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.
Evaluate survival and re-operation after repair of transposition of great arteries (TGA) by linking to administrative databases. ⋯ Patient survival is excellent 3 decades after TGA repair. We found disconcerting evidence of a late increase in neo-aortic valve re-operations >17-years post-ASO due to enlarging neo-aortic roots and/or neo-aortic valve insufficiency. Future improvement following ASO hinges on better strategies for the subset of <7% with high-risk coronary artery patterns and avoiding neo-aortic root distortion.
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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 demonstrate survival benefit. To date, no study has compared the efficacy between pure neoadjuvant and perioperative approaches, especially in patients who achieve substantial pathological responses. ⋯ 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.
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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 five years post-implantation. Derived from high-quality, rigorous randomized trial data, these findings can guide decision-making in young patients requiring MVR.