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Training pathway and early career trajectories in cardiothoracic surgery: A national cohort study 心胸外科的培训途径和早期职业轨迹:一项国家队列研究
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-30 DOI: 10.1016/j.xjon.2026.101977
Maria Rain Jennings PhD, Alexander J. Tinana BS, Ashley Riley BS, Brandi B. Scully MD, MS, James S. Gammie MD, Stephen C. Yang MD, Hanghang Wang MD, PhD
{"title":"Training pathway and early career trajectories in cardiothoracic surgery: A national cohort study","authors":"Maria Rain Jennings PhD,&nbsp;Alexander J. Tinana BS,&nbsp;Ashley Riley BS,&nbsp;Brandi B. Scully MD, MS,&nbsp;James S. Gammie MD,&nbsp;Stephen C. Yang MD,&nbsp;Hanghang Wang MD, PhD","doi":"10.1016/j.xjon.2026.101977","DOIUrl":"10.1016/j.xjon.2026.101977","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to compare educational outcomes and early career practice patterns of cardiothoracic surgery graduates by training pathway: direct entry through the integrated thoracic surgery residency and the independent fellowship pathways comprising fast-track entry and the 2- and 3-year fellowship programs.</div></div><div><h3>Methods</h3><div>We assembled a national cohort of graduates from Accreditation Council for Graduate Medical Education–accredited integrated thoracic surgery residencies and independent cardiothoracic surgery fellowships between 2013 and 2023. Graduates were identified using institutional alumni resources and self-identification in the Doximity Residency Navigator. Demographic, educational, and professional characteristics were abstracted from institutional websites, advertised professional profiles, and state and national provider databases.</div></div><div><h3>Results</h3><div>Women were most represented among integrated thoracic surgery residency and fast-track graduates, whereas international medical graduates and osteopathic physicians were more common among 2- and 3-year independent graduates. Independent graduates had higher odds of thoracic subspecialization, but lower odds of adult cardiac subspecialization compared with integrated thoracic surgery residency graduates. Fast-track and 3-year independent graduates had similar odds of congenital cardiac subspecialization compared with integrated thoracic surgery graduates, whereas 2-year independent graduates had lower odds. Among adult subspecialists, only 3-year independent graduates had lower odds of superfellowship completion compared with integrated thoracic surgery residency graduates. Integrated thoracic surgery residency graduates completed fewer postgraduate training years than all independent-pathway groups regardless of subspecialization. Within subspecialties, integrated thoracic surgery and independent graduates had similar odds of entering academic practice.</div></div><div><h3>Conclusions</h3><div>Integrated thoracic surgery residency and independent pathways have attracted trainees with distinct demographic, educational, and subspecialization patterns. After accounting for subspecialization, graduates achieve comparable early career outcomes. Maintaining multiple entry pathways broadens access to cardiothoracic surgery and supports workforce diversity.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 101977"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214366","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}
引用次数: 0
Real-world outcomes of induction chemoimmunotherapy in patients with non–small cell lung cancer who have never smoked 从未吸烟的非小细胞肺癌患者诱导化学免疫治疗的实际结果
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-08-03 DOI: 10.1016/j.xjon.2026.101983
Alison S. Baskin MD, Maureen Canavan PhD, MPH, Benjamin J. Resio MD, Daniel J. Boffa MD, MBA, Giorgio Caturegli MD
{"title":"Real-world outcomes of induction chemoimmunotherapy in patients with non–small cell lung cancer who have never smoked","authors":"Alison S. Baskin MD,&nbsp;Maureen Canavan PhD, MPH,&nbsp;Benjamin J. Resio MD,&nbsp;Daniel J. Boffa MD, MBA,&nbsp;Giorgio Caturegli MD","doi":"10.1016/j.xjon.2026.101983","DOIUrl":"10.1016/j.xjon.2026.101983","url":null,"abstract":"","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 101983"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214453","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}
引用次数: 0
Influence of concomitant mitral valve intervention on late survival in patients with moderate ischemic mitral regurgitation undergoing surgical revascularization 合并二尖瓣介入治疗对行外科血运重建术中度缺血性二尖瓣返流患者晚期生存的影响
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-08-21 DOI: 10.1016/j.xjon.2026.102072
Sameer K. Singh MD, Arnar Geirsson MD, Ernest Traad MD, Paul Kurlansky MD, George Ebra EdD, PhD
{"title":"Influence of concomitant mitral valve intervention on late survival in patients with moderate ischemic mitral regurgitation undergoing surgical revascularization","authors":"Sameer K. Singh MD,&nbsp;Arnar Geirsson MD,&nbsp;Ernest Traad MD,&nbsp;Paul Kurlansky MD,&nbsp;George Ebra EdD, PhD","doi":"10.1016/j.xjon.2026.102072","DOIUrl":"10.1016/j.xjon.2026.102072","url":null,"abstract":"<div><h3>Objective</h3><div>In patients with moderate ischemic mitral regurgitation, the influence of concomitant mitral valve (MV) intervention at the time of revascularization on late survival remains unclear. The purpose of this study was to compare the lifetime survival of patients with moderate ischemic mitral regurgitation who underwent revascularization alone versus concomitant MV repair or replacement.</div></div><div><h3>Methods</h3><div>Retrospective review was performed for 776 consecutive patients, ages 65 years and older with coronary artery disease and moderate ischemic mitral regurgitation who underwent isolated coronary artery bypass grafting (CABG) (n = 372), CABG with MV repair (n = 131, CABG + MV repair), or CABG with MV replacement (n = 273, CABG + MV replacement) from 1976 to 2005. Propensity score matching, Kaplan-Meier survival analysis, and Cox regression were used to compare perioperative and long-term survival. Cross-sectional follow-up utilized the Centers for Disease Control and Prevention National Death Index as well as government and genealogical internet sites, publicly available online obituaries, and death notices. Follow up was 98% complete.</div></div><div><h3>Results</h3><div>The mean age of the cohort was 74.1 ± 5.8 years with 42.4% female patients. Preoperatively, 54.5% had prior myocardial infarction, 47.7% had a history of congestive heart failure, and 69.1% had an abnormal ejection fraction. Matched patients undergoing CABG or CABG + MV repair had similar incidence of major perioperative morbidity (29.0% vs 22.1%; <em>P</em> = .202) and operative mortality (8.4% vs 6.1%; <em>P</em> = .475). Late survival was similar between groups (<em>P</em> = .630). Among matched patients undergoing CABG versus CABG + MV replacement, those undergoing concomitant replacement had significantly increased perioperative major morbidity (35.2% vs 20.9%; <em>P</em> &lt; .001) and operative mortality (16.9% vs 7.7%; <em>P</em> &lt; .001). CABG + MV replacement patients experienced an increased risk of late mortality (hazard ratio, 1.23; 95% CI, 1.01-1.49; <em>P</em> = .035), compared with those undergoing isolated CABG.</div></div><div><h3>Conclusions</h3><div>In patients with moderate ischemic mitral regurgitation undergoing surgical revascularization, concomitant MV repair did not demonstrate a clear late survival benefit over isolated CABG, whereas concomitant MV replacement was associated with increased early and late mortality risk.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 102072"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214441","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}
引用次数: 0
Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis 70岁及以上患者经导管与手术主动脉瓣置换术的长期结果:重叠加权分析
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-24 DOI: 10.1016/j.xjon.2026.101972
Rieko Kutsuzawa MD, Naonori Kawamoto MD, PhD, Kimito Minami MD, PhD, Satoshi Kainuma MD, PhD, Kizuku Yamashita MD, PhD, Kota Suzuki MD, PhD, Takashi Kakuta MD, PhD, Ayumi Ikuta MD, PhD, Yuki Tadokoro MD, Yojiro Machii MD, Kentaro Mitsui MD, PhD, Shinichi Kurashima MD, Yuki Irie MD, Atsushi Okada MD, PhD, Kensuke Takagi MD, PhD, Makoto Amaki MD, PhD, Hideaki Kanzaki MD, PhD, Yasuhide Asaumi MD, PhD, Takeshi Kitai MD, PhD, Chisato Izumi MD, PhD, Satsuki Fukushima MD, PhD
{"title":"Long-term outcomes of transcatheter versus surgical aortic valve replacement in patients aged 70 years and older: An overlap-weighted analysis","authors":"Rieko Kutsuzawa MD,&nbsp;Naonori Kawamoto MD, PhD,&nbsp;Kimito Minami MD, PhD,&nbsp;Satoshi Kainuma MD, PhD,&nbsp;Kizuku Yamashita MD, PhD,&nbsp;Kota Suzuki MD, PhD,&nbsp;Takashi Kakuta MD, PhD,&nbsp;Ayumi Ikuta MD, PhD,&nbsp;Yuki Tadokoro MD,&nbsp;Yojiro Machii MD,&nbsp;Kentaro Mitsui MD, PhD,&nbsp;Shinichi Kurashima MD,&nbsp;Yuki Irie MD,&nbsp;Atsushi Okada MD, PhD,&nbsp;Kensuke Takagi MD, PhD,&nbsp;Makoto Amaki MD, PhD,&nbsp;Hideaki Kanzaki MD, PhD,&nbsp;Yasuhide Asaumi MD, PhD,&nbsp;Takeshi Kitai MD, PhD,&nbsp;Chisato Izumi MD, PhD,&nbsp;Satsuki Fukushima MD, PhD","doi":"10.1016/j.xjon.2026.101972","DOIUrl":"10.1016/j.xjon.2026.101972","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare long-term outcomes of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients aged 70 to 89 years with aortic stenosis (AS).</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, 1100 patients who underwent primary TAVR (n = 599) or SAVR (n = 501) between 2008 and 2023 were included. An overlap-weighted propensity-score analysis was conducted using 36 baseline variables, including age, procedural year, frailty scale, Society of Thoracic Surgeons risk score, New York Heart Association class, history of coronary artery and cerebrovascular disease, and AS severity. The primary end point was the composite of all-cause mortality or cerebrovascular events.</div></div><div><h3>Results</h3><div>During long-term follow-up, the composite end point occurred more frequently after TAVR than after SAVR. In the overlap-weighted analysis, TAVR was associated with a greater risk of the composite outcome (hazard ratio [HR], 1.8; 95% CI, 1.1-3.0; <em>P</em> = .024), with Kaplan-Meier curves diverging early and remaining separated. All-cause mortality did not differ between the groups (HR, 1.2; 95% CI, 0.7-2.1; <em>P</em> = .426); however, cerebrovascular events occurred predominantly after TAVR and remained significantly more frequent after overlap weighting (HR, 15; 95% CI, 2.8-89; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>In the overlap-weighted population of patients aged 70 to 89 years with AS, SAVR and TAVR were associated with comparable all-cause mortality; however, cerebrovascular events occurred more frequently after TAVR.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 101972"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214476","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}
引用次数: 0
Practice patterns and outcomes of local and systemic therapy for single-site metastatic non–small cell lung cancer in the era of immunotherapy 免疫治疗时代单部位转移性非小细胞肺癌局部和全身治疗的实践模式和结果
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-02 DOI: 10.1016/j.xjon.2026.101949
Gabriela Esnaola BA, Maureen Canavan PhD, Giorgio Caturegli MD, Abigail Lynch BS, Benjamin Resio MD
{"title":"Practice patterns and outcomes of local and systemic therapy for single-site metastatic non–small cell lung cancer in the era of immunotherapy","authors":"Gabriela Esnaola BA,&nbsp;Maureen Canavan PhD,&nbsp;Giorgio Caturegli MD,&nbsp;Abigail Lynch BS,&nbsp;Benjamin Resio MD","doi":"10.1016/j.xjon.2026.101949","DOIUrl":"10.1016/j.xjon.2026.101949","url":null,"abstract":"<div><h3>Objective</h3><div>Prognosis of lung cancer with single metastatic sites in the era of immunotherapy remains poorly described. We used the National Cancer Database to assess how metastatic site and the use of local therapy with systemic immunotherapy is associated with prognosis in the United States.</div></div><div><h3>Methods</h3><div>Patients with clinical stage IVA lung cancer treated with immunotherapy were identified in the National Cancer Database (2018-2023). Patients were stratified by metastatic site and treatment: systemic immunotherapy with or without local therapy (immunotherapy + local therapy or immunotherapy). Prognosis was evaluated using Kaplan–Meier and Cox survival analysis landmarked at median time from diagnosis to local therapy.</div></div><div><h3>Results</h3><div>Among included patients (N = 20,214), metastases included lung (N = 5308; 26.3%), brain (N = 3516; 17.4%), bone (N = 3142; 15.5%), distant lymph node (N = 1219; 6.0%), liver (N = 874; 4.3%), and other metastases (N = 6155; 30.4%). A total of 13,890 patients (68.7%) were treated with immunotherapy, and 6324 patients (31.3%) were treated with immunotherapy + local therapy (70.2% received chemotherapy, 27.2% radiation, and 9.8% surgery). Poor 5-year overall survival was associated with bone (20.9%) and liver (15.9%) metastases compared with brain (33.4%). Five-year survival was greater in patients selected for local therapy (30.3% vs 20.5%, <em>P</em> &lt; .001); thoracic and extrathoracic local therapy was associated with greater overall survival compared with extrathoracic local therapy alone (37.7% vs 28.2%, <em>P</em> &lt; .001). Differences in 5-year survival with local therapy varied by metastatic site (10.4% lung, 7.1% brain, 0.1% liver).</div></div><div><h3>Conclusions</h3><div>The addition of local therapy to a systemic regimen containing immunotherapy was common for patients with single metastatic sites. Patients selected for local therapy had a more favorable prognosis, which varied by metastatic site.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 101949"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214480","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}
引用次数: 0
Differences in patterns of relapse and survival after relapse between lobectomy and sublobar resection for stage IA non–small cell lung cancer 肺叶切除术与叶下切除术治疗IA期非小细胞肺癌复发模式及复发后生存率的差异
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-04 DOI: 10.1016/j.xjon.2026.101952
Masahiro Adachi MD, Yukihiro Yoshida MD, Chihiro Takemura MD, Masaya Yotsukura MD, Tomohiro Haruki MD, Hidehito Horinouchi MD, Yasushi Goto MD, Shun-Ichi Watanabe MD
{"title":"Differences in patterns of relapse and survival after relapse between lobectomy and sublobar resection for stage IA non–small cell lung cancer","authors":"Masahiro Adachi MD,&nbsp;Yukihiro Yoshida MD,&nbsp;Chihiro Takemura MD,&nbsp;Masaya Yotsukura MD,&nbsp;Tomohiro Haruki MD,&nbsp;Hidehito Horinouchi MD,&nbsp;Yasushi Goto MD,&nbsp;Shun-Ichi Watanabe MD","doi":"10.1016/j.xjon.2026.101952","DOIUrl":"10.1016/j.xjon.2026.101952","url":null,"abstract":"<div><h3>Objective</h3><div>In the Japan Clinical Oncology Group 0802 trial, lung cancer-specific mortality was comparable between lobectomy and segmentectomy despite a higher rate of locoregional relapse after segmentectomy. We evaluated relapse patterns and postrelapse survival following lobectomy or sublobar resection.</div></div><div><h3>Methods</h3><div>This single-institution retrospective study included patients who underwent surgery for primary non–small cell lung cancer (NSCLC) between 2003 and 2022 and subsequently developed relapse. Overall survival was defined as the period from surgery (OS1) or from the date of relapse diagnosis (OS2) to death from any cause.</div></div><div><h3>Results</h3><div>Among 362 patients with clinical stage IA NSCLC who developed relapse, isolated locoregional relapse accounted for 110 of 297 relapsed patients (37.0%) after lobectomy and 36 of 65 relapsed patients (55.4%) after sublobar resection. Among 59 patients treated with local consolidative therapy for isolated locoregional relapse, the 4-year OS2 rate was 76.4% (95% CI, 64.9%-89.8%). After inverse probability of treatment weighting, the 7-year OS1 rates were 49.3% (95% CI, 42.2%-57.6%) after lobectomy and 64.9% (95% CI, 52.4%-80.3%) after sublobar resection, and the 4-year OS2 rates were 49.6% (95% CI, 42.4%-57.9%) and 62.7% (95% CI, 49.5%-79.3%), respectively.</div></div><div><h3>Conclusions</h3><div>In this exploratory cohort of patients who developed postoperative relapse, relapse patterns differed between surgical groups, with isolated locoregional relapse representing a larger proportion of relapse in the sublobar resection group. Long-term survival was observed in selected patients treated with modern postrelapse therapies, including local consolidative therapy. These findings should be interpreted cautiously as hypothesis-generating.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 101952"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214482","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}
引用次数: 0
Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy 小儿扩张型心肌病的肺动脉束带治疗的二十年
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-08-28 DOI: 10.1016/j.xjon.2026.102088
Thushiha Logeswaran MD, Blanka Steinbrenner MD, Dietmar Schranz MD, Sabine Recla MD, Karin Klingel MD, Matthias Müller MD, Kerstin Gummel MD, Lucie Rüblinger MD, Bettina Reich MD, PhD, Martin Farr PhD, Christian Jux MD, Hakan Akintürk MD
{"title":"Two decades of targeted pulmonary artery banding in pediatric dilated cardiomyopathy","authors":"Thushiha Logeswaran MD,&nbsp;Blanka Steinbrenner MD,&nbsp;Dietmar Schranz MD,&nbsp;Sabine Recla MD,&nbsp;Karin Klingel MD,&nbsp;Matthias Müller MD,&nbsp;Kerstin Gummel MD,&nbsp;Lucie Rüblinger MD,&nbsp;Bettina Reich MD, PhD,&nbsp;Martin Farr PhD,&nbsp;Christian Jux MD,&nbsp;Hakan Akintürk MD","doi":"10.1016/j.xjon.2026.102088","DOIUrl":"10.1016/j.xjon.2026.102088","url":null,"abstract":"<div><h3>Objectives</h3><div>Dilated cardiomyopathy (DCM) with severe left ventricular (LV) dysfunction in infants and young children is a life-threatening condition and carries a high risk of mechanical circulatory support and heart transplantation (HTx). Pulmonary artery banding (PAB) has been proposed as a recovery strategy, but data on medium- and long-term outcomes remain limited.</div></div><div><h3>Methods</h3><div>This retrospective, single-center observational study included infants and young children who underwent surgical PAB between 2006 and 2024. Inclusion criteria were ROSS functional class (FC) III/IV, spherical left ventricular-dilated cardiomyopathy (LV-DCM) with left ventricular ejection fraction (LVEF) &lt;35%, and left ventricular end-diastolic diameter (LVEDD) z-score &gt;+4 with preserved right ventricular function. Primary endpoints were overall survival and transplant-free recovery, defined as sustained normalization of LV systolic function with reverse remodeling.</div></div><div><h3>Results</h3><div>Fifty patients (27 female) met the inclusion criteria and underwent PAB at a median age of 188 days, 70% were in ROSS FC IV, and 42% were listed as urgent for HTx. DCM etiology was idiopathic in 42%, genetic in 22%, and myocarditis-associated in 36%. There was no procedural mortality. Overall survival was 90% and 72% achieved transplant-free functional recovery. Following PAB, magnetic resonance imaging–derived LVEF improved from 19% ± 7% to 56% ± 11%, and LVEDD z-scores decreased from +6.3 to +1 (<em>P</em> &lt; .001). In 33 patients, recovery was sustained over a median follow-up of 7 years, including 15 patients with stable LV function for over 10 years.</div></div><div><h3>Conclusions</h3><div>In infants and young children with severe LV-DCM, PAB is associated with high long-term survival, sustained transplant-free recovery, and durable reverse cardiac remodeling.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 102088"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214491","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}
引用次数: 0
Interpretable machine learning risk model to predict readmission after coronary artery bypass grafting 可解释的机器学习风险模型预测冠状动脉搭桥术后再入院
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-08-07 DOI: 10.1016/j.xjon.2026.102050
Rameshbabu Manyam PhD, Conglin Bao MSPH, Yixuan He MSPH, Sheena Warner MS, CRNA, APN, Yanqing Zhang PhD, William Brent Keeling MD
{"title":"Interpretable machine learning risk model to predict readmission after coronary artery bypass grafting","authors":"Rameshbabu Manyam PhD,&nbsp;Conglin Bao MSPH,&nbsp;Yixuan He MSPH,&nbsp;Sheena Warner MS, CRNA, APN,&nbsp;Yanqing Zhang PhD,&nbsp;William Brent Keeling MD","doi":"10.1016/j.xjon.2026.102050","DOIUrl":"10.1016/j.xjon.2026.102050","url":null,"abstract":"<div><h3>Objective</h3><div>Readmission within 30 days of discharge after coronary artery bypass grafting (CABG) continues to be a concern for patients and health care systems in cardiothoracic care. We developed an interpretable machine learning (ML) risk model to evaluate, understand, and integrate preoperative risk factors to predict 30-day readmission after CABG.</div></div><div><h3>Methods</h3><div>The study analyzed a population of patients who had undergone isolated CABG between 2014 and 2023, drawn from a multihospital academic health system. The primary outcome was an index readmission within 30 days of discharge after isolated CABG. The study evaluated 34 patient-specific preoperative variables using the recursive feature elimination with cross-validation method and ML algorithms to evaluate an optimal set of risk factors to predict readmission after CABG. SHapley Additive exPlanations framework was used to understand the contribution of risk factors to model prediction.</div></div><div><h3>Results</h3><div>A total of 8999 patients were identified, and the overall observed 30-day all-cause same system readmission rate was 9.56%, n = 860. The model produced the top 7 preoperative risk factors: hematocrit, Model for End-Stage Liver Disease score, hemoglobin, creatinine, body mass index, white blood cell count, and platelets. The random forest model demonstrated good performance with an area under the receiver operating characteristics curve of 0.74.</div></div><div><h3>Conclusions</h3><div>This study used interpretable ML techniques to identify and interpret an optimal set of preoperative risk factors for 30-day readmission after CABG. The random forest model demonstrated good discrimination in identifying at-risk patients. Individual hospitals can apply the proposed method to their large datasets and assess risk factors that may help identify patients who would experience 30-day readmission after CABG.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"33 ","pages":"Article 102050"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214531","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}
引用次数: 0
Endoscopic versus open vein harvesting technique and 2-year saphenous vein graft patency: A subanalysis of the Newton-CABG CardioLink-5 randomized trial 内镜下与开放静脉采集技术和2年隐静脉移植通畅:Newton-CABG CardioLink-5随机试验的亚分析
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-08-18 DOI: 10.1016/j.xjon.2026.102063
Raj Verma, Hwee Teoh PhD, Lawrence A. Leiter MD, G.B. John Mancini MD, Adrian Quan MPhil, Randi Elituv BA, BScN, Meena Verma, Shubh K. Patel, Michael Szarek PhD, Peter Jüni MD, Michael J. Koren MD, Stephen J. Nicholls MBBS, PhD, Subodh Verma MD, PhD, Deepak L. Bhatt MD, MPH, MBA, C. David Mazer MD
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引用次数: 0
Diagnosis and minimally invasive surgical treatment of peritoneal dialysis–associated pleuroperitoneal fistula: A case report and literature review 腹膜透析相关胸膜瘘的诊断和微创手术治疗:1例报告并文献复习
IF 2.2
JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-04 DOI: 10.1016/j.xjon.2026.101951
Yangle Zhao MM, Enxiang Zhang MM, Xiaodan Hu MM, Xiao Wang MM, Yun Zhao MM, Yongwu Yu MM, Jian Cui MM
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引用次数: 0
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