The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multiday maintenance of extracorporeal lungs using cross-circulation with conscious swine.
Lung remains the least-utilized solid organ for transplantation. Efforts to recover donor lungs with reversible injuries using ex vivo perfusion systems are limited to <24 hours of support. Here, we demonstrate the feasibility of extending normothermic extracorporeal lung support to 4 days using cross-circulation with conscious swine. ⋯ We demonstrate feasibility of normothermic maintenance of extracorporeal lungs for 4 days by cross-circulation with conscious swine. Cross-circulation approaches could support the recovery of damaged lungs and enable organ bioengineering to improve transplant outcomes.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
EditorialThe immunotherapeutic landscape in non-small cell lung cancer and its surgical horizons.
Lung cancer continues to be a leading cause of cancer-related death worldwide. Despite tremendous advances in surgical technique, chemotherapy regimens, radiation, and targeted therapies, survival is <50% at 5 years. Immunotherapy, specifically immune checkpoint inhibitors (ICIs), demonstrates promise as a solution to this clinical problem. ⋯ Although ICIs have demonstrated meaningful efficacy in NSCLC and other advanced malignancies, they are not without adverse toxicities. Furthermore, there are minimal data on their use in the perioperative period. Here we discuss the current domain of ICIs and their surgical implications in NSCLC.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multidisciplinary selection of pulmonary nodules for surgical resection: Diagnostic results and long-term outcomes.
Pulmonary nodules found incidentally or by lung cancer screening differ in prevalence, risk profile, and diagnostic intervention. The results of surgical intervention for incidental versus screening lung nodules during multidisciplinary Pulmonary Nodule and Lung Cancer Screening Clinic (PNLCSC) follow-up have not been reported. ⋯ A unique multidisciplinary PNLCSC for incidental and lung cancer screening-detected nodules with individualized risk assessment reliably identifies primary and metastatic tumors while exposing few patients to diagnostic excision for benign disease. Longer-term outcomes, strategies to limit radiation exposure, and cost control need further study.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Transcriptome-based molecular subtyping of non-small cell lung cancer may predict response to immune checkpoint inhibitors.
We set out to investigate whether transcriptome-based molecular subtypes in lung adenocarcinoma and lung squamous cell carcinoma are predictive of the response to programmed cell death 1 blockade. ⋯ Molecular stratification by transcriptome sequencing data in non-small cell lung cancer identifies distinct immunomolecular subtypes that predict the response to programmed cell death 1 blockade.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Surgical treatment of tetralogy of Fallot in symptomatic neonates and young infants.
Optimal management of tetralogy of Fallot in symptomatic neonates and young infants remains controversial. ⋯ The surgical strategy for symptomatic tetralogy of Fallot should be individualized according to the initial size of the pulmonary valve annulus.