The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jun 2024
Perioperative and oncologic outcomes of pulmonary resection for synchronous oligometastatic non-small cell lung cancer: Evidence for surgery in advanced disease.
Recent randomized trials have demonstrated a survival advantage with the use of local consolidative therapy in oligometastatic non-small cell lung cancer; however, the indications for and outcomes after pulmonary resection as a component of local consolidative therapy remain ill defined. We sought to characterize the perioperative and long-term survival outcomes among patients with resected oligometastatic non-small cell lung cancer. ⋯ Pulmonary resection as a means of maximum locoregional control in oligometastatic non-small cell lung cancer is feasible and safe, and may be associated with durable long-term survival benefits. The frequency of systemic postoperative progression highlights an urgent need to characterize perioperative and oncologic outcomes after pulmonary resection in the current era of novel systemic therapies.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
The Majority of Pediatric Fontan Patients Have Excellent Post-Transplant Survival.
Many pediatric Fontan patients require heart transplant, but this cohort is understudied given the difficulty in identifying these patients in national registries. We sought to characterize survival post-transplant in a large cohort of pediatric patients undergoing the Fontan. ⋯ Pediatric Fontan post-transplant outcomes are promising, although early mortality remains high. For nondecompensated pediatric patients at transplant without end-organ disease (>63% of cohort), early mortality is circumvented and post-transplant survival is excellent and similar to all pediatric transplantation.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
The predictive capability of aortic stiffness index for aortic dissection among dilated ascending aortas.
We created a finite element model to predict the probability of dissection based on imaging-derived aortic stiffness and investigated the link between stiffness and wall tensile stress using our model. ⋯ Noninvasive transthoracic echocardiogram-derived aortic stiffness measurements may serve as an impactful metric toward predicting aortic dissection or quantifying dissection risk. A correlation between longitudinal stress and stiffness establishes an evidence-based link between a noninvasive stiffness parameter and stress state of the aorta with clinically apparent dissection events.
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J. Thorac. Cardiovasc. Surg. · Jun 2024
In Search of Similarity in Adverse Events Journeys of Left Ventricular Assist Device Patients.
The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Event data set contains an expansive collection of longitudinal evidence of the course of adverse events (AEs) of >15,000 patients who have received a left ventricular assist device (LVAD). Buried in the huge Event data set is knowledge that can provide a deeper understanding of the patterns of the "AE journey" of patients with LVAD. Thus, the goal of this study was to examine the Event data set from a comprehensive perspective to identify unique relationships and patterns of AEs, alert potential challenges, and suggest future research directions. ⋯ The high diversity and sparsity of the types and timing of AE occurrences make the AE journeys of patients dissimilar from each other, impeding the discovery of highly-patterned AE journeys among the patients. This study suggests 2 salient directions for future studies to tackle this issue using cluster analysis to cluster patients into more similar groups and translate these results into a practical clinical tool to forecast the next AE based on the history of previous AEs.