JTCVS open最新文献

英文中文

A custom preservation solution extends the ex vivo availability of living heart valves for transplantation 定制的保存解决方案扩展了活体心脏瓣膜移植的体外可用性

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.08.019

Elizabeth M. Cordoves BA , Baoqi Liu MS , Olivier Pont BS , V. Reed LaSala MD , Griffin Welsh Daly BS , Keith Yeager MS , Lucie Chicaud BS , Richard Zhuang MS , Senay Ustunel PhD , Kavya Rajesh MD , Nicole Julia , Sophia Jackman MD , Sharon Fleischer PhD , Emile A. Bacha MD , Emmanuel Zorn PhD , Giovanni Ferrari PhD , Gordana Vunjak-Novakovic PhD , David M. Kalfa MD, PhD

Objectives

Although heart valve transplantation delivers living, growth-capable valves, its clinical implementation is restricted by transplant logistics and donor availability. We developed a preservation solution for the ex vivo storage of living valves that maintains tissue viability for at least 7 weeks.

Methods

Porcine pulmonary roots (N = 25) were dissected, treated with a clinically used antibiotic cocktail, and stored in a custom-made preservation solution (Valve Preservation Solution, VPS) or Hanks’ Balanced Salt Solution with serum for up to 7 weeks. Tissues were preserved in normothermia (37 °C, 5% CO₂) and hypothermia (4 °C, control group). Tissue preservation was monitored weekly by evaluating viability (AlamarBlue), metabolic activity (media glucose), histologic tissue preservation (hematoxylin and eosin, Movat Pentachrome stain), and valve cell phenotype (immunostaining).

Results

Cold-stored valves (VPS and Hanks’ Balanced Salt Solution) demonstrated significantly reduced viability within 1 to 2 weeks ex vivo. In contrast, normothermic storage in VPS preserved leaflet viability for 7 weeks, with consistent glucose metabolism. Immunostaining of normothermic VPS-stored valve leaflets showed a quiescent cell phenotype with little expression of alpha-smooth muscle actin or proliferation markers (relative to baseline), and baseline-level leaflet Vimentin expression. Despite preserved cellular viability, leaflet microarchitectural integrity was only maintained for 3 weeks of ex vivo storage.

Conclusions

Normothermic preservation of living valves can support tissue viability for at least 7 weeks ex vivo. With additional preclinical validation, stored living valves could act as a tissue source for heart valve transplantation, with key advantages in enhanced availability and resource-efficiency.

虽然心脏瓣膜移植提供了活的、能生长的瓣膜，但其临床实施受到移植后勤和供体可用性的限制。我们开发了一种用于活体瓣膜离体储存的保存溶液，可保持组织活力至少7周。方法将25例菌素肺根解剖，用临床常用的抗生素鸡尾酒处理，用特制的保存液（Valve preservation solution， VPS）或汉克斯平衡盐溶液与血清保存7周。组织保存在常温（37°C, 5% CO2）和低温（4°C，对照组）。每周通过评估活力（AlamarBlue）、代谢活性（培养基葡萄糖）、组织学组织保存（苏木精和伊红，Movat五色染色）和瓣膜细胞表型（免疫染色）来监测组织保存。结果冷冻瓣膜（VPS和Hanks平衡盐溶液）在离体1 ~ 2周内存活率显著降低。相比之下，常温储存的VPS保存了7周的小叶活力，并保持了一致的葡萄糖代谢。常温vps储存的瓣膜小叶的免疫染色显示静止细胞表型，α -平滑肌肌动蛋白或增殖标志物的表达很少（相对于基线），小叶Vimentin的表达水平与基线水平相当。尽管保存了细胞活力，但小叶微结构的完整性仅维持了3周的离体储存。结论体外保存活瓣膜可维持组织存活至少7周。通过额外的临床前验证，储存的活体瓣膜可以作为心脏瓣膜移植的组织来源，其关键优势在于提高可用性和资源效率。

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引用次数: 0

Decoding intertumoral heterogeneity in multifocal ground-glass nodule lung cancers: Clonal evolutionary insight for precision management 解读多灶磨玻璃结节肺癌的肿瘤间异质性：克隆进化对精确管理的洞察

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.09.009

Chu-Long Xie MD , Xiao-Yang Hua MD , Qi Zhao PhD , Ji-Bin Li MD , Zi-Hui Tan MD , Peng Li MD , Jie-Tian Jin MD , Lin Gao PhD , Zai-Xian Tai BS , Jing-Sheng Cai MD , Xue Hou MD, PhD , Hao-Xian Yang MD, PhD

Objective

The management of multifocal ground-glass nodule (GGN) lung cancers remains hindered by insufficient knowledge of intertumoral heterogeneity, which complicates accurate diagnosis and effective treatment strategies. This study aims to characterize intertumoral heterogeneity of multifocal GGN lung cancers and to inform an evidence-based framework for diagnostic and therapeutic decision-making.

Methods

We performed multiregion whole-exome sequencing (WES) on 60 surgically resected lung GGNs and their matched normal tissues. Clonal evolution analysis (CEA), focusing on subclonal expansion, was compared with comprehensive histologic assessment (CHA) to evaluate clonal relationships among multifocal lung GGNs. Longitudinal follow-up was conducted to validate the findings' robustness.

Results

A total of 43 tumor pairs were included in the analysis. CEA classified 41 pairs (95.3%) as independent primary tumors (IPTs) and 2 pairs (4.7%) as intrapulmonary metastases (IMs). CHA initially identified 37 pairs (86.0%) as IPTs and 6 pairs (14.0%) as IMs. However, CEA reclassified 4 of the 6 CHA-identified IM pairs (66.7%) as IPTs, demonstrating superior diagnostic accuracy. Over a median follow-up of 57.5 months, 1 patient with IMs experienced recurrence and progression, whereas no such events occurred in patients with IPTs.

Conclusions

CEA reveals noteworthy intertumoral heterogeneity in multifocal GGN lung cancers, highlighting the added diagnostic value of genetic profiling. Although most cases represent independent primaries, a subset aligns with metastatic processes, underscoring the need for vigilant assessment. These findings support a precision framework that integrates molecular data to optimize surveillance and therapeutic strategies, contributing to addressing the intertumoral heterogeneity challenges outlined in current management paradigms.

目的肺癌多灶磨玻璃结节（GGN）的治疗一直受到肿瘤间异质性认识不足的阻碍，这给准确诊断和有效治疗策略带来了困难。本研究旨在描述多灶性GGN肺癌的肿瘤间异质性，并为诊断和治疗决策提供循证框架。方法对60例手术切除的肺ggn及其匹配的正常组织进行多区域全外显子组测序（WES）。以亚克隆扩增为重点的克隆进化分析（CEA）与综合组织学评估（CHA）进行比较，以评价多灶性肺ggn之间的克隆关系。进行纵向随访以验证研究结果的稳健性。结果共纳入43对肿瘤。CEA将41对（95.3%）归为独立原发肿瘤（IPTs）， 2对（4.7%）归为肺内转移瘤（IMs）。CHA初步鉴定出37对（86.0%）为ipt， 6对（14.0%）为im。然而，CEA将6对cha鉴定的IM对中的4对（66.7%）重新分类为ipt，显示出更高的诊断准确性。在中位57.5个月的随访中，1例IMs患者出现复发和进展，而ipt患者没有发生此类事件。结论scea显示了多灶性GGN肺癌的肿瘤间异质性，突出了基因谱的附加诊断价值。虽然大多数病例代表独立的原发，但有一部分与转移过程一致，强调了警惕评估的必要性。这些发现支持一个精确的框架，整合分子数据来优化监测和治疗策略，有助于解决当前管理范式中概述的肿瘤间异质性挑战。

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引用次数: 0

The clinical and financial impact of new-onset atrial fibrillation after coronary bypass grafting: From indexed procedure to long-term follow-up 冠状动脉旁路移植术后新发心房颤动的临床和经济影响：从索引手术到长期随访

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.09.012

Niv Ad MD , Clifford E. Fonner BA , Diane Alejo BA , Ramon Riojas MD , Glenn J.R. Whitman MD , Terri Haber MPH , Charles Evans MD , Sari D. Holmes PhD , Maryland Cardiac Surgery Quality Initiative

Objective

New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) is common. Additional information regarding long-term clinical and financial outcomes is important. This statewide analysis compares periprocedural and long-term outcomes between patients with and without POAF.

Methods

Data on patients who underwent isolated CABG from 2013 to 2021 without atrial fibrillation (AF) history from a statewide Society of Thoracic Surgeons database (N = 18,377) were merged with the state health services database. Patients with POAF (n = 4656) were compared with those without POAF (n = 13,721). Outcomes were incidence and cost of readmissions, examined with χ² tests and regressions.

Results

The incidence of POAF was 25% (male = 26% vs female = 24%, P = .002). Patients with POAF had worse risk-adjusted outcomes, more often were discharged on oral anticoagulation (29% vs 7%, P < .001), and incurred greater procedural cost ($52K vs $46K, P < .001). The POAF group had a greater incidence of readmissions for AF (12% vs 3%, P < .001), heart failure (HF) (15% vs 10%, P < .001), and major bleeding (2.4% vs 1.6%, P = .001) but not ischemic stroke (5% vs 4%, P = .100). After risk adjustment, POAF remained at greater risk for AF, HF, and major bleeding readmissions. The proportion of patients’ readmission costs associated with AF (11% vs 3%, P < .001), HF (12% vs 9%, P < .001), and major bleeding (2.1% vs 1.4%, P = .009) was greater for patients with POAF but not ischemic stroke (4% vs 4%, P = .591).

Conclusions

POAF remains common after CABG, with greater cost and risk-adjusted morbidity reported. Follow-up data reveal a significant number of patients continue to be impacted by AF. This study suggests targeted discharge planning and surveillance for patients with POAF to improve long-term outcomes and reduce cost of complications.

目的冠状动脉旁路移植术（CABG）术后并发心房颤动（POAF）较为常见。关于长期临床和财务结果的附加信息很重要。这项全州范围的分析比较了有和没有POAF患者的围手术期和长期预后。方法将2013年至2021年接受孤立性冠状动脉搭桥且无房颤（AF）病史的患者数据（N = 18,377）与州卫生服务数据库合并。将POAF患者（n = 4656）与非POAF患者（n = 13721）进行比较。结果为再入院的发生率和费用，采用χ2检验和回归检验。结果POAF发生率为25%（男性为26%，女性为24%，P = 0.002）。POAF患者的风险调整后结果更差，出院时更经常使用口服抗凝治疗（29%对7%，P < 001），并且需要更多的手术费用（5.2万美元对4.6万美元，P < 001）。POAF组因房颤（12% vs 3%, P < 0.001）、心力衰竭（HF）（15% vs 10%, P < 0.001）和大出血（2.4% vs 1.6%, P = 0.001）再入院的发生率更高，但缺血性卒中发生率较低（5% vs 4%, P = 0.001）。风险调整后，POAF发生房颤、心衰和大出血再入院的风险仍然较高。与房颤（11%对3%，P < 0.001）、心衰（12%对9%，P < 0.001）和大出血（2.1%对1.4%,P = 0.009）相关的患者再入院费用比例在POAF患者中高于缺血性卒中患者（4%对4%，P = 0.591）。结论：冠脉搭桥后spoaf仍然很常见，有更高的成本和风险调整后的发病率报道。随访数据显示，大量患者仍然受到房颤的影响。本研究建议对POAF患者进行有针对性的出院计划和监测，以改善长期预后并降低并发症的成本。

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引用次数: 0

Utilization and outcomes of cardiopulmonary resuscitated donor hearts in the modern era 现代心肺复苏供体心脏的利用及效果

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.10.020

Zach Rollins MD , Ye In Christopher Kwon BA , Mythili Vigneshwar MD , Elizabeth Bashian MD , Matthew Ambrosio MS , Inna Tchoukina MD , Keyur Shah MD , Zachary Fitch MD , Josue Chery MD , Mohammed Quader MD , Vigneshwar Kasirajan MD , Zubair A. Hashmi MD

Objective

Donor hearts that have undergone cardiopulmonary resuscitation (CPR) were previously considered marginal donors. We aimed to determine how donor CPR influences recipient outcomes (CPR+ vs CPR−). Additionally, we evaluated the overall use of CPR+ donor hearts in the modern era.

Methods

All single heart organ transplants in the United States from 2014 to 2023 were obtained for adults older than age 18 years. Survival curves were built for overall and graft survival using a Kaplan-Meier method with a log-rank test used to test for differences. Multivariate Cox-regression was performed on recipient survival with CPR status and other recipient variables as covariates.

Results

From 2014 to 2023, there were 13 994 CPR− donors and 15 601 CPR+ donors throughout the study period. There was no significant difference in patient survival at 30 days, 1 year, and 5 years (P = .09). Graft survival over 5 years was similar between subgroups of CPR ≤15 minutes, 16 to 30 minutes, or >30 minutes (P = .94). Use of heart transplants from donors resuscitated using CPR increased throughout the study, with CPR+ donors representing >50% of all donors since 2017.

Conclusions

Heart donors who are CPR+ are being used at an increased frequency and now represent most donors. CPR+ hearts have statistically equivalent patient and graft survival outcomes over 5 years. Hearts that have undergone CPR, even for periods of >30 minutes, can be safely utilized.

目的：接受过心肺复苏（CPR）的供体心脏以前被认为是边缘供体。我们的目的是确定供者CPR如何影响接受者的结果（CPR+ vs CPR -）。此外，我们评估了现代心肺复苏术+供体心脏的总体使用情况。方法2014 - 2023年美国所有单器官移植患者均为18岁以上成人。采用Kaplan-Meier法建立总体和移植物生存曲线，并采用log-rank检验来检验差异。以心肺复苏术状态和其他受体变量为协变量，对受者生存率进行多变量cox回归。结果2014年至2023年期间，共有13 994名CPR -献血者和15 601名CPR+献血者。患者30天、1年和5年生存率无显著差异（P = 0.09）。在CPR≤15分钟、16 ~ 30分钟和30分钟的亚组中，移植物5年生存率相似（P = 0.94）。在整个研究过程中，使用心肺复苏术复苏的捐赠者的心脏移植的使用增加了，自2017年以来，心肺复苏术+捐赠者占所有捐赠者的50%。结论心肺复苏术+心脏供者的使用频率越来越高，占供者的大多数。CPR+心脏在5年内的患者和移植物生存结果在统计学上是相同的。接受过心肺复苏术的心脏，即使只有30分钟，也可以安全地使用。

{"title":"Utilization and outcomes of cardiopulmonary resuscitated donor hearts in the modern era","authors":"Zach Rollins MD , Ye In Christopher Kwon BA , Mythili Vigneshwar MD , Elizabeth Bashian MD , Matthew Ambrosio MS , Inna Tchoukina MD , Keyur Shah MD , Zachary Fitch MD , Josue Chery MD , Mohammed Quader MD , Vigneshwar Kasirajan MD , Zubair A. Hashmi MD","doi":"10.1016/j.xjon.2025.10.020","DOIUrl":"10.1016/j.xjon.2025.10.020","url":null,"abstract":"<div><h3>Objective</h3><div>Donor hearts that have undergone cardiopulmonary resuscitation (CPR) were previously considered marginal donors. We aimed to determine how donor CPR influences recipient outcomes (CPR+ vs CPR−). Additionally, we evaluated the overall use of CPR+ donor hearts in the modern era.</div></div><div><h3>Methods</h3><div>All single heart organ transplants in the United States from 2014 to 2023 were obtained for adults older than age 18 years. Survival curves were built for overall and graft survival using a Kaplan-Meier method with a log-rank test used to test for differences. Multivariate Cox-regression was performed on recipient survival with CPR status and other recipient variables as covariates.</div></div><div><h3>Results</h3><div>From 2014 to 2023, there were 13 994 CPR− donors and 15 601 CPR+ donors throughout the study period. There was no significant difference in patient survival at 30 days, 1 year, and 5 years (<em>P</em> = .09). Graft survival over 5 years was similar between subgroups of CPR ≤15 minutes, 16 to 30 minutes, or >30 minutes (<em>P</em> = .94). Use of heart transplants from donors resuscitated using CPR increased throughout the study, with CPR+ donors representing >50% of all donors since 2017.</div></div><div><h3>Conclusions</h3><div>Heart donors who are CPR+ are being used at an increased frequency and now represent most donors. CPR+ hearts have statistically equivalent patient and graft survival outcomes over 5 years. Hearts that have undergone CPR, even for periods of >30 minutes, can be safely utilized.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"28 ","pages":"Pages 312-319"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698172","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}

引用次数: 0

Optimizing surgical management for pulmonary artery sarcoma: A 24-year single-center analysis 优化肺动脉肉瘤的手术治疗：一项24年的单中心分析

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.08.006

Hang Xu MD, PhD , Xinhe Xu MD , Wu Song MD, PhD , Jiade Zhu MD, PhD , Zhaoji Zhong MD, PhD , Sheng Liu MD, PhD

Objective

Pulmonary artery sarcoma (PAS) is a rare and aggressive malignancy often misdiagnosed as chronic thromboembolic pulmonary hypertension. This study aimed to evaluate long-term outcomes after surgical treatment and to compare traditional surgical approaches with an integrated strategy developed at a high-volume center.

Methods

We retrospectively reviewed 31 patients who underwent surgery for PAS at Fuwai Hospital between January 2000 and March 2024. Patients were categorized into 2 groups on the basis of surgical approach: traditional resection versus an integrated strategy involving imaging-guided planning, en bloc resection, selective pulmonary endarterectomy, and vascular reconstruction. Kaplan-Meier survival analysis was performed among 26 patients who survived the perioperative period.

Results

The median follow-up duration was 38 months. Tumor recurrence occurred in 13 of 26 patients, with local recurrence in 9 and distant metastasis in 8. The 1-, 3-, and 5-year survival rates were 78.1% (95% confidence interval [CI], 60.0%-95.0%), 50.5% (95% CI, 30.2%-70.8%), and 19.9% (95% CI, 6.2%-33.6%), respectively, with a median overall survival of 44.0 months. Patients in the integrated surgery group demonstrated significantly improved survival compared with those undergoing traditional surgery (log-rank P = .0234), with no early postoperative deaths and lower recurrence rates.

Conclusions

An integrated surgical approach combining radical resection, pulmonary endarterectomy, and vascular reconstruction may confer a survival advantage in selected patients with PAS. Early diagnosis and tailored surgical planning are critical to optimizing long-term outcomes in this rare and lethal disease.

目的肺动脉肉瘤是一种罕见的侵袭性恶性肿瘤，常被误诊为慢性血栓栓塞性肺动脉高压。本研究旨在评估手术治疗后的长期结果，并将传统手术方法与大容量中心开发的综合策略进行比较。方法回顾性分析2000年1月至2024年3月在阜外医院行PAS手术的31例患者。根据手术入路将患者分为两组：传统切除与综合策略，包括成像引导计划、整体切除、选择性肺动脉内膜切除术和血管重建。对围手术期存活的26例患者进行Kaplan-Meier生存分析。结果中位随访时间为38个月。26例患者中肿瘤复发13例，局部复发9例，远处转移8例。1年、3年和5年生存率分别为78.1%（95%可信区间[CI]， 60.0%-95.0%）、50.5% （95% CI, 30.2%-70.8%）和19.9% (95% CI, 6.2%-33.6%)，中位总生存期为44.0个月。与接受传统手术的患者相比，综合手术组患者的生存率显著提高（log-rank P = 0.0234），无术后早期死亡，复发率较低。结论联合根治性切除、肺动脉内膜切除术和血管重建的综合手术方法可能会给特定的PAS患者带来生存优势。早期诊断和量身定制的手术计划对于优化这种罕见且致命的疾病的长期预后至关重要。

{"title":"Optimizing surgical management for pulmonary artery sarcoma: A 24-year single-center analysis","authors":"Hang Xu MD, PhD , Xinhe Xu MD , Wu Song MD, PhD , Jiade Zhu MD, PhD , Zhaoji Zhong MD, PhD , Sheng Liu MD, PhD","doi":"10.1016/j.xjon.2025.08.006","DOIUrl":"10.1016/j.xjon.2025.08.006","url":null,"abstract":"<div><h3>Objective</h3><div>Pulmonary artery sarcoma (PAS) is a rare and aggressive malignancy often misdiagnosed as chronic thromboembolic pulmonary hypertension. This study aimed to evaluate long-term outcomes after surgical treatment and to compare traditional surgical approaches with an integrated strategy developed at a high-volume center.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 31 patients who underwent surgery for PAS at Fuwai Hospital between January 2000 and March 2024. Patients were categorized into 2 groups on the basis of surgical approach: traditional resection versus an integrated strategy involving imaging-guided planning, en bloc resection, selective pulmonary endarterectomy, and vascular reconstruction. Kaplan-Meier survival analysis was performed among 26 patients who survived the perioperative period.</div></div><div><h3>Results</h3><div>The median follow-up duration was 38 months. Tumor recurrence occurred in 13 of 26 patients, with local recurrence in 9 and distant metastasis in 8. The 1-, 3-, and 5-year survival rates were 78.1% (95% confidence interval [CI], 60.0%-95.0%), 50.5% (95% CI, 30.2%-70.8%), and 19.9% (95% CI, 6.2%-33.6%), respectively, with a median overall survival of 44.0 months. Patients in the integrated surgery group demonstrated significantly improved survival compared with those undergoing traditional surgery (log-rank <em>P</em> = .0234), with no early postoperative deaths and lower recurrence rates.</div></div><div><h3>Conclusions</h3><div>An integrated surgical approach combining radical resection, pulmonary endarterectomy, and vascular reconstruction may confer a survival advantage in selected patients with PAS. Early diagnosis and tailored surgical planning are critical to optimizing long-term outcomes in this rare and lethal disease.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"28 ","pages":"Pages 404-414"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698237","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}

引用次数: 0

Reply: Response to concerns regarding single-anesthesia robotic bronchoscopy for lung nodules 回复：关于单次麻醉机器人支气管镜检查肺结节的关注

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.10.002

Harmik J. Soukiasian MD, Claire Perez MD, Raffaele Rocco MD, Philicia Moonsamy MD, MPH, Andrew R. Brownlee MD

引用次数: 0

Peer review of cardiothoracic surgical manuscripts: Does timing of review impact the outcome? 心胸外科手稿的同行评议：评议的时机会影响结果吗？

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.09.013

Sara Sakowitz MD, MPH, MBA , Ravi Rajaram MD , Mara B. Antonoff MD

引用次数: 0

A career in cardiothoracic surgery in the United States: Guidance and resources for international medical graduates 美国心胸外科的职业生涯：国际医学毕业生的指导和资源

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.08.008

Kevin Rivas , Ahmed A. Abdelrehim MD , Alejandro Suarez-Pierre MD , Mahnoor Imran MD , Jason J. Han MD , Vakhtang Tchantchaleishvili MD

引用次数: 0

Heart under pressure: The hidden battle of posttraumatic stress disorder in aortic dissection survivors 压力下的心脏：主动脉夹层幸存者创伤后应激障碍的隐藏战斗

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.08.005

Martina Spanevello MD , Luca Galassi MD , Vito Domenico Bruno MD, PhD , Ruth A. Lanius MD, PhD , Michael W.A. Chu MD, MEd

引用次数: 0

Interpreting low body mass index outcomes after coronary artery bypass grafting: The need for mechanistic data and stratified analyses 解释冠状动脉旁路移植术后低体重指数的结果：需要机制数据和分层分析

IF 1.9

JTCVS open

Pub Date : 2025-12-01 DOI: 10.1016/j.xjon.2025.09.004

Pradeep Narayan FRCS(CTh)

引用次数: 0

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