Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.017
Rajab Msemo MD , Paul Itule MD, MMed , Charles Komba MD, MMed , Laurean Rwanyuma MD, MMed , Frederick Lyimo MD, MMed , Ally Mwanga MD, MMed , Dammy Shimbo MD, MMed , Ibrahim Mkoma MD, MMed , Nadir Meghji MD, MSc , Adelaida Mghase MBBS, FCS-Plastic
Solitary plasmacytoma of the sternum is a rare plasma cell neoplasm, challenging to manage in resource-limited settings. We present a 48-year-old man with a recurrent, ulcerated anterior chest wall mass. Imaging showed a destructive sternal lesion, confirmed as solitary bone plasmacytoma via histopathology. Radical excision and chest wall reconstruction using pectoralis major flaps and improvised wiring were performed. Postoperative wound infection occurred. At 6 months, recovery was favorable, with adjuvant radiotherapy planned. This case highlights diagnostic and reconstructive challenges and demonstrates feasible management in a low-resource setting.
{"title":"Giant Ulcerative Solitary Plasmacytoma of the Sternum: Resection with Reconstruction in a Resource-Limited Setting","authors":"Rajab Msemo MD , Paul Itule MD, MMed , Charles Komba MD, MMed , Laurean Rwanyuma MD, MMed , Frederick Lyimo MD, MMed , Ally Mwanga MD, MMed , Dammy Shimbo MD, MMed , Ibrahim Mkoma MD, MMed , Nadir Meghji MD, MSc , Adelaida Mghase MBBS, FCS-Plastic","doi":"10.1016/j.atssr.2025.06.017","DOIUrl":"10.1016/j.atssr.2025.06.017","url":null,"abstract":"<div><div>Solitary plasmacytoma of the sternum is a rare plasma cell neoplasm, challenging to manage in resource-limited settings. We present a 48-year-old man with a recurrent, ulcerated anterior chest wall mass. Imaging showed a destructive sternal lesion, confirmed as solitary bone plasmacytoma via histopathology. Radical excision and chest wall reconstruction using pectoralis major flaps and improvised wiring were performed. Postoperative wound infection occurred. At 6 months, recovery was favorable, with adjuvant radiotherapy planned. This case highlights diagnostic and reconstructive challenges and demonstrates feasible management in a low-resource setting.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 950-953"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.03.009
Cassidy Evelyn Lounsbury BS , Christopher J. Knott-Craig MD, FACS , Angel Doño MD , Jerry Allen CCP , Umar Boston MD , Karthik Vaidyanathan Ramakrishnan MD, FRCS
Background
Aortic homograft root replacement is an alternative to mechanical aortic valve replacement or a Ross operation for children with aortic valve disease. This study aimed to evaluate the long-term outcomes of aortic homograft root replacement.
Methods
Between 2004 and 2021, 38 children underwent replacement of their aortic valves with an aortic homograft at a single institution. Electronic medical records were reviewed. Survival and reinterventions were the 2 main end points of interest.
Results
The median age and weight were 14 years (interquartile range [IQR], 7-17 years) and 52 kg (IQR, 26-75 kg). Six patients were syndromic (6/38 [16%]), and 4 patients had active endocarditis (4/38 [13%]). Median aortic homograft size implanted was 23 mm in diameter (IQR, 21-24 mm). There was no early mortality and 2 late deaths (5.3%); 8 homografts (21%) were replaced at follow-up with no deaths after replacement of the homograft. Of the 38 implanted homografts, 28 (74%) were functioning well at a median of 81 months after initial implantation. The actuarial reintervention-free survival was 50% at 224 months. The Kaplan-Meier estimated survival at 220 months was 90%.
Conclusions
Replacement of the aortic valve with an aortic homograft is a reasonable valve substitute in children, recognizing that some of these homografts will need to be replaced over time. The risk of reoperation is low, and it can be performed safely.
背景：同种主动脉瓣根置换术是治疗儿童主动脉瓣疾病的一种替代机械主动脉瓣置换术或Ross手术的方法。本研究旨在评估同种主动脉移植物根置换的长期疗效。方法2004年至2021年间，38名儿童在同一机构接受了同种主动脉移植物主动脉瓣置换术。审查了电子医疗记录。生存期和再干预是研究的两个主要终点。结果年龄和体重中位数为14岁（四分位间距[IQR]， 7 ~ 17岁）和52 kg （IQR, 26 ~ 75 kg）。6例为综合征型（6/38[16%]），4例为活动性心内膜炎（4/38[13%]）。植入的中位主动脉同种移植物直径为23 mm （IQR, 21-24 mm）。无早期死亡，2例晚期死亡（5.3%）；8例（21%）同体移植物在随访中被替换，替换后无死亡病例。在38例同种移植物中，28例（74%）在首次植入后的中位81个月功能良好。精算无再干预生存率为50%，为224个月。Kaplan-Meier估计220个月生存率为90%。结论同种异体主动脉瓣置换术对儿童是一种合理的瓣膜替代物，但随着时间的推移，一些同种异体主动脉瓣移植物需要更换。再次手术的风险低，可以安全进行。
{"title":"Midterm to Long-term Outcomes After Aortic Valve Replacement With Homograft in Children","authors":"Cassidy Evelyn Lounsbury BS , Christopher J. Knott-Craig MD, FACS , Angel Doño MD , Jerry Allen CCP , Umar Boston MD , Karthik Vaidyanathan Ramakrishnan MD, FRCS","doi":"10.1016/j.atssr.2025.03.009","DOIUrl":"10.1016/j.atssr.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Aortic homograft root replacement is an alternative to mechanical aortic valve replacement or a Ross operation for children with aortic valve disease. This study aimed to evaluate the long-term outcomes of aortic homograft root replacement.</div></div><div><h3>Methods</h3><div>Between 2004 and 2021, 38 children underwent replacement of their aortic valves with an aortic homograft at a single institution. Electronic medical records were reviewed. Survival and reinterventions were the 2 main end points of interest.</div></div><div><h3>Results</h3><div>The median age and weight were 14 years (interquartile range [IQR], 7-17 years) and 52 kg (IQR, 26-75 kg). Six patients were syndromic (6/38 [16%]), and 4 patients had active endocarditis (4/38 [13%]). Median aortic homograft size implanted was 23 mm in diameter (IQR, 21-24 mm). There was no early mortality and 2 late deaths (5.3%); 8 homografts (21%) were replaced at follow-up with no deaths after replacement of the homograft. Of the 38 implanted homografts, 28 (74%) were functioning well at a median of 81 months after initial implantation. The actuarial reintervention-free survival was 50% at 224 months. The Kaplan-Meier estimated survival at 220 months was 90%.</div></div><div><h3>Conclusions</h3><div>Replacement of the aortic valve with an aortic homograft is a reasonable valve substitute in children, recognizing that some of these homografts will need to be replaced over time. The risk of reoperation is low, and it can be performed safely.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 668-671"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.03.007
Arjun Verma BS , Justin J. Kim BA , Sara Sakowitz MS, MPH , Yas Sanaiha MD , Joseph Hadaya MD, PhD , Peyman Benharash MD, MS
Background
Coronary artery bypass grafting (CABG) is traditionally performed though median sternotomy for multivessel coronary artery disease. Robotic CABG, a viable alternative, comprises less than 1% of CABG procedures in the United States despite its potential benefits. This study aimed to compare the trends and outcomes of conventional and robotic CABG by using a contemporary national cohort.
Methods
A retrospective study was conducted using the 2016 to 2020 Nationwide Readmissions Database (NRD). Adult patients (aged ≥18 years) who underwent single-vessel CABG were identified using International Classification of Diseases, 10th revision procedure codes. Patients were categorized into robotic (totally endoscopic or robotic-assisted) and conventional CABG cohorts. Outcomes evaluated included in-hospital mortality, major adverse events (MAEs), length of stay, hospitalization costs, nonhome discharge, and 30-day readmissions.
Results
Among 21,870 patients, 3433 (15.7%) underwent robotic CABG. The use of robotic CABG increased modestly over the study period. Patients who underwent robotic CABG had lower in-hospital mortality (0.4% vs 1.7%; P < .001) and MAEs (11.4% vs 18.9%; P < .001) compared with conventional CABG. Moreover, the robotic CABG cohort was associated with shorter length of stay and reduced hospitalization costs. After adjusting for baseline characteristics, robotic CABG showed lower odds of in-hospital mortality (adjusted odds ratio, 0.35; 95% CI, 0.15-0.84; P = .019) and MAEs (adjusted odds ratio, 0.72; 95% CI, 0.59-0.88; P = .001).
Conclusions
Robotic CABG is associated with reduced in-hospital mortality, complications, LOS, and hospitalization costs compared with conventional CABG. Despite these benefits, its adoption remains limited, potentially because of the steep learning curve and resource requirements. Further efforts to overcome these barriers could enhance the adoption of robotic CABG and improve patient outcomes.
背景对于多支冠状动脉疾病，冠状动脉旁路移植术（CABG）传统上是通过胸骨正中切口进行的。机器人CABG是一种可行的替代方案，尽管有潜在的好处，但在美国，它只占CABG手术的不到1%。本研究旨在通过使用当代国家队列来比较传统和机器人CABG的趋势和结果。方法采用2016 - 2020年全国再入院数据库（NRD）进行回顾性研究。接受单血管冠脉搭桥的成年患者（年龄≥18岁）采用国际疾病分类第10版程序代码进行鉴定。患者分为机器人（完全内窥镜或机器人辅助）和传统CABG组。评估的结果包括住院死亡率、主要不良事件（MAEs）、住院时间、住院费用、非家庭出院和30天再入院。结果在21870例患者中，3433例（15.7%）接受了机器人冠脉搭桥。在研究期间，机器人冠状动脉搭桥的使用适度增加。与传统CABG相比，接受机器人CABG的患者住院死亡率（0.4% vs 1.7%; P < 0.001）和MAEs （11.4% vs 18.9%; P < 0.001）较低。此外，机器人CABG队列与更短的住院时间和更低的住院费用相关。在调整基线特征后，机器人CABG显示出较低的院内死亡率（调整优势比0.35;95% CI, 0.15-0.84; P = 0.019）和MAEs（调整优势比0.72;95% CI, 0.59-0.88; P = 0.001）。结论与传统CABG相比，机器人CABG可降低住院死亡率、并发症、LOS和住院费用。尽管有这些好处，但它的采用仍然有限，可能是因为陡峭的学习曲线和资源需求。克服这些障碍的进一步努力可以提高机器人冠脉搭桥的采用，并改善患者的预后。
{"title":"Association of Robotic Assistance With Short-term Outcomes After Coronary Artery Bypass Grafting","authors":"Arjun Verma BS , Justin J. Kim BA , Sara Sakowitz MS, MPH , Yas Sanaiha MD , Joseph Hadaya MD, PhD , Peyman Benharash MD, MS","doi":"10.1016/j.atssr.2025.03.007","DOIUrl":"10.1016/j.atssr.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery bypass grafting (CABG) is traditionally performed though median sternotomy for multivessel coronary artery disease. Robotic CABG, a viable alternative, comprises less than 1% of CABG procedures in the United States despite its potential benefits. This study aimed to compare the trends and outcomes of conventional and robotic CABG by using a contemporary national cohort.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted using the 2016 to 2020 Nationwide Readmissions Database (NRD). Adult patients (aged ≥18 years) who underwent single-vessel CABG were identified using International Classification of Diseases, 10th revision procedure codes. Patients were categorized into robotic (totally endoscopic or robotic-assisted) and conventional CABG cohorts. Outcomes evaluated included in-hospital mortality, major adverse events (MAEs), length of stay, hospitalization costs, nonhome discharge, and 30-day readmissions.</div></div><div><h3>Results</h3><div>Among 21,870 patients, 3433 (15.7%) underwent robotic CABG. The use of robotic CABG increased modestly over the study period. Patients who underwent robotic CABG had lower in-hospital mortality (0.4% vs 1.7%; <em>P</em> < .001) and MAEs (11.4% vs 18.9%; <em>P</em> < .001) compared with conventional CABG. Moreover, the robotic CABG cohort was associated with shorter length of stay and reduced hospitalization costs. After adjusting for baseline characteristics, robotic CABG showed lower odds of in-hospital mortality (adjusted odds ratio, 0.35; 95% CI, 0.15-0.84; <em>P</em> = .019) and MAEs (adjusted odds ratio, 0.72; 95% CI, 0.59-0.88; <em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>Robotic CABG is associated with reduced in-hospital mortality, complications, LOS, and hospitalization costs compared with conventional CABG. Despite these benefits, its adoption remains limited, potentially because of the steep learning curve and resource requirements. Further efforts to overcome these barriers could enhance the adoption of robotic CABG and improve patient outcomes.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 603-608"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.02.014
Yi-jiu Ren MD , Jie Mi MD , Chen-lu Yang MD , Xue-fei Hu MD , Chang Chen MD
Carina resection and reconstruction pose a great challenge. We present a successful case of carina defect repair with extended bronchial flap of the lateral walls of the right main and middle bronchi, together with a bronchoplasty method by single-port thoracoscopy. This is a novel technique for repairing carinal defects with an extended pedicled bronchial flap in specific situations.
{"title":"A Novel Technique of Carina Reconstruction With Extended Bronchial Flap by Single-port Thoracoscopy","authors":"Yi-jiu Ren MD , Jie Mi MD , Chen-lu Yang MD , Xue-fei Hu MD , Chang Chen MD","doi":"10.1016/j.atssr.2025.02.014","DOIUrl":"10.1016/j.atssr.2025.02.014","url":null,"abstract":"<div><div>Carina resection and reconstruction pose a great challenge. We present a successful case of carina defect repair with extended bronchial flap of the lateral walls of the right main and middle bronchi, together with a bronchoplasty method by single-port thoracoscopy. This is a novel technique for repairing carinal defects with an extended pedicled bronchial flap in specific situations.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 714-717"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.02.001
Usman Khan BS , Steven J. Keteyian PhD , Francis D. Pagani MD, PhD , Michael P. Thompson PhD
{"title":"The Important and Untapped Role of the Surgeon in Cardiac Rehabilitation","authors":"Usman Khan BS , Steven J. Keteyian PhD , Francis D. Pagani MD, PhD , Michael P. Thompson PhD","doi":"10.1016/j.atssr.2025.02.001","DOIUrl":"10.1016/j.atssr.2025.02.001","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 805-807"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.02.005
Michael J. Weyant MD , Abhishek Kumar BS , Kathryn Bush MD , Kei Suzuki MD, FACS
Background
Uninterrupted access to thoracic surgical care is limited to large tertiary care centers. Our aim was to characterize the value that interhospital transfers bring to a tertiary care center.
Methods
Retrospective review of access center calls for patients with thoracic surgery needs between April 2022 and August 2023 was performed. Data collected included number/time of calls, diagnosis of requested transfer, number of transfers, number/type of procedures performed, distance of transfer, and characteristics of in-system vs out-of-system patients. Procedures performed were defined as major (performed by thoracic surgeons) or minor (performed by nonthoracic surgery proceduralists).
Results
In total, 367 phone calls occurred over 17 months (22 calls/mo) with 261 calls (71%) leading to transfers. Of those transferred, 169 patients (65%) received an intervention, totaling 218 procedures. Of these procedures, 93 (43%) were major operations, accounting for 15% of thoracic surgery volume, and 125 (57%) were minor procedures. The most common major operations were decortication (33 of 94, 35%), and wedge resections (16 of 94, 17%). Fifty-one out-of-system hospitals accounted for a higher volume (58% vs 42%), and a longer median transfer distance (13.8 vs 48.1 miles). However, in-system transfers were more likely to lead to major thoracic procedures (49% vs 38%).
Conclusions
This is the first study to provide details on interhospital transfers for thoracic surgery needs. A substantial portion of transferred patients undergo an invasive procedure by thoracic surgeons and other proceduralists. The study highlights an underappreciated part of thoracic surgeons’ contribution to patient care in the community and hospital system.
{"title":"Outcomes of Access Center Transfers for Thoracic Surgical Issues","authors":"Michael J. Weyant MD , Abhishek Kumar BS , Kathryn Bush MD , Kei Suzuki MD, FACS","doi":"10.1016/j.atssr.2025.02.005","DOIUrl":"10.1016/j.atssr.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Uninterrupted access to thoracic surgical care is limited to large tertiary care centers. Our aim was to characterize the value that interhospital transfers bring to a tertiary care center.</div></div><div><h3>Methods</h3><div>Retrospective review of access center calls for patients with thoracic surgery needs between April 2022 and August 2023 was performed. Data collected included number/time of calls, diagnosis of requested transfer, number of transfers, number/type of procedures performed, distance of transfer, and characteristics of in-system vs out-of-system patients. Procedures performed were defined as major (performed by thoracic surgeons) or minor (performed by nonthoracic surgery proceduralists).</div></div><div><h3>Results</h3><div>In total, 367 phone calls occurred over 17 months (22 calls/mo) with 261 calls (71%) leading to transfers. Of those transferred, 169 patients (65%) received an intervention, totaling 218 procedures. Of these procedures, 93 (43%) were major operations, accounting for 15% of thoracic surgery volume, and 125 (57%) were minor procedures. The most common major operations were decortication (33 of 94, 35%), and wedge resections (16 of 94, 17%). Fifty-one out-of-system hospitals accounted for a higher volume (58% vs 42%), and a longer median transfer distance (13.8 vs 48.1 miles). However, in-system transfers were more likely to lead to major thoracic procedures (49% vs 38%).</div></div><div><h3>Conclusions</h3><div>This is the first study to provide details on interhospital transfers for thoracic surgery needs. A substantial portion of transferred patients undergo an invasive procedure by thoracic surgeons and other proceduralists. The study highlights an underappreciated part of thoracic surgeons’ contribution to patient care in the community and hospital system.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 822-827"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.01.004
Krish C. Dewan MD , Alejandro A. Lobo MD , Zachary W. Fitch MD , Alejandro Murillo MD , Angela Pollak MD, FASE , Alina Nicoara MD, FASE , Violet G. Johnston BS , Carmelo A. Milano MD
Aortic root thrombosis (ART) is an uncommon complication after left ventricular assist device implantation. We describe a unique postoperative presentation of intractable ventricular tachycardia as a result of an aortic root thrombus extending into the left main coronary artery. This case highlights the importance of a high degree of suspicion and anticoagulation for ART in the setting of intractable postoperative ventricular tachycardia and limited opening of the aortic valve. Second, whereas most reported cases of ART have been managed conservatively by optimizing left ventricular assist device speed and anticoagulation, we demonstrate the feasibility of early surgical management.
{"title":"Aortic Root Thrombus in a Left Ventricular Assist Device Patient as a Cause for Intractable Ventricular Tachycardia","authors":"Krish C. Dewan MD , Alejandro A. Lobo MD , Zachary W. Fitch MD , Alejandro Murillo MD , Angela Pollak MD, FASE , Alina Nicoara MD, FASE , Violet G. Johnston BS , Carmelo A. Milano MD","doi":"10.1016/j.atssr.2025.01.004","DOIUrl":"10.1016/j.atssr.2025.01.004","url":null,"abstract":"<div><div>Aortic root thrombosis (ART) is an uncommon complication after left ventricular assist device implantation. We describe a unique postoperative presentation of intractable ventricular tachycardia as a result of an aortic root thrombus extending into the left main coronary artery. This case highlights the importance of a high degree of suspicion and anticoagulation for ART in the setting of intractable postoperative ventricular tachycardia and limited opening of the aortic valve. Second, whereas most reported cases of ART have been managed conservatively by optimizing left ventricular assist device speed and anticoagulation, we demonstrate the feasibility of early surgical management.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 777-779"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.01.011
Louis F. Chai MD , Whitney M. Burrows MD , Joseph S. Friedberg MD , Charles T. Bakhos MD , Lisa Rae MD , Cherie P. Erkmen MD
Xylazine has caused increasing drug-related mortality and necrotic wounds. Neck and chest injections have caused destructive lesions that have engaged thoracic surgeons. We present 3 cases from Philadelphia, the epicenter of xylazine use, and discuss the multidisciplinary care effort. Providers should be aware of the symptoms of xylazine use to appropriately treat patients.
{"title":"Destructive Xylazine Wounds: A New Entity Faced by Thoracic Surgeons","authors":"Louis F. Chai MD , Whitney M. Burrows MD , Joseph S. Friedberg MD , Charles T. Bakhos MD , Lisa Rae MD , Cherie P. Erkmen MD","doi":"10.1016/j.atssr.2025.01.011","DOIUrl":"10.1016/j.atssr.2025.01.011","url":null,"abstract":"<div><div>Xylazine has caused increasing drug-related mortality and necrotic wounds. Neck and chest injections have caused destructive lesions that have engaged thoracic surgeons. We present 3 cases from Philadelphia, the epicenter of xylazine use, and discuss the multidisciplinary care effort. Providers should be aware of the symptoms of xylazine use to appropriately treat patients.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 797-801"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.02.007
Bernadette Peltier MD , Brittney Williams MD, MPH , Onkar Khullar MD, MSc , Manu Sancheti MD , Felix Fernandez MD, MSc , Seth Force MD , Alicia Bonanno MD
Malignant neoplasms of the chest wall often require radical resection, leaving large defects in which soft tissue coverage alone is inadequate. Reconstruction of these defects must provide structural support to protect thoracic viscera, to reestablish adequate respiratory function, and to achieve acceptable cosmetic outcomes. Techniques described in the literature are varied, and there is no consensus on best practices. We present 3 cases of large chest wall defects that were reconstructed by a method in which titanium mesh is sandwiched between sheets of porcine acellular dermal matrix. We find this method safe and applicable to large anterior defects.
{"title":"Chest Wall Reconstruction Using Titanium Mesh With Fortiva Acellular Dermal Matrix Sandwich Technique","authors":"Bernadette Peltier MD , Brittney Williams MD, MPH , Onkar Khullar MD, MSc , Manu Sancheti MD , Felix Fernandez MD, MSc , Seth Force MD , Alicia Bonanno MD","doi":"10.1016/j.atssr.2025.02.007","DOIUrl":"10.1016/j.atssr.2025.02.007","url":null,"abstract":"<div><div>Malignant neoplasms of the chest wall often require radical resection, leaving large defects in which soft tissue coverage alone is inadequate. Reconstruction of these defects must provide structural support to protect thoracic viscera, to reestablish adequate respiratory function, and to achieve acceptable cosmetic outcomes. Techniques described in the literature are varied, and there is no consensus on best practices. We present 3 cases of large chest wall defects that were reconstructed by a method in which titanium mesh is sandwiched between sheets of porcine acellular dermal matrix. We find this method safe and applicable to large anterior defects.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 818-821"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.atssr.2025.02.002
Andrew Behrmann BS , Blake Wojciechowski MD , Chase Schlesselman BS , Jussuf Kaifi MD, PhD , Sebastian Wiesemann MD
Background
Thoracic surgery can damage intercostal nerves and cause muscular atrophy and bulging of the anterior abdominal wall (pseudohernia). This pilot study investigated the incidence of and risk factors for development of pseudohernias after anatomic lung resection in either robotic video-assisted thoracoscopic surgery (R-VATS) or thoracotomy cases.
Methods
A retrospective cohort analysis of 319 patients undergoing either R-VATS or thoracotomy for anatomic lung resection at a single institution from 2017 to 2021 was performed to determine pseudohernia incidence rates and possible risk factors.
Results
Only patients who underwent R-VATS had pseudohernias, with an incidence rate of 7.6%. Readmission within 30 days of operation was higher in patients with pseudohernias (P = .02). Cryoablation at or below the seventh intercostal space was significantly correlated with pseudohernia development (P = .04). Diabetes trended toward increasing the risk for pseudohernias (P = .05). Acute and chronic pain scores were higher in patients with pseudohernias.
Conclusions
Robotic surgery and cryoablation are associated with an increased risk of pseudohernias, and the incidence may be higher than previous case reports suggest. Possible explanations are decreased tactile feedback, larger-diameter trocars, and lower intercostal access levels, leading to thoracoabdominal nerve damage. Understanding the incidence and risk factors for pseudohernias may inform surgical practices to improve patient outcomes and quality of life.
{"title":"Anterior Abdominal Wall Pseudohernias After Anatomic Lung Resection: Incidence and Risk Factors","authors":"Andrew Behrmann BS , Blake Wojciechowski MD , Chase Schlesselman BS , Jussuf Kaifi MD, PhD , Sebastian Wiesemann MD","doi":"10.1016/j.atssr.2025.02.002","DOIUrl":"10.1016/j.atssr.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic surgery can damage intercostal nerves and cause muscular atrophy and bulging of the anterior abdominal wall (pseudohernia). This pilot study investigated the incidence of and risk factors for development of pseudohernias after anatomic lung resection in either robotic video-assisted thoracoscopic surgery (R-VATS) or thoracotomy cases.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis of 319 patients undergoing either R-VATS or thoracotomy for anatomic lung resection at a single institution from 2017 to 2021 was performed to determine pseudohernia incidence rates and possible risk factors.</div></div><div><h3>Results</h3><div>Only patients who underwent R-VATS had pseudohernias, with an incidence rate of 7.6%. Readmission within 30 days of operation was higher in patients with pseudohernias (<em>P</em> = .02). Cryoablation at or below the seventh intercostal space was significantly correlated with pseudohernia development (<em>P</em> = .04). Diabetes trended toward increasing the risk for pseudohernias (<em>P</em> = .05). Acute and chronic pain scores were higher in patients with pseudohernias.</div></div><div><h3>Conclusions</h3><div>Robotic surgery and cryoablation are associated with an increased risk of pseudohernias, and the incidence may be higher than previous case reports suggest. Possible explanations are decreased tactile feedback, larger-diameter trocars, and lower intercostal access levels, leading to thoracoabdominal nerve damage. Understanding the incidence and risk factors for pseudohernias may inform surgical practices to improve patient outcomes and quality of life.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 3","pages":"Pages 693-698"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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