Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Successful pediatric heart transplantation with bivalirudin use in a cyanotic single ventricle patient with an intracorporeal continuous flow ventricular assist device and heparin-induced thrombocytopenia.","authors":"Sandeep Sainathan, Leonardo Mulinari","doi":"10.1007/s12055-024-01892-6","DOIUrl":"10.1007/s12055-024-01892-6","url":null,"abstract":"<p><p>We describe a case of profound coagulopathy during orthotopic heart transplantation in a cyanotic single ventricle pediatric patient with an intracorporeal continuous flow ventricular assist device performed on bivalirudin for heparin-induced thrombocytopenia. This was successfully managed with central veno-arterial extracorporeal membrane oxygenation and hemofiltration as an adjunct to treat bivalirudin-induced coagulopathy due to lack of a reversal agent for bivalirudin.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"933-936"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325554","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":"Duplication of the umbilical vein along with an extrahepatic, intrathoracic right umbilical vein in the setting of Taussig-Bing anomaly with atrioventricular septal defect.","authors":"Faezeh Soveyzi, Hourieh Soleimani, Elahe Aleebrahim-Dehkordi, Jamal Jandaghi","doi":"10.1007/s12055-024-01885-5","DOIUrl":"10.1007/s12055-024-01885-5","url":null,"abstract":"<p><p>The incidence of persistent right umbilical vein (PRUV) is approximately 2 per 1000 pregnancies, with cases utilizing extrahepatic and intrathoracic routes to connect to the superior vena cava (SVC) being notably rarer. The case in question involved an 18-week fetus presenting with concurrent cardiac anomalies: D-transposition of the great arteries (TGA) classified as Taussig-Bing anomaly and atrioventricular septal defect (AVSD), highlighting the uniqueness of the presentation. A second-trimester ultrasound, including echocardiographic assessment, identified Taussig-Bing anomaly, AVSD, pulmonary stenosis (PS), and a right-sided stomach position with a left-sided umbilical vein exhibiting a PRUV with an anomalous trajectory towards the SVC. These findings indicate a rare association of multiple congenital malformations. The right-sided stomach raised concerns for potential cardiosplenic syndromes, such as heterotaxy. Additionally, two vessels observed posterior to the heart in the four-chamber view raised suspicion for inferior vena cava (IVC) interruption, possibly suggesting an azygos vein formation. However, a thorough assessment of the IVC confirmed normal anatomy, with the posterior vessel identified as the PRUV.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01885-5.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"919-923"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325543","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":"Double bubble trouble: a case of sub-epicardial aneurysms.","authors":"Jecco Ani Babu, Dillip Kumar Mishra, Krishnaswamy Chandrasekaran","doi":"10.1007/s12055-025-01898-8","DOIUrl":"10.1007/s12055-025-01898-8","url":null,"abstract":"<p><p>Here we validate a case of sub-epicardial aneurysms, the precursor for rupture that leads to pseudo-aneurysm (PSA) in a patient with associated coronary artery disease. Sub-epicardial aneurysms are rare and can lead to cardiac tamponade and death. We discuss a rare case of a 42-year-old female with two large sub-epicardial aneurysms and coronary artery disease initially diagnosed as true aneurysm, highlighting the importance of surveillance and the challenges of using echocardiography to diagnose and manage these aneurysms effectively. These PSA are difficult to be differentiated form a true aneurysm with transthoracic echocardiography. Echocardiographic criteria, such as a neck-to-sac diameter ratio of less than 0.5 and a reduction in wall thickness near the aneurysmal neck by more than 50%, were considered valuable in differentiating these aneurysms. Now simultaneous bi-plane and real-time three-dimensional imaging features of trans-esophageal echo will aid echo cardiologists in better identifying the characteristics of the outpouching, to further aid in differentiating pseudo from true aneurysms and even recognize the stage of the sub-epicardial aneurysms. Subjecting the patient to a surgery also depends on the time of occurrence of the myocardial infarction. It is highly advocated that an urgent procedure should be conducted for left ventricle (LV) PSA found within the first 3 months after an infarction, since the onset of rupture is unforeseeable. Although an accurate separation between false and true aneurysms is foremost critical for appropriate management, this differentiation is often challenging clinically and radiologically even with reasonable experience.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"942-946"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325542","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":"Best evidence for coronary revascularization - multisociety endorsement of the 2024 ESC guidelines.","authors":"Adnaldo da Silveira Maia","doi":"10.1007/s12055-025-01971-2","DOIUrl":"10.1007/s12055-025-01971-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"826-829"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325540","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 great masquerade: TB endomyocarditis as left ventricular mass.","authors":"Ikshudhanva Tharranath, Channabasavaraj Shivalingayya Hiremath, Sudheer Arava, Veeksha Venugopal Gowda","doi":"10.1007/s12055-024-01875-7","DOIUrl":"10.1007/s12055-024-01875-7","url":null,"abstract":"<p><p>Cardiac masses are rare and often diagnosed via imaging due to difficulties in obtaining tissue samples. This case highlights an unusual presentation of tuberculosis (TB) endomyocarditis as a left ventricular mass. A 25-year-old male presented with intermittent fever, chills, atypical chest pain, and weight loss over 6 months, with no other cardiac symptoms or TB exposure. Imaging revealed a left ventricular mass (5 × 4 × 2 cm) with a high standardised uptake value (SUV) of 28 and mediastinal lymph nodes with an SUV of 8, raising suspicions of sarcoma or lymphoma. After multidisciplinary evaluation, the patient underwent three cycles of ifosfamide and epirubicin, but the mass did not decrease in size. A biopsy showed necrotising abscesses and epithelioid cell granulomas, but no atypical cells, ruling out malignancy. A positive tuberculin test prompted initiation of intensive anti-tubercular treatment (HRZE). Two months later, follow-up magnetic resonance imaging (MRI) indicated a reduction in mass size by over 90%. This case illustrates a rare instance of primary intracardiac tubercular endomyocarditis and emphasizes the need to consider TB in atypical cardiac masses. The patient continues anti-tubercular therapy and is under follow-up.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"911-914"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325557","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":"Redefining weaning in a VA ECMO: a case report on pump-controlled retrograde trial off.","authors":"Raghavendra Deshpande, Rajavardhan Rangappa, Saikat Kanjilal, Narayana Swamy Moola, Suriyanathan Madhan Kumar","doi":"10.1007/s12055-025-01895-x","DOIUrl":"10.1007/s12055-025-01895-x","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) is widely recognized as a life-saving measure. The use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) is on the rise, serving as an effective mechanical circulatory support (MCS) device that aids in the restoration of systemic perfusion in patients suffering from cardiogenic shock. Weaning methods for VA ECMO exhibit considerable variability, with pump-controlled retrograde trial off (PCRTO) being one of the methods employed. PCRTO is a practical weaning method due to its physiological approach. In this case report, we discuss the application of PCRTO, in conjunction with a pulmonary artery catheter, for weaning a 41-year-old male patient from VA ECMO. The patient presented with acute coronary syndrome with cardiogenic shock. PCRTO played a pivotal role in the successful explantation of the ECMO cannulae, particularly given the patient's uncertain cardiorespiratory recovery. The PCRTO method, being both feasible and reversible, serves as a significant predictor for successful weaning from VA ECMO through a preload stress test. This case underscores the potential of PCRTO as a valuable tool in the weaning process from VA ECMO.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01895-x.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"937-941"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325551","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":"Rare cause of hemoptysis: bronchial Dieulafoy's disease-what not to do.","authors":"Srikant K Malegaonkar","doi":"10.1007/s12055-025-01902-1","DOIUrl":"10.1007/s12055-025-01902-1","url":null,"abstract":"<p><p>Hemoptysis is an alarming symptom caused by diverse etiologies. Dieulafoy's disease is an uncommon vascular anomaly commonly described as a cause of gastrointestinal bleed. It is characterized by abnormal dysplastic submucosal artery with mucosal branches that can lead to recurrent bleeding. Herein, we present a rare case of bronchial dieulafoy's disease (BDD) presenting as recurrent hemoptysis, also highlighting important aspects of its management.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"951-954"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325550","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":"Extubation in the operating room after elective on-pump CABG surgery: impact on patient outcome and clinical practice during the COVID-19 pandemic.","authors":"Anna Fischbach, Julia Alexandra Simons, Steffen Bernhard Wiegand, Celiné Lang, Rüdger Kopp, Gernot Marx, Sebastian Johannes Bauer, Patrick Winnersbach, Payam Akhyari, Gereon Schälte","doi":"10.1007/s12055-025-01908-9","DOIUrl":"10.1007/s12055-025-01908-9","url":null,"abstract":"<p><strong>Purpose: </strong>Coronary artery bypass graft (CABG) surgery is the standard treatment for advanced coronary artery disease. Despite evidence supporting enhanced recovery after surgery (ERAS) programs, many hospitals continue to keep patients intubated following on-pump CABG surgery. The coronavirus disease 2019 (COVID-19) pandemic further strained intensive care unit (ICU) capacities, leading to the consideration of immediate extubation after elective surgeries like CABG surgeries. The aim of this study was to assess whether extubation in the operating room after elective on-pump CABG surgery would reduce the ICU length of stay, the ICU readmission, and the ICU mortality in a population of patients undergoing on-pump CABG surgery as opposed to the conventional approach with patients remaining intubated.</p><p><strong>Methods: </strong>This study is a retrospective single-center study, including data from the University Hospital Aachen, Germany. Clinical data from 2019 to 2022 were analyzed, focusing on patients who underwent on-pump CABG surgery. Primary endpoints studied were the duration of ICU stay, rates of ICU readmission, and ICU mortality. Secondary outcomes included the hospital length of stay, hospital mortality, and the occurrence of postoperative pneumonia.</p><p><strong>Results: </strong>Ninety-seven patients who underwent elective on-pump CABG surgery were identified. There were no variations in outcomes, including ICU and hospital stays, mortality, ICU readmission, or postoperative pneumonia between the two groups.</p><p><strong>Conclusion: </strong>Extubation in the operating room after on-pump CABG surgery did not result in significant differences in outcomes compared to patients who remained intubated.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01908-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"863-873"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325545","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":"FFR-guided PCI in multivessel disease: a close match, or an underpowered verdict on CABG?","authors":"Pradeep Narayan","doi":"10.1007/s12055-025-01973-0","DOIUrl":"10.1007/s12055-025-01973-0","url":null,"abstract":"<p><p>In this review, we critically examine the 5-year outcomes of the Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery in Patients With Multivessel Coronary Artery Disease (FAME 3) trial. While the composite outcome of death, stroke, or myocardial infarction showed no significant difference between the two strategies at 5 years, percutaneous coronary intervention was associated with higher rates of myocardial infarction and repeat revascularization. Coronary artery bypass graft surgery demonstrated greater benefit in patients with more complex coronary lesions. These findings stress the need for cautious interpretation of the trial findings and emphasize the value of long-term follow-up in assessing meaningful differences in clinical outcomes.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"955-957"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325546","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":"Systematic reviews and meta-analyses for cardiothoracic surgeons: part 7 - synthesizing evidence.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-025-01940-9","DOIUrl":"10.1007/s12055-025-01940-9","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses are powerful tools within the evidence-based framework, with significant utility in cardiothoracic surgery. Systematic reviews represent the gold standard in evidence synthesis and adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring a reproducible methodology. They include subtypes such as qualitative and mixed-methods reviews, as well as extrapolations like umbrella reviews. A meta-analysis (plural: meta-analyses) is a statistical technique used to synthesize results from multiple studies, providing a more precise and reliable estimate of an effect size. Together, these approaches help inform clinical practice and shape evidence-based guidelines. However, their findings should be interpreted in light of their limitations.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"958-969"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325556","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}