Pub Date : 2025-03-03DOI: 10.1016/j.jtcvs.2025.02.004
Rajika Jindani, Cecilia Pompili
{"title":"Strengthening support for cardiothoracic surgery trainees in the face of reproductive rights challenges.","authors":"Rajika Jindani, Cecilia Pompili","doi":"10.1016/j.jtcvs.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.004","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1016/j.jtcvs.2025.01.032
Rirong Qu, Xiangning Fu
{"title":"Esophageal cancer invading adjacent organs: Esophagectomy combined organ resection may be a good approach.","authors":"Rirong Qu, Xiangning Fu","doi":"10.1016/j.jtcvs.2025.01.032","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.032","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.jtcvs.2025.02.005
Marc W Gerdisch
{"title":"Reply: Moonlight and Sunlight are the same.","authors":"Marc W Gerdisch","doi":"10.1016/j.jtcvs.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.005","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1016/j.jtcvs.2025.01.033
Thomas Bilfinger, Anne Bennett, Thomas A Bogue, Samuel Greenberg, Joshua Zhu, Joseph Pizzuti, Lee Ann Santore, Samantha Novotny, Jonathan D Price, Henry J Tannous, Lichun He, Jie Yang, A Laurie Shroyer
Background: Healthcare consolidation may force cardiac surgeons to operate at multiple centers. Little data exists as to this phenomenon's effect upon patients' quality of care as measured by risk-adjusted outcome (RAO) rates.
Objectives: To compare mitral valve repair (MVr) RAO rates between surgeons operating at multiple centers (MC) versus single-centers (SC); for MC surgeons, to compare MVr RAO rates between their primary and secondary centers.
Methods: The 2011-2019 Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database's MVr records were analyzed. MC surgeons performed MVr procedures at > 2 centers within a year; each MC surgeon's highest MVr volume ("primary") center was identified. Applying the STS-approved 2018 isolated-MVr risk models, study endpoints included risk-adjusted 30-day major morbidity or mortality (RA-MMM; based on operative death, dialysis, stroke, prolonged ventilation, mediastinitis, or repeat procedure) and prolonged length of stay (RA-PLOS). The impacts of surgeon's and hospital's MVr and total cardiac surgery volumes were evaluated.
Results: Compared to MC surgeons, SC surgeons had lower RA-MMM (OR 1.170, p < 0.001). After adjusting for surgeon and center volumes, this finding persisted (OR 1.141, p = 0.0155). MC surgeons experienced lower RA-MMM at their primary versus secondary centers (OR 1.269, p<.001); this finding was partially due to center-based volume variations (OR 1.130, p=.098). No SC versus MC surgeon RA-PLOS differences were found; however, regional RA-PLOS differences persisted.
Conclusion: Compared to single-center surgeons, reallocating surgeons' caseload across multiple centers has a statistically significant, negative impact on their MVr RAO rates.
{"title":"Mitral Valve Repair in the United States: Single-Center versus Multi-Center Surgeons' Risk-Adjusted Outcomes (13 words, 96 characters).","authors":"Thomas Bilfinger, Anne Bennett, Thomas A Bogue, Samuel Greenberg, Joshua Zhu, Joseph Pizzuti, Lee Ann Santore, Samantha Novotny, Jonathan D Price, Henry J Tannous, Lichun He, Jie Yang, A Laurie Shroyer","doi":"10.1016/j.jtcvs.2025.01.033","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.033","url":null,"abstract":"<p><strong>Background: </strong>Healthcare consolidation may force cardiac surgeons to operate at multiple centers. Little data exists as to this phenomenon's effect upon patients' quality of care as measured by risk-adjusted outcome (RAO) rates.</p><p><strong>Objectives: </strong>To compare mitral valve repair (MVr) RAO rates between surgeons operating at multiple centers (MC) versus single-centers (SC); for MC surgeons, to compare MVr RAO rates between their primary and secondary centers.</p><p><strong>Methods: </strong>The 2011-2019 Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database's MVr records were analyzed. MC surgeons performed MVr procedures at > 2 centers within a year; each MC surgeon's highest MVr volume (\"primary\") center was identified. Applying the STS-approved 2018 isolated-MVr risk models, study endpoints included risk-adjusted 30-day major morbidity or mortality (RA-MMM; based on operative death, dialysis, stroke, prolonged ventilation, mediastinitis, or repeat procedure) and prolonged length of stay (RA-PLOS). The impacts of surgeon's and hospital's MVr and total cardiac surgery volumes were evaluated.</p><p><strong>Results: </strong>Compared to MC surgeons, SC surgeons had lower RA-MMM (OR 1.170, p < 0.001). After adjusting for surgeon and center volumes, this finding persisted (OR 1.141, p = 0.0155). MC surgeons experienced lower RA-MMM at their primary versus secondary centers (OR 1.269, p<.001); this finding was partially due to center-based volume variations (OR 1.130, p=.098). No SC versus MC surgeon RA-PLOS differences were found; however, regional RA-PLOS differences persisted.</p><p><strong>Conclusion: </strong>Compared to single-center surgeons, reallocating surgeons' caseload across multiple centers has a statistically significant, negative impact on their MVr RAO rates.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.jtcvs.2025.02.020
Amit Iyengar, Cindy Song, Pavan Atluri
{"title":"Commentary: Looking to the future: Revisiting the volume-outcome relationship in mitral valve repair.","authors":"Amit Iyengar, Cindy Song, Pavan Atluri","doi":"10.1016/j.jtcvs.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.020","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1016/j.jtcvs.2025.02.016
Jenny Bui, Stanley Kalata, Rishindra M Reddy, Melissa Clark, Mary Hollenbeck, Nathan Mollberg, Shelly Lall, Andrew M Popoff
Objective: Evaluate the effectiveness of nodal harvest in sublobar resections (SLR) for peripheral non-small cell lung cancer (NSCLC).
Methods: Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for NSCLC from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥ 10 LNs, ≥5 lymph node stations (LNS), or 3 mediastinal LNS and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted (VATS), robot-assisted (RATS)).
Results: A total of 1398 patients receiving SLR were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNS harvested. RATS was associated with higher rates of harvesting ≥10 LNs (p < .001) or harvesting ≥5 LNS or 3/1 LNS (p < .001) compared with VATS for WR. Compared with open procedures and VATS, RATS was associated with higher rates of harvesting ≥5 LNS or 3/1 LNS for SG (p = 0.002; p = 0.003, respectively).
Conclusion: WR and SG have low rates of adequate LN harvesting. Robotic surgery was associated with improved LN harvesting rates. Given the increase interest in SLRs, continued focus on improving and increasing LN harvesting are needed.
{"title":"An Evaluation of Lymph Node Harvest in Sublobar Resections in a Statewide Quality Collaborative.","authors":"Jenny Bui, Stanley Kalata, Rishindra M Reddy, Melissa Clark, Mary Hollenbeck, Nathan Mollberg, Shelly Lall, Andrew M Popoff","doi":"10.1016/j.jtcvs.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.02.016","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effectiveness of nodal harvest in sublobar resections (SLR) for peripheral non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>Retrospective review of prospectively collected data for patients who underwent wedge resection (WR) and segmentectomy (SG) for NSCLC from January 2015 to March 2023 at 21 centers within a statewide quality collaborative. The primary end point was the extent of lymph node (LN) harvest defined as ≥ 10 LNs, ≥5 lymph node stations (LNS), or 3 mediastinal LNS and 1 hilar LNS (3/1 LNS). We also examined the LN harvest stratified by operative approach (open, video-assisted (VATS), robot-assisted (RATS)).</p><p><strong>Results: </strong>A total of 1398 patients receiving SLR were reviewed: 919 (65.7%) with WR and 479 (34.3%) with SG. Only 15.6% (152) WR and 54.6% (263) SG had an adequate number of LNS harvested. RATS was associated with higher rates of harvesting ≥10 LNs (p < .001) or harvesting ≥5 LNS or 3/1 LNS (p < .001) compared with VATS for WR. Compared with open procedures and VATS, RATS was associated with higher rates of harvesting ≥5 LNS or 3/1 LNS for SG (p = 0.002; p = 0.003, respectively).</p><p><strong>Conclusion: </strong>WR and SG have low rates of adequate LN harvesting. Robotic surgery was associated with improved LN harvesting rates. Given the increase interest in SLRs, continued focus on improving and increasing LN harvesting are needed.</p>","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-22DOI: 10.1016/j.jtcvs.2025.01.024
Anthony V Norman, Irving L Kron
{"title":"Reply: Saving hearts: Utilizing cardiac catheterization after coronary artery bypass grafting.","authors":"Anthony V Norman, Irving L Kron","doi":"10.1016/j.jtcvs.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.024","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.jtcvs.2025.01.019
Ali Hage, Eugene A Grossi
{"title":"Commentary: Standing on the shoulders of giants to slide down the learning curve.","authors":"Ali Hage, Eugene A Grossi","doi":"10.1016/j.jtcvs.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.019","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-20DOI: 10.1016/j.jtcvs.2025.01.018
Yunpeng Liu, Mengxia Qi, YanBo Wang
{"title":"Exploring the impact of fenestration closure on long-term outcomes in the modified Fontan operation.","authors":"Yunpeng Liu, Mengxia Qi, YanBo Wang","doi":"10.1016/j.jtcvs.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.jtcvs.2025.01.018","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1016/S0022-5223(25)00085-6
{"title":"Information for readers; CMK","authors":"","doi":"10.1016/S0022-5223(25)00085-6","DOIUrl":"10.1016/S0022-5223(25)00085-6","url":null,"abstract":"","PeriodicalId":49975,"journal":{"name":"Journal of Thoracic and Cardiovascular Surgery","volume":"169 3","pages":"Page 1032"},"PeriodicalIF":4.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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