Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.08.010
Lauren C. Ryan BS , Sania Choudhary , Ntemena Kapula MAS , Augustine Kang PhD , Laura G. Shula PA-C , Irmina A. Elliott MD , Brandon A. Guenthart MD , Douglas Z. Liou MD , Leah M. Backhus MD, MPH , Mark F. Berry MD , Joseph B. Shrager MD , Natalie S. Lui MD
Background
Lung cancer remains the leading cause of cancer mortality in the United States, but only 4.5% of eligible people undergo recommended screening. We hypothesize that low community awareness remains a barrier to lung cancer screening.
Methods
A cross-sectional survey was conducted in a convenience sample of attendees at our institution’s community health fair. Survey topics included demographics, smoking history, cancer history, lung cancer screening knowledge, and perceptions of screening risks and benefits.
Results
Of 214 survey participants, 139 (65%) were women, and there were 98 (46%) Asian and 86 (40%) White participants. Almost a third of the sample had worked in health care, and just more than a half had completed some graduate school. There were only 6 (2.8%) current smokers and 28 (13%) former smokers. Most participants (71%) did not know there was a way to screen for lung cancer. Most participants (66%) knew that cigarette smoking was the risk factor considered for lung cancer screening, but very few knew the screening criteria. More than 75% of participants chose “strongly agree” or “agree” that several benefits of lung cancer screening are important to consider, but only 50.0% to 66.3% for several risks. Most participants (71%) responded that they are “very likely” or “likely” to undergo screening if eligible.
Conclusions
In a survey study at a community health fair, community awareness of lung cancer screening was very low, but most participants said they would be willing to be screened if eligible. Community education is critical in increasing our lung cancer screening rates.
{"title":"Community Awareness of Lung Cancer Screening: A Cross-Sectional Survey","authors":"Lauren C. Ryan BS , Sania Choudhary , Ntemena Kapula MAS , Augustine Kang PhD , Laura G. Shula PA-C , Irmina A. Elliott MD , Brandon A. Guenthart MD , Douglas Z. Liou MD , Leah M. Backhus MD, MPH , Mark F. Berry MD , Joseph B. Shrager MD , Natalie S. Lui MD","doi":"10.1016/j.atssr.2024.08.010","DOIUrl":"10.1016/j.atssr.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer remains the leading cause of cancer mortality in the United States, but only 4.5% of eligible people undergo recommended screening. We hypothesize that low community awareness remains a barrier to lung cancer screening.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in a convenience sample of attendees at our institution’s community health fair. Survey topics included demographics, smoking history, cancer history, lung cancer screening knowledge, and perceptions of screening risks and benefits.</div></div><div><h3>Results</h3><div>Of 214 survey participants, 139 (65%) were women, and there were 98 (46%) Asian and 86 (40%) White participants. Almost a third of the sample had worked in health care, and just more than a half had completed some graduate school. There were only 6 (2.8%) current smokers and 28 (13%) former smokers. Most participants (71%) did not know there was a way to screen for lung cancer. Most participants (66%) knew that cigarette smoking was the risk factor considered for lung cancer screening, but very few knew the screening criteria. More than 75% of participants chose “strongly agree” or “agree” that several benefits of lung cancer screening are important to consider, but only 50.0% to 66.3% for several risks. Most participants (71%) responded that they are “very likely” or “likely” to undergo screening if eligible.</div></div><div><h3>Conclusions</h3><div>In a survey study at a community health fair, community awareness of lung cancer screening was very low, but most participants said they would be willing to be screened if eligible. Community education is critical in increasing our lung cancer screening rates.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 113-117"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Ross procedure can be an ideal option in infective endocarditis (IE) due to greater resistance to infection. However, limited literature has highlighted the comparison with conventional prostheses in this setting.
Methods
Between February 2013 and September 2022, 25 patients (median age, 50 years) underwent a Ross procedure for IE (Ross group). The results were compared with those after other aortic valve procedures (aortic valve replacement and aortic root replacement) for IE (n = 37, other group.
Results
The patients in the Ross group included more intravenous drug users and had more prosthetic valve endocarditis and annular abscess formation compared with the other group. Although cardiopulmonary bypass time and aortic cross-clamp time were significantly longer (P < .001 and P = .003, respectively) and the blood requirements were significantly higher (P = .001) in the Ross group, most postoperative short-term outcomes were equivalent between the 2 groups. During follow-up, 1 patient (4%) required reoperation in the Ross group, whereas 6 patients (16%) required reoperation in the other group. Freedom from composite events was significantly better in the Ross group (P = .04). Multivariable analysis found the Ross procedure, compared with other procedures, was a significant independent protective factor for composite end points (P = .03).
Conclusions
For IE, despite surgical complexity, the Ross procedure yielded short-term outcomes similar to other procedures. In the midterm, the Ross procedure provides a lower reoperation rate, resulting in significantly fewer composite events. The Ross procedure appears to be a better option for patients with IE, but long-term follow-up is necessary.
{"title":"The Ross Procedure in Active Infective Endocarditis: A Comparison With Conventional Prostheses","authors":"Hiromu Kehara MD, PhD , Mohammed Kashem MD, PhD , Huaqing Zhao PhD , Sebastian A. Iturra MD , Suyog A. Mokashi MD , Ravishankar Raman MD , Roh Yanagida MD, PhD , Kewal Krishan MD , Norihisa Shigemura MD, PhD , Yoshiya Toyoda MD, PhD","doi":"10.1016/j.atssr.2024.08.011","DOIUrl":"10.1016/j.atssr.2024.08.011","url":null,"abstract":"<div><h3>Background</h3><div>The Ross procedure can be an ideal option in infective endocarditis (IE) due to greater resistance to infection. However, limited literature has highlighted the comparison with conventional prostheses in this setting.</div></div><div><h3>Methods</h3><div>Between February 2013 and September 2022, 25 patients (median age, 50 years) underwent a Ross procedure for IE (Ross group). The results were compared with those after other aortic valve procedures (aortic valve replacement and aortic root replacement) for IE (n = 37, other group.</div></div><div><h3>Results</h3><div>The patients in the Ross group included more intravenous drug users and had more prosthetic valve endocarditis and annular abscess formation compared with the other group. Although cardiopulmonary bypass time and aortic cross-clamp time were significantly longer (<em>P</em> < .001 and <em>P</em> = .003, respectively) and the blood requirements were significantly higher (<em>P</em> = .001) in the Ross group, most postoperative short-term outcomes were equivalent between the 2 groups. During follow-up, 1 patient (4%) required reoperation in the Ross group, whereas 6 patients (16%) required reoperation in the other group. Freedom from composite events was significantly better in the Ross group (<em>P</em> = .04). Multivariable analysis found the Ross procedure, compared with other procedures, was a significant independent protective factor for composite end points (<em>P</em> = .03).</div></div><div><h3>Conclusions</h3><div>For IE, despite surgical complexity, the Ross procedure yielded short-term outcomes similar to other procedures. In the midterm, the Ross procedure provides a lower reoperation rate, resulting in significantly fewer composite events. The Ross procedure appears to be a better option for patients with IE, but long-term follow-up is necessary.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 47-51"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Repair of an asymmetrical bicuspid aortic valve remains a complicated endeavor. Here, we present a successful aortic valve repair for severe aortic regurgitation associated with such a bicuspid aortic valve, further complicated by an anomalous coronary artery. The nonsevered dilated aortic root was reshaped by the sleeve procedure with a Valsalva graft, and the raphe was lifted up to reconstruct the functional commissure, which enabled tricuspidization. Correcting the anomalous aortic origin of the right coronary artery, which posed a risk of myocardial ischemia because of its interarterial course, was achieved by translocating it to the right sinus of Valsalva.
{"title":"Successful Tricuspidization of Bicuspid Aortic Valve Complicated by Anomalous Coronary Artery","authors":"Kazuki Hisatomi MD, PhD , Kiyoyuki Eishi MD, PhD , Ichiro Matsumaru MD, PhD , Kikuko Obase MD, PhD , Takashi Miura MD, PhD","doi":"10.1016/j.atssr.2024.07.018","DOIUrl":"10.1016/j.atssr.2024.07.018","url":null,"abstract":"<div><div>Repair of an asymmetrical bicuspid aortic valve remains a complicated endeavor. Here, we present a successful aortic valve repair for severe aortic regurgitation associated with such a bicuspid aortic valve, further complicated by an anomalous coronary artery. The nonsevered dilated aortic root was reshaped by the sleeve procedure with a Valsalva graft, and the raphe was lifted up to reconstruct the functional commissure, which enabled tricuspidization. Correcting the anomalous aortic origin of the right coronary artery, which posed a risk of myocardial ischemia because of its interarterial course, was achieved by translocating it to the right sinus of Valsalva.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 57-59"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.08.006
Rawn Salenger MD
{"title":"Understanding Oxygen Delivery","authors":"Rawn Salenger MD","doi":"10.1016/j.atssr.2024.08.006","DOIUrl":"10.1016/j.atssr.2024.08.006","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Page 270"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.09.012
Savan K. Shah MD , Arsalan A. Khan MD , Sanjib Basu PhD , Gillian C. Alex MD , Nicole M. Geissen DO , Michael J. Liptay MD , Christopher W. Seder MD
Background
Little is known about the prognostic impact of the Social Vulnerability Index (SVI) in patients with early-stage non-small cell lung cancer (NSCLC) who are undergoing video-assisted thoracoscopic lung resection.
Methods
Patients who underwent lung resection for stage IA-IIB NSCLC at a single institution between 2010 and 2021 were included in the study. The Society of Thoracic Surgeons definition of major morbidity, consisting of 14 postoperative events, was used. The SVI was determined by geocoding the permanent addresses of Illinois residents and using the Centers for Disease Control and Prevention calculator for a census-tract level SVI. Univariate and multivariate logistic regression analyses were used to examine the association between the SVI and major morbidity. Cut-point analysis was performed to determine the SVI cutoff that most strongly correlated with major morbidity.
Results
A total of 551 patients met inclusion criteria, and 65% (356 of 551) of these patients underwent lobectomy. The SVI cutoff was determined to be 0.831 (P = .010). In the high-SVI cohort , 58% (26 of 45) were Black, compared with 9% (45 of 506) in the low-SVI cohort (P < .001). For high-SVI patients, the major morbidity rate was 27% vs 9% for low-SVI patients (P = .0174), and the 1-year mortality rate was 8.9% vs. 3.0% for those with a low SVI (P = .061). On univariate analysis, high SVI status was associated with 30-day major morbidity (odds ratio, 2.84; CI, 1.28-6.29; P = .010). On multivariate analysis, after controlling for age, race, sex, tumor histologic type, procedure type, preoperative comorbidities, smoking history, and forced expiratory volume in 1 second, this association persisted (odds ratio, 3.16; CI, 1.11-8.99; P = .031).
Conclusions
A high SVI is associated with major morbidity after video-assisted thoracoscopic lung resection for NSCLC.
{"title":"Social Vulnerability Index Is Associated With Major Morbidity After Lung Resection","authors":"Savan K. Shah MD , Arsalan A. Khan MD , Sanjib Basu PhD , Gillian C. Alex MD , Nicole M. Geissen DO , Michael J. Liptay MD , Christopher W. Seder MD","doi":"10.1016/j.atssr.2024.09.012","DOIUrl":"10.1016/j.atssr.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the prognostic impact of the Social Vulnerability Index (SVI) in patients with early-stage non-small cell lung cancer (NSCLC) who are undergoing video-assisted thoracoscopic lung resection.</div></div><div><h3>Methods</h3><div>Patients who underwent lung resection for stage IA-IIB NSCLC at a single institution between 2010 and 2021 were included in the study. The Society of Thoracic Surgeons definition of major morbidity, consisting of 14 postoperative events, was used. The SVI was determined by geocoding the permanent addresses of Illinois residents and using the Centers for Disease Control and Prevention calculator for a census-tract level SVI. Univariate and multivariate logistic regression analyses were used to examine the association between the SVI and major morbidity. Cut-point analysis was performed to determine the SVI cutoff that most strongly correlated with major morbidity.</div></div><div><h3>Results</h3><div>A total of 551 patients met inclusion criteria, and 65% (356 of 551) of these patients underwent lobectomy. The SVI cutoff was determined to be 0.831 (<em>P</em> = .010). In the high-SVI cohort , 58% (26 of 45) were Black, compared with 9% (45 of 506) in the low-SVI cohort (<em>P</em> < .001). For high-SVI patients, the major morbidity rate was 27% vs 9% for low-SVI patients (<em>P</em> = .0174), and the 1-year mortality rate was 8.9% vs. 3.0% for those with a low SVI (<em>P</em> = .061). On univariate analysis, high SVI status was associated with 30-day major morbidity (odds ratio, 2.84; CI, 1.28-6.29; <em>P</em> = .010). On multivariate analysis, after controlling for age, race, sex, tumor histologic type, procedure type, preoperative comorbidities, smoking history, and forced expiratory volume in 1 second, this association persisted (odds ratio, 3.16; CI, 1.11-8.99; <em>P</em> = .031).</div></div><div><h3>Conclusions</h3><div>A high SVI is associated with major morbidity after video-assisted thoracoscopic lung resection for NSCLC.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 144-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.021
Jennie Hocking MPAS , John B. Eisenga MD , Austin Kluis MD , Kyle A. McCullough MD , Ghadi Moubarak MD , J. Michael DiMaio MD , William Ryan MD
Background
Triple valve surgery is a complex operation with high perioperative mortality. Limited data exist regarding the predictors of success associated with this surgery. We report our experience.
Methods
A total of 211 sequential patients underwent triple valve surgery at 1 hospital from November 2007 through July 2022. Baseline characteristics, operative details, and mortality outcomes were reviewed.
Results
Eighty-two (38.9%) were redo operations and 68 (32.2%) were urgent. Commonly, aortic (n = 194; 91.4%) and mitral (n = 140; 66.4%) valves were replaced, and the tricuspid valve (n = 189; 89.6%) repaired. Concomitant procedures were done in 28% of patients. Thirty-day mortality was 21 of 211 (9.95%). Kaplan-Meyer survival at 1 and 7 years was 86.0% (interquartile range, 79%-93%) and 64.0% (interquartile range, 55%-74%), respectively. On multivariate regression, end-stage renal disease (hazard ratio, 4.16; P = .003) was associated with mortality, and mitral valve replacement (hazard ratio, 0.44; P = .009) was associated with improved long-term survival.
Conclusions
Despite the high number of redo and concomitant procedures, we report a 30-day mortality rate under 10% and an 86% 1-year survival. In our series, mitral valve replacement conferred a long-term survival benefit.
{"title":"Predictors of Survival After Triple Valve Surgery: A Single Center Analysis","authors":"Jennie Hocking MPAS , John B. Eisenga MD , Austin Kluis MD , Kyle A. McCullough MD , Ghadi Moubarak MD , J. Michael DiMaio MD , William Ryan MD","doi":"10.1016/j.atssr.2024.07.021","DOIUrl":"10.1016/j.atssr.2024.07.021","url":null,"abstract":"<div><h3>Background</h3><div>Triple valve surgery is a complex operation with high perioperative mortality. Limited data exist regarding the predictors of success associated with this surgery. We report our experience.</div></div><div><h3>Methods</h3><div>A total of 211 sequential patients underwent triple valve surgery at 1 hospital from November 2007 through July 2022. Baseline characteristics, operative details, and mortality outcomes were reviewed.</div></div><div><h3>Results</h3><div>Eighty-two (38.9%) were redo operations and 68 (32.2%) were urgent. Commonly, aortic (n = 194; 91.4%) and mitral (n = 140; 66.4%) valves were replaced, and the tricuspid valve (n = 189; 89.6%) repaired. Concomitant procedures were done in 28% of patients. Thirty-day mortality was 21 of 211 (9.95%). Kaplan-Meyer survival at 1 and 7 years was 86.0% (interquartile range, 79%-93%) and 64.0% (interquartile range, 55%-74%), respectively. On multivariate regression, end-stage renal disease (hazard ratio, 4.16; <em>P</em> = .003) was associated with mortality, and mitral valve replacement (hazard ratio, 0.44; <em>P</em> = .009) was associated with improved long-term survival.</div></div><div><h3>Conclusions</h3><div>Despite the high number of redo and concomitant procedures, we report a 30-day mortality rate under 10% and an 86% 1-year survival. In our series, mitral valve replacement conferred a long-term survival benefit.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 25-30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.05.005
Emmanuel Lansac MD, PhD , Kevin M. Veen MD, PhD , Andria Joseph MSc , Paula Blancarte Jaber MD, MSc , Frieda Sossi MSc , Zofia Das-Gupta PhD , Suleman Aktaa MD, PhD , J. Rafael Sádaba MD, PhD , Vinod H. Thourani MD , Gry Dahle MD, PhD , Wilson Y. Szeto MD , Faisal Bakaeen MD , Elena Aikawa MD, PhD , Frederick J. Schoen MD, PhD , Evaldas Girdauskas MD , Aubrey Almeida MBBS , Andreas Zuckermann MD , Bart Meuris MD, PhD , John Stott , Jolanda Kluin MD, PhD , Johanna J.M. Takkenberg MD, PhD
Background
Globally significant variation in treatment and course of heart valve disease (HVD) exists, and outcome measurement is procedure focused instead of patient focused. This article describes the development of a patient-related (International Consortium for Health Outcomes Measurement) standard set of outcomes and case mix to be measured in patients with HVD.
Methods
A multisociety working group was formed that included patient representatives and representatives from scientific cardiology and cardiothoracic surgery societies that publish current guidelines for HVD. The standard set was developed to monitor the patient’s journey from diagnosis to treatment with either a surgical or transcatheter procedure. Candidate clinical and patient-reported outcome measures (PROMs) and case mix were identified through benchmark analyses and systematic reviews. Using an online modified Delphi process, the working group voted on final outcomes/case mix and corresponding definition.
Results
Patients with aortic/mitral/tricuspid valve disease or root/ascending aorta >40 mm were included in the standard set. Patients entered the dataset when the diagnosis of HVD was established, allowing outcome measurement in the preprocedural, periprocedural, and postprocedural phases of patients’ lives. The working group defined 5 outcome domains: vital status, patient-reported outcomes, progression of disease, cardiac function and durability, and complications of treatment. Subsequently, 16 outcome measures, including 2 patient-reported outcomes, were selected to be tracked in patients with HVD. Case-mix variables included demographic factors, demographic variables, echocardiographic variables, heart catheterization variables, and specific details on aortic/mitral/tricuspid valves and their specific interventions.
Conclusions
Through a unique collaborative effort between patients and cardiology and cardiothoracic surgery societies, a standard set of measures for HVD was developed. This dataset focuses on outcome measurement regardless of treatment, moving from procedure- to patient-centered outcomes. Implementation of this dataset will facilitate global standardization of outcome measurement, allow meaningful comparison between health care systems and evaluation of clinical practice guidelines, and eventually improve patient care for those experiencing HVD worldwide.
{"title":"The First International Consortium for Health Outcomes Measurement (ICHOM) Standard Dataset for Reporting Outcomes in Heart Valve Disease: Moving From Device- to Patient-Centered Outcomes","authors":"Emmanuel Lansac MD, PhD , Kevin M. Veen MD, PhD , Andria Joseph MSc , Paula Blancarte Jaber MD, MSc , Frieda Sossi MSc , Zofia Das-Gupta PhD , Suleman Aktaa MD, PhD , J. Rafael Sádaba MD, PhD , Vinod H. Thourani MD , Gry Dahle MD, PhD , Wilson Y. Szeto MD , Faisal Bakaeen MD , Elena Aikawa MD, PhD , Frederick J. Schoen MD, PhD , Evaldas Girdauskas MD , Aubrey Almeida MBBS , Andreas Zuckermann MD , Bart Meuris MD, PhD , John Stott , Jolanda Kluin MD, PhD , Johanna J.M. Takkenberg MD, PhD","doi":"10.1016/j.atssr.2024.05.005","DOIUrl":"10.1016/j.atssr.2024.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Globally significant variation in treatment and course of heart valve disease (HVD) exists, and outcome measurement is procedure focused instead of patient focused. This article describes the development of a patient-related (International Consortium for Health Outcomes Measurement) standard set of outcomes and case mix to be measured in patients with HVD.</div></div><div><h3>Methods</h3><div>A multisociety working group was formed that included patient representatives and representatives from scientific cardiology and cardiothoracic surgery societies that publish current guidelines for HVD. The standard set was developed to monitor the patient’s journey from diagnosis to treatment with either a surgical or transcatheter procedure. Candidate clinical and patient-reported outcome measures (PROMs) and case mix were identified through benchmark analyses and systematic reviews. Using an online modified Delphi process, the working group voted on final outcomes/case mix and corresponding definition.</div></div><div><h3>Results</h3><div>Patients with aortic/mitral/tricuspid valve disease or root/ascending aorta >40 mm were included in the standard set. Patients entered the dataset when the diagnosis of HVD was established, allowing outcome measurement in the preprocedural, periprocedural, and postprocedural phases of patients’ lives. The working group defined 5 outcome domains: vital status, patient-reported outcomes, progression of disease, cardiac function and durability, and complications of treatment. Subsequently, 16 outcome measures, including 2 patient-reported outcomes, were selected to be tracked in patients with HVD. Case-mix variables included demographic factors, demographic variables, echocardiographic variables, heart catheterization variables, and specific details on aortic/mitral/tricuspid valves and their specific interventions.</div></div><div><h3>Conclusions</h3><div>Through a unique collaborative effort between patients and cardiology and cardiothoracic surgery societies, a standard set of measures for HVD was developed. This dataset focuses on outcome measurement regardless of treatment, moving from procedure- to patient-centered outcomes. Implementation of this dataset will facilitate global standardization of outcome measurement, allow meaningful comparison between health care systems and evaluation of clinical practice guidelines, and eventually improve patient care for those experiencing HVD worldwide.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 71-85"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.029
Scott DeRoo MD , Christopher Burke MD
Quadricuspid pulmonary valve is an uncommon congenital anomaly. Little information is available about use of nonstandard pulmonary valves for the Ross procedure. Here we report the use of a symmetric quadricuspid pulmonary valve as a Ross autograft, including technical implantation details, and demonstrate an acceptable 1-year outcome.
{"title":"Ross Procedure With a Symmetric Quadricuspid Pulmonary Autograft","authors":"Scott DeRoo MD , Christopher Burke MD","doi":"10.1016/j.atssr.2024.07.029","DOIUrl":"10.1016/j.atssr.2024.07.029","url":null,"abstract":"<div><div>Quadricuspid pulmonary valve is an uncommon congenital anomaly. Little information is available about use of nonstandard pulmonary valves for the Ross procedure. Here we report the use of a symmetric quadricuspid pulmonary valve as a Ross autograft, including technical implantation details, and demonstrate an acceptable 1-year outcome.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 60-63"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.07.025
Aravind Krishnan MD , Elbert Heng MD , Chawannuch Ruaengsri MD , Amit Banga MD , Brandon A. Guenthart MD , Y. Joseph Woo MD , John Ward MacArthur MD
The donor shortage in lung transplantation is further exacerbated by the highest organ turn-down rate among all solid organ transplants. Here we present a case of planned single-lung ex-vivo lung perfusion that enabled the use of a single lung for transplantation, that otherwise may have gone unallocated. Creative management of the donor trachea enabled use of both the left and right lungs for separate recipients. Techniques like this may inspire confidence in expansion in use of ex-vivo lung perfusion and a commensurate increase in donor organ utilization for lung transplantation.
{"title":"Use of Ex-Vivo Lung Perfusion for Planned Left Single-Lung Transplant","authors":"Aravind Krishnan MD , Elbert Heng MD , Chawannuch Ruaengsri MD , Amit Banga MD , Brandon A. Guenthart MD , Y. Joseph Woo MD , John Ward MacArthur MD","doi":"10.1016/j.atssr.2024.07.025","DOIUrl":"10.1016/j.atssr.2024.07.025","url":null,"abstract":"<div><div>The donor shortage in lung transplantation is further exacerbated by the highest organ turn-down rate among all solid organ transplants. Here we present a case of planned single-lung ex-vivo lung perfusion that enabled the use of a single lung for transplantation, that otherwise may have gone unallocated. Creative management of the donor trachea enabled use of both the left and right lungs for separate recipients. Techniques like this may inspire confidence in expansion in use of ex-vivo lung perfusion and a commensurate increase in donor organ utilization for lung transplantation.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 247-249"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01DOI: 10.1016/j.atssr.2024.09.016
Akshay Kumar MD , Amit Alam MD , Michael Dorsey MD , Les James MD, MPH , Syed Hussain MD , Bernard Kadosh MD , Randal Goldberg MD , Alex Reyentovich MD , Nader Moazami MD , Deane Smith MD
Background
Donation after circulatory death (DCD) with cardiopulmonary bypass for thoracoabdominal normothermic regional perfusion (TA-NRP) has led to increased use of donor hearts. Rejection rates and long-term survival outcomes are not known.
Methods
A single-center retrospective cohort review of patients who underwent DCD heart transplantation from January 2020 to December 2023 was performed. Donor and recipient characteristics, operative characteristics, and posttransplantation outcomes were analyzed. Subgroup analysis comparing co-localized vs distant donors and recipients was performed. The primary end point was 1-year survival. Secondary end points included incidences of primary graft dysfunction (PGD), cardiac allograft vasculopathy (CAV), rejection rate, and overall mortality. Our TA-NRP protocol has remained the same, consisting of sternotomy, ligation of aortic arch vessels, establishment of cardiopulmonary bypass, reintubation, resuscitation of the heart, and cold static storage during transport.
Results
In total, 32 recipients underwent DCD heart transplantation, including 26 isolated hearts, 3 heart-lungs, and 3 heart-kidneys. The median age was 56 years for recipients and 39 years for donors; 21 donors and recipients were co-localized, whereas 11 were distant. One-year survival was 100%. Two patients required mechanical circulatory support for PGD. Four patients experienced grade 2R acute cellular rejection. Five patients had grade 1 CAV at 1 year. On subgroup analysis, distant donors and recipients had longer warm (47 vs 30 minutes; P < .005) and cold (213 vs 76 minutes; P < .005) ischemia times, without any other differences.
Conclusions
Outcomes after DCD heart transplantation using TA-NRP remain encouraging with acceptable rates of rejection, PGD, CAV, and survival at 1 year.
{"title":"Outcomes of Donation After Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion","authors":"Akshay Kumar MD , Amit Alam MD , Michael Dorsey MD , Les James MD, MPH , Syed Hussain MD , Bernard Kadosh MD , Randal Goldberg MD , Alex Reyentovich MD , Nader Moazami MD , Deane Smith MD","doi":"10.1016/j.atssr.2024.09.016","DOIUrl":"10.1016/j.atssr.2024.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Donation after circulatory death (DCD) with cardiopulmonary bypass for thoracoabdominal normothermic regional perfusion (TA-NRP) has led to increased use of donor hearts. Rejection rates and long-term survival outcomes are not known.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort review of patients who underwent DCD heart transplantation from January 2020 to December 2023 was performed. Donor and recipient characteristics, operative characteristics, and posttransplantation outcomes were analyzed. Subgroup analysis comparing co-localized vs distant donors and recipients was performed. The primary end point was 1-year survival. Secondary end points included incidences of primary graft dysfunction (PGD), cardiac allograft vasculopathy (CAV), rejection rate, and overall mortality. Our TA-NRP protocol has remained the same, consisting of sternotomy, ligation of aortic arch vessels, establishment of cardiopulmonary bypass, reintubation, resuscitation of the heart, and cold static storage during transport.</div></div><div><h3>Results</h3><div>In total, 32 recipients underwent DCD heart transplantation, including 26 isolated hearts, 3 heart-lungs, and 3 heart-kidneys. The median age was 56 years for recipients and 39 years for donors; 21 donors and recipients were co-localized, whereas 11 were distant. One-year survival was 100%. Two patients required mechanical circulatory support for PGD. Four patients experienced grade 2R acute cellular rejection. Five patients had grade 1 CAV at 1 year. On subgroup analysis, distant donors and recipients had longer warm (47 vs 30 minutes; <em>P</em> < .005) and cold (213 vs 76 minutes; <em>P</em> < .005) ischemia times, without any other differences.</div></div><div><h3>Conclusions</h3><div>Outcomes after DCD heart transplantation using TA-NRP remain encouraging with acceptable rates of rejection, PGD, CAV, and survival at 1 year.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 229-234"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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