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Journal and News Scan
January 9, 2025
Submitted by: EACTS Staff
This study aimed to assess changes in the results of septal myectomy (SM) following the introduction of three-dimensional (3D) imaging and 3D printing in surgical interventions planning and execution within a single-center setting. Between January 2007 and March 2022, 268 patients with hypertrophic obstructive cardiomyopathy underwent either conventional SM or SM with 3D heart modelling. Comparative analysis and long-term follow-up revealed that 3D modelling SM (2PSM) was associated with a lower five-year cumulative incidence of major adverse cardiovascular events and cardiac-related death. These findings suggest that SM based on 3D virtual and printed heart models is more effective than conventional SM.
January 9, 2025
Submitted by: Akshay Patel
This study investigates lung transplant outcomes across age groups, highlighting key survival trends and risk factors. Among the 33,644 recipients, older patients (aged 65–79 years) more frequently underwent single lung transplantation. Bilateral lung transplantation provided a significant survival advantage over single lung transplantation for recipients up to 74 years of age, but not for those aged 75–79, who showed poor long-term survival regardless of procedure type. A history of prior cardiac surgery was identified as a significant risk factor for decreased survival, with older patients more likely to receive single lung transplants if they had such a history.
This research underscores the importance of tailored patient selection and surgical approaches for older lung transplant candidates. The findings offer valuable insights into optimizing outcomes and resource allocation for an increasingly older transplant population.
January 9, 2025
Submitted by: Andre Tyszka
The treatment of aortic valve disease has evolved, and it is expected that TAVR will be available to most patients in the next few years. However, TAVR with a bioprosthesis will continue to be indicated and used. It is well documented that the use of a small valve, particularly in young patients, presents clinical challenges. During the index operation, consideration must be given to the potential need for future TAVR.
To prevent patient prosthesis mismatch (PPM), aortic annulus enlargement is not widely used, as surgeons are concerned about the complexity of the operation, especially in minimally invasive procedures. This innovation allows for the combination of TAVR and SAVR experiences, offering patients a larger valve at minimal cost. It would be prudent to consider incorporating this technique into our surgical armamentarium.
January 9, 2025
Submitted by: EACTS Staff
This study examined the preoperative status and surgical outcomes of male versus female degenerative mitral valve regurgitation patients undergoing surgery. The authors reviewed the institutional database for all patients who underwent surgery for degenerative mitral regurgitation between 2013 and 2021. Preoperative clinical and echocardiographic variables, surgical characteristics, and outcomes were compared. A total of 963 patients were included, 32.6 percent of whom were female. Results showed that women were older and more likely to have bileaflet prolapse, mitral annular calcification, and tricuspid regurgitation. Women also required mechanical circulatory support more frequently, had longer stays in the intensive care unit, were on mechanical ventilation for longer periods, and had longer overall hospitalization. Guidelines may need to be adjusted to address these disparities and improve postoperative recovery.
January 2, 2025
Submitted by: EACTS Staff
This methodology manual is the result of a collaboration between the governing bodies of the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS) to present a comprehensive pathway for creating multidisciplinary clinical practice guidelines (CPGs). CPGs are essential documents that provide practical recommendations designed to enhance patient care and inform healthcare practices. This document integrates existing independent methodologies into a singular collaborative methodology, further enriched by adopting the basic development standards proposed by key stakeholders.
January 2, 2025
Submitted by: Akshay Patel
This article addresses the evolving role of invasive mediastinal restaging in managing resectable stage II and III NSCLC in the era of neoadjuvant chemoimmunotherapy. It emphasizes that while invasive restaging is not routinely required for all patients after neoadjuvant therapy, it remains essential in cases with suspected disease progression—particularly to exclude new N3 status or differentiate between true disease progression and benign nodal immune flare. The authors underscore that surgical resection continues to be a critical component of curative-intent treatment, even for patients with persistent N2 disease, due to the lack of definitive evidence supporting radiation-based or systemic-only alternatives in such scenarios.
This article is significant to the cardiothoracic surgery community as it highlights the need for multidisciplinary decision-making and ongoing research to refine treatment strategies. This article also provides practical insights into integrating novel therapeutic paradigms with surgical care to optimize outcomes in NSCLC.
January 2, 2025
Submitted by: EACTS Staff
This study reports on initial experiences with the da Vinci single-port system. The authors retrospectively reviewed patients with an anterior mediastinal mass who underwent surgery using the da Vinci single-port system via a subxiphoid approach between October 2020 and April 2024. A total of 14 patients were included, all of whom underwent complete resection without conversion to multiport or open surgery. No complications were reported following surgery, and the da Vinci single-port system was deemed safe and feasible. However, further experience and technological advancements are necessary to expand its indications in thoracic surgery.
January 2, 2025
Submitted by: Akshay Patel
This study evaluates the outcomes of bilateral lung transplantation (LTx) using grafts from donors aged 70 years or older, compared with those from younger donors. Conducted at a single center in Leuven, Belgium, the retrospective cohort study included 69 older donors, matched 1:1 with younger donors based on key variables. Primary endpoints included the incidence of primary graft dysfunction (PGD) grade 3 within 72 hours post-transplant, five-year patient survival, and chronic lung allograft dysfunction (CLAD)-free survival.
There were no significant differences in PGD-3 rates (26 percent in older donors versus 29 percent in younger donors), five-year survival (73.6 percent versus 73.1 percent), or CLAD-free survival (51.5 percent versus 59.2 percent).
Carefully selected older donors (mean age 74 years) demonstrated similar short- and long-term outcomes as younger donors.
The study indicates that using lungs from donors aged 70 years or older can effectively address organ shortages, thus expanding the donor pool, without compromising recipient outcomes.
December 27, 2024
Submitted by: Mateo Marin-Cuartas
In this multicenter study, the authors aimed to review patients undergoing surgical intervention for infective endocarditis caused by Cutibacterium acnes and analyze the diagnostic challenges and operative results. A total of 8,812 patients undergoing cardiac surgery for infective endocarditis at 12 cardiac surgical departments across Germany were included and retrospectively analyzed. Primary outcomes were in-hospital mortality, one- and five-year survival. The overall population was divided based on the type of endocarditis (i.e., native and prosthetic valve endocarditis) for comparison.
Cutibacterium acnes caused endocarditis in 269 patients (3.1 percent). The median age was 65 years (range, 54-72 years), and 237 (88.1 percent) were male. Native valve infective endocarditis was more common in patients aged 21-40 years, whereas prosthetic valve endocarditis was more common in all other age groups (p < 0.001). Blood culture-negative infective endocarditis was initially reported in 54.3 percent of the patients. The overall in-hospital mortality was 13 percent, with no statistically significant difference between patients with native valve (9.8 percent) and prosthetic valve (14.7 percent) infective endocarditis (p = 0.340). Survival at one year (97 percent versus 76 percent) and five years (87 percent versus 69 percent) was significantly higher in the native valve infective endocarditis group (p<0.001).
The authors conclude that Cutibacterium acnes causes native valve infective endocarditis, especially in younger patients. The incidence of infective endocarditis caused by Cutibacterium acnes is high and is at par with well-known endocarditis pathogens, such as the HACEK group. The pathogen has low virulence and presents with a rather indolent course. Diagnosing Cutibacterium acnes infective endocarditis is challenging and requires a multimodal, specialized approach. Surgical treatment is associated with acceptable outcomes.
December 27, 2024
Submitted by: Jessica Luc
This study evaluates the impact of antegrade stenting of the distal arch and proximal descending aorta in patients with acute type A aortic dissection (ATAAD) who underwent nontotal arch procedures. The analysis includes 733 nonsyndromic patients treated between 2005 and 2022, of whom 95 received antegrade stenting. A propensity-score analysis matched 95 pairs from each group.
The survival rates at 10 years were similar between the two groups. Additionally, the cumulative incidence of reintervention, accounting for the competing risk of death, was also similar between the two groups, with the nonstented group showing a 27 percent incidence of reintervention and the stented group showing 22 percent (P = 0.44).
The study suggests that antegrade thoracic endovascular aortic repair may not improve long-term survival or reduce the need for reintervention in acute type A aortic dissection. However, it may offer benefits for remodeling the aorta and facilitating future endovascular interventions, particularly in cases of malperfusion. Therefore, while the procedure does not appear to significantly affect survival or reintervention rates, it could still play a major role in the management and future treatment of these patients, particularly by reducing the need for later interventions related to malperfusion.