Pub Date : 2026-01-07DOI: 10.1016/j.athoracsur.2025.12.023
Hoang Duy Chiem, Phuong Thuy Nguyen, Manh Dien Truong, Buu Linh Tran, Kinh Bang Nguyen, Hoang Dinh Nguyen
Background: This study gives evaluations of the early-term results of minimally invasive cardiac surgery for definitive treatment of tetralogy of Fallot (TOF).
Methods: A study of 46 patients who were aged ≥3 months and suffered TOF was carried out during a period from May 2023 to May 2024.
Results: All 46 patients (mean age, 8.4 months; weight, 7.1 ± 1.8 kg) underwent TOF repair through right vertical infra-axillary thoracotomy. Only 1 patient required reintervention for electrode wire bleeding, managed through the same incision. Mean cardiopulmonary bypass and aortic clamp times were 174 ± 48 minutes and 108 ± 35 minutes, respectively. Average postoperative hospital stay was 10.3 ± 8.6 days. The most common early complications were postoperative pneumonia (26.1%) and junctional ectopic tachycardia (23.9%). Follow-up was conducted in all patients, with an average duration of 8.1 ± 4.3 months. At the last follow-up, right ventricular outflow tract pressure gradient decreased from 63 ± 23.2 mm Hg to 20 ± 9.8 mm Hg, and pulmonary valve annulus size increased from 8.7 ± 1.9 mm to 11.6 ± 1.8 mm. No deaths occurred during follow-up. Mild and moderate right ventricular outflow tract stenosis was observed in 22 (47.8%) and 2 (4.2%) patients, respectively. Moderate pulmonary valve regurgitation developed in 1 patient (2.1%).
Conclusions: The early-term result of minimally invasive cardiac surgery in the treatment of TOF is relatively positive, making this a promising alternative to the traditional method. However, further practice in a narrow space is required to reach proficiency.
{"title":"Minimally Invasive Cardiac Surgery for Treating Tetralogy of Fallot in Children in the Modern Era.","authors":"Hoang Duy Chiem, Phuong Thuy Nguyen, Manh Dien Truong, Buu Linh Tran, Kinh Bang Nguyen, Hoang Dinh Nguyen","doi":"10.1016/j.athoracsur.2025.12.023","DOIUrl":"10.1016/j.athoracsur.2025.12.023","url":null,"abstract":"<p><strong>Background: </strong>This study gives evaluations of the early-term results of minimally invasive cardiac surgery for definitive treatment of tetralogy of Fallot (TOF).</p><p><strong>Methods: </strong>A study of 46 patients who were aged ≥3 months and suffered TOF was carried out during a period from May 2023 to May 2024.</p><p><strong>Results: </strong>All 46 patients (mean age, 8.4 months; weight, 7.1 ± 1.8 kg) underwent TOF repair through right vertical infra-axillary thoracotomy. Only 1 patient required reintervention for electrode wire bleeding, managed through the same incision. Mean cardiopulmonary bypass and aortic clamp times were 174 ± 48 minutes and 108 ± 35 minutes, respectively. Average postoperative hospital stay was 10.3 ± 8.6 days. The most common early complications were postoperative pneumonia (26.1%) and junctional ectopic tachycardia (23.9%). Follow-up was conducted in all patients, with an average duration of 8.1 ± 4.3 months. At the last follow-up, right ventricular outflow tract pressure gradient decreased from 63 ± 23.2 mm Hg to 20 ± 9.8 mm Hg, and pulmonary valve annulus size increased from 8.7 ± 1.9 mm to 11.6 ± 1.8 mm. No deaths occurred during follow-up. Mild and moderate right ventricular outflow tract stenosis was observed in 22 (47.8%) and 2 (4.2%) patients, respectively. Moderate pulmonary valve regurgitation developed in 1 patient (2.1%).</p><p><strong>Conclusions: </strong>The early-term result of minimally invasive cardiac surgery in the treatment of TOF is relatively positive, making this a promising alternative to the traditional method. However, further practice in a narrow space is required to reach proficiency.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946788","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}
Pub Date : 2026-01-02DOI: 10.1016/j.athoracsur.2025.12.022
Nicholas G Smedira
{"title":"Curing Outflow Tract Obstruction Through Smaller Incisions.","authors":"Nicholas G Smedira","doi":"10.1016/j.athoracsur.2025.12.022","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.12.022","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901555","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}
Pub Date : 2026-01-02DOI: 10.1016/j.athoracsur.2025.12.021
Samuel Creden, Rakesh C Arora
{"title":"Preoperative Frailty Assessments: More than Meets the Eye.","authors":"Samuel Creden, Rakesh C Arora","doi":"10.1016/j.athoracsur.2025.12.021","DOIUrl":"https://doi.org/10.1016/j.athoracsur.2025.12.021","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901565","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.019
Angelo M Dell'Aquila
{"title":"Management of Type A Aortic Dissection: First, Exclude Cardiac Ischemia Intraoperatively, Then Proceed With Repair.","authors":"Angelo M Dell'Aquila","doi":"10.1016/j.athoracsur.2025.12.019","DOIUrl":"10.1016/j.athoracsur.2025.12.019","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893286","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.015
Whitney S Brandt
{"title":"Synchronous Primary Lung Cancer: Sequence of Therapy and Tumor Biology.","authors":"Whitney S Brandt","doi":"10.1016/j.athoracsur.2025.12.015","DOIUrl":"10.1016/j.athoracsur.2025.12.015","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893346","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.018
Joseph Seitlinger, Bertrand Routy, Moishe Liberman, Jonathan Spicer
{"title":"Toward Personalized Neoadjuvant Strategies: Using Metabolic and Biological Response to Guide Treatment Deescalation or Intensification.","authors":"Joseph Seitlinger, Bertrand Routy, Moishe Liberman, Jonathan Spicer","doi":"10.1016/j.athoracsur.2025.12.018","DOIUrl":"10.1016/j.athoracsur.2025.12.018","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890517","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.008
Cherie P Erkmen, Aitua Salami, Anastasiia K Tompkins, Ravi Ghanta, Matthew Romano, Aundrea Oliver, Panos Vardas, Richard D Mainwaring, Kirsten Freeman, Sara Periera, Adam A Doty, Ahmet Kilic, Stephen Yang, David T Cooke
Background: The Thoracic Surgery Directors Association In-Training Exam (TSITE) provides an annual, formative standardized assessment for cardiothoracic surgery trainees. This report outlines its historical development, governance, administration, and performance data from exams delivered from 2020 to 2025.
Methods: The TSITE is administered annually by the Thoracic Surgery Directors Association to assess trainee knowledge by using a structured taxonomy aligned with American Board of Thoracic Surgery qualification content. The multiple-choice question exam comprises 160 questions (80 cardiac, 80 thoracic) derived through a rigorous question-writing and vetting process. Annual metrics included exam completion time, average scores, performance distribution, and Cronbach alpha.
Results: Examinee numbers increased from 437 in 2020 to 567 in 2025. Cronbach alpha ranged from 0.80 to 0.86, reflecting high reliability. A shift from 4 options with 3 distractors to 3 options and 2 distractors in 2025 decreased average exam time. Score distributions demonstrated stable performance trends, with most trainees scoring between 50% and 69%.
Conclusions: The TSITE is a valid, reliable, and evolving personalized learning tool that supports both trainee self-assessment and programmatic benchmarking. Its iterative refinement reflects ongoing efforts to align with evolving clinical practice, American Board of Thoracic Surgery expectations, and user feedback.
{"title":"The Thoracic Surgery Directors Association In-Training Exam: Development, Implementation, and 6-Year Trends.","authors":"Cherie P Erkmen, Aitua Salami, Anastasiia K Tompkins, Ravi Ghanta, Matthew Romano, Aundrea Oliver, Panos Vardas, Richard D Mainwaring, Kirsten Freeman, Sara Periera, Adam A Doty, Ahmet Kilic, Stephen Yang, David T Cooke","doi":"10.1016/j.athoracsur.2025.12.008","DOIUrl":"10.1016/j.athoracsur.2025.12.008","url":null,"abstract":"<p><strong>Background: </strong>The Thoracic Surgery Directors Association In-Training Exam (TSITE) provides an annual, formative standardized assessment for cardiothoracic surgery trainees. This report outlines its historical development, governance, administration, and performance data from exams delivered from 2020 to 2025.</p><p><strong>Methods: </strong>The TSITE is administered annually by the Thoracic Surgery Directors Association to assess trainee knowledge by using a structured taxonomy aligned with American Board of Thoracic Surgery qualification content. The multiple-choice question exam comprises 160 questions (80 cardiac, 80 thoracic) derived through a rigorous question-writing and vetting process. Annual metrics included exam completion time, average scores, performance distribution, and Cronbach alpha.</p><p><strong>Results: </strong>Examinee numbers increased from 437 in 2020 to 567 in 2025. Cronbach alpha ranged from 0.80 to 0.86, reflecting high reliability. A shift from 4 options with 3 distractors to 3 options and 2 distractors in 2025 decreased average exam time. Score distributions demonstrated stable performance trends, with most trainees scoring between 50% and 69%.</p><p><strong>Conclusions: </strong>The TSITE is a valid, reliable, and evolving personalized learning tool that supports both trainee self-assessment and programmatic benchmarking. Its iterative refinement reflects ongoing efforts to align with evolving clinical practice, American Board of Thoracic Surgery expectations, and user feedback.</p>","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893349","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.020
Nicole M Mott, Elizabeth A David
{"title":"Mentorship, Sponsorship, and Beyond-Additional Considerations for Women in Cardiothoracic Surgery.","authors":"Nicole M Mott, Elizabeth A David","doi":"10.1016/j.athoracsur.2025.12.020","DOIUrl":"10.1016/j.athoracsur.2025.12.020","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893311","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}
Pub Date : 2025-12-31DOI: 10.1016/j.athoracsur.2025.12.017
Angelo M Dell'Aquila, Gabor Szabó
{"title":"A Step-by-Step Approach to Avoid Intraoperative Ischemia During Surgical Repair of Type A Aortic Dissection.","authors":"Angelo M Dell'Aquila, Gabor Szabó","doi":"10.1016/j.athoracsur.2025.12.017","DOIUrl":"10.1016/j.athoracsur.2025.12.017","url":null,"abstract":"","PeriodicalId":50976,"journal":{"name":"Annals of Thoracic Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890593","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}
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