The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Comparative StudySurgical and Endoscopic Management of Clinical T1b Esophageal Cancer.
Esophageal cancers that invade the submucosa (T1b) have increased risk for occult lymph node metastases. To avoid the morbidity and recovery from esophagectomy, patients with cT1bN0 tumors have been increasingly managed endoscopically. We hypothesized that tumor attributes could predict upstaging and outcome associated with surgical and endoscopic treatment. Our objective was to evaluate the comparative effectiveness of esophagectomy across different cT1bN0 tumor attributes. ⋯ Esophagectomy was associated with improved survival for cT1bN0 esophageal cancer; however, endoscopic treatment may achieve similar survival in patients with favorable tumor attributes. Further study is warranted.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Rare Coronary Artery Variants are Associated with Increased Mortality and Reinterventions Following the Arterial Switch Operation.
To determine the influence of coronary anatomy on long-term outcomes of the arterial switch operation (ASO). ⋯ Rare coronary artery variants-particularly intramural-are associated with increased mortality and coronary reinterventions after ASO. A low threshold for unroofing intramurals is likely associated with declining mortality and improved outcomes. Additional investigations are needed to determine the long-term fate of the coronary arteries after ASO.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Comparative StudyComparing 3-Year Survival and Readmissions between HeartMate 3 and Heart Transplant as Primary Treatment for Advanced Heart Failure.
To compare 3-year survival and readmissions of patients who received the HeartMate 3 (HM3) left ventricular assist device (LVAD) or underwent orthotopic heart transplantation (OHT) as primary treatment for advanced heart failure. ⋯ This exploratory analysis suggests that for similar patients, HM3 may provide comparable 3-year survival to OHT as a primary treatment for heart failure but may result in more readmissions.
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J. Thorac. Cardiovasc. Surg. · Jan 2025
Preoperatively Predicting Survival Outcome for Clinical Stage IA Pure-Solid Non-Small Cell Lung Cancer by Radiomics-based Machine Learning.
Clinical stage IA non-small cell lung cancer (NSCLC) showing a pure-solid appearance on computed tomography is associated with a worse prognosis. This study aimed to develop and validate machine-learning models using preoperative clinical and radiomic features to predict overall survival (OS) in clinical stage IA pure-solid NSCLC. ⋯ A radiomics-based machine-learning model can preoperatively and accurately predict OS and improve survival stratification in clinical stage IA pure-solid NSCLC.