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Journal and News Scan
January 16, 2025
Submitted by: EACTS Staff
This study compared robotic and video-assisted thymectomy to assess pathological resection status, as well as overall and disease-free survival. Data were retrieved from the European Society of Thoracic Surgeons prospectively maintained thymic database, which includes 82 international centers, 37 of which agreed to participate in this study. Between October 2001 and May 2021, a total of 899 patients with thymic malignancy and who underwent minimal access surgical resection were included. After adjusting for thymoma stage, the odds of incomplete surgical resection were higher in patients undergoing video-assisted surgery than robotic. Further research is required to compare outcomes for different surgical approaches with a standardized pathological work-up.
January 16, 2025
Submitted by: Mateo Marin-Cuartas
In this study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) versus clinical surveillance (CS) in patients with asymptomatic severe aortic stenosis (AS), four RCTs were identified and included for analysis: AVATAR, RECOVERY, EARLY TAVR, EVOLVED. Prespecified outcomes included all-cause and cardiovascular mortality, unplanned cardiovascular or heart failure (HF) hospitalization, and stroke. A total of 1,427 patients (719 in the early AVR group and 708 in the CS group) were included for analysis.
At an average follow-up time of 4.1 years, early AVR was associated with a significant reduction in unplanned cardiovascular or HF hospitalization (14.6 percent versus 31.9 percent; HR: 0.40; 95 percent CI: 0.30-0.53;P<0.01) and stroke (4.5 percent versus 7.2 percent; HR: 0.62; 95 percent CI: 0.40-0.97;P=0.03). However, no statistically significant differences in all-cause mortality (9.7 percent versus 13.7 percent; HR: 0.68; 95 percent CI: 0.40-1.17;P=0.17) and cardiovascular mortality (5.1 percent versus 8.3 percent; HR: 0.67; 95 percent CI: 0.35-1.29; P=0.23) were observed with early AVR compared with CS. The authors conclude that early AVR is associated with a significant reduction in unplanned cardiovascular or HF hospitalization and stroke, but no difference in all-cause or cardiovascular mortality compared with CS.
January 16, 2025
Submitted by: EACTS Staff
The development of robotic surgical systems in cardiac surgery has significantly impacted the field, reducing the invasive nature of certain cardiac surgical procedures in recent decades. Multiple minimally invasive techniques have become routine, with the introduction of robotic surgical systems and Enhanced Recovery After Cardiac Surgery (ERACS) becoming integral to modern cardiac surgery. However, there have been delays in the widespread adoption of the robotic coronary artery bypass grafting (CABG) procedure, which may present an opportunity for cardiac surgeons in Europe to invest in robotic programs.
January 16, 2025
Submitted by: Mateo Marin-Cuartas
In this article, the authors provide the first global quantification of women cardiac surgeons (WCS) and examine factors related to workforce diversity. The authors report that women constitute 8.0 percent (1,178/14,651) of the international cardiac surgical workforce, with a median of 0.00 WCS per million women (IQR: 0.00–0.09). North America (11.4 percent) and Europe (10.3 percent) have the highest regional representation, while East Asia (2.9 percent) and the Middle East (1.7 percent) have the lowest. High-income countries (9.9 percent) have double the proportion of WCS compared to low- and middle-income countries (4.8 percent), with a notable absence in low-income countries. Female representation correlates with Gross National Income (GNI) per capita (τ = 0.39), the Global Gender Gap Index (GGGI) (τ = 0.26), and health expenditure (τ = 0.26).
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.