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Commentary: T3N0M0 NSCLC Subtypes - A Signal for Disparate Outcomes after Surgery
The 8th edition of the TNM staging system for non-small cell lung cancer (NSCLC) was a leap forward from prior versions in stratifying the T-stage of small tumors.1 However, certain categories still remain more ambiguous than desired. The T3N0M0 stage (IIb) has been encompassing a heterogeneous group of locally advanced tumors with a variety of T3 defining features - namely, larger size (5-7 cm), invasion into some structures, and separate and/or ”satellite” nodules in the same lobe. Tumors with any of the T3 descriptors may be still amenable for a complete resection, which is the common ground for this stage, but the ...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 20, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Dana Ferrari-Light, Peter J. Kneuertz Tags: THORACIC – Commentary Source Type: research

Commentary: Aortopulmonary Collaterals in Hypoplastic Left heart Syndrome: Chicken or the Egg?
In this issue, Schmiel and colleagues present a retrospective, single-center study evaluating the relationship of hypoplastic left heart syndrome (HLHS) subtype and shunt type at the Norwood procedure on the development of aortopulmonary collaterals (APCs).1 Aortopulmonary collaterals were determined by angiography, which was undertaken in all patients prior to stage 2 (bidirectional Glenn procedure) and prior to stage 3 (extra-cardiac Fontan procedure). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 20, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Timothy S. Lancaster, Vikram Sood Tags: CONGENITAL – Commentary Source Type: research

Commentary: Outcomes of Coronary Artery Bypass Grafting – More than Just a Knife
Coronary artery bypass grafting (CABG) has been established as the gold standard treatment for patients with multivessel coronary artery disease. Interrogation of large national and international societies databases has revealed this procedure to be associated with excellent post-operative outcomes with an expected in-hospital morality rate of less than 1%. Although the most important factor driving these excellent results is the major improvement and refinement of intra-operative techniques (such as the proper use of cardioplegia protection and meticulous surgical techniques), advancements in pre- and post-operative manag...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 20, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ali Hage, Fadi Hage Source Type: research

T3N0M0 NSCLC Subtypes - A Signal for Disparate Outcomes after Surgery
The 8th edition of the TNM staging system for non-small cell lung cancer (NSCLC) was a leap forward from prior versions in stratifying the T-stage of small tumors.1 However, certain categories remain more ambiguous than desired. The T3N0M0 stage (IIb) has been encompassing a heterogeneous group of locally advanced tumors with a variety of T3 defining features - namely, larger size (5-7cm), invasion into some structures, and separate/ ”satellite” nodules in the same lobe. Tumors with any of the T3 descriptors may be still amenable for a complete resection, which is the common ground for this stage, but the different fea...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 20, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Dana Ferrari-Light DO, Peter J. Kneuertz Tags: THORACIC – Commentary Source Type: research

Making a Painless Drain: Proof of Concept
The objective of this study was to develop a novel, cost-effective, easy-to-use, lidocaine-eluting coating to reduce pain associated with postoperative chest tubes. A lidocaine-eluting hydrogel was developed by dispersing lidocaine-loaded nanoparticles in an aqueous solution containing gelatin (5%). Glutaraldehyde (1%) was added to crosslink the gelatin into a hydrogel. The hydrogel was dehydrated, resulting in a thin, stable polymer. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 19, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Anna K. Gergen, Helen J. Madsen, Adam J. Rocker, Allana M. White, Kendra Jones, Daniel T. Merrick, Daewon Park, Jessica Y. Rove Tags: THORACIC – Original Submission Source Type: research

Shift in the Future of Cardiothoracic Surgery Applications: Holistic or Too Optimistic?
In this issue of Seminars in Thoracic and Cardiovascular Surgery, Aranda-Michel and colleagues evaluated the change in cardiothoracic surgery residency application towards a more holistic approach. This is a shift away from traditional numerical metrics such as USMLE scores to research, sub-internships and away rotations, interviews, and letters of recommendation (LOR)1. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ariadna Marrero, Lin Chen, Tara Karamlou, Alejandro Bribriesco Source Type: research

Reply: A paradigm shift is starting point
We thank Marrero and colleagues for their thoughtful response to our recent manuscript exploring the changing evaluatory paradigms in cardiothoracic surgery1,2. Discourse is essential to any paradigm shift, as we all grapple with what these new ideas signify in the context of our own lives and programs, and their letter raises thoughtful questions about equitability. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Edgar Aranda-Michel, Lena Trager, Jason Han, Ibrahim Sultan Tags: ADULT – Reply to Letter to the Editor Source Type: research

A Recurrence Predictive Model for Node-negative Esophageal Squamous Cell Carcinoma After Upfront Esophagectomy
The prognosis for pathologically node-negative (pN0) esophageal squamous cell carcinoma (ESCC) with surgery alone remains poor. We aimed to develop a model for a more precise prediction of recurrence, which will allow personalized management for pN0 ESCC after upfront complete resection. Clinical and pathological records of patients with completely resected pT1-3N0M0 ESCC were retrospectively analyzed between January 2014 and December 2019. A nomogram for the prediction of recurrence was established based on the Cox regression analysis and evaluated by C-index, AUC, and calibration curves. (Source: Seminars in Thoracic and...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 8, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Shi-Yu Hu, Hui-Jiang Gao, Zhi-hui Jiang, Guo-Dong Shi, Hua-Feng Wang, Jiang-Shan Ai, Yu-Cheng Wei Tags: THORACIC – Original Submission Source Type: research

Staged Ventricular Septation in Double-Inlet Ventricle - A Strategy to Avoid Fontan?
Single-stage ventricular septation for double-inlet left or right ventricle (DILV or DIRV) has historically been associated with poor outcomes. We hypothesize that staged ventricular septation may demonstrate favorable clinical outcomes to be an alternative to Fontan palliation. This single-center retrospective study reviewed patients with DILV or DIRV who underwent staged ventricular septation between 2015 to 2021. The strategy involves pulmonary artery banding or Norwood procedure during infancy (stage 1), followed by partial ventricular septation to anchor the septum, while maintaining systemic RV pressure to avoid sept...
Source: Seminars in Thoracic and Cardiovascular Surgery - September 7, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Anagha Prasanna, Rebecca S. Beroukhim, Sunil Ghelani, Eric N. Feins, Pedro J. del Nido, Sitaram M. Emani Tags: CONGENITAL – Original Submission Source Type: research

Identifying Patients Vulnerable to Inadequate Pain Resolution After Cardiac Surgery
We examined retrospective data from 2810 cardiac surgical patients at a single center. The k-means algorithm for longitudinal data was used to generate clusters of pain trajectories over the first five postoperative days. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - September 6, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Ian Kelly, Kara Fields, Pankaj Sarin, Amanda Pang, Martin Sigurdsson, Stanton K. Shernan, Amanda A. Fox, Simon C. Body, Jochen D. Muehlschlegel Tags: ADULT – Original Submission Source Type: research

Lung Transplantation in Patients With COVID-19-The Early National Experience
Lung transplant (LT) has become a viable option for COVID-19 patients suffering from end-stage Acute Respiratory Distress Syndrome (ARDS). This analysis sought to describe the early national experience of COVID-19 patients who received LT and compare transplant characteristics and short-term outcomes of COVID-19 and non-COVID-19 ARDS LT recipients. We queried the Organ Procurement and Transplantation database for adults ( ≥18 years old) receiving LT from January 2009 to March 31, 2022 with diagnoses of COVID-19 or ARDS. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - August 26, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Isabella S. Florissi, Eric W. Etchill, Iulia Barbur, Katherine G. Verdi, Christian Merlo, Errol L. Bush Tags: THORACIC – Original Submission Source Type: research

Oncologic outcomes of patients with resected T3N0M0 non-small cell lung cancer
This study aims to compare the oncologic outcomes associated with individual T3 features. We performed a single-institution, retrospective analysis of 280 consecutive patients with pT3 N0M0 NSCLC. Multivariate regression models were used to estimate associations of clinical factors with oncologic outcomes. The patients were grouped according to their T3 features into 4 prognostic groups: chest wall infiltration (CWI-PG), largest diameter> 5 cm and ≤ 7cm (Size-PG), presence of a satellite nodule (SN-PG), and all other T3 features. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - August 26, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Edouard Marques, Kevin F. Kennedy, Dorothy J. Giroux, Vanessa B. Cilento, Katherine K. Nishimura, Wentao Fang, Paula Ugalde Figueroa Tags: THORACIC – Original Submission Source Type: research

Commentary: Is Resistance Futile?
“Things are only impossible until they are not.” -Jean-Luc Picard (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - August 26, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Danielle Gottlieb Sen Tags: CONGENITAL – Commentary Source Type: research

Is exercise stress testing useful for risk stratification in anomalous aortic origin of a coronary artery?
Data on maximal exercise-stress-testing (m-EST) in anomalous-aortic-origin-of-coronary-arteries (AAOCA) is limited and correlation with stress perfusion imaging has not been demonstrated. AAOCA patients ≤20 years were prospectively enrolled from 6/2014-01/2020. A m-EST was defined as heart rate>85%ile on ECG-EST and respiratory-exchange-ratio (RER) ≥1.05 on cardiopulmonary-exercise-testing (CPET). Abnormal m-EST included significant ST-changes or high-grade arrhythmia, ໿V̇O2max and/or O2 pulse (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - August 26, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Amna Qasim, Tam T Doan, Tam Dan Pham, Dana Reaves-O'Neal, Shagun Sachdeva, Carlos M Mery, Ziyad Binsalamah, Silvana Molossi Tags: CONGENITAL – Original Submission Source Type: research

Lung transplantation in patients with COVID-19- the early national experience
Lung transplant (LT) has become a viable option for COVID-19 patients suffering from end-stage Acute Respiratory Distress Syndrome (ARDS). This analysis sought to describe the early national experience of COVID-19 patients who received LT and compare transplant characteristics and short-term outcomes of COVID-19 and non-COVID-19 ARDS LT recipients. We queried the Organ Procurement and Transplantation database for adults ( ≥18 years old) receiving LT from January 2009 to March 31, 2022 with diagnoses of COVID-19 or ARDS. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - August 26, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Isabella Florissi, Eric W. Etchill, Iulia Barbur, Katherine Verdi, Christian Merlo, Errol L. Bush Tags: THORACIC – Original Submission Source Type: research