Journal and News Scan

This retrospective study analyzed outcomes of 970 bilateral lung transplant recipients at a single center from 2007–2023, stratified by age groups: 15–64, 65–69, 70–74, and 75–years. Findings showed that older recipients (greater than or equal to 65 years) had similar short-term outcomes, including 1-year survival rates, compared to younger patients, despite longer hospital stays and less frequent need for extracorporeal membrane oxygenation (ECMO) at 72 hours post-transplant. Median survival decreased with age: 6.1 years (15–64), 4.8 years (65–69), 4.7 years (70–74), and 4.5 years (75–79). Five-year survival rates were 58.0 percent, 46.8 percent, 44.5 percent, and 47.2 percent, respectively. Causes of death varied with age; graft failure was more common in younger patients, while infection, malignancy, and cardiovascular disease predominated in older groups. This study highlights the increasing acceptance of lung transplantation in elderly patients, especially those aged 70–74, demonstrating that careful selection can yield acceptable perioperative outcomes and that advanced age should not be considered an absolute contraindication for lung transplantation. 

This article presents a large, population-based study using UK primary care data to identify comorbid conditions associated with lung cancer in never-smokers (LCINS). Across two independent data sets (CPRD-GOLD and CPRD-Aurum), the study found several inflammatory and autoimmune conditions significantly associated with an increased risk of LCINS, particularly COPD/emphysema, gastroesophageal reflux disease (GERD), gastritis, type 1 diabetes mellitus, anemia, and bronchitis. These associations persisted even after adjusting for medication use, socioeconomic status, and body mass index. This study underscores the biological plausibility of chronic inflammation as a contributing factor to the pathogenesis of LCINS. 
 
This research is of high relevance to the CTSNet global cardiothoracic surgery audience, as it informs risk stratification and screening strategies for lung cancer in patients without a history of smoking. Understanding these associations could enhance early detection and influence surgical evaluations in the growing population of LCINS patients. 

Heart valve disease is a leading cause of mortality, with increasing incidence due to an aging population. Early referral to specialized heart networks is vital, as late diagnosis often leads to palliative rather than curative treatment. Geographic variations exist in diseases causes, and less than 25 percent of patients are referred for necessary interventions, partly due to perceived treatment risks. Establishing multidisciplinary heart networks can improve patient survival by tailoring treatment plans and facilitating early referrals, demonstrating that timely interventions enhance long-term outcomes for those with heart valve disease.  

Mitral valve leaflet and subvalvular apparatus abnormalities can cause left ventricular outflow tract obstruction in the absence of septal hypertrophy. The authors discuss different techniques to address this situation, based on two key principles: modifying the effects of altered flow vortices that change the position of mitral valve leaflets with relation to the outflow tract and restoring posterior coaptation of the leaflets. The preoperative workup is detailed, including echocardiography and cardiac MRI to assess leaflet and papillary muscle anatomy. Various repair techniques are described, including anterior leaflet shortening, reduction of posterior leaflet height, papillary muscle head reorientation and partial resection, as well as mitral valve replacement when necessary.