Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Postoperative antithrombotic strategy after coronary endarterectomy: confounding by indication and the bleeding endpoint warrant further consideration.","authors":"Tahir Ullah, Muhammad Hussain, Luqman Khan, Muhammad Hamza, Romail Khan","doi":"10.1007/s12055-026-02265-x","DOIUrl":"10.1007/s12055-026-02265-x","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1185-1186"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024862","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":"Guidelines do not come out of thin air.","authors":"Pradeep Narayan","doi":"10.1007/s12055-026-02278-6","DOIUrl":"10.1007/s12055-026-02278-6","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1113-1114"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024794","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":"Beyond 15 mmHg: feasible but not vindicated.","authors":"Jack Gibb, Massimo Caputo","doi":"10.1007/s12055-026-02260-2","DOIUrl":"10.1007/s12055-026-02260-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1134-1136"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024817","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":"Endobronchial cryptococcosis mimicking bronchogenic carcinoma: a case report.","authors":"Sunila Jain, Md Ali Osama, Ujjwal Parakh, Ethel Shangne","doi":"10.1007/s12055-026-02237-1","DOIUrl":"10.1007/s12055-026-02237-1","url":null,"abstract":"<p><p>Endobronchial cryptococcosis is an uncommon manifestation of pulmonary fungal infection that can present with nonspecific clinical and radiological findings. We report a patient with persistent respiratory symptoms and weight loss, in whom imaging and bronchoscopy revealed an endobronchial lesion suspicious for neoplasia. Histopathological examination of the bronchoscopic biopsy established the diagnosis of cryptococcal infection, enabling appropriate antifungal therapy. This case highlights the pivotal role of tissue diagnosis in establishing the correct aetiology of endobronchial lesions and highlights the importance of considering fungal infections in the differential diagnosis of suspected pulmonary malignancy.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1165-1168"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024802","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":"Thoracoscopic management of intraoperatively detected tracheobronchial injuries during esophagectomy: a brief research report.","authors":"Subramanyeshwar Rao Thammineedi, Kalidindi Venkata Vijaya Narsimha Raju, Sujith Chyau Patnaik, Basanth Kumar Rayani, Vibhavari Milind Naik, Srijan Sandesh Shukla, Yogesh Kumar Vashist, Syed Nusrath","doi":"10.1007/s12055-026-02263-z","DOIUrl":"10.1007/s12055-026-02263-z","url":null,"abstract":"<p><p>Intraoperative tracheobronchial injury (TBI) during esophagectomy is rare potentially life-threatening condition. Among 941 esophagectomies performed at a tertiary cancer center over 14 years, the incidence of intraoperative TBI was 0.85% (8 patients). Conventional repair often requires thoracotomy with flap reinforcement. This study evaluated outcomes of primary thoracoscopic repair without flap reinforcement. Between January 2010 and January 2024, eight patients with intraoperative TBI were identified on retrospective review. The median age was 54.5 years, and six patients were female. Surgical approaches included six transthoracic and two transhiatal esophagectomies with gastric pullup and cervical anastomosis. TBIs occurred during transcervical mobilization (<i>n</i> = 5) or transthoracic dissection (<i>n</i> = 3), involving the trachea (<i>n</i> = 6) or left main bronchus (<i>n</i> = 2). Five injuries were > 3 cm. Seven patients underwent primary thoracoscopic repair without flap reinforcement, while one was managed by gastric conduit reinforcement. All patients were extubated on the day of surgery, with no postoperative air leaks. Complications included pneumonia (<i>n</i> = 2), transient recurrent laryngeal nerve palsy (<i>n</i> = 2), and anastomotic leak (<i>n</i> = 1). There was no 30-day mortality. No clinically evident late stricture, delayed repair dehiscence, air leak, or sepsis occurred during follow up. Thoracoscopic primary repair is feasible in selected patients with intraoperatively detected TBI.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1158-1164"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024807","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":"Letter to the Editor: Comparative outcomes of anticoagulant versus antiplatelet therapy in coronary endarterectomy: a meta‑analysis.","authors":"Laiba Malik, Said Umair Shah, Muhammad Usman Taj","doi":"10.1007/s12055-026-02259-9","DOIUrl":"10.1007/s12055-026-02259-9","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1189-1190"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024820","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":"Post-surgical outpatient chest drain management using digital devices and a social media application-based protocol.","authors":"Abhishek Mohan, Sabyasachi Bal, Shyam Sunder Rengan, Haritha Therese Joseph, Rohit Kumar Rathi, Roman Dutta","doi":"10.1007/s12055-026-02251-3","DOIUrl":"10.1007/s12055-026-02251-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Persistent air leak and prolonged pleural drainage are common causes of delayed discharge following thoracic surgery, leading to increased hospital stay. This increases healthcare costs, blocks bed availability, and increases the risk of hospital-acquired infections. Outpatient chest drain management (OPCDM) has been used as a strategy to reduce length of stay, but its use has traditionally been limited to selected patients with low air leaks and stable lung expansion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the feasibility and safety (defined as successful outpatient completion without readmission or major intervention) of a structured OPCDM protocol using digital drainage devices and remote monitoring, and to describe the incidence of complications and to estimate the institutional economic impact of the protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, single-center study included 167 consecutive patients discharged with an intercostal drain (88% with digital devices on suction) between January 2024 and October 2025, based on predefined clinical criteria. Patients were monitored using a standardized protocol involving daily WhatsApp-based image transmission of device data and scheduled outpatient follow-up. Outcomes assessed included treatment success, complications, readmissions, and the relationship of air leak magnitude with the duration of outpatient management. An exploratory institutional cost analysis was done.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Outpatient management was successful in 157 patients (94%). Complications occurred in ten patients (6%), of whom five required readmission and five were managed as outpatients. Pleural infections occurred in three patients (1.9%), two of whom required additional surgery (1.2%). Most patients required one to two follow-up visits (7-14 days). A total of 17/87 (19.5%) patients with air leaks required outpatient care beyond 14 days (10.2% of the entire cohort). A clear relationship was observed between the magnitude of air leaks and the duration of outpatient management. No formal health economic evaluation was performed. An exploratory institutional cost-based analysis suggested potential savings and reduced inpatient bed utilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;OPCDM using digital drainage devices and remote monitoring was feasible in selected patients, including those with moderate-to-high air leaks. It was associated with low complication and readmission rates. The combination of digital drainage and telemonitoring may have the potential to support an extension of OPCDM eligibility to selected patients previously considered unsuitable. Our limited institutional cost analysis suggests that OPCDM has the potential to reduce hospital stay, improve inpatient bed utilization, and reduce costs. Since our economic analysis was exploratory and institution-specific and a formal health economic evaluation was not performed, a definitive conclusion is n","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1137-1147"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024854","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":"Beyond DAPT versus anticoagulation: methodological considerations in antithrombotic evaluation after coronary endarterectomy.","authors":"Weijie Zhou, Shiyuan Li, Xinhao Pei, Yu Deng, Mingchen Huang, Zheng Zhang","doi":"10.1007/s12055-026-02264-y","DOIUrl":"10.1007/s12055-026-02264-y","url":null,"abstract":"<p><p>Comentale et al. provide a timely meta-analysis comparing anticoagulant and antiplatelet strategies after coronary endarterectomy. Their conclusion that dual antiplatelet therapy may reduce short-term myocardial infarction is clinically relevant, but several methodological issues deserve further consideration. In particular, exposure misclassification, heterogeneous myocardial infarction definitions, limited integration of bleeding outcomes, and insufficient procedural granularity may affect interpretation. Future studies should evaluate time-dependent antithrombotic exposure, standardised ischaemic and bleeding endpoints, and patient- and procedure-level modifiers to develop individualised postoperative regimens.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1187-1188"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024788","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":"Entrapped coronary balloon with shaft disruption during LAD PCI requiring emergency surgical extraction: a case report.","authors":"Anand Kumar Mishra, Yash Paul Sharma, Sanketh Edem, Lasya Reddy, Akshay Kheni, Tnc Pranav","doi":"10.1007/s12055-026-02235-3","DOIUrl":"10.1007/s12055-026-02235-3","url":null,"abstract":"<p><p>Entrapment of an undeflated angioplasty balloon with subsequent shaft disruption is a rare, life-threatening complication of percutaneous coronary intervention (PCI). When percutaneous retrieval fails, emergency surgical extraction with concomitant revascularization may be the only lifesaving option. Shaft disruption of a non-deflating angioplasty balloon represents an exceptionally rare subset of PCI device entrapment, with only isolated cases reported in the literature. A 76-year-old hypertensive and diabetic woman presented with a 5-day history of exertional dyspnea, palpitations, and generalized fatigue. Diagnostic coronary angiography revealed triple-vessel coronary artery disease involving distal left main, proximal left anterior descending artery (LAD), ramus, left circumflex (LCx), and right coronary artery (RCA). She underwent multivessel PCI. LCx and ramus were stented uneventfully. During attempted LAD lesion preparation, the dilatation balloon failed to deflate; the distal tip collapsed while the proximal segment remained inflated; a stent was therefore never deployed in the LAD. Attempts to withdraw the balloon led to shaft fracture, with the partially inflated balloon retained in the LAD and guidewire fragment prolapsing into the aorta. Multiple retrieval maneuvers with fresh guidewires failed and hemodynamics deteriorated despite intra-aortic balloon pump (IABP) and dual inotropic support. Emergency surgery revealed hemorrhagic pericardial effusion and a hematoma along the proximal LAD. Under cardiopulmonary bypass (CPB), an oblique aortotomy exposed the guidewire exiting the left coronary ostium. The retained wire (≈25 cm) and inflated 2-cm balloon were extracted en bloc. Two reversed saphenous vein grafts (rSVGs) were placed to mid-LAD and posterior descending artery (PDA). The patient was weaned off bypass uneventfully and discharged on postoperative day 6. Entrapment of an undeflatable balloon during LAD PCI with shaft disruption is exceedingly rare. Early recognition, prompt surgical conversion, and complete revascularization are crucial for survival in this high-risk complication.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1175-1179"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024797","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":"Short-term safety outcomes of carotid artery stenting with double-layer stents: a systematic review.","authors":"Husam Eldin Abuelgassim Hassan Balila, Hekmat Elsheikh Abakar Elsheik, Mohamed Eltayeb Abdelrahman Naiem, Manal Hashim Saeid Othman, Mohammed Elbashir Mohammedani Elbashir, Nahla Adam Elnayir Agabna","doi":"10.1007/s12055-026-02234-4","DOIUrl":"10.1007/s12055-026-02234-4","url":null,"abstract":"<p><p>Carotid artery stenting (CAS) with double-layer stents (DLS) has been increasingly adopted for carotid revascularization, particularly in patients considered high risk for surgery. However, evidence regarding their early clinical outcomes remains limited and heterogeneous. This systematic review aims to assess the 30-day safety outcomes of CAS using DLS, focusing on stroke, mortality, myocardial infarction (MI), and device-related complications. A systematic search was conducted across PubMed/MEDLINE, Embase, IEEE Xplore, Scopus, and Cochrane Library for studies published between January 2020 and August 2025. Eligible studies included randomized controlled trials (RCTs), prospective and retrospective cohort studies, and registry analyses reporting 30-day safety outcomes after CAS with DLS. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias 2 (RoB 2) tool for randomized trials. Ten studies comprising 6067 patients were included. The 30-day stroke rate ranged from 0 to 3.4%, though these rates should be interpreted cautiously given the lack of head-to-head comparisons and potential influence of patient selection. Mortality rates were consistently low, and the composite stroke/death endpoint ranged from 0 to 5.3%. MI rates were infrequently reported but remained low. Device-related complications were rare, with access site issues and in-stent thrombosis being the most reported. Comparative data between double-layer and single-layer stents were limited, and heterogeneity in outcome reporting precluded meta-analysis. Accordingly, all conclusions are based on narrative synthesis of the available data. Risk of bias assessment indicated low risk in 8 of 10 studies using the selected tools; however, the overall certainty remains limited by the observational nature of most included studies. CAS with DLS was associated with low reported rates of stroke, death, and complications in the included studies. The effect of the micromesh design on embolic protection remains uncertain due to limited comparative evidence. Further randomized trials and standardized outcome reporting are needed to validate these findings and guide clinical practice.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 10","pages":"1148-1157"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024805","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}