The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Incidence, risk factors, and long-term outcomes associated with permanent pacemaker implantation after aortic root replacement.
Permanent pacemaker implantation (PPI) after aortic valve replacement is associated with long-term mortality. However, data regarding PPI after aortic root replacement (ARR) is lacking. Herein we describe the incidence, risk factors, and long-term outcomes of PPI after ARR. ⋯ The incidence of PPI after ARR remains low, particularly after VSRR. Preoperative conduction disturbance, prior AVR, and bicuspid aortic valve are all associated with increased risk of PPI. Although PPI is associated with longer length of stay, it is not associated with early or late mortality.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Aortic valve cusp size and shape in dilated trileaflet aortic roots.
The objective of the study was to quantify the differences in cusp size and shape in patients with normal and dilated trileaflet aortic roots and in dilated roots with or without aortic regurgitation. ⋯ The cusps in dilated roots elongate transversely and to a lesser degree radially. Functional aortic regurgitation is caused by extensive commissural dilatation and not by inadequate cusp adaptation.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Longitudinal Outcomes of Thoracic Endovascular Aortic Repair for Ruptured Thoracic Aortic Aneurysms.
Limited data exist on long-term mortality and reintervention rates after emergent thoracic endovascular aortic repair (TEVAR) for ruptured thoracic aortic aneurysm (rTAA). This study aimed to characterize the long-term outcomes of emergent TEVAR for rTAA. ⋯ The present study is the largest to focus on long-term outcomes following TEVAR for rupture TAA. Unsuprisingly, short-term outcomes are worse in patients presenting with ruptured vs intact aneurysms. However, importantly, long-term survival in rTAA patients who do survive 90 days is comparable to that of iTAA patients.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Sex-based Differences in the Lung Immune Microenvironment Are Associated with an Increased Risk of Lung Cancer in Women.
Lung cancer remains a major cause of mortality worldwide, necessitating further understanding of carcinogenesis and its driving factors, including those influenced by sex-dependent variables. We hypothesized that sex-specific lung immune composition may contribute to a greater risk of lung cancer in women. ⋯ Female smokers display higher risk for lung cancer. In murine models and humans, female sex is associated with robust immunosuppression within the lung. Further examination of this link will be important in developing immune-based approaches to lung cancer interception and their optimal application across the sexes.
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J. Thorac. Cardiovasc. Surg. · Jul 2024
Impact of Dual Thoracic Recovery from Circulatory Death Donors on Heart and Lung Transplant Outcomes.
Concomitant heart and lung recovery can result in increased operative complexity, ischemic time, and competition for resources and anatomic territory. Dual thoracic recovery from circulatory death donors may have additional risks that are not fully understood. We investigated the effects of dual heart and lung recovery from circulatory death donors on thoracic transplant outcomes. ⋯ Recovering both the heart and lungs from a circulatory death donor does not negatively impact transplant outcomes. Outcomes in this population should continue to be investigated as more data and longer-term follow-up become available.