The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Mar 2023
Meta AnalysisCoronary artery bypass with single versus multiple arterial grafts in women: A meta-analysis.
The study objective was to investigate the impact of multiple arterial grafting on long-term all-cause mortality in women undergoing isolated coronary artery bypass grafting. ⋯ The use of multiple arterial grafting in women undergoing coronary artery bypass grafting is associated with lower long-term mortality, although the difference is mostly driven by small series. Further studies, including randomized trials, are needed to evaluate the efficacy of multiple arterial grafting in women undergoing coronary artery bypass grafting.
-
J. Thorac. Cardiovasc. Surg. · Mar 2023
Multicenter StudySurgical results of the Lung Cancer Mutation Consortium 3 trial: A phase II multicenter single-arm study to investigate the efficacy and safety of atezolizumab as neoadjuvant therapy in patients with stages IB-select IIIB resectable non-small cell lung cancer.
Multimodality treatment for resectable non-small cell lung cancer has long remained at a therapeutic plateau. Immune checkpoint inhibitors are highly effective in advanced non-small cell lung cancer and promising preoperatively in small clinical trials for resectable non-small cell lung cancer. This large multicenter trial tested the safety and efficacy of neoadjuvant atezolizumab and surgery. ⋯ Neoadjuvant atezolizumab in resectable stage IB to IIIB non-small cell lung cancer was well tolerated, yielded a 20% major pathological response rate, and allowed safe, complete surgical resection. These results strongly support the further development of immune checkpoint inhibitors as preoperative therapy in locally advanced non-small cell lung cancer.
-
J. Thorac. Cardiovasc. Surg. · Mar 2023
Differences among sexes in presentation and outcomes in acute type A aortic dissection repair.
Female sex is a known risk factor in most cardiac surgery, including coronary and valve surgery, but unknown in acute type A aortic dissection repair. ⋯ Physicians and women should be cognizant of the risk of acute type A aortic dissection later in life in women. Surgeons should strongly consider operations for acute type A aortic dissection in women, especially in patients aged 70 years or more.
-
J. Thorac. Cardiovasc. Surg. · Mar 2023
Multicenter StudyPrevalence and anatomical characteristics of subsuperior segment in lung lower lobe.
The subsuperior segment is an atypical pulmonary segment of the lung lower lobe. With the increased application of segmentectomy, it has received increased attention from thoracic surgeons. Studies of the subsuperior segment are scarce and mostly on the basis of small-sample autopsy studies, whose described characteristics are inconsistent with intraoperative observations. Our objective was to accurately define the subsuperior segment and elucidate its prevalence and anatomical characteristics in detail. ⋯ Using a multicenter large-sample study, we calculated a 32.04% prevalence and systematically detailed the anatomical characteristics of the subsuperior segment in the lung lower lobe, corrected previous reports, and supplemented pulmonary anatomical studies.
-
J. Thorac. Cardiovasc. Surg. · Mar 2023
Cardiovascular intensive care unit variables inform need for feeding tube utilization in infants with hypoplastic left heart syndrome.
Feeding strategies in infants with hypoplastic left heart syndrome (HLHS) following stage 1 palliation (S1P) include feeding tube utilization (FTU). Timely identification of infants who will fail oral feeding could mitigate morbidity in this vulnerable population. We aimed to develop a novel clinical risk prediction score for FTU. ⋯ Abnormal head imaging, duration of ventilation, and presence of vocal cord dysfunction were associated with FTU in infants with HLHS following S1P. The predictive HV2 risk score supports routine perioperative head imaging and vocal cord evaluation. Future application of the HV2 score may improve nutritional morbidity and hospital length of stay in this population.