Introduction: Immunotherapy has revolutionized the treatment for locally advanced resectable non-small-cell lung cancer (NSCLC). In clinical trials, the combination of neoadjuvant immunotherapy and chemotherapy has resulted in a higher rate of pathologic complete response in comparison with neoadjuvant chemotherapy alone. Our study aims to describe surgical and oncological outcomes after neoadjuvant chemoimmunotherapy and lung resection at our academic center outside clinical trials. Methods: We retrospectively analyzed 54 patients who received neoadjuvant chemoimmunotherapy and underwent surgical resection from 2018 to 2024. Demographics, pre-operative systemic treatment, surgical approach and postoperative outcomes were evaluated. Results: The median age was 65 years, 46% were female, and 67% of patients had a non-squamous histology, chiefly adenocarcinoma. The most common clinical stage was IIIA (54%). Major findings include a 41% pathologic complete response (pCR) and 52% major pathologic response (MPR) rate. Neoadjuvant chemoimmunotherapy resulted in downstaging in 78% (n = 42) of patients. Most patients (83%) had their operation completed robotically. R0 resection was achieved in 96%. Median length of stay was significantly shorter after robotic operations, with no significant difference in complications compared to the open group. At a median follow up of 16 months, 24 months of recurrence-free survival was estimated at 76% (95% CI: 61–94) and overall survival, 93% (CI: 84–100). Conclusion: At our medical center, induction chemoimmunotherapy followed by anatomic lung resection has resulted in a high rate of complete pathologic response, overall survival and recurrence-free survival. The robotic approach after induction chemoimmunotherapy is safe and associated with shorter length of stay and faster recovery time.

Introduction Rheumatoid arthritis (RA) is associated with increased cardiovascular risk and chronic systemic inflammation, which may influence outcomes of heart failure (HF) hospitalization. However, the effect of RA on acute inpatient complications, bleeding risk, and mortality during HF admissions remains unclear. Methods We conducted a retrospective cohort study of adults hospitalized with HF across a large tertiary healthcare system from 2016 to 2024. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay, gastrointestinal (GI) and major bleeding, pneumonia, respiratory failure, acute kidney injury (AKI), thromboembolism, and major adverse cardiac events (MACE). Multivariable logistic and negative binomial regression were used to assess associations after adjusting for demographics, comorbidities, laboratory values, and medications. Propensity score matching (PSM) minimized baseline confounding. Results The study included 81,366 HF patients. Those with RA were older, more often female, and had higher rates of chronic lung disease, systemic lupus erythematosus (SLE), and thrombocytopenia. After adjustment, RA was associated with higher odds of GI and major bleeding and longer hospital stays, but not with increased mortality or cardiovascular complications. Among those with RA, elevated C-reactive protein was associated with a higher risk of thromboembolic and cardiac complications. Pre-admission disease-modifying antirheumatic drug use was associated with lower thromboembolic risk, but higher risk of major adverse cardiac events. Conclusion RA was associated with a greater risk of bleeding complications and prolonged hospitalization during HF admissions but not increased in-hospital mortality. Elevated inflammatory markers and immunosuppressive therapy may contribute to thrombotic and cardiac complications and highlight the need for targeted monitoring strategies during hospitalization.

Background: Ventricular septal rupture (VSR) is a rare but devastating complication of acute myocardial infarction (MI), associated with high mortality despite advances in reperfusion therapy. However, contemporary data examining national trends in VSR outcomes and the evolving role of mechanical circulatory support (MCS) in this population remain limited. Aims: This study aimed to evaluate modern trends in VSR incidence, inpatient mortality, and MCS utilization among patients with MI using a nationally representative database. Methods: We analyzed the Nationwide Inpatient Sample from 2016 to 2021, identifying MI hospitalizations in adults ≥ 40 years. Outcomes included in‐hospital mortality (primary), length of stay, adverse disposition, cardiogenic shock (CS), and MCS use (secondary). Results: Of 5.4 million acute MI admissions, 2605 (0.05%) involved VSR. Patients with VSR experienced significantly higher mortality (49.9% vs. 8.6%), CS (70.1% vs. 6.7%), and greater reliance on MCS (ECMO 4.4% vs. 0.1%, IABP 47.6% vs. 3.2%, LVAD 15.9% vs. 1.2%; all p < 0.001). Regression analysis revealed increased odds of mortality (aOR 4.53, 95% CI 3.41–6.02), prolonged hospitalization, shock, adverse disposition, and MCS use. Across the study period, VSR incidence (0.03%–0.06%), mortality (43%–55%), and MCS rates (53%–68%) remained stable. Conclusions: Despite advances in cardiovascular care, VSR outcomes in the acute MI setting have not substantially improved. However, the incidence of this mechanical complication has decreased in the contemporary era of early reperfusion and advanced therapies as suggested by our cohort. Use of MCS with MI complicated by VSR remains high, and a nuanced approach for modality selection is necessary, especially in candidates for delayed repair. Trends in VSR incidence, mortality, and MCS remained stable throughout the study period. These findings underscore the persistent challenge in post‐MI VSR management and emphasize the need for prospective randomized trials to define optimal repair timing and clarify whether MCS modality selection influences outcomes in this high‐risk population.

Hepatic artery aneurysms represent 20% of visceral artery aneurysms and carry a high risk of fatal outcomes. We describe an 8.6-cm common hepatic artery aneurysm previously treated with endovascular stenting and coiling that progressively enlarged and was complicated by endoleak and mural thrombus. Open partial resection was performed without reconstruction, and the patient made a full recovery with no recurrence at the 2-year follow-up. This case underscores the therapeutic challenges in treating giant aneurysms and highlights the importance of assessing collateral circulation when considering an aneurysmectomy.