Journal and News Scan

With the improvement in survival rates for heart transplant recipients, cardiac valvular disease is more frequently being encountered in this group of patients. This includes conditions such as aortic stenosis and mitral regurgitation in the transplanted heart. This article discusses the role of transcatheter-based therapies, including transcatheter aortic valve implantation (TAVI) and mitral transcatheter edge-to-edge repair (M-TEER), in heart transplant recipients. Fifteen patients were studied, with nine undergoing TAVI and six receiving M-TEER. The authors found these procedures to be feasible and efficient in improving echocardiographic allograft function, reporting a median survival of two years post-elective procedures. However, survival outcomes were found to be dependent on the urgency of the intervention performed. 

This meta-analysis evaluated the performance of The German Registry of Acute Aortic Dissection Type A (GERAADA) score in predicting 30-day mortality after type A acute aortic dissection (TAAAD) surgery across 11 studies. With an observed mortality of 12.2 percent, GERAADA showed moderate discrimination (AUC 0.70) and good calibration, with a pooled expected mortality of 18.4 percent compared to EuroSCORE II's 5.8 percent. When both scores were directly compared in five studies, GERAADA showed better calibration than EuroSCORE II, while the discrimination between the two remained similar. The study concludes GERAADA offers better calibration for predicting 30-day postoperative mortality following TAAAD and highlights the challenges of predicting outcomes in complex cases. 

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.