The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Evolving Concern: Late Outcomes after Repair of Transposition of the Great Arteries.
To evaluate survival and reoperation after repair of transposition of the great arteries (TGA) by linking to administrative databases. ⋯ Patient survival was excellent 3 decades after TGA repair. We found disconcerting evidence of a late increase in neoaortic valve reoperations >17-years post-ASO attributable to enlarging neoaortic roots and/or neoaortic valve insufficiency. Future improvement after ASO hinges on better strategies for the subset of <7% with high-risk coronary artery patterns and avoiding neoaortic root distortion.
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Midterm Survival, Clinical, and Hemodynamic Outcomes of a Novel Mechanical Mitral Valve Prosthesis.
To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT). ⋯ The On-X mechanical mitral valve demonstrated favorable survival, stable hemodynamics, and enhanced quality of life up to 5 years postimplantation. Derived from high-quality, rigorous randomized trial data, these findings can guide decision making in young patients requiring MVR.
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J. Thorac. Cardiovasc. Surg. · Nov 2024
Adjuvant Immunotherapy Does Not Improve Survival in Non-small Cell Lung Cancer with Major/Complete Pathological Response after Induction Immunotherapy.
In patients with resectable non-small cell lung cancer (NSCLC), immune checkpoint inhibitor (ICI)-based regimens in both neoadjuvant and perioperative settings have demonstrated a survival benefit. However, no previous study has compared the efficacy between pure neoadjuvant and perioperative approaches, especially in patients who achieve a substantial pathologic response. ⋯ Adjuvant ICI does not improve survival in NSCLC patients who achieve pCR/MPR following neoadjuvant immunochemotherapy. A de-escalation strategy could be considered, given the adverse events associated with postoperative ICI treatment.