Journal and News Scan

The EACTS recently released an expert consensus statement on the Ross procedure in adult patients, highlighting the renewed focus in this area due to increasing evidence of excellent long-term outcomes. These outcomes include restoration of life expectancy and improved valve-related outcomes. The Ross procedure is now considered a viable first-line option for selected young and middle-aged adults with nonrepairable aortic valve disease. Currently, its adoption remains inconsistent across institutions, partly due to concerns about surgical complexity, long-term durability, and the need for structured follow-up. This expert consensus statement discusses the rationale for increasing adoption, surgical technique, patient selection, and standardization procedures in centers of excellence. 

This article presents the first comparative analysis of outcomes after tracheobronchoplasty (TBP) for excessive dynamic airway collapse (EDAC) and tracheobronchomalacia (TBM), two distinct but often conflated causes of excessive central airway collapse (ECAC). In this single-center retrospective study of 73 patients (47 with EDAC and 26 with TBM), the authors used dynamic CT imaging reviewed by airway experts to establish a gold-standard diagnosis. Despite anatomical and pathophysiologic differences, postoperative outcomes were comparable between EDAC and TBM in terms of complication rates, intensive care units (ICU) and hospital stays, readmissions, and quality-of-life improvements. Both groups experienced significant gains in respiratory symptoms and six-minute walk test performance following TBP. 
 
The study highlights that while differentiating EDAC from TBM remains diagnostically challenging, these distinctions do not translate into differences in surgical benefit, supporting TBP as a definitive and effective treatment for severe ECAC regardless of the cause. Importantly, the findings underscore the need for refined diagnostic standards, multidisciplinary evaluation, and expanded surgical candidacy criteria. 
 
For the global cardiothoracic surgery audience, this paper is significant because it clarifies disease mechanisms and outcomes for a rare but increasingly recognized cause of airway obstruction. It informs evolving robotic and open TBP approaches, emphasizes the importance of multidisciplinary collaboration between surgeons and interventional pulmonologists, and sets the stage for multicenter efforts to standardize diagnosis and management of complex airway disorders. 

The European Association for Cardio-Thoracic Surgery (EACTS) has developed a unified Core Curriculum for cardiac surgical training to address variations in training standards across Europe. Created with contributions from 26 national programs, the curriculum outlines competencies across three stages of training—introductory, intermediate, and advanced. It emphasizes competency-based progression, minimum case requirements, standardized assessments, and robust quality assurance. While adoption is voluntary, the curriculum is designed to enhance training quality, safeguard patient care, and support surgeon mobility across European borders. 

The authors conducted a randomized study involving 40 patients undergoing off-pump coronary artery bypass grafting (CABG) to compare techniques for preparing internal thoracic arteries. They found that skeletonized grafts showed endothelial disruption, reduced endothelial nitric oxide synthase staining, and lower plasma nitric oxide levels when compared with pedicled grafts without endothoracic fascia. Endothelin-1 release and EDN1 mRNA expression were significantly higher in skeletonized arteries. The authors concluded that skeletonization impairs endothelial integrity and shifts the nitric oxide-endothelin balance, which may negatively affect graft performance.