant increase after bilateral pulmonary artery banding (−0.27 ± 1.04 vs 0.06 ± 1.58, <em>P =</em> .26), whereas aortic valve size demonstrated a significant increase (−4.33 ± 2.60 vs −3.13 ± 2.64, <em>P =</em> .02).</div></div><div><h3>Conclusions</h3><div>In cases of a “borderline” left ventricle, a large mitral valve from birth and growth of the aortic valve are crucial for successful biventricular repair. Three months after bilateral pulmonary artery banding is considered the appropriate time to decide the management course to be pursued.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"25 ","pages":"Pages 326-331"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321014","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}