Journal and News Scan

In this article, the authors evaluate a novel lung preservation strategy for uncontrolled donation after circulatory death by combining lung inflation with topical cooling. Using a porcine model with 1.5 hours of warm ischemia, lungs preserved with combined inflation and cooling demonstrated superior post-transplant oxygenation, higher dynamic compliance, lower pulmonary edema, and reduced histological injury compared with cooling or inflation alone. Apoptosis and vascular injury were also attenuated. These findings indicate that simultaneous inflation and cooling synergistically may mitigate warm ischemic damage. Together, this offers an approach that may substantially increase utilization and early functional outcomes of lungs from uncontrolled donation after circulatory death donors. 

This retrospective study reviewed 148,628 lung operations from 2001 to 2023 to examine how national gross domestic product (GDP) per capita influences minimally invasive techniques. Thoracotomy rates declined significantly, while robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) adoption increased. VATS adoption was negatively associated with GDP, whereas RATS showed no correlation. Significant country-level variability was found, with faster adoption in France and Italy compared to Turkey. Results suggest economic factors drive initial VATS adoption, but systemic factors (reimbursement, procurement) govern advanced technology uptake, highlighting the need for coordinated infrastructure and policy improvements in which the authors believe scientific societies could play a significant role. 

This retrospective single-center study compared automated titanium fasteners to hand-tied knots in 2,678 patients undergoing mitral valve surgery between 2008 and 2024, with the primary endpoint being prosthetic dehiscence requiring reintervention. Among participants, 1,072 (40 percent) received automated titanium fasteners, while 1,606 (60 percent) received hand-tied sutures. Over a median follow-up of 5.3 years, automated fasteners demonstrated a significantly lower risk of prosthetic dehiscence in both univariable (sub-hazard ratio 0.32, 95 percent confidence interval (CI) 0.12-0.86, p=0.023) and multivariable analysis (adjusted sub-hazard ratio 0.34, 95 percent CI 0.12-0.91, p=0.033), with no increased risk of stroke, intracranial bleeding, or mortality. The authors conclude that automated titanium fasteners may reduce prosthetic dehiscence through consistent suture tension; however, they emphasize cautious interpretation given the limited dehiscence events and the potential for residual confounding, recommending randomized trials for a more robust assessment. 

This prospective, multicenter study conducted in China evaluated the two-year outcomes of the Corheart 6, a novel miniaturized magnetically levitated left ventricular assist device, in 50 adults with advanced heart failure (left ventricular ejection fraction (LVEF) less than 30 percent, cardiac index less than 2.0 L/min/m²) enrolled across 12 centers between January and July 2022. The primary endpoint was the composite survival free of disabling stroke or device replacement at two years. Results demonstrated an 86 percent event-free survival (95 percent confidence interval (CI): 73.3 percent to 94.2 percent), with 78 percent of patients remaining on device support, six percent undergoing transplantation, and two percent being explanted for recovery. Major adverse events included stroke (six percent), right heart failure (four percent), driveline infection (12 percent), and gastrointestinal bleeding (four percent). Notably, no pump thrombosis, hemolysis, or device malfunction occurred despite lower-intensity anticoagulation (median international normalized ratio (INR) 1.96). The authors conclude that the Corheart 6 demonstrates promising long-term efficacy and safety for advanced heart failure management.