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Volume 67, Issue 4, April 2025

Editorials

Paola Quattroni and Edgar Daeter
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf087, https://doi.org/10.1093/ejcts/ezaf087
Gilbert Massard and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf040, https://doi.org/10.1093/ejcts/ezaf040

Thoracic

Néstor J Martínez-Hernández and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf108, https://doi.org/10.1093/ejcts/ezaf108

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].

Yener Aydin and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf114, https://doi.org/10.1093/ejcts/ezaf114

Hydatid cyst disease is a long-known parasitic disease caused by the larval stage (metacestode) of Echinococcus granulosus, a type of tapeworm [1].

Yu-An Zheng and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf069, https://doi.org/10.1093/ejcts/ezaf069

Thoracic surgery’s intricate nature, due to the delicate organs involved, necessitates precise handling and avoidance of iatrogenic harm, particularly in complex cases [1].

Yuxin Yang and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf124, https://doi.org/10.1093/ejcts/ezaf124

Esophagectomy is the standard treatment for oesophageal cancer [1], representing one of the most complicated surgeries of all fields.

Linyan Xie and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf098, https://doi.org/10.1093/ejcts/ezaf098

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.

Yuan-Liang Zheng and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf122, https://doi.org/10.1093/ejcts/ezaf122

Thymomas are the most common mediastinal tumours, accounting for 47% of all anterior mediastinal tumours.

Norifumi Tsubokawa and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf072, https://doi.org/10.1093/ejcts/ezaf072

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].

Hirofumi Takenaka and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf130, https://doi.org/10.1093/ejcts/ezaf130

Lung cancer is a leading cause of death in patients with malignant disease.

Gaojun Lu and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf140, https://doi.org/10.1093/ejcts/ezaf140

Mediastinal masses are relatively common findings, with approximately half of these lesions located in the anterior mediastinum [1].

Thoracic oncologic

Takashi Suda and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf127, https://doi.org/10.1093/ejcts/ezaf127

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

Yener Aydin and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf126, https://doi.org/10.1093/ejcts/ezaf126

Congenital

Sakura Horie and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf100, https://doi.org/10.1093/ejcts/ezaf100

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].

Peter Murin and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf102, https://doi.org/10.1093/ejcts/ezaf102

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].

Fumiya Yoneyama and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf105, https://doi.org/10.1093/ejcts/ezaf105

Postoperative conduction disorders as complications of ventricular septal defect (VSD) closure are commonly reported, particularly in isolated VSD and tetralogy of Fallot (ToF) repairs.

Eleftherios Protopapas and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf119, https://doi.org/10.1093/ejcts/ezaf119

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.

Shunji Sano and Yasuyuki Kobayashi
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf074, https://doi.org/10.1093/ejcts/ezaf074
Richard A Jonas
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf136, https://doi.org/10.1093/ejcts/ezaf136
Andrei Fetcu and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf134, https://doi.org/10.1093/ejcts/ezaf134

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

Shi-Lin Wei and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf106, https://doi.org/10.1093/ejcts/ezaf106

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

Sabine Meier and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf117, https://doi.org/10.1093/ejcts/ezaf117

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

Laurin Micek and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf089, https://doi.org/10.1093/ejcts/ezaf089

Left ventricular assist device (LVAD) outflow graft obstruction (OGO) is a rare but serious condition in patients undergoing LVAD therapy.

Ahad Firoz and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf141, https://doi.org/10.1093/ejcts/ezaf141

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

Robert Pruna-Guillen and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf115, https://doi.org/10.1093/ejcts/ezaf115

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). .

Joon Chul Jung and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf131, https://doi.org/10.1093/ejcts/ezaf131

Despite significant advancements in aortic arch surgery, neurological deficit remains a major complication.

Nitish Bhatt and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf128, https://doi.org/10.1093/ejcts/ezaf128

Patients with ascending thoracic aortic aneurysms (ATAA) are at risk of aortic dissection, rupture and sudden death.

Lu Wang and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf121, https://doi.org/10.1093/ejcts/ezaf121

Type A aortic dissection (TAAD) is a highly aggressive cardiovascular emergency with insidious onset and rapid progression.

General Adult Cardiac

Kyriakos Anastasiadis and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf112, https://doi.org/10.1093/ejcts/ezaf112

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

Ari Mennander and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf110, https://doi.org/10.1093/ejcts/ezaf110

Coronary artery bypass grafting (CABG) offers a means to treat complex coronary artery disease.

Conventional valve operations

Hendrik Jan Ankersmit and Johann Auer
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf086, https://doi.org/10.1093/ejcts/ezaf086
Amit Sharir and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf104, https://doi.org/10.1093/ejcts/ezaf104

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].

Vincenzo Rizza and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf109, https://doi.org/10.1093/ejcts/ezaf109

Bicuspid aortic valve (BAV) is the most frequent congenital heart valve abnormality, affecting ∼1–2% of the general population [1].

Antonio Piperata and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf107, https://doi.org/10.1093/ejcts/ezaf107

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].

Majd Ismail and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf118, https://doi.org/10.1093/ejcts/ezaf118

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.

Shekhar Saha and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf111, https://doi.org/10.1093/ejcts/ezaf111

Infective endocarditis (IE) has a different clinical profile in elderly patients, with a 5-fold higher risk of IE as compared to younger patients.

Lawrence M Wei and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf103, https://doi.org/10.1093/ejcts/ezaf103

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).

Lisa O F Bearpark and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf125, https://doi.org/10.1093/ejcts/ezaf125

Infective endocarditis (IE) is a rare, but often deadly disease, which causes structural damage to the heart valves.

Thomas Denisselle and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf133, https://doi.org/10.1093/ejcts/ezaf133

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

John B Eisenga and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf064, https://doi.org/10.1093/ejcts/ezaf064

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

Samuel Heuts and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf139, https://doi.org/10.1093/ejcts/ezaf139

For statistical inference, cardiovascular researchers often rely on observed outcome frequencies in sample data and calculated P values [1–4].

Letters to Editor

Dominique Vervoort
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf092, https://doi.org/10.1093/ejcts/ezaf092
Huihong Xie and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf090, https://doi.org/10.1093/ejcts/ezaf090
Domenico Paparella and Richard P Whitlock
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf116, https://doi.org/10.1093/ejcts/ezaf116
Khaled Moustafa and Akram Adam
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf095, https://doi.org/10.1093/ejcts/ezaf095
Vadim Irimie and Paul P Urbanski
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf078, https://doi.org/10.1093/ejcts/ezaf078
Olga Papazisi and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf091, https://doi.org/10.1093/ejcts/ezaf091
Marek J Jasinski
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf094, https://doi.org/10.1093/ejcts/ezaf094
Vadim Irimie and Paul P Urbanski
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf093, https://doi.org/10.1093/ejcts/ezaf093
Yoshikazu Ono and others
European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf096, https://doi.org/10.1093/ejcts/ezaf096

Corrigendum

European Journal of Cardio-Thoracic Surgery, Volume 67, Issue 4, April 2025, ezaf123, https://doi.org/10.1093/ejcts/ezaf123
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