Background: Thoracic surgeons are increasingly facing situations for which patients are eligible for iterative thoracic surgery. With growing experience in minimally invasive thoracic surgery, the question of the safety and feasibility of minimally invasive redo procedure is rising. Our study aims to report the results of video-assisted thoracoscopic surgery (VATS) as surgical approach for reintervention after a previous ipsilateral intrathoracic surgery.
View Article and Find Full Text PDFJ Heart Lung Transplant
November 2024
Targeted vasopeptide therapies have significantly advanced the management of pulmonary arterial hypertension (PAH). However, due to insufficient preclinical evidence regarding the involvement of the endothelin-1 (ET-1) pathway in chronic thromboembolic pulmonary hypertension (CTEPH) pathophysiology, the potential of ET-1 receptor antagonism in treating CTEPH remains uncertain. In this study, we investigated the role of the ET-1 pathway in CTEPH microvasculopathy using a multifaceted approach.
View Article and Find Full Text PDFThe use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no multidisciplinary consensus document has examined the perioperative considerations of how to best manage these patients. To address this challenge, this perioperative utilization of ECLS in lung transplantation consensus statement was approved for development by the International Society for Heart and Lung Transplantation Standards and Guidelines Committee.
View Article and Find Full Text PDFBalloon pulmonary angioplasty (BPA) to treat chronic thromboembolic pulmonary hypertension (CTEPH) is generally reserved for distal obstruction precluding pulmonary endarterectomy (PEA) but can be used in patients with proximal disease who are at high surgical risk or refuse surgery. This single-center retrospective study compared BPA efficacy in patients with proximal versus distal CTEPH. Of the 478 patients, 36 had proximal disease, follow-up was 11.
View Article and Find Full Text PDFDespite the progress made in medical therapies for treating pulmonary hypertension (PH), a subset of patients remain susceptible to developing a maladaptive right ventricular phenotype. The effective management of end-stage PH presents substantial challenges, necessitating a multidisciplinary approach and early identification of patients prone to acute decompensation. Identifying potential transplant candidates and assessing the feasibility of such a procedure are pivotal tasks that should be undertaken early in the treatment algorithm.
View Article and Find Full Text PDFThe recent advent of tyrosine kinase inhibitors (TKIs) and immune checkpoint blockers (ICBs) in early-stage non-small cell lung cancer (NSCLC) has dramatically modified treatment strategies by improving the prognosis in this setting. Osimertinib and alectinib, both TKIs, have shown significant improvements in outcomes for patients with resected - and -positive NSCLC, respectively, changing the standard of care in these subgroups. More recently, the LAURA trial showed the efficacy of osimertinib after chemoradiotherapy in patients with unresectable stage III NSCLC harboring mutations.
View Article and Find Full Text PDFObjectives: Lower bilobectomy (LBL) leaves a residual pleural space potentially associated with adverse postoperative outcomes. In selected patients, right sleeve lower lobectomy (RSLL) with anastomosis between the middle lobe bronchus and intermediate bronchus is feasible. The outcomes of RSLL and LBL have not been compared.
View Article and Find Full Text PDFBackground: Leiomyosarcoma of the vena cava (LMS-VC) is a rare entity with poor oncological outcomes and a lack of histological staging prognostic factors.
Methods: Outcomes of consecutive patients operated on LMS-VC between March 2003 and May 2022, in two specialized sarcoma centers were reported.
Result: Forty-one patients were identified.
Interdiscip Cardiovasc Thorac Surg
July 2024
Objectives: Neo-oesophageal-airway fistula (NEAF) between gastric conduit and airway is a rare but life-threatening complication of oesophagectomy for oesophageal cancer. Optimal treatment remains unknown. A meta-analysis of good-quality case series may help determine whether nonoperative management (NOM) only, upfront surgery (S), or NOM followed by surgery is associated with better 1-year post-treatment mortality, resumption of oral diet and fistula recurrence.
View Article and Find Full Text PDFPerivascular collagen deposition by activated fibroblasts promotes vascular stiffening and drives cardiovascular diseases such as pulmonary hypertension (PH). Whether and how vascular fibroblasts rewire their metabolism to sustain collagen biosynthesis remains unknown. Here, we found that inflammation, hypoxia, and mechanical stress converge on activating the transcriptional coactivators YAP and TAZ (WWTR1) in pulmonary arterial adventitial fibroblasts (PAAFs).
View Article and Find Full Text PDFPurpose: To assess the prognostic factors and patterns of failure of patients consecutively treated with surgery and postoperative radiation therapy (PORT) for thymic epithelial tumours (TET).
Patients And Methods: Data from 192 TET patients who were operated and received PORT at a single centre from 1990 to 2019 was retrospectively analysed.
Results: Most patients had thymoma (77 %, B247%), were classified Masaoka-Koga stage III (35 %) or IV (32 %) and had a R0 (75 %) resection.
Pulmonary arterial (PA) hypertension (PAH) is a severe cardiopulmonary disease that may be triggered by exposure to drugs such as dasatinib or facilitated by genetic predispositions. The incidence of dasatinib-associated PAH is estimated at 0.45%, suggesting individual predispositions.
View Article and Find Full Text PDFObjective: To evaluate outcomes of surgical repair of postesophagectomy neoesophagus-airway fistulas (NEAFs).
Methods: We retrospectively included consecutive patients with NEAF managed by various techniques at our center between August 2009 and July 2021.
Result: Of the 11 patients (median age, 60 years; interquartile range, 58, 62), 4 had received induction chemoradiotherapy and 4 others induction chemotherapy.
Background: Lung or heart-lung transplantation (LT/HLT) for severe pulmonary hypertension (PH) as the primary disease indication carries a high risk of waiting list mortality and post-transplant complications. France and the UK both have coordinated PH patient services but with different referral pathways for accessing LT services.
Methods: We conducted a comparative analysis of adult PH patients listed for LT/HLT in the UK and France.
Purpose: To describe the technique and review the oncological and surgical results of the En Bloc resection assisted by retroperitoneal laparoscopy in a single prone position for tumors in the thoracolumbar region.
Methods: Monocentric retrospective case study. Procedure was performed in a single prone position by a dual team of spine and thoracovascular surgeons.
Background: Reverse Potts shunt (RPS) and lung or heart-lung transplantation are life-extending surgical interventions for pediatric patients with severe pulmonary arterial hypertension (PAH). Robust criteria for identifying patients who will benefit from these procedures remain elusive. Based on 30 years of experience, we sought to refine the surgical indications.
View Article and Find Full Text PDFBackground And Objective: Extracorporeal membrane oxygenation (ECMO) may be used as a substitute of traditional cardiopulmonary bypass (CPB) in thoracic surgeries. Extended resections for the treatment of non-small cell lung cancer (NSCLC) occasionally require extracorporeal life support. We present a narrative review of the current clinical uses of extracorporeal devices in this setting of patients.
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