Seminars in Thoracic and Cardiovascular Surgery最新文献

英文中文

Preference for Segmentectomy Over Wedge Resection for Small-Sized Non-Small Cell Lung Cancer. 非小细胞肺癌的节段切除术优于楔形切除术。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-04 DOI: 10.1053/j.semtcvs.2025.05.013

Yasuhiro Tsutani

引用次数: 0

The Ninth Edition TNM Stage Classification of Lung Cancer: What's New? 第九版TNM肺癌分期分类：有什么新进展？

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-04 DOI: 10.1053/j.semtcvs.2025.05.014

James Huang, Frank Detterbeck

引用次数: 0

Novel Valve Sparing Aortic Root Replacement Device: Between a David and a Yacoub. 新型主动脉根部置换术：介于大卫和雅各布之间。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-03 DOI: 10.1053/j.semtcvs.2025.06.004

Joon Bum Kim, Y Joseph Woo

引用次数: 0

Bentall Procedure: A Long-term, Single Center Experience 本特尔手术：一个长期的，单中心的经验。

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-03 DOI: 10.1053/j.semtcvs.2025.06.003

Giacomo Murana MD, PhD , Luca Di Marco MD, PhD , Luca Zanella MD , Paola Rucci Dstat , Marta Di Carlo MD , Chiara Nocera MD , Francesco Brandini MD , Francesco Campanini MD , Davide Pacini MD, PhD

Though the Bentall operation is widely performed worldwide, data on long-term outcomes and rates of proximal reintervention is lacking. This study describes 15-year outcomes from a single center focusing on the risk of proximal reintervention and comparing biological vs mechanical Bentall. Two thousand patients underwent Bentall procedure at our institution from October 1979 to May 2023. The bio-Bentall group included 874 patients (43.7%), the mechanical group 1126 (56.3%). Patients from the biological group were older (mean age biological group=68.3, SD=8.0 vs 53.6 years for mechanical group, SD=12.4, p<0.001). They presented a higher incidence of comorbidities and urgent or emergent surgery. Mechanical Bentall patients were more likely to have Marfan syndrome, bicuspid aortic valve (BAV) and previous cardiac surgery. In-hospital mortality showed no significant difference between groups (47 −4.18%- vs 52 −5.95%-, p=0.069). Patients with a biological prosthesis had lower survival rates at 10 and 15 years (57.8% and 28.6%, respectively, vs 69.5% and 56.1%, p<0.001) and a threefold risk of proximal redo at follow-up compared to mechanical Bentall (8.2% and 15.2% at 10 and 15 years vs 2.4% and 4.6%, respectively, HR=3.512) The risk of reintervention was higher in the biological group in each age group. In the overall sample, the risk declines with age until 55 years, then slowly increases. The Bentall operation provides satisfactory long-term outcomes. Patients treated with a bio-Bentall showed a worse survival and freedom from proximal reintervention, even in the same age-group as mechanical Bentall. However, reintervention rates in the biological group are still acceptable.

尽管Bentall手术在世界范围内广泛应用，但缺乏长期疗效和近端再介入率的数据。本研究描述了单个中心15年的结果，重点关注近端再干预的风险，并比较了生物和机械本特尔。从1979年10月到2023年5月，2000名患者在我们机构接受了本特尔手术。bio-Bentall组874例（43.7%），机械组1126例（56.3%）。生物学组患者年龄较大(生物学组平均年龄68.3岁，SD=8.0，而机械组平均年龄53.6岁，SD=12.4, p

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引用次数: 0

Lung Protection in Donation after Circulatory Death with Thoracoabdominal Normothermic Regional Perfusion. 胸腹恒温区域灌注对循环性死亡后肺捐献的保护作用。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-03 DOI: 10.1053/j.semtcvs.2025.05.011

Sarah Y Park, Elizabeth J Bashian, Emily Hay-Arthur, Thomas F O'Shea, Michael T Cain, Jordan R H Hoffman

Donation after circulatory death (DCD) has expanded the lung transplantation donor pool akin to other solid organ transplants, and thoracoabdominal normothermic regional perfusion (TA-NRP) of DCD lung allografts is a growing area of study. There remain some concerns regarding the impact of TA-NRP on DCD lung allograft pulmonary edema and subsequent development of primary graft dysfunction impacting graft and recipient survival and postoperative lung function. Here we present a review article discussing the existing literature on DCD lung transplantation, with a focus on TA-NRP recovery, and lung protection strategies during DCD lung recovery with TA-NRP.

与其他实体器官移植一样，循环性死亡后的捐赠扩大了肺移植供体池，而循环性死亡后的肺同种异体移植胸腹恒温区域灌注（TA-NRP）是一个日益增长的研究领域。TA-NRP对DCD同种异体肺移植肺水肿的影响以及随后发生的原发性移植物功能障碍影响移植物和受体生存和术后肺功能的影响仍存在一些担忧。在此，我们回顾了现有的关于DCD肺移植的文献，重点讨论了TA-NRP的恢复，以及TA-NRP在DCD肺恢复过程中的肺保护策略。

引用次数: 0

Chest Wall Resection and Reconstruction for T4 Non-Small Cell Lung Cancer. T4非小细胞肺癌的胸壁切除与重建。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-07-02 DOI: 10.1053/j.semtcvs.2025.05.012

Raul Caso, Whitney Sutton, Manjit S Bains, Farooq Shahzad, David R Jones, Gaetano Rocco

Chest wall resection and reconstruction for T4 non-small cell lung cancer (NSCLC) represents a challenging surgical scenario; T4 Pancoast tumors and tumors involving the spine (T4 spine) are the most frequently encountered subsets. Multidisciplinary assessment is performed to select the optimal surgical approach, determine the extent of resection necessary to obtain tumor-free margins, define the geometric characteristics of the chest wall defect, and choose the most appropriate reconstructive materials. Two or 3 incisions, selected on the basis of the individual patient, are recommended to access T4 Pancoast tumors. Depending on the level of involvement of the vertebral structure, the approach to the T4 spine may require a thoracotomy and a midline posterior incision. Chest wall reconstruction is often complicated by sequelae of chemoradiation or chemoimmunotherapy, superimposed infection, or anatomic derangement after previous surgery. Since 2019, the Chest Wall Multidisciplinary Team at Memorial Sloan Kettering Cancer Center has generated several recommendations for chest wall resection and reconstruction for patients with T4 tumors. Anterior defects are generally reconstructed using rigid materials. T4 Pancoast tumors are preferentially reconstructed using semirigid (biologic) materials and a bulky free flap, which provide similar stability as rigid materials and avoid impingement on the thoracic inlet neurovascular bundle. For posterior defects, semirigid resorbable materials are used to avoid pleural fluid extravasation and seromas. The use of free flaps allows more-extensive chest wall resection and promises a high likelihood of R0 resection, with morbidity similar to that with regional flaps. A multidisciplinary approach ensures optimal management of these complex cases.

T4非小细胞肺癌（NSCLC）的胸壁切除和重建是一个具有挑战性的手术方案；T4 Pancoast肿瘤和累及脊柱（T4脊柱）的肿瘤是最常见的亚群。进行多学科评估以选择最佳手术入路，确定获得无肿瘤边缘所需的切除程度，确定胸壁缺损的几何特征，并选择最合适的重建材料。建议根据患者的具体情况选择2个或3个切口进入T4 Pancoast肿瘤。根据椎体结构受累程度的不同，进入T4脊柱可能需要开胸和后路中线切口。胸壁重建常伴随放化疗或免疫化疗的后遗症、叠加感染或先前手术后的解剖紊乱。自2019年以来，纪念斯隆凯特琳癌症中心的胸壁多学科团队已经为T4肿瘤患者的胸壁切除和重建提出了几项建议。前路缺损一般采用刚性材料重建。T4 Pancoast肿瘤优先使用半刚性（生物）材料和大块自由皮瓣重建，其提供与刚性材料相似的稳定性，并避免对胸入口神经血管束的冲击。对于后侧缺损，采用半刚性可吸收材料以避免胸腔积液外溢和血清肿。自由皮瓣的使用允许更广泛的胸壁切除，并有很高的R0切除的可能性，其发病率与区域皮瓣相似。多学科方法确保这些复杂病例的最佳管理。

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引用次数: 0

Current Challenges to In-Hospital Extracorporeal Cardiopulmonary Resuscitation. 当前院内体外心肺复苏面临的挑战。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-06-27 DOI: 10.1053/j.semtcvs.2025.06.001

Kaitlyn A Brennan, Aditi Balakrishna, Christina Anne Jelly

引用次数: 0

Intraoperative Imaging and Localization Techniques. 术中成像和定位技术。

IF 2.6 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-06-27 DOI: 10.1053/j.semtcvs.2025.05.010

Yelizaveta Gribkova, Katherine D Gray

引用次数: 0

Improving Repair Durability in Severe Ischemic Mitral Regurgitation: Revisiting Patient Selection and Adjunctive Repair Techniques 提高严重缺血性二尖瓣返流的修复耐久性：重新审视患者选择和辅助修复技术。

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-06-27 DOI: 10.1053/j.semtcvs.2025.04.009

Rui Li MD, PhD, Min Hu MD, PhD, Jing Fang MD, PhD, Xiang Wei MD, PhD, Song Wan MD, FRCS

Ischemic mitral regurgitation (IMR) is a complex heterogeneous complication following myocardial infarction, characterized by left ventricular (LV) remodeling and subsequent valvular distortion. The primary mechanisms include papillary muscle displacement, mitral leaflet tethering, and impaired coaptation following annular dilatation. IMR is associated with poor prognosis and an increased incidence of heart failure. We reviewed studies on the surgical management of IMR published over the past 2 decades. While mitral valve repair has been favored for its advantages of low perioperative mortality and LV function preservation, high rates of mitral regurgitation recurrence limit its long-term durability. Regarding repair strategy, apart from restrictive mitral annuloplasty, the adjunctive techniques of papillary muscle relocation, papillary muscle approximation, and leaflet augmentation have been proposed. These approaches aim to address LV remodeling and improve leaflet coaptation by mitigating subvalvular tethering. Moreover, the application of true-size annuloplasty and “functional repair” strategies in IMR patients with enlarged LV emphasizes the need to tailor interventions to patients’ LV dimensions and dynamic changes. Accumulating clinical evidence highlights the importance of meticulous patient selection and functional mitral valve repair, which remains a promising approach contingent on enhanced understanding of IMR’s pathophysiology and its interplay with LV remodeling. The current review summarizes our patient selection criteria and indications for surgical repair (including the use of adjunctive techniques of subvalvular intervention) or mitral valve replacement.

缺血性二尖瓣反流（IMR）是心肌梗死后的一种复杂的异质并发症，其特征是左室（LV）重构和随后的瓣膜畸变。其主要机制包括乳头肌移位、二尖瓣小叶栓系以及环扩张后的适应功能受损。IMR与预后不良和心力衰竭发生率增加有关。我们回顾了过去二十年来发表的关于IMR手术治疗的研究。二尖瓣修复术因其低围手术期死亡率和保留左室功能的优势而受到青睐，但二尖瓣返流的高复发率限制了其长期的持久性。关于修复策略，除了限制性二尖瓣环成形术外，还提出了乳头肌移位、乳头肌逼近和小叶增大的辅助技术。这些方法旨在通过减轻瓣下栓系来解决左室重塑和改善小叶适应。此外，在LV扩大的IMR患者中应用真实尺寸的环成形术和“功能修复”策略，强调需要根据患者的LV尺寸和动态变化量身定制干预措施。越来越多的临床证据强调了细致的患者选择和功能二尖瓣修复的重要性，这仍然是一种有前途的方法，取决于对IMR病理生理学及其与左室重塑的相互作用的进一步了解。目前的综述总结了我们的患者选择标准和手术修复（包括使用瓣下介入辅助技术）或二尖瓣置换术的适应症。

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引用次数: 0

Commentary: The Knife’s Edge of Carinal Resection 评论：隆突切除的刀口。

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Seminars in Thoracic and Cardiovascular Surgery

Pub Date : 2025-06-25 DOI: 10.1053/j.semtcvs.2025.06.002

Marie L. Jacobs MD, Paul L. Feingold MD, MHS, (Assistant Professor)

引用次数: 0

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