Volume 67, Issue 4, April 2025
Editorials
Data insights for quality improvement: the latest EUROMACS report
A common exit examination for thoracic surgery in Europe—the Unified European Board of Thoracic Surgery
Thoracic
Long-term outcomes and predictors of compensatory sweating after bilateral endoscopic thoracic sympathectomy
Bilateral endoscopic thoracic sympathectomy (BETS) has consistently proven to be an effective technique for the treatment of primary hyperhidrosis (PHH), with success rates exceeding 90% [1, 2].
Treatment of pulmonary hydatid cysts: a single-centre analysis of 872 cases
Hydatid cyst disease is a long-known parasitic disease caused by the larval stage (metacestode) of Echinococcus granulosus, a type of tapeworm [1].
Enhancing three-dimensional anatomical understanding in complex thoracic surgery: a comparative study of OpVerse and Synapse 3D
Thoracic surgery’s intricate nature, due to the delicate organs involved, necessitates precise handling and avoidance of iatrogenic harm, particularly in complex cases [1].
Risk factors and prediction of intensive care unit readmission after oesophagectomy for cancer
Esophagectomy is the standard treatment for oesophageal cancer [1], representing one of the most complicated surgeries of all fields.
Think twice before diagnosing tension pneumothorax: a retrospective analysis of pseudotension pneumothorax
Tension pneumothorax (TP) refers to the accumulation of air between the parietal and visceral pleura, leading to lung collapse and a shift of the mediastinum due to positive intrathoracic pressure.
Same-day discharge for patients undergoing subxiphoid thoracoscopic thymectomy for small tumours without myasthenia gravis: a prospective, single-arm clinical trial
Thymomas are the most common mediastinal tumours, accounting for 47% of all anterior mediastinal tumours.
Comparative oncological features of centrally and peripherally located small-sized radiologically solid-dominant non-small-cell lung cancer
Two large trials, JCOG0802/WJOG4607L and CALGB140503, recently revealed the efficacy of sublobar resection as compared to lobectomy in peripheral early-stage non-small-cell lung cancer (NSCLC) [1, 2].
Prognosis of adenocarcinoma with innumerable pure ground-glass nodules and/or part-solid nodules
Lung cancer is a leading cause of death in patients with malignant disease.
Incidental mediastinal masses detected on chest computed tomography scans during the COVID-19 pandemic
Mediastinal masses are relatively common findings, with approximately half of these lesions located in the anterior mediastinum [1].
Thoracic oncologic
Subxiphoid uniportal robotic thymectomy using da Vinci Xi system
Endoscopic thymectomy is generally performed via the lateral intercostal space, but the usefulness of the subxiphoid approach has recently been reported [1].
Thoracic non-oncologic
Diffuse invasion of pulmonary arterial and venous structures due to Echinococcus granulosus infection
Congenital
Liver fibrosis marker is a potential predictor of the development of Fontan-associated liver diseases
Since its introduction in 1971, the Fontan procedure has significantly improved, along with better postoperative care, reducing surgical mortality from 15–30% to <5%, with a 20-year survival rate nearing 85% [1, 2].
Optimized outcome of the Ross procedure in children: single-centre experience
The Ross procedure, introduced by Donald Ross in 1967, remains a preferred method for aortic valve replacement, particularly in patients undergoing surgery during somatic growth [1].
Right bundle branch in ventricular septal defects
Postoperative conduction disorders as complications of ventricular septal defect (VSD) closure are commonly reported, particularly in isolated VSD and tetralogy of Fallot (ToF) repairs.
The European Congenital Heart Surgeons Association congenital cardiac database: A 25-year summary of congenital heart surgery outcomes
The European Congenital Heart Surgeons Association Congenital Database (ECHSA-CCDB) has grown steadily over the last 25 years and today is the second-largest clinical paediatric and congenital cardiac surgical database in the world and the largest in Europe: it contains data from 377 606 procedures in 294 206 patients, contributed by participating centres across Europe and other continents.
Long-term outcome of Fontan procedure in heterotaxy—towards further improvement of outcome
Twenty-five-year milestone for the ECHSA database: time to focus on patient survival rather than procedural success
Benefits and risks of implantable cardioverter-defibrillators in children and young adults with congenital heart disease, primary electrical disease or paediatric cardiomyopathy
Implantable cardioverter-defibrillators (ICDs) are the most important tools for preventing sudden cardiac arrest due to malignant ventricular arrhythmias (VAs) in children and young adults with congenital heart disease (CHD).
Experimental
Veno-venous extracorporeal membrane oxygenation exacerbates lung ischaemia–reperfusion injury in a rat model
Lung transplantation (LTx) is an effective treatment for patients with advanced lung disease, including pulmonary hypertension, chronic obstructive pulmonary disease and cystic fibrosis Kotloff and Thabut [1].
Translational Research
Distal perfusion during complex aortic arch procedure reduces kidney injury in newborn piglets at moderate hypothermia
Cardiac surgery-associated acute kidney injury (AKI) is usually attributed to cardiopulmonary bypass (CPB) [1, 2] and affects up to 54% of the paediatric population [3].
TX & MCS
An innovative approach to treat left ventricular assist device outflow graft obstruction—the basket-handle technique
Left ventricular assist device (LVAD) outflow graft obstruction (OGO) is a rare but serious condition in patients undergoing LVAD therapy.
Disparities in heart transplant survival and graft rejection outcomes persist in the modern era: a call to race towards a more equitable future
Despite exponential advancements in medicine and technology, our modern society continues to grapple with long-standing social issues, such as racial inequality.
Conventional Aortic Surgery
Hybrid thoraco-abdominal aortic repair via limited thoraco-phreno-laparotomy using Thoracoflo® Graft
Clinical trial registration number: The Barts Heart Centre (BHC) approved the use of the New Interventional Procedure application, ensuring compliance with regulatory standards and ethical guidelines (17 January 2024). .
Safety and limitations of line pressure-targeted cerebral perfusion strategy in aortic arch surgery
Despite significant advancements in aortic arch surgery, neurological deficit remains a major complication.
Imaging-based biomechanical parameters for assessing risk of aortic dissection and rupture in thoracic aortic aneurysms
Patients with ascending thoracic aortic aneurysms (ATAA) are at risk of aortic dissection, rupture and sudden death.
Reconstruction of the isolated left vertebral artery in total aortic arch replacement for type A aortic dissection via a single upper right hemisternotomy approach
Type A aortic dissection (TAAD) is a highly aggressive cardiovascular emergency with insidious onset and rapid progression.
General Adult Cardiac
Minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery: a contemporary systematic review and meta-analysis
Despite the considerable improvements in cardiac surgical techniques, the incidence of postoperative morbidity and mortality after cardiac surgery remains substantial, as consistently demonstrated by large-scale registry data [1].
Myocardial Revascularization
Long-term risk for incident cancer in patients undergoing coronary artery bypass grafting with or without cardiopulmonary bypass: a nationwide population-based study
Coronary artery bypass grafting (CABG) offers a means to treat complex coronary artery disease.
Conventional valve operations
Implant mechanical aortic valves and start anticoagulation and save young patients (<70 years) or ‘dogs howl and the caravan will move on’
The association between commissural height and graft size selection in valve-sparing aortic root replacement
The valve-sparing aortic root replacement (VSARR) is a well-established surgical technique aimed at preserving native aortic valve while replacing the diseased aortic root [1–3].
Prevalence, clinical characterization, management and evolution of bicuspid aortic valve classified according to the 2021 International Consensus Statement in a tertiary care hospital
Bicuspid aortic valve (BAV) is the most frequent congenital heart valve abnormality, affecting ∼1–2% of the general population [1].
Long-term outcomes after bioprosthetic tricuspid valve replacement: a multicenter study
Tricuspid valve replacement (TVR) with bioprostheses is generally performed as a concomitant procedure during left heart valve surgery, while isolated TVR is performed less frequently [1, 2].
Femoral vessel cannulation strategies in minimally invasive cardiac surgery: single Perclose ProGlide versus open cut-down
In recent years, there has been a growing trend towards minimally invasive cardiac surgery (MICS) of the atrioventricular valves, driven by both advancements in surgical techniques and patient preferences for less traumatic incisions.
Infective endocarditis in octogenarians—a multicenter analysis
Infective endocarditis (IE) has a different clinical profile in elderly patients, with a 5-fold higher risk of IE as compared to younger patients.
Longitudinal outcomes following international multicentre experience with robotic aortic valve replacement
In the current era of available minimally invasive transcatheter and surgical options for the initial management of symptomatic aortic valve disease, patients and providers continue to seek alternatives to a traditional sternotomy approach to surgical aortic valve replacement (SAVR).
Implications of pacemaker implantation after aortic valve surgery for endocarditis: a nationwide study
Infective endocarditis (IE) is a rare, but often deadly disease, which causes structural damage to the heart valves.
Modified Ross procedure with pulmonary autograft reinforcement within a Valsalva Dacron graft: long-term results
In children and selected non-elderly adults, replacement of a diseased aortic valve with a pulmonary autograft (PA) [Ross procedure (RP)] provides a living substitute with haemodynamic properties comparable to healthy control subjects [1], avoidance of long-life anticoagulation, excellent quality of life and a low-rate of valve-related complications.
Residents’ Corner
Surgeon proclivity for coronary endarterectomy during isolated coronary artery bypass grafting in Medicare beneficiaries
Coronary endarterectomy (CE) is an adjunctive procedure performed during isolated coronary artery bypass grafting (CABG) in the setting of heavily diseased and/or calcified coronary arteries [1].
Statistical Primer
Statistical primer: an introduction into the principles of Bayesian statistical analyses in clinical trials
For statistical inference, cardiovascular researchers often rely on observed outcome frequencies in sample data and calculated P values [1–4].