Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large role in the treatment methodology chosen for each patient. Selection of valve type and surgical intervention requires strong considerations of age and compatibility with vitamin K antagonists (VKAs) to ensure optimal post-operative outcomes. Due to the development of novel surgical techniques, including transcatheter AVR (TAVR) and placement of sutureless valves, patients who previously had limited access to AVD surgical options can now be considered for AVR. Further research into therapeutic development is imperative to improve patient short- and long-term outcomes as well as widen surgical candidacy for those seeking AVR for the management of AVD. Overall, AVR will continue to hold its prominent role in the treatment of AVD.

Myocardial infarction (MI) is a leading cause of mortality globally and is predominantly attributed to coronary artery disease (CAD). MI is categorized as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI), each with distinct etiologies and treatment pathways. The goal in treatment for both is restoring blood flow back to the myocardium. STEMI, characterized by complete occlusion of a coronary artery, is managed urgently with reperfusion therapy, typically percutaneous coronary intervention (PCI). In contrast, NSTEMI involves a partial occlusion of a coronary artery and is treated with medical management, PCI, or coronary artery bypass grafting (CABG) depending on risk scores and clinical judgment. The Heart Team approach can assist in deciding which reperfusion technique would provide the greatest benefit to the patient and is especially useful in complicated cases. Despite advances in treatment, complications such as cardiogenic shock (CS) and ischemic heart failure (HF) remain significant. While percutaneous coronary intervention (PCI) is considered the primary treatment for MI, it is important to recognize the significance of cardiac surgery in treatment, especially when there is complex disease or MI-related complications. This comprehensive review analyzes the role of cardiac surgery in MI management, recognizing when it is useful, or not.

Introduction: Patients with metastatic melanoma to the lung typically have poor outcomes. Although a pulmonary metastasectomy for selected patients has been shown to improve survival, the role of surgical resection following the introduction of immunotherapy for metastatic melanoma is unknown. The objective of this study was to determine predictors of survival for patients with melanoma metastatic to the lung in the era of immunotherapy. Methods: In this retrospective study, data from the National Cancer Database were abstracted for patients with melanoma lung metastases. The overall survival was evaluated using Kaplan–Meier and Cox proportional hazard analysis, adjusting for previously described risk factors for mortality. Patients with concomitant metastases to organs other than the lung were excluded from the study. Results: A total of 625 patients with lung metastases at the time of a skin melanoma diagnosis were identified. A total of 280 patients underwent a pulmonary metastasectomy, 267 received immunotherapy, and 78 were treated with both a metastasectomy and immunotherapy. During a median follow-up time of 34.6 months [IQR: 14.2, 75.9], a metastasectomy was found to offer significantly improved survival compared to immunotherapy alone. No difference was noted between a metastasectomy and a combination of a metastasectomy and immunotherapy in the adjusted Cox proportional hazard model. Conclusions: When statistical models were adjusted for risk factors, a metastasectomy maintained a significant survival advantage compared to immunotherapy. The addition of immunotherapy to the treatment of patients treated with a pulmonary metastasectomy did not improve survival. Our findings support the role of surgery for patients with pulmonary metastatic melanoma.

Right heart failure (RHF) is a common manifestation after left ventricular assist device (LVAD) placement and is associated with a high mortality rate. Historically, RV failure requiring an RVAD at the time of LVAD implantation has been associated with an especially high mortality. However, more recently, some studies have shown reasonable outcomes after LVAD implantation even when an RVAD is required, especially if RV failure is recognized early and treated with RV mechanical support. This article analyzes the current trends and studies investigating the use of RVAD placement post-LVAD implantation with an emphasis on the newest devices and treatment paradigms.

Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision making plays a large role in the treatment methodology chosen for each patient. Selection of valve type and surgical intervention require strong considerations to age and compatibility with vitamin K antagonists (VKAs) to ensure optimal post-operative outcomes. Due to the development of novel surgical techniques, including transcatheter AVR (TAVR) and placement of sutureless valves, patients who previously had limited access to AVD surgical options can now be considered for AVR. Further research into therapeutic development is imperative to improve patient short- and long-term outcomes as well as widening surgical candidacy for those seeking AVR for management of AVD. Overall, AVR will continue to hold its prominent role in the treatment of AVD.