Volume 62, Issue 3, September 2022

Since the 1990s, the utility of video-assisted thoracoscopic surgery (VATS) has been rapidly accepted worldwide as the standardized treatment for early-stage non-small-cell lung cancer (NSCLC) when performing a lobectomy [1].

Prolonged air leak (PAL) is a common complication of lung resection.

Lung cancer has been the leading cause of cancer-related deaths worldwide in the last few decades [1], with non-small cell lung cancer (NSCLC) being the predominant type of lung cancer [2].

Although there are multiple retrospective series that have shown a lower rate of complications and postoperative stay in patients operated on by video-assisted thoracic surgery (VATS), there are more discrepancies on the impact that the surgical approach could have on postoperative mortality.

Pulmonary lymph is mainly drained via lymphatics running along the bronchi [1–3].

In 2020, lung cancer was the second most commonly diagnosed cancer and the leading cause of oncological death [1].

Surgical resection via median sternotomy has been the most common treatment approach for thymic carcinoma.

Smoking is the leading cause of lung cancer and low pulmonary function [1, 2].

The current clinical T classification focuses on the radiological size of the solid tumour component but does not consider the presence of the ground-glass opacity (GGO) component [1, 2].

Surgical risk prediction models are an invaluable tool for assessing perioperative results, counselling patients and benchmarking [1–4].

Video-assisted thoracic surgery (VATS) is increasingly used to perform thoracic procedures that previously required a thoracotomy, including lobectomy, thymectomy and diaphragm plication [1–3].

Prolonged air leak (PAL) after pulmonary resection is a common complication, with a significant impact on the duration of the hospital stay after surgery.

Minimally invasive chest surgery has several postoperative advantages, such as less postoperative pain, shorter hospitalization and lower morbidity [1–5].

Lung cancer is the leading cause of cancer-related death in humans [1].

At present, the recommended treatment for early-stage lung cancer is still a combination of anatomical resection (usually lobar) and systematic hilar and mediastinal lymphadenectomy.

The gold standard for the treatment of early-stage non-small-cell lung cancer (NSCLC) has been anatomic lobectomy.

Despite improvements in perioperative care and surgical techniques for the treatment of neonates with single ventricle (SV) abnormalities, hypoplastic left heart syndrome (HLHS) and its variants, who needed the Norwood stage I procedure (S1P), are still associated with the highest mortality risk of any common form of congenital heart disease [1–3].

Systemic right ventricular (RV) failure, significant tricuspid regurgitation and clinical decompensation are common late complications following the atrial switch procedure for transposition of the great arteries (TGA) [1–6].

Isolated tricuspid valve (TV) disease in paediatric patients is rare, the most common congenital cause being Ebstein’s anomaly (EA).

The bidirectional cavopulmonary shunt (BCPS) is a standard intermediate procedure for patients with various types of the single-ventricle physiology, followed by extra-cardiac total cavopulmonary connection (TCPC) [1–3].

Coronary artery stenosis is rare in children.

The technique of retrograde aortic valve (AV)-crossing was developed for left ventricular catheterization by Zimmerman in 1950 [1].

Lung transplantation (LTx) has evolved to be a routinely performed procedure in selected patients with end-stage lung disease.

Ventricular assist devices (VAD) have become an important aspect in the treatment of children with end-stage heart failure and often act as a last resort for these severely sick children awaiting a cardiac transplant.

Obesity, defined as a body mass index (BMI) ≥30 kg/m², has a global prevalence of ∼12% [1].

The unmet clinical need in the management of ascending thoracic aortic aneurysms (ATAA) is the lack of an accurate predictive model or biomarker for the risk of acute aortic syndrome [1, 2], Current guidelines rely only on aneurysm size and growth to determine the risk of type A aortic dissection (TAAD) [3].

While total aortic root replacement (Bentall procedure) has been considered the gold standard for the management of aortic root aneurysms in patients with heritable aortic disorders (HADs), valve-sparing root replacement (VSRR) has recently emerged as the preferred procedure whenever feasible.

Aortic intramural haematoma (IMH) is one of the typical entities of the acute aortic syndrome and probably accounts for 5–25% of all cases [1].

Owing to the high rate of positive remodelling following total arch replacement (TAR) with the frozen elephant trunk (FET) technique, there is an argument for the extended and even indiscriminate application of this procedure for DeBakey type I acute aortic dissection.

In patients with heritable thoracic aortic disease (HTAD), aortic complications predominantly affect the proximal aorta and a relatively small proportion require intervention on the descending thoracic (DTA) and thoracoabdominal aorta (TAA) [1] for aneurysmal progression of chronic DeBakey type I (after prior proximal aortic surgery) and type III dissections.

Connective tissue syndromes are genetic disorders that frequently involve musculoskeletal, cardiovascular and ocular manifestations.

The incidence of thoracic aortic dissection in Sweden has been reported to be 7.2/100,000/year.

Total aortic arch replacement with frozen elephant trunk (FET) is widely regarded as a recommended option for type A aortic dissection (TAAD), and right axillary and femoral artery were well adopted as the preferred arterial cannulation in the current practice [1].

The European Association of Cardiothoracic Surgery’s current consensus document recommends the frozen elephant trunk (FET) technique for total aortic arch replacement (TAR) due to its anticipatory nature for later frequently necessary distal interventions.

Effective cardiopulmonary bypass (CPB) at the time of type A dissection repair is key to avoid malperfusion and ensure optimum outcomes [1, 2].

Despite a worldwide long-lasting interest in the prognostic impact of the clinical presentation, repairing techniques and postoperative complications of type A acute aortic dissection (TAAAD), only a few studies have focused on the potential prognostic role of gender in the surgical outcome of TAAAD [1–4].

The aortic arch is a less frequent location of isolated aortic pathologies and presents anatomical challenges to both surgical and endovascular management [1].

Patients with liver cirrhosis are known to be at high risk for cardiac surgery in terms of outcome and mortality.

Postoperative atrial fibrillation (POAF) is the most commonly detected arrhythmia following coronary artery bypass graft (CABG) surgery [1, 2].

Patients after coronary artery bypass graft (CABG) for severe coronary artery disease continue to be at higher risk for ischaemic events due to progression of the disease in their native vessels or due to degeneration of the grafts.

Coronary artery disease (CAD) is an important manifestation of cardiovascular disease (CVD), causing about one-third of all deaths in individuals older than 35 years [1].

Surgical aortic valve replacement (SAVR) is one of the most frequently performed cardiac operations.

Tricuspid annuloplasty (TAP) is a common and useful procedure for treating tricuspid regurgitation (TR) with annular dilatation.

In patients with aortic root aneurysm with or without concomitant aortic regurgitation (AR), very good long-term results have been reported for aortic root and valve replacement, as well as for valve-sparing aortic root replacement (VSARR) [1–5].

Tricuspid regurgitation (TR) is a common finding in patients with concomitant left-sided valvular disease and is associated with poor outcome and predicts poor survival, heart failure and reduced functional capacity [1].

Surgical treatment of the mitral valve with a minimally invasive approach via a right mini-thoracotomy represents a valid and widely documented strategy [1].

In recent decades, valve-sparing aortic root replacement (VSRR), which can preserve the native valve and avoid the risks of anticoagulation, has been developed using various techniques and is performed in various heart centres.

Infective endocarditis (IE) is a relatively rare but still challenging disease with an estimated incidence of 3–10 cases per 100 000 people per year [1].

Mitral repair is the gold-standard treatment for severe degenerative mitral regurgitation and has been shown to provide superior intermediate-term survival and freedom from valve-related adverse events when compared to mitral replacement.

Surgical aortic valve replacement (SAVR) is the recommended option for the treatment of aortic stenosis in patients at lower surgical risk, as well as patients suffering from aortic regurgitation if valve-sparing surgery is not possible [1, 2].

The isolated tricuspid disease is a complex pathology most frequently associated with previous left heart surgery, atrial fibrillation or endocarditis [1].

Old trials focusing on the safety and efficacy of the implantable cardioverter defibrillator demonstrated a significant decrease in the rate of sudden death [1, 2].

A 26-year-old patient was examined for aortic valve repair.

Robotic-assisted thoracic surgery (RATS) has the advantages of manoeuvrability and three-dimensional view.

The Commando procedure [1] and its alternatives [2, 3] have been reported to help manage double-valve, aortomitral curtain (AMC) and aortic root diseases in patients with infective endocarditis (IE).

Recently, the National Aeronautics and Space Administration calculated as low as 0.041% the probability for Asteroid 2018VP1 to impact the earth’s surface.

Despite improvements in surgical techniques for tracheal resection and reconstruction, post-tracheotomy tracheoesophageal fistula (TEF) remains clinically complex.

The indication for surgical repair in patients with thoraco-abdominal aortic aneurysms mainly depends on aneurysm size, but repair is also recommended in patients with symptoms, as these may represent acute aortic expansion and therefore imminent rupture [1].