Annals of thoracic surgery short reports最新文献

英文中文

The Impact of COVID-19 Infection Prior to Lung Resection on Postoperative Complications

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.08.004

Allen Tingjun Yu MD, PhD , Shubham Gulati MS , Shivam Joshi MS , Alex L. Huang MD , Daniel Laskey MD , Andrea Wolf MD , Emanuela Taioli MD, PhD , Raja M. Flores MD

Background

We hypothesize that previous COVID-19 infection could be associated with postoperative complications (POCs) and outcomes of thoracic surgery for lung cancer. It is unknown whether the respiratory damage caused by COVID-19 infection is permanent. In addition, there is a lack of studies investigating POCs and prior COVID-19 infection in thoracic surgery.

Methods

A retrospective study was performed on patients who underwent resections for lung cancer between May 2020 and July 2022. Variables relevant to the Society of Thoracic Surgeons database were collected, as well as COVID-19 status. The primary outcome was postoperative complications.

Results

A total of 361 patients underwent a resection for lung cancer. Patients with a prior COVID-19 infection (n = 21) had significantly more POCs than patients without a history of COVID-19 infection (n = 340, P < .05). Pneumothorax and infections requiring intravenous antibiotics were significantly enriched in patients with a prior COVID-19 infection. COVID-19 infection was independently associated with increased POCs at multivariable analysis (adjust odds ratio, 4.36; 95% CI, 1.48-12.8). Matched case-control analysis also reviewed similar findings, where COVID-19 infection was the only significant variable as a risk factor for POCs (P < .05).

Conclusions

After a COVID-19 infection, patients undergoing lung cancer resections were at an increased risk of POCs. This suggests that a previous COVID-19 infection should be considered as a potential risk factor for complications after lung cancer resections.

{"title":"The Impact of COVID-19 Infection Prior to Lung Resection on Postoperative Complications","authors":"Allen Tingjun Yu MD, PhD , Shubham Gulati MS , Shivam Joshi MS , Alex L. Huang MD , Daniel Laskey MD , Andrea Wolf MD , Emanuela Taioli MD, PhD , Raja M. Flores MD","doi":"10.1016/j.atssr.2024.08.004","DOIUrl":"10.1016/j.atssr.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><div>We hypothesize that previous COVID-19 infection could be associated with postoperative complications (POCs) and outcomes of thoracic surgery for lung cancer. It is unknown whether the respiratory damage caused by COVID-19 infection is permanent. In addition, there is a lack of studies investigating POCs and prior COVID-19 infection in thoracic surgery.</div></div><div><h3>Methods</h3><div>A retrospective study was performed on patients who underwent resections for lung cancer between May 2020 and July 2022. Variables relevant to the Society of Thoracic Surgeons database were collected, as well as COVID-19 status. The primary outcome was postoperative complications.</div></div><div><h3>Results</h3><div>A total of 361 patients underwent a resection for lung cancer. Patients with a prior COVID-19 infection (n = 21) had significantly more POCs than patients without a history of COVID-19 infection (n = 340, <em>P</em> < .05). Pneumothorax and infections requiring intravenous antibiotics were significantly enriched in patients with a prior COVID-19 infection. COVID-19 infection was independently associated with increased POCs at multivariable analysis (adjust odds ratio, 4.36; 95% CI, 1.48-12.8). Matched case-control analysis also reviewed similar findings, where COVID-19 infection was the only significant variable as a risk factor for POCs (<em>P</em> < .05).</div></div><div><h3>Conclusions</h3><div>After a COVID-19 infection, patients undergoing lung cancer resections were at an increased risk of POCs. This suggests that a previous COVID-19 infection should be considered as a potential risk factor for complications after lung cancer resections.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 156-160"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511697","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}

引用次数: 0

Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.033

Berk Aykut MD , Douglas M. Overbey MD, MPH , Cathlyn K. Medina BA , Tariq M. Omer MS , T. Konrad Rajab MD , Smith M. Ngeve BA , Ziv Beckerman MD , Joseph W. Turek MD, PhD

Background

Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. This study introduces and evaluates the novel use of domino and split-root procedures within PHT.

Methods

We describe 6 pediatric cardiac patients who underwent either domino or split-root PHT at our institution.

Results

From May to August 2023, our team successfully executed 3 domino and 3 split-root PHTs, including 1 procedure that involved interinstitutional collaboration. These cases highlight the procedural feasibility and the potential for broader application.

Conclusions

The implementation of PHT represents a significant advance in pediatric heart care. Domino and split-root techniques within the PHT framework have the potential to substantially increase both donor availability and recipient capacity. These strategies usher in a new era of organ stewardship through addressing the challenge of donor organ shortage.

{"title":"Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots","authors":"Berk Aykut MD , Douglas M. Overbey MD, MPH , Cathlyn K. Medina BA , Tariq M. Omer MS , T. Konrad Rajab MD , Smith M. Ngeve BA , Ziv Beckerman MD , Joseph W. Turek MD, PhD","doi":"10.1016/j.atssr.2024.07.033","DOIUrl":"10.1016/j.atssr.2024.07.033","url":null,"abstract":"<div><h3>Background</h3><div>Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. This study introduces and evaluates the novel use of domino and split-root procedures within PHT.</div></div><div><h3>Methods</h3><div>We describe 6 pediatric cardiac patients who underwent either domino or split-root PHT at our institution.</div></div><div><h3>Results</h3><div>From May to August 2023, our team successfully executed 3 domino and 3 split-root PHTs, including 1 procedure that involved interinstitutional collaboration. These cases highlight the procedural feasibility and the potential for broader application.</div></div><div><h3>Conclusions</h3><div>The implementation of PHT represents a significant advance in pediatric heart care. Domino and split-root techniques within the PHT framework have the potential to substantially increase both donor availability and recipient capacity. These strategies usher in a new era of organ stewardship through addressing the challenge of donor organ shortage.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 86-91"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511808","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}

引用次数: 0

Acute Mitral Papillary Muscle Rupture Secondary to Cardiac Amyloidosis

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.020

Takashi Nagase MD , Noriyuki Kashiyama MD , Natsumi Horikawa MD , Nozomu Sakai MD , Masahiro Ryugo MD , Osamu Monta MD , Yasushi Tsutsumi MD , Shinichiro Oda MD

Acute mitral valve regurgitation due to papillary muscle rupture secondary to cardiac amyloidosis is rare. A 75-year-old woman without prior heart disease or chest trauma presented with acute mitral regurgitation and shock. Coronary angiography demonstrated patent coronary arteries. Emergency surgery revealed a prolapse of the anterior leaflet with posteromedial papillary muscle rupture. Mitral valvuloplasty was performed using artificial chordae and an annuloplasty ring. Histopathologic examination of the ruptured papillary muscle confirmed amyloid deposition between the cardiomyocytes. This case underscores the importance of cardiac amyloidosis in the differential diagnosis of patients with papillary muscle rupture without coronary artery stenosis.

引用次数: 0

Robotic First Rib Resection With Adjuvant Endovascular Therapy for Chronic Paget-Schroetter Syndrome

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.019

Alejandro Zulbaran-Rojas MD , Miguel Montero-Baker MD , Nihanth Palivela BS , Catherine Park PhD , Bijan Najafi PhD , Jayer Chung MD , Joseph L. Mills MD , Bryan M. Burt MD

Background

Patients with acute Paget-Schroetter syndrome (PSS) are treated with endovascular therapy and first rib resection (FRR); however the care of patients with chronic PSS is less well understood. This report describes an emerging approach of robotic-FRR, with adjuvant endovascular therapy, for chronic PSS.

Methods

A single-center, retrospective analysis was conducted of patients undergoing robotic-FRR for chronic PSS between 2017 and 2020. Chronic PSS was defined by subclavian vein (SCV) fibrosis identified on duplex ultrasound examination. Patency and clinical outcomes were compared before and after robotic-FRR.

Results

Fifteen robotic-FRRs in 14 patients with chronic PSS were analyzed. Median time between acute thrombosis and presentation to our clinic was 167 days. Eleven SCVs were previously treated with anticoagulants only, and 4 had a history of thrombolysis. At the time of presentation, all SCVs displayed chronic thrombosis on duplex ultrasound; 7 (46.7%) were treated with angioplasty followed by robotic-FRR, and 8 (53.3%) proceeded first to robotic-FRR. Postoperative duplex ultrasound examination at a median of 34 days from robotic-FRR demonstrated patency in 5 (33.3%) SCVs. Postoperative angioplasty was performed in 9 (60%) SCVs after a median of 59 days from robotic-FRR, resulting in 6 (40%) additional patent SCVs. The total number of SCVs achieving patency was 11 (73.3%). There were no complications during angioplasties or robotic-FRR. Eleven patients (73.3%) achieved complete symptom resolution with decrease in swelling (P < .001) and pain (P = .016).

Conclusions

Robotic-FRR in combination with adjuvant endovascular therapy was associated with favorable clinical and patency outcomes for chronic PSS.

{"title":"Robotic First Rib Resection With Adjuvant Endovascular Therapy for Chronic Paget-Schroetter Syndrome","authors":"Alejandro Zulbaran-Rojas MD , Miguel Montero-Baker MD , Nihanth Palivela BS , Catherine Park PhD , Bijan Najafi PhD , Jayer Chung MD , Joseph L. Mills MD , Bryan M. Burt MD","doi":"10.1016/j.atssr.2024.07.019","DOIUrl":"10.1016/j.atssr.2024.07.019","url":null,"abstract":"<div><h3>Background</h3><div>Patients with acute Paget-Schroetter syndrome (PSS) are treated with endovascular therapy and first rib resection (FRR); however the care of patients with chronic PSS is less well understood. This report describes an emerging approach of robotic-FRR, with adjuvant endovascular therapy, for chronic PSS.</div></div><div><h3>Methods</h3><div>A single-center, retrospective analysis was conducted of patients undergoing robotic-FRR for chronic PSS between 2017 and 2020. Chronic PSS was defined by subclavian vein (SCV) fibrosis identified on duplex ultrasound examination. Patency and clinical outcomes were compared before and after robotic-FRR.</div></div><div><h3>Results</h3><div>Fifteen robotic-FRRs in 14 patients with chronic PSS were analyzed. Median time between acute thrombosis and presentation to our clinic was 167 days. Eleven SCVs were previously treated with anticoagulants only, and 4 had a history of thrombolysis. At the time of presentation, all SCVs displayed chronic thrombosis on duplex ultrasound; 7 (46.7%) were treated with angioplasty followed by robotic-FRR, and 8 (53.3%) proceeded first to robotic-FRR. Postoperative duplex ultrasound examination at a median of 34 days from robotic-FRR demonstrated patency in 5 (33.3%) SCVs. Postoperative angioplasty was performed in 9 (60%) SCVs after a median of 59 days from robotic-FRR, resulting in 6 (40%) additional patent SCVs. The total number of SCVs achieving patency was 11 (73.3%). There were no complications during angioplasties or robotic-FRR. Eleven patients (73.3%) achieved complete symptom resolution with decrease in swelling (<em>P</em> < .001) and pain (<em>P</em> = .016).</div></div><div><h3>Conclusions</h3><div>Robotic-FRR in combination with adjuvant endovascular therapy was associated with favorable clinical and patency outcomes for chronic PSS.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 271-275"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512429","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}

引用次数: 0

Repeated Systolic Anterior Motion of the Mitral Valve After Double Outlet Right Ventricle Repair

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.003

Junya Sugiura MD , Hajime Sakurai MD , Wataru Kato MD , Keisuke Tanaka MD , Koji Morita MD , Koshi Yamaki MD , Taisei Nagashima MD

We herein report a rare case of double outlet right ventricle repair complicated by repeated systolic anterior motion of the mitral valve after weaning from cardiopulmonary bypass and postoperatively. Even in patients without obvious preoperative left ventricular outflow tract obstruction, systolic anterior motion and mitral regurgitation may still occur from functional factors, such as intraoperative or postoperative inotropic drug use, tachycardia, or intraventricular volume loss in patients with severe ventricular septal hypertrophy and left ventricular hypertrophy.

引用次数: 0

Three-Dimensional Printed Model of the Mediastinum for Cardiothoracic Surgery Resident Education

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.031

Catherine T. Byrd MD , Winston L. Trope BE , H. Henry Guo MD, PhD , Kyle Gifford BA , Prasha Bhandari MPH , Jalen Benson AB , Douglas Z. Liou MD , Leah M. Backhus MD, MPH , Mark F. Berry MD , Joseph B. Shrager MD , Natalie S. Lui MD, MAS

Background

Mediastinoscopy remains an important component of lung cancer staging. The development of endobronchial ultrasonography has meant residents perform fewer mediastinoscopies. We hypothesized that a 3-dimensional printed model of the mediastinum would be an effective tool for teaching residents the anatomy and techniques for mediastinoscopy.

Methods

A color model of the mediastinum was 3-dimensionally printed based on segmented computed tomographic images. For 2 years, residents and attendings were asked to provide a skills assessment after every mediastinoscopy. During the second year, all residents received standardized instruction for mediastinoscopy using the 3-dimensional model. Skills assessments were compared between the residents taught with and without the 3-dimensional model.

Results

There were 49 resident and 65 attending surveys completed. Residents taught with the 3-dimensional model were more likely to answer that they could identify normal anatomy “well”/“very well” compared with residents taught without the model (86% vs 52%, P = .015). Residents taught with the 3-dimensional model more frequently answered they were able to perform an uncomplicated mediastinoscopy “well”/ “very well” (59% vs 31%, P = .079) compared with residents taught without the 3-dimensional model, although this was not significant. Attendings were equally likely to answer “well”/“very well” that residents taught with the 3-dimensional model could identify normal anatomy (52% vs 55%, P > .99) and perform an uncomplicated mediastinoscopy (48% vs 43%, P = .79) compared with those taught without the model.

Conclusions

A 3-dimensional printed model of the mediastinum may be an effective tool for teaching mediastinoscopy.

背景纵隔镜检查仍然是肺癌分期的重要组成部分。支气管内超声检查的发展意味着住院医师进行纵隔镜检查的次数减少。我们假设纵隔的三维打印模型将成为向住院医师传授纵隔镜检查解剖和技术的有效工具。在两年的时间里，住院医师和主治医师被要求在每次纵隔镜检查后提供技能评估。第二年，所有住院医师都接受了使用三维模型进行纵隔镜检查的标准化指导。结果共有 49 名住院医师和 65 名主治医师完成了问卷调查。与未使用三维模型教学的住院医师相比，使用三维模型教学的住院医师更有可能回答他们能 "很好"/"非常好 "地识别正常解剖结构（86% vs 52%，P = .015）。与未使用三维模型的住院医师相比，使用三维模型教学的住院医师更常回答他们能够 "很好"/"非常好 "地完成无并发症纵隔镜检查（59% vs 31%，P = .079），但这一比例并不显著。与未使用三维模型教学的住院医师相比，主治医师同样可能回答 "好"/"非常好 "使用三维模型教学的住院医师能够识别正常解剖结构（52% vs 55%，P = .99）和进行无并发症纵隔镜检查（48% vs 43%，P = .79）。

{"title":"Three-Dimensional Printed Model of the Mediastinum for Cardiothoracic Surgery Resident Education","authors":"Catherine T. Byrd MD , Winston L. Trope BE , H. Henry Guo MD, PhD , Kyle Gifford BA , Prasha Bhandari MPH , Jalen Benson AB , Douglas Z. Liou MD , Leah M. Backhus MD, MPH , Mark F. Berry MD , Joseph B. Shrager MD , Natalie S. Lui MD, MAS","doi":"10.1016/j.atssr.2024.07.031","DOIUrl":"10.1016/j.atssr.2024.07.031","url":null,"abstract":"<div><h3>Background</h3><div>Mediastinoscopy remains an important component of lung cancer staging. The development of endobronchial ultrasonography has meant residents perform fewer mediastinoscopies. We hypothesized that a 3-dimensional printed model of the mediastinum would be an effective tool for teaching residents the anatomy and techniques for mediastinoscopy.</div></div><div><h3>Methods</h3><div>A color model of the mediastinum was 3-dimensionally printed based on segmented computed tomographic images. For 2 years, residents and attendings were asked to provide a skills assessment after every mediastinoscopy. During the second year, all residents received standardized instruction for mediastinoscopy using the 3-dimensional model. Skills assessments were compared between the residents taught with and without the 3-dimensional model.</div></div><div><h3>Results</h3><div>There were 49 resident and 65 attending surveys completed. Residents taught with the 3-dimensional model were more likely to answer that they could identify normal anatomy “well”/“very well” compared with residents taught without the model (86% vs 52%, <em>P</em> = .015). Residents taught with the 3-dimensional model more frequently answered they were able to perform an uncomplicated mediastinoscopy “well”/ “very well” (59% vs 31%, <em>P</em> = .079) compared with residents taught without the 3-dimensional model, although this was not significant. Attendings were equally likely to answer “well”/“very well” that residents taught with the 3-dimensional model could identify normal anatomy (52% vs 55%, <em>P</em> > .99) and perform an uncomplicated mediastinoscopy (48% vs 43%, <em>P</em> = .79) compared with those taught without the model.</div></div><div><h3>Conclusions</h3><div>A 3-dimensional printed model of the mediastinum may be an effective tool for teaching mediastinoscopy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 193-199"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512549","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}

引用次数: 0

Lung Transplantation Outcomes and Peritransplant Sirolimus Use in Lymphangioleiomyomatosis 淋巴管瘤肺移植结果与移植前使用西罗莫司的关系

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.011

Emily L. Larson BS , Reed T. Jenkins BA , Jessica M. Ruck MD , Laura B. Zeiser MS , Alice L. Zhou MS , Alfred J. Casillan MD, PhD , Dorry L. Segev MD , Allan B. Massie MD , Jinny S. Ha MD , Pali D. Shah MD , Christian A. Merlo MD, MPH , Errol L. Bush MD

Background

With the introduction of sirolimus as medical therapy for lymphangioleiomyomatosis (LAM), an updated evaluation of LAM lung transplant (LT) outcomes and characterization of peritransplant sirolimus use is needed.

Methods

We identified adult LT recipients from 2005-2021 using the Scientific Registry of Transplant Recipients database and stratified by diagnosis (LAM vs other). Multivariable Cox regression was performed to calculate the adjusted hazard ratio for LAM vs other diagnoses. A pharmacy claims database was linked to provide sirolimus prescription information, and a subgroup analysis comparing outcomes with pre- vs posttransplant sirolimus use was performed.

Results

Of 32,337 recipients identified, 156 (0.5%) were diagnosed with LAM. Operative complications, including airway dehiscence, did not significantly differ between groups. After adjusting for donor and recipient characteristics, LAM diagnosis was associated with 45% lower mortality than other diagnoses. Among recipients with pharmacy data, 32% were prescribed sirolimus at any point. Compared with only post-LT use only, recipients with pre-LT sirolimus use had increased mortality (log-rank P = .003).

Conclusions

This study supports lung transplant as a treatment for severe pulmonary LAM and identifies increased mortality associated with pre-LT sirolimus, though this may be due to uncharacterized baseline differences.

{"title":"Lung Transplantation Outcomes and Peritransplant Sirolimus Use in Lymphangioleiomyomatosis","authors":"Emily L. Larson BS , Reed T. Jenkins BA , Jessica M. Ruck MD , Laura B. Zeiser MS , Alice L. Zhou MS , Alfred J. Casillan MD, PhD , Dorry L. Segev MD , Allan B. Massie MD , Jinny S. Ha MD , Pali D. Shah MD , Christian A. Merlo MD, MPH , Errol L. Bush MD","doi":"10.1016/j.atssr.2024.07.011","DOIUrl":"10.1016/j.atssr.2024.07.011","url":null,"abstract":"<div><h3>Background</h3><div>With the introduction of sirolimus as medical therapy for lymphangioleiomyomatosis (LAM), an updated evaluation of LAM lung transplant (LT) outcomes and characterization of peritransplant sirolimus use is needed.</div></div><div><h3>Methods</h3><div>We identified adult LT recipients from 2005-2021 using the Scientific Registry of Transplant Recipients database and stratified by diagnosis (LAM vs other). Multivariable Cox regression was performed to calculate the adjusted hazard ratio for LAM vs other diagnoses. A pharmacy claims database was linked to provide sirolimus prescription information, and a subgroup analysis comparing outcomes with pre- vs posttransplant sirolimus use was performed.</div></div><div><h3>Results</h3><div>Of 32,337 recipients identified, 156 (0.5%) were diagnosed with LAM. Operative complications, including airway dehiscence, did not significantly differ between groups. After adjusting for donor and recipient characteristics, LAM diagnosis was associated with 45% lower mortality than other diagnoses. Among recipients with pharmacy data, 32% were prescribed sirolimus at any point. Compared with only post-LT use only, recipients with pre-LT sirolimus use had increased mortality (log-rank <em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>This study supports lung transplant as a treatment for severe pulmonary LAM and identifies increased mortality associated with pre-LT sirolimus, though this may be due to uncharacterized baseline differences.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 133-137"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849698","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}

引用次数: 0

Treatment of Unsuspected T4 Non-Small Cell Lung Cancer With Additional Intrapulmonary Nodules

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.09.009

Arvind Kumar MD , Deepti Srinivasan BS , Gabe Smock HSD , Alexandra L. Potter BS , Camille A. Mathey-Andrews MD , Chi-Fu Jeffrey Yang MD

Background

There is limited consensus on the optimal treatment for patients with non-small cell lung cancer (NSCLC) who are found to have additional intrapulmonary nodules in a different ipsilateral lobe (unsuspected pT4-Add) during surgical intervention. This study compared outcomes of patients with unsuspected pT4-Add NSCLC after resection of the primary site tumor with or without resection of additional nodules.

Methods

Patients who underwent surgical intervention for cT1-3 N0-1 M0 NSCLC with unsuspected pT4-Add disease in the National Cancer Database (2010-2015) were included. Overall survival and short-term outcomes were compared between patients who underwent resection of only the primary tumor (“primary site resection”) and those who underwent resection of the primary tumor and additional nodules (“extended resection)” by using Kaplan-Meier analysis and propensity score matching on 10 variables.

Results

Of the 339 patients included in this study, 245 (72.3%) underwent primary site resection and 94 (27.7%) underwent extended resection. In a 2:1 variable ratio propensity score-matched analysis of 83 patients who underwent primary site resection and 42 patients who underwent extended resection, no significant difference was found in 5-year overall survival between the 2 groups.

Conclusions

The results of this national analysis suggest that in the setting of unsuspected pT4-Add NSCLC, proceeding without resection of additional nodules may confer similar overall survival for carefully selected patients with appropriate adjuvant therapy.

{"title":"Treatment of Unsuspected T4 Non-Small Cell Lung Cancer With Additional Intrapulmonary Nodules","authors":"Arvind Kumar MD , Deepti Srinivasan BS , Gabe Smock HSD , Alexandra L. Potter BS , Camille A. Mathey-Andrews MD , Chi-Fu Jeffrey Yang MD","doi":"10.1016/j.atssr.2024.09.009","DOIUrl":"10.1016/j.atssr.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>There is limited consensus on the optimal treatment for patients with non-small cell lung cancer (NSCLC) who are found to have additional intrapulmonary nodules in a different ipsilateral lobe (unsuspected pT4-Add) during surgical intervention. This study compared outcomes of patients with unsuspected pT4-Add NSCLC after resection of the primary site tumor with or without resection of additional nodules.</div></div><div><h3>Methods</h3><div>Patients who underwent surgical intervention for cT1-3 N0-1 M0 NSCLC with unsuspected pT4-Add disease in the National Cancer Database (2010-2015) were included. Overall survival and short-term outcomes were compared between patients who underwent resection of only the primary tumor (“primary site resection”) and those who underwent resection of the primary tumor and additional nodules (“extended resection)” by using Kaplan-Meier analysis and propensity score matching on 10 variables.</div></div><div><h3>Results</h3><div>Of the 339 patients included in this study, 245 (72.3%) underwent primary site resection and 94 (27.7%) underwent extended resection. In a 2:1 variable ratio propensity score-matched analysis of 83 patients who underwent primary site resection and 42 patients who underwent extended resection, no significant difference was found in 5-year overall survival between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The results of this national analysis suggest that in the setting of unsuspected pT4-Add NSCLC, proceeding without resection of additional nodules may confer similar overall survival for carefully selected patients with appropriate adjuvant therapy.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 1","pages":"Pages 123-127"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511746","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}

引用次数: 0

Surgery for Chronic Postinfarct Ventricular Pseudoaneurysm Using 3-Dimensional Printing

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.014

Kevin Wang MD , Abel Cherian BS , Alex Ryan BS , Yash Rohilla , Chidiebere Peter Echieh FRCS , Michael D. Seckeler MD, MSc , Toshinobu Kazui MD, PhD

The use of 3-dimensional printing allows for preoperative planning in complex cardiac surgery. It provides a digital and physical model of patient-specific anatomy that may aid in decision making. Our case describes a 64-year-old patient with a late presentation of myocardial infarction complicated by the development of chronic postinfarction ventricular septal defect with interventricular pseudoaneurysm. We utilized a 3-dimensional-printed model of the patient’s heart to identify the location of the defect preoperatively. From this case, we believe that 3-dimensional modeling may aid preoperative planning, particularly in complex anatomy. Time, cost, and precision are limitations to the routine clinical application of this technology.

引用次数: 0

Approaching a Brachiocephalic Artery Aneurysm With Porcelain Aorta

Annals of thoracic surgery short reports

Pub Date : 2025-03-01 DOI: 10.1016/j.atssr.2024.07.034

German J. Chaud MD , Joaquín Gundelach MD , Marcos Durand MD , Pablo A. Filippa MD , Jorge Yañez Villa MD , Jaime Horta MD , Carolina González MD , Gustavo Meriño MD , Cristóbal Alvarado MD

Brachiocephalic arterial trunk aneurysms, comprising 3% of supraaortic aneurysms, often manifest with local compression, thrombosis, or embolization. Surgical exclusion is preferred because of the risks of embolism and aneurysm rupture. We describe the case of a 51-year-old man with a pulsatile neck mass, a 48-mm brachiocephalic trunk aneurysm, and a porcelain aorta. Surgical steps included cannulation, aortic replacement, aortic root treatment, and coronary artery bypass. The patient recovered well postoperatively, and he was discharged on day 5 with no complications. Aortic arch aneurysms, primarily atherosclerotic aneurysms, pose challenges, especially in patients with a porcelain aorta, thus necessitating meticulous surgical planning for optimal outcomes and risk mitigation.

引用次数: 0

首页上一页

下一页尾页

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 short reports

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.

﹀