Field Of Cardiothoracic Surgery Research Articles

Navigating the Cardiothoracic Publication Landscape: A Primer for Journal Selection.

Journal selection is very important for any researcher in every field. Publication in a reputable journal not only has a higher reach among a greater number of people but also sets a benchmark for significance and quality. This primer aims to guide researchers in the field of cardiothoracic research, including medicine, surgery, and imaging, to assist in journal selection for their respective articles. Journal selection depends on a variety of factors, such as impact factors, publication charges, review processes, article types that a journal accepts, and indexing. This primer highlights all these factors in detail that are essential for the selection of a suitable journal. The article emphasizes the importance of these factors in making a reasoned decision about journal selection. This article also focuses on different types of publication models and their implications, including hybrid open access, gold open access, and diamond open access. In conclusion, this primer aims to provide insights to researchers in the fields of cardiothoracic surgery, medicine, and imaging about the publication landscapes and guide them to strategically plan their submissions.

Thoracic Surgery Litigation: Analysis Using the Westlaw Legal Database

BackgroundIn the United States, medical malpractice bears a significant financial risk associated with surgery, particularly in the field of cardiothoracic surgery. Approximately 18.9% of cardiothoracic surgeons face litigation. We report an analysis of litigation in thoracic surgery. MethodsThe Westlaw legal database was used to identify thoracic surgery cases. Search terms were identified for various thoracic procedures. Case characteristics were analyzed. ResultsMedical malpractice in thoracic surgery results in a median payout of $1,183,000 million for plaintiff verdicts and a mean settlement award of $550,000. Outcomes of litigation are variable. Geographic location does not play a significant role in litigation. Thoracic surgeons in New York, California, Florida, and Illinois faced the most lawsuits. Intraoperative or procedural error and inadequate informed consent accounted for 52% of all cases. ConclusionsAttempts to increase patient understanding and education may be beneficial for reducing litigation. Analysis of why New York, California, and Illinois are highly litigious is warranted. Future analysis would also be useful to evaluate whether advances in techniques, such as robotic or thoracoscopic approaches, are associated with reduced incidence of litigation.

The Effect of Previous Transradial Catheterization on Radial Forearm Free Flaps

Radial forearm free flaps (RFFF) are a versatile option for the reconstruction of a wide variety of soft tissue defects and are particularly common in head and neck surgery. Benefits of RFFF include a relatively short operating time, a long pedicle, and a thinner, more pliable flap. However, in addition to its role in reconstructive surgery, the radial artery may be utilized for a number of other procedures including coronary angiography and percutaneous coronary interventions. Concern has previously been raised that prior catheterization may deleteriously affect the function of the radial artery and in the field of cardiothoracic surgery, individuals are increasingly advising against its use as a graft for coronary artery bypass graft surgery in such circumstances. Despite this, little is known about the effect on RFFF. In this review article, we concisely consider the available evidence of the effect of previous transradial catheterization on the radial artery and discuss the implications for reconstructive surgery. We then summarize the key considerations regarding their use in current practice.

Lessons learned from the EACTS-MSTCVS quality fellowship: a call to action for continuous improvement of cardiothoracic surgery outcomes in Europe.

The Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS), a pioneer in initiating and nurturing quality improvement strategies in statewide cardiothoracic surgery, has been running the Quality Collaborative (MSTCVS-QC) program since 2001. This initiative has significantly grown over the years, facilitating at least 4 in-person meetings annually. It actively engages cardiac and general thoracic surgeons, data managers and researchers from all 32 non-federally funded cardiothoracic surgery sites across Michigan. Broadening its influence on joint learning and clinical outcomes, the MSTCVS-QC formed a strategic partnership with Blue Cross Blue Shield of Michigan, the state's largest private insurer, to further promote its initiatives. The MSTCVS-QC, operating from a dedicated QC centre employs an STS-associated database with additional aspects for data collection and analysis. The QC centre also organizes audits, facilitates collaborative meetings, disseminates surgical outcomes and champions the development and implementation of quality improvement initiatives related to cardiothoracic surgery in Michigan. Recognizing the MSTCVS-QC's successful efforts in advancing quality improvement, the European Association for Cardiothoracic Surgery (EACTS) introduced a fellowship program in 2018, facilitated through the EACTS Francis Fontan Fund (FFF). This program allows early-career academic physicians to spend 4-6 months with the MSTCVS-QC team in Ann Arbor. This article chronicles the evolution and functionality of the MSTCVS-QC, enriched by the experiences of the inaugural 4 EACTS/FFF fellows. Our objective is to emphasize the critical importance of fostering a culture of quality improvement and patient safety in the field of cardiothoracic surgery with open discussion of audited, high-quality data points. This principle, while implemented locally, has implications and value extending far beyond Europe, resonating globally.

General thoracic surgery in Finland, a perspective from the Helsinki University Hospital

The field of thoracic surgery is a rapidly developing field due to exciting developments in technology and oncologic treatments as well as continuous innovation in surgical technique. Although the population of Finland is relatively small, general thoracic surgery is represented at a high level in five centralized university centers, Helsinki University Hospital, Tampere University Hospital, Turku University Hospital, Kuopio University Hospital and Oulu University Hospital. Thus, high case volume and good results are achieved in these centers. Here, we describe a short history, current state and future prospects of the field of cardiothoracic surgery in Finland, with a focus on general thoracic surgery and the perspective of Helsinki University Hospital. From the field’s birth in Finland, marked by the first lobectomy, in the late 1930’s, it has grown and adapted more and more modern techniques such as totally minimally invasive esophagectomy and robotic lung cancer surgery. Nowadays, most of general thoracic surgery in Helsinki University Hospital is either minimally invasive or robotic and open surgery is the exception to the norm. Helsinki University Hospital has a strong presence in the European general thoracic surgery community and aims to do so in the future by investing on training & education, research and surgical innovation.

Development of an organ procurement team in South Australia in response to COVID-19.

BackgroundDue to the nature of border closures and quarantine requirements in Australia during the COVID‐19 pandemic, the feasibility of interstate travel for organ retrieval created complex logistics. An organ procurement service in South Australia, to procure heart and lungs of local donors, was commenced to mitigate the impact of the travel restrictions imposed due to COVID‐19. The purpose of this review was to examine the initial data and feasibility of the service.MethodsA single unit, multi‐site retrospective review from April 2020–August 2021 of all organ retrievals undertaken by the Flinders Medical Centre cardiothoracic service across Adelaide metropolitan area. Data was prospectively collected and analysed from the DonateLife South Australian centralized database. All data was de identified.ResultsA total of 25 organ procurements had been undertaken across 17 months since commencing the program. Total of 9 hearts and 16 bilateral lungs were procured with median age of donor of hearts 49 years (IQR 35.5–51. 5) and 60 years (IQR 44–72) for lung donation. Six organs were donated after determination of circulatory death and 19 after neurological determination of death. Median ischaemic time for heart donation was 4.4 h (IQR 3.0–5.8) and lung donation 4.4 h (IQR 3.4–6.1). All organs procured by the local South Australian team were successfully transplanted at the recipient site. Recipient sites included 8 in Victoria, 10 in New South Wales, 4 in Western Australia and 3 in Queensland.ConclusionsThe necessity of flexibility within the field of cardiothoracic surgery is evident during the COVID‐19 pandemic. The implementation of an organ retrieval service in South Australia has been successful with no apparent increased risk to successful transplant outcomes.

Digital communication platforms in cardiothoracic surgery during COVID-19 pandemic: keeping us connected or isolated?

During the COVID-19 pandemic, performing a surgeon’s duties has become challenging while adhering to social distancing mandates. To aid in the continuity of healthcare services, rapid implementation of digital communication tools became a necessity. This is an account of experiences using digital communication platforms, namely Microsoft Teams and Zoom, for clinical and educative purposes in the field of Cardiothoracic Surgery in the UK. While enabling ongoing virtual clinical meetings, conferences and learning opportunities for residents with little face-to-face contact, are these digital communication platforms keeping us connected or isolated?

Selecting the Modern Cardiothoracic Surgery Trainee

In this issue of The Annals of Thoracic Surgery, in their review of the latest National Residency Matching Program’s report coupled with survey data from more than half of the country’s 6-year Integrated Thoracic Surgery (I-6) residency program directors, Obafemi and colleagues1 explore the ever-intensifying process of securing a training position in the field of cardiothoracic surgery. Whereas the metrics speak for themselves (average United States Medical Licensing Examination scores continue to rise, research experiences surpass those of applicants to any other specialty), excellence in these aspects on the part of a candidate can now be viewed only as a prerequisite for consideration.

Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage.

Remodeling is a commonly encountered term in the field of cardiothoracic surgery that is often used to describe various pathophysiological changes in the dimension, structure, and function of various cardiac chambers, including the aorta. Stanford type A or DeBakey type 1 aortic dissection (TAAD) is a perplexing pathologic condition that can present surgical teams with the need to navigate a maze of complex decision-making. Ascending or hemi-arch replacement leaves behind a significant amount of distal diseased aortic tissue, which might have a persistent false lumen or primary or secondary intimal tears (or communications between lumina), which can lead to dilatation of the aortic arch. Unfavorable aortic remodeling is a major cause of distal aortic deterioration after the index surgery. Cardiac surgeons are aware of post-surgical cardiac chamber remodeling, but the concept of distal aortic remodeling is still idealized. The contemporary literature from established aortic centers supports aggressive management of the residual aortic pathology during the index surgery, and with continuing technical advancements, endovascular stenting options are readily available for patients with TAAD or for complicated type B aortic dissection cases. This review discusses the pathophysiology and treatment options for favorable distal aortic remodeling, as well as its impact on mid- to long-term outcomes following TAAD repair.

Extended Reality Platforms: A Technological Solution Still Finding the Right Problem

In this issue of The Annals of Thoracic Surgery, Sadeghi and colleagues1 provide a review of the current state-of-the-art use of extended reality in the field of cardiothoracic surgery. They summarize current applications of virtual, augmented, and mixed reality platforms for cardiothoracic surgery in clinical practice and medical education. The included studies provide early examples of the use of these innovative technologies for preoperative planning, intraoperative guidance, postoperative rehabilitation, patient education, and surgical simulation.

An Approach to Diversity and Inclusion in Cardiothoracic Surgery

While the United States (US) population at large is rapidly diversifying, cardiothoracic surgery is among the least diverse specialties in terms of racial and gender diversity. Lack of diversity is detrimental to patient care, physician well-being, and the relevance of cardiothoracic surgery on our nation's health. Recent events, including the coronavirus disease 2019 pandemic and the Black Lives Matter protests, have further accentuated the gross inequities that underrepresented minorities face in our country and have reignited conversations on how to address bias and systemic racism within our institutions. The field of cardiothoracic surgery has a responsibility to adopt a culture of diversity and inclusion. This kind of systemic change is daunting and overwhelming. With bias ubiquitously entangled with everyday experiences, it can be difficult to know where to start. The Society of Thoracic Surgeons Workforce on Diversity and Inclusion presents this approach for addressing diversity and inclusion in cardiothoracic surgery. This framework was adapted from a model developed by the National Institute on Minority Health and Health Disparities and includes information and recommendations generated from our literature review on diversity and inclusion. A MEDLINE search was conducted using keywords "diversity," "inclusion," and "surgery," and approaches to diversity and inclusion were drawn from publications in medicine as well as non-healthcare fields. Recommendations were generated and approved by The Society of Thoracic Surgeons Executive Committee. We present an overarching framework that conceptualizes diversity and inclusion efforts in a series of concentric spheres of influence, from the global environment to the cardiothoracic community, institution, and the individual surgeon. This framework organizes the approach to diversity and inclusion, grouping interventions by level while maintaining a broader perspective of how each sphere is interconnected. We include the following key recommendations within the spheres of influence: It is important to note that each of the spheres of influence is interconnected. Interventions to improve diversity must be coordinated across spheres for concerted change. Altogether, this multilevel framework (global environment, cardiothoracic community, institution, and individual) offers an organized approach for cardiothoracic surgery to assess, improve, and sustain progress in diversity and inclusion.

Development and Evolution of the Thoracic Surgery Residents Association

The Thoracic Surgery Residents Association (TSRA) was established in 1997 as a trainee-led organization under the guidance of the Thoracic Surgery Directors Association (TSDA) to represent the interests and meet the educational needs of cardiothoracic surgery residents across North America. Since its founding, the TSRA has continuously evolved and expanded to further its primary mission. In addition to now offering text- and audio-based educational resources, the TSRA acts to connect students, trainees, and faculty, with the ultimate goal of fostering relationships that will benefit not only individuals but also the field of cardiothoracic surgery as a whole.

Participating in a TweetChat: Practical Tips From The Thoracic Surgery Social Media Network (#TSSMN)

The Thoracic Surgery Social Media Network (TSSMN) was formed as a collaborative effort by leading journals in the field of cardiothoracic surgery, The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery. The primary goals of the initiative are to bring social media attention to key publications from both journals and to highlight major accomplishments in the specialty. The aim of this article is to describe in a step-by-step fashion how to effectively participate in a TSSMN TweetChat, provide an overview of the various tweeting platforms available, and show best practices on the use of social media.

The application progress of three dimensional printing in the field of cardiothoracic surgery in children

Three dimensional(3D)printing technology has been adapted to medical applications at an impressive rate since 2011.It has been widely used in the field of craniofacial, oromaxillofacial, orthopedic and cardiothoracic specialties.3D biometric printing represents one of the highest levels of 3D printing technology and it can be used to print individual anatomical models, implants, prosthetics, external fixators, splints, surgical instrumentation, and for surgical guidance.The application of 3D printing technology in pediatric cardiothoracic surgery start late and has difficulties.This technology is mainly used for cardiothoracic surgery guidance and preoperative schemes selection, organ and tissue transplantation at present.It is of high value in the diagnosis and treatment of complex congenital heart disease, complex trachea and esophagus malformation and thoracic tumor.This article reviews the application progress and prospect of 3D printing technology in the field of pediatric cardiothoracic surgery. Key words: Three dimensional printing; Surgical application; Children; Cardiothoracic surgery

Improved dynamic predictions from joint models of longitudinal and survival data with time-varying effects using P-splines.

In the field of cardio-thoracic surgery, valve function is monitored over time after surgery. The motivation for our research comes from a study which includes patients who received a human tissue valve in the aortic position. These patients are followed prospectively over time by standardized echocardiographic assessment of valve function. Loss of follow-up could be caused by valve intervention or the death of the patient. One of the main characteristics of the human valve is that its durability is limited. Therefore, it is of interest to obtain a prognostic model in order for the physicians to scan trends in valve function over time and plan their next intervention, accounting for the characteristics of the data. Several authors have focused on deriving predictions under the standard joint modeling of longitudinal and survival data framework that assumes a constant effect for the coefficient that links the longitudinal and survival outcomes. However, in our case, this may be a restrictive assumption. Since the valve degenerates, the association between the biomarker with survival may change over time. To improve dynamic predictions, we propose a Bayesian joint model that allows a time-varying coefficient to link the longitudinal and the survival processes, using P-splines. We evaluate the performance of the model in terms of discrimination and calibration, while accounting for censoring.

In Memoriam: Lawrence H. Cohn, MD (1937–2016)

In Memoriam: Lawrence H. Cohn, MD (1937–2016)

History of Cardiothoracic Surgery at New York University

This monograph outlines the rich history of cardiothoracic surgery at New York University (NYU), beginning with its origins at The Bellevue Hospital in the mid-1800's. Numerous early clinical accomplishments were significant, leading up to the arrival of Dr Frank Spencer in 1966. Under Dr Spencer's leadership, the department progressed with development of a culture of innovation, leadership and education that carries through today. The program encompasses three major hospitals and will soon graduate its 50th class of trainees, many of whom have had outstanding careers and a major impact on the field of cardiothoracic surgery. This culture continues under the direction of our current chair, Dr Aubrey Galloway, whose vision has orchestrated and refined a new period of innovation and excellence.

History of Cardiothoracic Surgery at Washington University in Saint Louis

The Division of Cardiothoracic Surgery at Washington University evolved a century ago to address what many considered to be the last surgical frontier, diseases of the chest. In addition, as one of the first training programs in thoracic surgery, Washington University has been responsible for educating more thoracic surgeons than nearly any other program in the world. Beginning with Evarts A. Graham and continuing through to Ralph J. Damiano Jr., the leaders of the division have had a profound impact on the field of cardiothoracic surgery.

Open Data: Can It Prevent Research Fraud, Promote Reproducibility, and Enable Big Data Analytics In Clinical Research?

Open Data: Can It Prevent Research Fraud, Promote Reproducibility, and Enable Big Data Analytics In Clinical Research?

Minimally invasive and alternative approaches for long-term LVAD placement: the Vanderbilt strategy.

Minimally invasive and alternative strategies for implantation have been anecdotally reported for contemporary continuous-flow left ventricular assist device (CF-LVAD) placement. We reviewed our experience at a single center with alternative strategies for implantation of the HeartMate II and HeartWare CF-LVADs, in patients with advanced heart failure (HF). This featured article focuses on the associated surgical techniques and patient management pitfalls. For appropriately selected cases, our group believes that these alternative strategies allow for the development of novel and less traumatic surgical approaches for CF-LVAD implantation. With reproducible outcomes, these approaches also promise the possibility of increasing the number of high-risk surgical patients who could benefit from CF-LVAD therapies. This work has detailed a variety of less invasive alternative strategies for implantation of long-term LVADs. These newer approaches have the potential for significant advancements in the field of cardiothoracic surgery. Large-scale collaborative studies will be needed to clarify the potential advantages and disadvantages of these novel techniques on patient outcomes.