Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"An uncommon complication of a minimally invasive procedure.","authors":"Valerio Massimo Magro, Andrea Sorbino, Nicola Manocchio, Gianluca Massaro, Gaetano Chiricolo, Concetta Ljoka, Calogero Foti","doi":"10.1007/s12055-025-01962-3","DOIUrl":"10.1007/s12055-025-01962-3","url":null,"abstract":"<p><p>Decision-making for intervention in symptomatic aortic stenosis should balance the risks of surgery and of transcatheter aortic valve implantation (TAVI). TAVI is a well-established technique for treating elderly and high-risk patients with aortic stenosis using a variety of different surgical approaches (a retrograde transfemoral, transaxillary, transaortic or an antegrade transapical approach). The transapical approach requires the involvement of the heart surgeon and is now limited to cases where the procedure cannot be performed by alternative approaches. We report the case of an 87-year-old patient with severe peripheral arterial disease and a history of TAVI via transapical approach, who presented with a syncopal episode 4 years post-procedure. Imaging revealed a left ventricular apex aneurysm, likely related to the previous transapical TAVI. This case underscores the importance of thorough pre-procedural assessment and long-term follow-up in patients undergoing alternative TAVI access routes, as well as the need for heightened awareness of rare but significant complications such as ventricular pseudoaneurysm. Careful patient selection and individualized procedural planning remain essential to optimize outcomes in this complex population.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1503-1506"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124367","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":"To AI or not to AI?","authors":"Om Prakash Yadava","doi":"10.1007/s12055-025-02096-2","DOIUrl":"https://doi.org/10.1007/s12055-025-02096-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1375-1376"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124605","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":"A scenario of left ventricular assist device suction mimicking external compression.","authors":"Branislav Bezak, Panagiotis Artemiou, Matej Ondrusek, Stefan Durdik, Ivo Gasparovic, Michal Hulman","doi":"10.1007/s12055-025-02000-y","DOIUrl":"10.1007/s12055-025-02000-y","url":null,"abstract":"<p><p>In this short report, we present a rare scenario involving a 60-year-old male patient, in whom higher pump speed and suction mimicked external compression of the left ventricle. Surgical revision revealed excessive suctioning of the left ventricle and left atrium by the left ventricular assist device, leading to atrioventricular groove distortion that mimicked external compression of the left ventricle. After adjustment of the pump speed, obstruction of the inflow cannula and collapse of the left ventricle were resolved.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1480-1482"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124414","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":"Pulmonary malignant tumor metastasis or alveolar echinococcosis metastasis: the radiological dilemma.","authors":"Yener Aydin, Hayri Ogul, Ali Bilal Ulas","doi":"10.1007/s12055-025-01992-x","DOIUrl":"https://doi.org/10.1007/s12055-025-01992-x","url":null,"abstract":"<p><p>Approximately one-third of patients with a malignant disease develop lung metastases. Two-thirds of malignant tumor metastases are located in the peripheral third of the lung and present as well-circumscribed nodules. In this study, we present a 35-year-old male patient diagnosed with alveolar echinococcosis, a rare condition that can radiologically mimic pulmonary malignant metastases, posing a diagnostic challenge.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1510-1512"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124604","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":"Pulmonary mucormycosis and aspergillosis co-infection in an immunocompetent host: a rare case report with review of literature.","authors":"Ezaz Ahmed, Aamir Mohammad, Bushra Siddiqui, Syed Shamayal Rabbani, Mohd Azam Haseen, Areeba Khursheed","doi":"10.1007/s12055-025-02002-w","DOIUrl":"https://doi.org/10.1007/s12055-025-02002-w","url":null,"abstract":"<p><p>Pulmonary aspergillosis and mucormycosis are rare opportunistic infections that usually occur in immunocompromised patients and in patients with multiple comorbidities. Mucormycosis is even rarer in immunocompetent patients. In this case report, we present a case of co-infection of mucormycosis and aspergillosis in a young female with no comorbidities and no immunosuppression. A 27-year-old female patient presents with a history of hemoptysis and intermittent fever for a year with associated history of weight loss. She also has a history of tuberculosis for which she completed treatment. There is no history of any known comorbidity or immunosuppression. High-resolution computed tomography (HRCT) was suggestive of air crescent sign involving the right upper lobe. The patient underwent right upper lobectomy through a right posterolateral approach. Histopathology was suggestive of a fungal ball (mucormycosis and aspergillosis). The patient was administered liposomal amphotericin B intravenously for 14 days and oral posaconazole 300 mg for 3 months. Postoperative follow-up period of 3 and 6 months was uneventful. Mucormycosis and aspergillosis are rare co-infections that could potentially lead to death. These infections usually occur in the immunocompromised population but a high index of suspicion is needed also in immunocompetent patients. Early detection by a multidisciplinary approach, appropriate antifungal therapy, and, if necessary, surgical resection are essential in the treatment of this co-infection. There is no clear consensus on the treatment of mixed co-infections that respond differently to standard treatment protocols; hence, antimicrobial therapy must be rationalized.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1488-1492"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124633","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":"Anesthetic challenges in tracheal resection and reconstruction in a patient with adenoid cystic carcinoma and retrosternal goiter.","authors":"Jieyuan Chen, Songsong Mao","doi":"10.1007/s12055-025-01991-y","DOIUrl":"https://doi.org/10.1007/s12055-025-01991-y","url":null,"abstract":"<p><p>This case demonstrates the successful surgical and anesthetic management of a rare combination of tracheal adenoid cystic carcinoma and retrosternal goiter, highlighting the critical interplay between surgical strategy and airway management. The multidisciplinary team implemented a staged approach: initial cervical thyroidectomy with conventional ventilation was followed by right thoracotomy for tracheal resection, utilizing left main bronchus cross-field ventilation to maintain oxygenation during airway reconstruction. Key to success was the coordinated transition between surgical phases and ventilation techniques, along with frozen section confirmation of tumor-free margins prior to anastomosis. Despite postoperative pulmonary complications requiring prolonged ventilation, the patient achieved complete recovery, underscoring how integrated surgical-anesthetic planning can address the dual challenges of tracheal obstruction and mediastinal mass effect.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1460-1463"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124381","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 value of miR-155 expression in predicting early and long-term outcome of coronary artery bypass grafting surgery.","authors":"Hidayet Demir, Mehmet Altuğ Tunçer, Mehrdad Sheikhvatan","doi":"10.1007/s12055-025-02016-4","DOIUrl":"https://doi.org/10.1007/s12055-025-02016-4","url":null,"abstract":"<p><strong>Background: </strong>The role of the expression of micro ribonucleic acid-155 (miR-155) in the modulation of inflammatory processes leading to the development of arterial atherosclerosis has been studied, but it is still not clear whether the change in the expression of miR-155 can predict the outcomes after the vascularization procedure.</p><p><strong>Objective: </strong>We assessed the value of assessing preoperative miR-155 expression for determining the severity of coronary artery involvement and then determined the association of the expression of this micro ribonucleic acid (microRNA) and poorer outcome of coronary artery bypass surgery.</p><p><strong>Methods: </strong>The background information was collected by reviewing the hospital database. To assess the level of miR-155, quantitative reverse transcriptase-polymerase chain reaction was set up using the Taq Polymerase plus PacMan (TaqMan) Assay kit. To evaluate the outcomes after surgery, patients were asked by telephone calls.</p><p><strong>Results: </strong>The mean miR-155 expression value in the patients with one, two, and three involved coronaries was 1.57 ± 0.21, 1.27 ± 0.28, and 1.23 ± 0.29 respectively indicating a lower level of expression in those with three-vessel disease as compared to other disease subgroups. The Gensini score was adversely associated with the level of miR-155 expression. The miR-155 expression level in patients who died in the hospital was significantly lower than in surviving patients. The presence of long-term major cardiovascular adverse events was associated with a lower level of miR-155 expression. These findings were also obtained after adjusting for background factors.</p><p><strong>Conclusion: </strong>Decreased expression of the miR-155 is associated with increased risk of mortality and long-term complications after coronary artery bypass surgery.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-02016-4.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1377-1386"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124616","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 reconstruction for superior vena cava syndrome following pacemaker lead implantation.","authors":"Michele D'Alonzo, Mariantonietta Piscitelli, Michela Romandini, Francesco Cilia, Antonio Fiore","doi":"10.1007/s12055-025-02006-6","DOIUrl":"https://doi.org/10.1007/s12055-025-02006-6","url":null,"abstract":"<p><p>Pacemaker-related superior vena cava (SVC) syndrome, caused by fibrosis along pacemaker leads, was identified in a 65-year-old woman with chronic renal failure and atrial fibrillation. Initial management with two vascular bypass grafts failed due to thrombosis, resulting in symptom recurrence. Surgical intervention was subsequently performed, involving SVC reconstruction below the azygos vein with a pericardium patch and concurrent tricuspid valve repair. This case illustrates the challenges associated with pacemaker-induced SVC syndrome and demonstrates the potential advantages of reconstructive surgery, which, by restoring venous anatomy, may improve long-term outcomes when performed in an experienced center.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1476-1479"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124622","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":"Impact of surgical re-exploration on 30-day mortality for post-operative bleeding in off-pump coronary artery bypass grafting.","authors":"Sufina Shales, Hari Govind Varma, Paramita Auddya Ghorai, Rahul Mahanty, Subhendu Adhikari, Tanulina Sarkar, Debasis Das, Pradeep Narayan","doi":"10.1007/s12055-025-01966-z","DOIUrl":"https://doi.org/10.1007/s12055-025-01966-z","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective cohort study aimed to investigate the incidence, predictors, and outcomes of surgical re-exploration for postoperative bleeding in patients undergoing elective, isolated off-pump coronary artery bypass grafting (OPCAB).</p><p><strong>Methods: </strong>Patients undergoing elective isolated OPCAB were included in the study. Patients were categorized into two groups: those requiring re-exploration for postoperative bleeding and those not requiring re-exploration. Demographic, clinical, and operative variables were compared. Multivariable logistic regression was used to identify independent risk factors for re-exploration and 30-day mortality.</p><p><strong>Results: </strong>Out of the 4,957 eligible patients, 178 (3.6%) required surgical re-exploration for postoperative bleeding. Patients undergoing re-exploration were significantly older (61.4 ± 7.25 years vs. 58.75 ± 8.97 years, <i>p</i> < 0.0001) and had a lower proportion of females (7.3% vs. 13.8%, <i>p</i> = 0.013). Independent risk factors for re-exploration included age [OR (Odds Ratio) 1.022; 95% Confidence Interval(CI): 1.002-1.042, <i>p</i> = 0.030)], Society of Thoracic Surgeons (STS) Score (OR 1.166; 95% CI: 1.054-1.289, <i>p</i> = 0.003), 24-h drainage volume OR 1.004; 95% CI: 1.003-1.004, <i>p</i> < 0.000), and Left ventricular ejection fraction < 40% (OR 1.49; 95%CI: 1.024-2.167, <i>p</i> = 0.037). Re-exploration for postoperative bleeding was associated with significantly higher rates of blood transfusion, respiratory complications, renal failure, and mechanical ventilation. The 30-day mortality was substantially higher in the re-exploration group (8.4% vs. 0.8%, <i>p</i> < 0.0001). Multivariable analysis revealed that re-exploration for postoperative bleeding was the most profound independent factor for 30-day mortality (OR 11.51; 95% CI: 5.861-22.616, p < 0.001).</p><p><strong>Conclusions: </strong>Re-exploration is not just a surgical technical event, but a critical turning point that dramatically alters patient outcome. It is, therefore, paramount to identify high-risk patients and develop strategies to reduce bleeding complications and re-explorations in order to improve patient outcomes.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01966-z.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1387-1395"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124650","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":"Primary spontaneous pneumothorax: reassessing the role of chest CT in surgical decision-making.","authors":"Mohammad Abu El Hija, Harbi Khalayleh, Guy Pines","doi":"10.1007/s12055-025-02014-6","DOIUrl":"10.1007/s12055-025-02014-6","url":null,"abstract":"<p><strong>Purpose: </strong>Primary spontaneous pneumothorax (PSP) is a common condition managed either conservatively or surgically. This study investigated whether specific chest X-ray or computed tomography (CT) characteristics can predict the need for surgical intervention and clarified the role of each imaging modality in surgical planning.</p><p><strong>Methods: </strong>We retrospectively reviewed records of all PSP patients at a university hospital from 2013 to 2024. Only patients with available imaging were included in the analysis. Radiographic characteristics, clinical data, and outcomes were collected. Univariate analysis and logistic regression were performed to identify predictors of surgical intervention.</p><p><strong>Results: </strong>Ninety-one patients were included, with 35 (38.5%) undergoing surgical intervention. Chest X-ray findings did not significantly correlate with surgical decisions (odds ratio (OR) = 0.920, 95% confidence interval (CI) 0.239-3.533, <i>P</i> = 0.903). Patients with recurrent pneumothorax were more likely to require surgery (74.3% vs. 25.7%, <i>P</i> < 0.0001). Logistic regression revealed that symptom onset 1 day prior to admission increased the likelihood of surgery 4.122-fold compared to same-day onset (95% CI 1.004-19.920, <i>P</i> = 0.049). Eighteen patients underwent CT scanning, and their chest X-ray findings closely correlated with CT findings (kappa's score = 0.944, 95% CI 0.83-1.00).</p><p><strong>Conclusions: </strong>Chest X-ray findings alone are insufficient predictors of surgical intervention in PSP. Instead, prolonged symptom duration and a history of recurrence are key determinants of surgical need. The strong correlation between X-ray and CT findings suggests that routine preoperative CT may add little value, particularly in young patients. Further prospective studies are needed to validate these results.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-02014-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 10","pages":"1432-1438"},"PeriodicalIF":0.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124635","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}