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Overly selective offer acceptance is associated with high waitlist mortality for the most ill lung transplant candidates
The demand for organs for lung transplantation (LTx) continues to outweigh supply. However, nearly 75% of donor lungs are never transplanted. LTx offer acceptance practices and the effects on waitlist/post-transplant outcomes by candidate clinical acuity are understudied. UNOS was used to identify all LTx candidates, donors, and offers from 2005-2019. Candidates were grouped by Lung Allocation Score (LAS; applicable post-2005, ages ≥12 years): LAS80. Offer acceptance patterns, waitlist death/decompensation, and post-transplant survival (PTS) were compared. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 7, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Jason W. Greenberg, David L.S. Morales, Hosam F. Ahmed, Mallika V. Desai, Kyle W. Riggs, Don Hayes, David G. Lehenbauer, Md. M. Hossain, Farhan Zafar Tags: THORACIC – Original Submission Source Type: research

Early and Mid-Term Outcomes of Coronary Artery Bypass Grafting in Adults with Congenital Heart Disease
This study examined patients who underwent coronary artery bypass grafting (CABG) during repair of ACHD. This was a retrospective study of patients who underwent CABG for CAD concomitant with ACHD repair 1972-2021. Demographic information, ACHD diagnosis, surgical history, operative details, and outcomes were analyzed. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 2, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Gabriel Graham, Joseph A. Dearani, Ahmed A. Abdelrehim, William R. Miranda, Hartzell Schaff, John M. Stulak, Ausitn L. Todd, Elizabeth H. Stephens Tags: CONGENITAL – Original Submission Source Type: research

Does Everyone Need High Technology Intervention Before They Die?
A persistent problem in cardiothoracic surgery, as in all of medicine, is when to offer or to withhold expensive technologies. The ethical requirement of balancing harms and benefits is often difficult to achieve. The use of LVADs is an example of such technologies, and when to offer it is explored in this paper. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 25, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Nicholas G. Smedira, Richard I. Whyte, Robert M. Sade Tags: ADULT – Education Source Type: research

Benefit of adjuvant chemotherapy for resected pathologic N1 non-small cell lung cancer is unrecognized: a subgroup analysis of the JBR10 trial
Adjuvant chemotherapy is underutilized in clinical practice, in part, because its anticipated survival benefit is 6%. We evaluated the impact of AC on overall and recurrence-free survival among completely resected pN1 NSCLC patients enrolled in the North American Intergroup phase III (JBR10) trial. A post-hoc subgroup analysis of pN1 NSCLC patients was performed. Participants were randomized to cisplatin+vinorelbine (AC) (n=118) or observation (n=116) following complete resection. The primary endpoint was overall survival (OS). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 19, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Omar Toubat, Li Ding, Keyue Ding, Sean C. Wightman, Scott M. Atay, Takashi Harano, Anthony W. Kim, Elizabeth A. David Tags: THORACIC – Original Submission Source Type: research

Commentary: A Tale of Two Operations
Ultra-hybrid repair of thoracoabdominal aortic aneurysms (TAAAs) involves endovascular stenting of the descending thoracic aorta followed by distal open completion with a graft sutured to the distal end of the endograft.1 Hypothesized benefits include avoiding deep hypothermic circulatory arrest (DHCA) and decreasing spinal cord ischemia by allowing vascular collateralization between operations, as demonstrated in porcine models.2,3 Thompson and colleagues evaluate their single-center experience with ultra-hybrid repair among 92 patients undergoing open TAAA repair after prior stenting in the descending thoracic aorta with...
Source: Seminars in Thoracic and Cardiovascular Surgery - October 19, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Omar M. Sharaf, Gilbert R. Upchurch, Thomas M. Beaver Tags: ADULT – Commentary Source Type: research

Well-being of Cardiothoracic Surgeons in the Time of COVID-19: A Survey by the Wellness Committee of the American Association for Thoracic Surgery
The prevalence of burnout among physicians has been increasing over the last decade, but data on burnout in the specialty of cardiothoracic surgery are lacking. We aimed to study this topic through a well-being survey. A 54-question well-being survey was developed by the Wellness Committee of the American Association for Thoracic Surgery (AATS) and sent by email from January through March of 2021 to AATS members and participants of the 2021 Annual Meeting. The 5-item Likert-scale survey questions were dichotomized, and associations were determined by Chi-square tests or independent samples t-tests, as appropriate. (Source:...
Source: Seminars in Thoracic and Cardiovascular Surgery - October 13, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ross M. Bremner, Ross M. Ungerleider, Jamie Ungerleider, Andrea S. Wolf, Cherie P. Erkmen, Jessica G.Y. Luc, Virginia R. Litle, Robert J. Cerfolio, David T. Cooke, the Wellness Committee of the American Association for Thoracic Surgery Tags: THORACIC – Original Submission Source Type: research

Computed Tomographic Angiography provides Reliable Coronary Artery Evaluation in Infants with Pulmonary Atresia Intact Ventricular Septum
Evaluate use of coronary CTA as initial assessment for determining Right Ventricle Dependent Coronary Circulation (RVDCC) in neonates with Pulmonary Atresia with Intact Ventricular Septum (PA IVS). Retrospective review of cases with coronary CTA and compare with available catheter angiography, pathology, surgical reports, and outcomes from Mar 2015-May 2022. In our cohort of 16 patients, 3 were positive for RVDCC, confirmed by pathologic evaluation, and there was concordance for presence or absence of RVDCC with catheter angiography in 5 patients (4 negative for RVDCC, 1 positive). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 13, 2022 Category: Cardiovascular & Thoracic Surgery Authors: LaDonna J. Malone, Lorna P. Browne, Gareth J. Morgan, Mark A. Lovell, David N. Campbell, James J. Jaggers, Ryan A. Leahy, Max B. Mitchell, David A. Mong, Jason P. Weinman, Jenny E. Zablah, Matthew L. Stone Tags: CONGENITAL – Original Submission Source Type: research

Ultra-Hybrid Repair: Open Thoracoabdominal Completion after Descending Stent Grafting
To characterize patient risk profiles and outcomes associated with staged ultra-hybrid repair of extensive aortic disease, in which open thoracoabdominal completion was performed after thoracic stent grafting. From 1/2006 to 1/2021, 92 patients underwent open thoracoabdominal repair of chronic dissection (n=58, 63%), degenerative aneurysm (n=28, 30%), endoleak (n=4, 4.3%), or symptomatic acute type B dissection (n=2, 2.2%) after descending thoracic stent grafting (69, 75%), frozen elephant trunk (5, 5%), or both (18, 20%). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 12, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Matthew A. Thompson, Ashley M. Lowry, Francis Caputo, Douglas R. Johnston, Christopher Smolock, Patrick Vargo, Eugene H. Blackstone, Eric E. Roselli, Collaborators in the Cleveland Clinic Aorta Center Tags: ADULT – Original Submission Source Type: research

Cessation of Routine Jejunostomy Tube Placement at Time of Minimally Invasive Ivor Lewis Esophagectomy and Impact on Body Mass Index
Jejunostomy tubes (j-tubes) are frequently placed at time of esophagectomy. The purpose of this study is to evaluate cessation of routine j-tube placement on postoperative body mass index (BMI), return to the emergency room (ER), and time until adjuvant therapy. Retrospective review of an institutional database for consecutive patients undergoing minimally invasive Ivor Lewis Esophagectomy, 2014-2021 (after January 2019, routine j-tube placement was abandoned). Data was analyzed using Pearson ′s Chi-squared tests and Student's t-test with 2-sided significance level of p (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 11, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Brian M. Till, Jenna Mandel, Ece Unal, Luke Juckett, Tyler Grenda, Olugbenga Okusanya, Francesco Palazzo, Karen Chojnacki, Nathaniel R. Evans Tags: THORACIC – Original Submission Source Type: research

Recent Articles in AATS Journals
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 10, 2022 Category: Cardiovascular & Thoracic Surgery Source Type: research

Homelessness and race are mortality predictors in US Veterans undergoing CABG
Coronary artery disease requiring surgical revascularization is prevalent in United States Veterans. We aimed to investigate pre-operative predictors of 30-day mortality following coronary artery bypass grafting (CABG) in the Veteran population. The Veterans Affairs Surgical Quality Improvement (VASQIP) national database was queried for isolated CABG cases between 2008-2018. The primary outcome was 30-day mortality. A multivariable logistic regression was performed to assess for independent predictors of the primary outcome. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - October 9, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Raghav Chandra, Jennie Meier, Mitri K. Khoury, Asher Weisberg, Yen T. Nguyen, Matthias Peltz, Michael E. Jessen, Christopher A. Heid Tags: ADULT – Original Submission Source Type: research

Change in Panel Reactive Antibodies in Patients Bridged to Lung Transplantation with Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation. ECMO-associated hemolysis and bleeding increases ECMO bridged candidates ’ need for blood transfusions. While transfusion can cause human leukocyte antigen (HLA) antibody development and, therefore, sensitization against potential donors,1 it is unclear whether ECMO itself induces HLA antibodies. Other mechanical life support devices such as ventricular assist devices (VAD) are associated with HLA antibody development independent of transfusion, possibly due to host immunologic interactions with device biomaterial. (Sourc...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 28, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Lydia E. Federico, Andrew M. Courtwright, Joshua M. Diamond, Maria M. Crespo, Christian A. Bermudez Tags: ADULT - Brief Research Report Source Type: research

Prognostic impact of very small ground-glass opacity component in stage IA solid predominant non-small cell lung cancer
We evaluated the prognostic role of the presence of very small ground glass opacity (GGO) component in stage IA solid-predominant non-small cell lung cancer (NSCLC). We evaluated surgically resected 1471 patients diagnosed with stage IA solid-predominant NSCLC. They were classified into 3 groups; i.e., GGO group (0.5 (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 27, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Aritoshi Hattori, Takeshi Matsunaga, Mariko Fukui, Kazuhiro Suzuki, Kazuya Takamochi, Kenji Suzuki Tags: THORACIC – Original Submission Source Type: research

Early Experience with Reverse Double Switch Operation for the Borderline Left Heart
This study reviews our early experience with the “reverse” double switch operation (R-DSO) for borderline left hearts. A retrospective review of children with borderline left hearts who underwent R-DSO between 2017 and 2021 was conducted. Patient characteristics and early hemodynamic and clinical outcomes were collected. R-DSO was performed in 8 patients with no operative or postoperative deaths; 5 underwent decompressing bidirectional Glenn. Left ventricular (LV) poor-compliance was the dominant pathophysiology. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 27, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Brandi Braud Scully, Eric N. Feins, Wayne Tworetzky, Sunil Ghelani, Rebecca Beroukhim, Pedro J. del Nido, Sitaram M. Emani Tags: CONGENITAL – Original Submission Source Type: research

Identifying Actionable Targets to Improve Patient Satisfaction After Cardiac Surgery
Patient satisfaction outcomes have been increasingly recognized as important adjunct factors to traditional outcome measures including morbidity, mortality and survival.1 The Society of Thoracic Surgeons Predicted Risks of Mortality and Morbidity (STS-PROM) provides robust objective clinical data that allow accurate prediction of early morbidity and mortality in patients undergoing cardiac surgery.2 However, it does not measure quality of care and patient satisfaction after surgery.3 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a validated and comprehensive survey that allows patients after ...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 24, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ko Bando Source Type: research