Noteworthy in Cardiothoracic Surgery 2024

Noteworthy in Cardiothoracic Surgery 2024 summarizes a few of the most high-impact trials and provocative trends in cardiothoracic surgery this past year. Specifically, this year saw the release of many in-depth reports comparing the long-term outcomes of transcatheter aortic valve replacement (TAVR) vs surgical approaches for aortic valve replacement, data which is expected to move the transcatheter pendulum. In particular, this included a national analysis of trends reporting the rapid increase of post-TAVR surgical aortic valve replacement (SAVR). This year's literature also reported ground-breaking milestones related robotics in cardiothoracic surgery, with publication of the first multicenter series of robotic aortic valve replacements, the first entirely robotic double lung and heart transplants, as well as the first combined robotic aortic valve replacement and coronary artery bypass grafting. Specific to lung cancer, data continues to emerge regarding the de-escalation of magnitude of surgical resection from lobectomy to sublobar when able, and in the benefit of immunotherapy in the neoadjuvant treatment of non-small cell lung cancer. Frequent in the literature this year were concerns about toxicity, surgical challenges after therapy, and potential increases in perioperative complications following neoadjuvant chemoimmunotherapy, with calls for surgeons to crucially assess these effects on surgical outcomes to help refine patient selection criteria. Finally, 2024 saw many advancements in intraoperative tumor localization focused on enhancing precision, minimizing invasiveness, and improving surgical outcomes, including robotic-assisted bronchoscopy, electromagnetic navigation bronchoscopy (ENB), and encouraging data regarding intraoperative molecular imaging.