Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Urgent mitral valve replacement after mechanical thrombectomy for ischemic stroke.","authors":"Unmesh Chakraborty, Abhinaba Sarkar, Tanulina Sarkar, Kaushik Sundar, Atanu Saha","doi":"10.1007/s12055-024-01870-y","DOIUrl":"https://doi.org/10.1007/s12055-024-01870-y","url":null,"abstract":"<p><p>Mitral valve replacement, or any major cardiac surgery, is usually delayed for a minimum of 6 weeks after a previous stroke, mainly to avoid recurrence, if not associated with infective endocarditis or aortic dissection. A 50-year-old lady, diagnosed with severe mitral stenosis with a large left atrial clot, had a sudden onset cerebrovascular accident (CVA) while awaiting surgery. Mechanical thrombectomy (MT) of large vessel M1 middle cerebral artery (MCA) occlusion was done, and after adequate neurological improvement, she was taken up for emergency mitral valve replacement within 12 h, because of hemodynamic instability leading to low cardiac output syndrome and to avoid the chance of future CVA due to large clot burden. A 23-mm mechanical mitral valve prosthesis was implanted, and the postoperative course was uneventful. She was discharged on the fifth postoperative day, with stable hemodynamics and no residual neurological deficit. She was asymptomatic with normal echocardiographic findings on 12 months' follow-up. Major cardiac surgery after MT for ischemic CVA may be a viable option, if indicated, provided post-MT neurological improvement is adequate.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"610-614"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the Prognostic Nutritional Index in predicting survival and rehospitalization after surgical aortic valve replacement.","authors":"Michele D'Alonzo, Baudo Massimo, Antonio Fiore, Jacopo Capussela, Gianluca Abrami, Thierry Folliguet, Claudio Muneretto","doi":"10.1007/s12055-024-01891-7","DOIUrl":"https://doi.org/10.1007/s12055-024-01891-7","url":null,"abstract":"<p><strong>Purpose: </strong>The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and blood lymphocyte count, reflects a patient's nutritional and immune status. It is commonly used as a prognostic tool following oncological surgery and in certain cardiovascular conditions. This study aims to assess whether the PNI can also serve as a prognostic indicator in patients undergoing surgical aortic valve replacement (SAVR).</p><p><strong>Methods: </strong>A total of 471 low-risk patients with EuroSCORE II (European System for Cardiac Operative Risk Evaluation II) of ≤4%, who underwent isolated SAVR, were retrospectively analysed. Patients were divided into two groups based on their PNI values (cut-off, 46.75). Outcomes such as length of hospital stay, 30-day mortality, 1-year survival, and rehospitalization rates were compared between the groups.</p><p><strong>Results: </strong>The Low PNI group consisted of 116 patients, while the High PNI group included 355 patients. The latter were younger, but both groups had comparable comorbidities. All patients underwent SAVR with a bioprosthesis. There was no significant difference in 30-day mortality between the groups (Low PNI, 2.6% vs. High PNI, 0.9%, <i>p</i> = 0.162). However, the 1-year survival rate was significantly lower in the Low PNI group (Low PNI, 5.2 ± 4.1% vs. High PNI, 1.7 ± 1.3%, <i>p</i> = 0.039). Additionally, the 1-year rehospitalization rate was significantly higher in the Low PNI group (Low PNI, 13.8 ± 6.3% vs. High PNI, 7.7 ± 2.7%, <i>p</i> = 0.040). Multivariate analysis identified PNI as a protective factor, while mechanical ventilation was associated with increased risk of death or rehospitalization at 1-year after SAVR.</p><p><strong>Conclusions: </strong>The PNI is an inexpensive, accessible, and reliable tool that can be easily integrated into existing risk stratification scores for SAVR.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01891-7.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"532-540"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes in mediastinal mature teratoma.","authors":"Mohan Venkatesh Pulle, Anmol Bhan, Sukhram Bishnoi, Belal Bin Asaf, Harsh Vardhan Puri, Sumit Bangeria, Manan Bharatkumar Parikh, Arvind Kumar","doi":"10.1007/s12055-024-01882-8","DOIUrl":"https://doi.org/10.1007/s12055-024-01882-8","url":null,"abstract":"<p><strong>Background: </strong>This study was aimed at reporting the clinical characteristics and perioperative surgical outcomes of mediastinal mature teratoma managed in a single surgical unit.</p><p><strong>Methods: </strong>This is a retrospective analysis of 35 cases of mediastinal mature teratoma cases managed in a tertiary level thoracic surgery center over 10 years. A comprehensive analysis of perioperative surgical outcomes including complications was performed.</p><p><strong>Results: </strong>Males (<i>n</i> = 22, 62.8%) were predominant in the study group. Mean age of the cohort was 31.2 ± 13.3 years. The diagnosis was unruptured mature teratoma in 17(48.6%), ruptured mature teratoma in 8 (22.8%) and mature cystic teratoma in 10 (28.6%) patients. The mean duration from symptoms was 5.5 months (range: 1 - 84 months). Open surgery was done in 22 patients (62.8%) followed by video-assisted thoracoscopic surgery in 4 (11.4%) and robotic surgery in 9 patients (25.7%). Conversion from minimal access surgery to open surgery was in 2 patients (5.7%). The mean duration of intercostal chest drainage (ICD) was 6.3 ± 1.3 days, and mean hospital stay averaged 5.8 ± 2.7 days. Most common postoperative complication was prolonged post-operative air leak (> 7 days) in 5 patients (14.3%). The peri-operative mortality was in 1 (2.8%) patient. Ruptured teratoma was a strong predictor of postoperative complications (<i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>Complete surgical resection is primary and effective treatment modality for mediastinal mature teratoma. A tailored approach is needed, considering the factors like tumor size, location, and relation with surrounding structures.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01882-8.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"541-551"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold agglutinin disease coexisting with left main coronary artery involvement and ventricular dysfunction - a challenging triad.","authors":"Dhiren Shah, Kishore Gupta, Ankit Jitani, Dhaval Naik, Chintan Sheth","doi":"10.1007/s12055-024-01834-2","DOIUrl":"https://doi.org/10.1007/s12055-024-01834-2","url":null,"abstract":"<p><p>Cold hemagglutinin disease (CHAD) is a rare autoimmune condition characterized by cold-reactive antibodies causing hemagglutination and complement-mediated hemolysis. This case report details the successful management of a 56-year-old male with CHAD, coronary artery disease, and left ventricular dysfunction. The patient underwent coronary artery bypass grafting (CABG) amid challenges, including a rapid drop in hemoglobin levels, limited compatible blood supply, and cardiac comorbidities. Treatment involved rituximab, bortezomib, and a meticulous perioperative protocol to prevent hypothermia. The multidisciplinary approach, including hematologists, anesthetists, and surgeons, played a crucial role in managing the triad highlighting the importance of tailored management in CHAD cases.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"582-586"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent sciatic artery - different facets of presentation.","authors":"Riju Nair, Shiv Nair, Mary Smitha, Dipin Ramdas","doi":"10.1007/s12055-024-01860-0","DOIUrl":"https://doi.org/10.1007/s12055-024-01860-0","url":null,"abstract":"<p><p>Persistent sciatic artery is a rare congenital vascular anomaly of the lower limb arterial system. The entity is known to swindle surgeons worldwide with its unusual way of presentation. Suspicion remains the key for early diagnosis and treatment primarily depends on the symptomatology of the patient. We intend to report a series of two cases where the surgeons were literally vexed before a diagnosis was made. The report emphasises the need for further evaluation in situations where symptoms and clinical findings are contradictory. Readily available computed tomography angiography confirms the diagnosis and an early diagnosis makes a huge difference in patient outcome.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"615-619"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of robotic cardiac surgery: the first robotic-assisted heart transplant and beyond.","authors":"Muhammad Faraz, Shazia Rahim, Syed Muhammad Hassan, Muhammad Hamza Khan, Anum Akbar","doi":"10.1007/s12055-025-01910-1","DOIUrl":"https://doi.org/10.1007/s12055-025-01910-1","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"650-652"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra-pulmonary invasive fungal infection in a post-heart transplant patient.","authors":"Biraj Majumder, Manoj Kumar Sahu, Milind Padmakar Hote, Sandeep Seth","doi":"10.1007/s12055-024-01861-z","DOIUrl":"https://doi.org/10.1007/s12055-024-01861-z","url":null,"abstract":"<p><p>Infectious complications remain a lifelong risk after organ transplantation. Invasive fungal infections (IFIs), including fungal brain abscess, in these patients can be very morbid and fatal. Decreased host immunity due to lifelong immunosuppressive therapy is the single most important risk factor for IFIs. Unlike in the general population, IFIs are difficult to diagnose in immunosuppressed patients because of atypical presentations, low yield of pathogens from microbial cultures, and long turnaround time for culture results. Late diagnosis and delayed initiation of treatment may influence the final outcome.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"605-609"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hegar dilators in cardiac surgery - a versatile instrument.","authors":"Haroon Shakir, Kathirvel Balasubramani, Krishnan Ganapathy Subramaniam, Gopal Karunanithy Jaikaran, Elilnambi Sundaramoorthy","doi":"10.1007/s12055-025-01945-4","DOIUrl":"https://doi.org/10.1007/s12055-025-01945-4","url":null,"abstract":"<p><p>Hegar's dilators are a set of innocuous instruments, which have found utility in various fields of medicine from gynecology to cardiac surgery. In this article, we document its role as a lifesaver in controlling emergency major vessel bleed, its role in unique technique of left ventricular assist device (LVAD) insertion and briefly review its other documented uses in cardiac surgery, showcasing its true versatility.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"645-649"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External jugular vein pseudoaneurysm in a case of sickle cell anemia.","authors":"Aalay Parikh, Kartik Patel, Herin Patel, Gowtham Thakut","doi":"10.1007/s12055-024-01876-6","DOIUrl":"https://doi.org/10.1007/s12055-024-01876-6","url":null,"abstract":"<p><p>Aneurysm and pseudoaneurysm of venous system are uncommon. Their association with external jugular vein (EJV) is relatively rare. There is no reported case of association of EJV aneurysm in a patient with sickle cell anemia. Small aneurysm/pseudoaneurysm, if asymptomatic, are managed conservatively. However, if large or thrombosed, surgical excision is the treatment of choice. Their association with sickle cell anemia makes it a challenge not only for the surgeon, but also for the anesthetist, and requires a planned and disciplinary approach.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"620-622"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tri-leaflet mitral valve in hypertrophic obstructive cardiomyopathy.","authors":"André Alexandre, André Dias-Frias, Bruno Brochado, Mário Jorge Amorim, Patrícia Rodrigues, João Silveira, Isabel Sá, Sofia Cabral, Severo Torres","doi":"10.1007/s12055-024-01871-x","DOIUrl":"https://doi.org/10.1007/s12055-024-01871-x","url":null,"abstract":"<p><p>A tri-leaflet mitral valve (MV) is an extremely rare phenomenon, often associated with significant mitral regurgitation (MR). It may represent a phenotypic expression of hypertrophic obstructive cardiomyopathy (HOCM). We present the case of a 69-year-old woman with HOCM, a tri-leaflet MV, and systolic anterior motion (SAM)-induced severe MR. Despite receiving optimal medical therapy, her refractory symptoms and significant MR prompted surgical consideration. The patient underwent surgical myectomy, resulting in improvement of left ventricular outflow tract obstruction, SAM-induced MR, and symptomatic relief. This case illustrates a unique presentation of HOCM with a tri-leaflet MV and significant MR, successfully managed with a tailored surgical myectomy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01871-x.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"623-625"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}