Annals of Thoracic Surgery最新文献

英文中文

Durability of Surgical Mitral Repair vs Transcatheter Edge-to-Edge Repair in Patients With Degenerative Mitral Regurgitation 退行性二尖瓣返流患者外科二尖瓣修复与经导管边缘到边缘修复的耐久性。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-08-21 DOI: 10.1016/j.athoracsur.2025.07.041

Nadia H. Bakir MD , Annalisa Bernabei MD , Daniel J.P. Burns MD, MPhil , Penny L. Houghtaling MS , Serge Harb MD , Lars G. Svensson MD, PhD , Eugene H. Blackstone MD , Tarek Malas MD, MPH , A. Marc Gillinov MD

Background

This study compared durability of mitral valve repair and changes in left ventricular function in patients with degenerative mitral regurgitation due to posterior leaflet prolapse undergoing transcatheter edge-to-edge mitral valve repair or surgical mitral valve repair.

Methods

From January 1, 2014, to January 1, 2023, 1046 adults underwent successful mitral repair (mitral regurgitation [MR] <2+ and mean mitral gradient <10 mm Hg at predischarge echocardiography) with transcatheter (n = 97 [9%]) or surgical (n = 949 [91%]) mitral repair (leaflet resection + prosthetic annuloplasty) for posterior leaflet prolapse. Longitudinal analysis of postoperative echocardiography data was used to assess durability of repair and temporal ventricular remodeling. Groups were propensity matched (n = 56 matched pairs) on cardiac functional and morphologic characteristics.

Results

Relative to the transcatheter group, surgical mitral repair patients had fewer comorbidities. Concomitant tricuspid repair was performed in 104 of 949 surgical (11%) and 11 of 97 transcatheter repairs (11%), and atrial fibrillation ablation in 112 of 949 surgical patients (12%). After adjusting for baseline differences in heart characteristics, 51 of 56 patients (91%) after transcatheter and 2 of 56 patients (4%) after surgical repair showed mild mitral regurgitation at predischarge echocardiography (P < .0001). In the matched groups, prevalence of moderate or severe mitral regurgitation at 1 and 3 years was 34% and 43% after transcatheter intervention and 1.6% and 3.4% after surgery (P < .0001), respectively. Freedom from reintervention at 3 years was 96% after transcatheter intervention and 100% after surgical repair.

Conclusions

Surgical repair provides superior midterm repair durability than transcatheter mitral repair in patients with degenerative mitral regurgitation caused by posterior leaflet prolapse. Further studies are warranted to better understand the clinical significance of this finding with regard to symptom burden and valve degeneration.

背景：比较二尖瓣后小叶脱垂致退行性二尖瓣返流患者行经导管边缘到边缘二尖瓣修复或手术二尖瓣修复的持久性和左心室功能的变化。方法：2014年1月1日至2023年1月1日，1046例成人二尖瓣修复成功(mr结果：相对于经导管组，手术二尖瓣修复患者的合并症较少。合并三尖瓣修复在104/949例（11%）手术患者和11/97例（11%）经导管修复患者中进行，房颤消融在112/949例（12%）手术患者中进行。在调整心脏特征的基线差异后，51/56（91%）经导管和2/56（4%）经手术修复的患者在出院前回声中显示轻度二尖瓣反流(结论：对于后小叶脱垂引起的退行性二尖瓣反流患者，手术修复比经导管二尖瓣修复具有更好的中期修复耐久性。为了更好地了解这一发现在症状负担和瓣膜变性方面的临床意义，需要进一步的研究。

{"title":"Durability of Surgical Mitral Repair vs Transcatheter Edge-to-Edge Repair in Patients With Degenerative Mitral Regurgitation","authors":"Nadia H. Bakir MD , Annalisa Bernabei MD , Daniel J.P. Burns MD, MPhil , Penny L. Houghtaling MS , Serge Harb MD , Lars G. Svensson MD, PhD , Eugene H. Blackstone MD , Tarek Malas MD, MPH , A. Marc Gillinov MD","doi":"10.1016/j.athoracsur.2025.07.041","DOIUrl":"10.1016/j.athoracsur.2025.07.041","url":null,"abstract":"<div><h3>Background</h3><div>This study compared durability of mitral valve repair and changes in left ventricular function in patients with degenerative mitral regurgitation due to posterior leaflet prolapse undergoing transcatheter edge-to-edge mitral valve repair or surgical mitral valve repair.</div></div><div><h3>Methods</h3><div>From January 1, 2014, to January 1, 2023, 1046 adults underwent successful mitral repair (mitral regurgitation [MR] <2+ and mean mitral gradient <10 mm Hg at predischarge echocardiography) with transcatheter (n = 97 [9%]) or surgical (n = 949 [91%]) mitral repair (leaflet resection + prosthetic annuloplasty) for posterior leaflet prolapse. Longitudinal analysis of postoperative echocardiography data was used to assess durability of repair and temporal ventricular remodeling. Groups were propensity matched (n = 56 matched pairs) on cardiac functional and morphologic characteristics.</div></div><div><h3>Results</h3><div>Relative to the transcatheter group, surgical mitral repair patients had fewer comorbidities. Concomitant tricuspid repair was performed in 104 of 949 surgical (11%) and 11 of 97 transcatheter repairs (11%), and atrial fibrillation ablation in 112 of 949 surgical patients (12%). After adjusting for baseline differences in heart characteristics, 51 of 56 patients (91%) after transcatheter and 2 of 56 patients (4%) after surgical repair showed mild mitral regurgitation at predischarge echocardiography (<em>P</em> < .0001). In the matched groups, prevalence of moderate or severe mitral regurgitation at 1 and 3 years was 34% and 43% after transcatheter intervention and 1.6% and 3.4% after surgery (<em>P</em> < .0001), respectively. Freedom from reintervention at 3 years was 96% after transcatheter intervention and 100% after surgical repair.</div></div><div><h3>Conclusions</h3><div>Surgical repair provides superior midterm repair durability than transcatheter mitral repair in patients with degenerative mitral regurgitation caused by posterior leaflet prolapse. Further studies are warranted to better understand the clinical significance of this finding with regard to symptom burden and valve degeneration.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"121 3","pages":"Pages 581-588"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Securing Lung Cancer Screening, The First Step 确保肺癌筛查，第一步。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-09-02 DOI: 10.1016/j.athoracsur.2025.08.022

Nicole M. Mott MD, MSCR, Robert A. Meguid MD, MPH, A. Mark Fendrick MD

引用次数: 0

Degenerative Mitral Disease: The Valve We Repair, The Future We Shape 退行性二尖瓣疾病：我们修复的瓣膜，我们塑造的未来

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-09-18 DOI: 10.1016/j.athoracsur.2025.09.004

Vinay Badhwar MD

引用次数: 0

Beyond Mentorship and Sponsorship, Persistent Inequities Faced by Female Cardiothoracic Surgeons 超越指导和赞助，女性心胸外科医生面临的持续不平等。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-01 DOI: 10.1016/j.athoracsur.2025.10.009

Ellelan Degife MD, Mavi Eyuboglu BS, A. Claire Watkins MD

引用次数: 0

Misinformation and Overestimation of Computed Tomography Lung Cancer Screening Harms—Methodology Matters: A Joint Statement from The Society of Thoracic Surgeons, the American Society for Radiation Oncology, and the American College of Radiology 计算机断层扫描肺癌筛查危害的错误信息和高估——方法问题：胸外科学会、美国放射肿瘤学学会和美国放射学会的联合声明。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.athoracsur.2025.11.005

Haley I. Tupper MD , Joseph B. Shrager MD , Drew Moghanaki MD , Charles B. Simone II MD , Ella A. Kazerooni MD , Eric M. Hart MD , David T. Cooke MD , Jeffrey B. Velotta MD , Betty C. Tong MD , Hari B. Keshava MD , Cherie P. Erkmen MD , Chi-Fu J. Yang MD , Elliot L. Servais MD

引用次数: 0

Lipoprotein(a) and Coronary Bypass Outcomes: Revisiting a Forgotten Predictor 脂蛋白(a)和冠状动脉搭桥的结果：重新审视一个被遗忘的预测因子。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-07-26 DOI: 10.1016/j.athoracsur.2025.07.006

Khaled Ebrahim Al Ebrahim FRCSC

引用次数: 0

Why Surgery Has a Role in Pleural Mesothelioma 为什么手术在胸膜间皮瘤中起作用。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-07-26 DOI: 10.1016/j.athoracsur.2025.07.011

Raphael Bueno MD

引用次数: 0

Securing CT Lung Cancer Screening Access: Implications of the Supreme Court’s Ruling in Kennedy v. Braidwood 确保CT肺癌筛查的可及性：最高法院对肯尼迪诉布莱德伍德案裁决的影响。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-08-12 DOI: 10.1016/j.athoracsur.2025.07.035

Elochukwu Ezenwankwo MS (Med), MPH

引用次数: 0

Outcomes of Re-Repair vs Replacement After Failed Primary Mitral Regurgitation Repair: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis 原发性二尖瓣返流修复失败后再修复与置换的结果：STS成人心脏外科数据库分析

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2025-11-22 DOI: 10.1016/j.athoracsur.2025.11.017

Michael E. Ibrahim MD, PhD , Omar Toubat MD, PhD , Alexandra E. Sperry MD , Levi Bonnell PhD , Christian Elenbaas MS , Isao Anzai MD , Paul N. Fiorilli MD , Robert O. Bonow MD , Robert L. Smith MD , Robert H. Habib PhD , Michael A. Acker MD , Wilson Y. Szeto MD

Background

With the increasing incidence of primary mitral valve repair, the number of patients requiring reintervention for degenerative mitral regurgitation (MR) has also increased. We examined whether mitral valve re-repair is superior to replacement after failed repair for degenerative MR.

Methods

Patients undergoing isolated surgical mitral valve repair for degenerative MR were identified from The Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2023. Failed mitral repair was defined as any subsequent reoperations after 30 days on the mitral valve. Predictors for re-repair were calculated by multivariable logistic regression, and longitudinal survival was analyzed with linkage to the National Death Index and the Centers for Medicare & Medicaid Services data using Cox regression.

Results

Overall, 1749 patients required reoperation on the mitral valve during the study period, including 410 (23.4%) re-repairs and 1339 (76.6%) replacements. Unadjusted overall survival was superior for patients undergoing re-repair compared with replacement (hazard ratio [HR], 3.54; 95% CI, 2.01-6.24; P < .001). This survival benefit persisted even after extensive risk adjustment (HR, 1.96; 95% CI, 1.10-3.52; P = .022) and propensity score matching (HR, 1.95; 95% CI, 1.01-3.82; P = .045) controlling for patient and valve-related characteristics. Re-repair patients had lower postoperative morbidity or mortality (6.8% vs 11%; P = .042), with no differences in postoperative stroke or reoperation.

Conclusions

In this largest to date analysis of reoperations for degenerative MR, those undergoing re-repair were found to have superior intermediate-term survival compared with mitral valve replacement. These findings suggest that re-repair may be preferred in eligible patients with recurrent MR.

背景：随着初级二尖瓣修复发生率的增加，退行性二尖瓣返流（MR）需要再干预的患者数量也在增加。方法：从2011年7月至2023年12月的STS成人心脏外科数据库中筛选行二尖瓣分离手术修复的退行性MR患者。二尖瓣修复失败定义为二尖瓣30天后的再手术。通过多变量logistic回归计算再修复的预测因子，并使用Cox回归分析纵向生存率与国家死亡指数和医疗保险和医疗补助服务中心数据的联系。结果：总体而言，1,749例患者在研究期间需要再次手术二尖瓣，其中410例（23.4%）重新修复，1,339例（76.6%）置换术。与二尖瓣置换术相比，接受再植术患者的未调整总生存率更高（风险比[HR] 3.54, 95% CI 2.01-6.24）。结论：在这项迄今为止最大的对退行性磁共振再手术的分析中，发现接受再植术患者的中期生存率优于二尖瓣置换术。这些发现表明，对于符合条件的复发性MR患者，再修复可能是首选。

{"title":"Outcomes of Re-Repair vs Replacement After Failed Primary Mitral Regurgitation Repair: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis","authors":"Michael E. Ibrahim MD, PhD , Omar Toubat MD, PhD , Alexandra E. Sperry MD , Levi Bonnell PhD , Christian Elenbaas MS , Isao Anzai MD , Paul N. Fiorilli MD , Robert O. Bonow MD , Robert L. Smith MD , Robert H. Habib PhD , Michael A. Acker MD , Wilson Y. Szeto MD","doi":"10.1016/j.athoracsur.2025.11.017","DOIUrl":"10.1016/j.athoracsur.2025.11.017","url":null,"abstract":"<div><h3>Background</h3><div>With the increasing incidence of primary mitral valve repair, the number of patients requiring reintervention for degenerative mitral regurgitation (MR) has also increased. We examined whether mitral valve re-repair is superior to replacement after failed repair for degenerative MR.</div></div><div><h3>Methods</h3><div>Patients undergoing isolated surgical mitral valve repair for degenerative MR were identified from The Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2023. Failed mitral repair was defined as any subsequent reoperations after 30 days on the mitral valve. Predictors for re-repair were calculated by multivariable logistic regression, and longitudinal survival was analyzed with linkage to the National Death Index and the Centers for Medicare & Medicaid Services data using Cox regression.</div></div><div><h3>Results</h3><div>Overall, 1749 patients required reoperation on the mitral valve during the study period, including 410 (23.4%) re-repairs and 1339 (76.6%) replacements. Unadjusted overall survival was superior for patients undergoing re-repair compared with replacement (hazard ratio [HR], 3.54; 95% CI, 2.01-6.24; <em>P</em> < .001). This survival benefit persisted even after extensive risk adjustment (HR, 1.96; 95% CI, 1.10-3.52; <em>P</em> = .022) and propensity score matching (HR, 1.95; 95% CI, 1.01-3.82; <em>P</em> = .045) controlling for patient and valve-related characteristics. Re-repair patients had lower postoperative morbidity or mortality (6.8% vs 11%; <em>P</em> = .042), with no differences in postoperative stroke or reoperation.</div></div><div><h3>Conclusions</h3><div>In this largest to date analysis of reoperations for degenerative MR, those undergoing re-repair were found to have superior intermediate-term survival compared with mitral valve replacement. These findings suggest that re-repair may be preferred in eligible patients with recurrent MR.</div></div>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":"121 3","pages":"Pages 571-579"},"PeriodicalIF":3.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Efficiency and Utility of The Society of Thoracic Surgeons General Thoracic Surgeons Database 提高胸外科医师学会普通胸外科医师数据库的效率和效用。

IF 3.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery

Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.athoracsur.2025.12.025

Benjamin D. Kozower MD, MPH

引用次数: 0

首页上一页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Annals of Thoracic Surgery

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀