Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"High aortic bifurcation with an extremely short left common iliac artery.","authors":"Vedat Yaman","doi":"10.1007/s12055-026-02231-7","DOIUrl":"10.1007/s12055-026-02231-7","url":null,"abstract":"<p><p>A rare congenital arterial variation was identified in a 17-year-old male undergoing abdominal computed tomography. Imaging demonstrated a high abdominal aortic bifurcation at the inferior margin of the L3 vertebral body, with a markedly short left common iliac artery bifurcating at the superior margin of L4. After bifurcation, the left internal and external iliac arteries coursed in close apposition along the anterior aspect of the L4-L5 vertebral bodies.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1107-1108"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678456","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":"Comparative outcomes of anticoagulant versus antiplatelet therapy in coronary endarterectomy: a meta-analysis.","authors":"Giuseppe Comentale, Armia Ahmadi-Hadad, Rachele Manzo, Valentina Parisi, Anna Milione, Anna Damiano, Concetta Calanni Macchio, Emanuele Pilato","doi":"10.1007/s12055-026-02221-9","DOIUrl":"10.1007/s12055-026-02221-9","url":null,"abstract":"<p><strong>Background: </strong>Coronary endarterectomy (CE) has recently returned to the limelight due to its advantages in achieving full revascularization in very complex cases. However, to date, there are no guidelines concerning the use of postoperative antiplatelet and anticoagulant therapy (ACT).</p><p><strong>Aim: </strong>In light of this, the present meta-analysis aimed to compare the impact of ACT versus antiplatelet therapy on short- and long-term outcomes after CE.</p><p><strong>Methods: </strong>PubMed, Embase, and Medline databases were searched without any restriction on the year or the language. Two reviewers screened the studies in two rounds in a blinded manner and extracted the data into an Excel spreadsheet. The third reviewer reconciled discrepancies.</p><p><strong>Results: </strong>Nineteen studies made our final selection. Short- and long-term mortality was similar between patients treated with ACT and those receiving double antiplatelet therapy (DAPT) (<i>p</i> = 0.15 and <i>p</i> = 0.98, respectively). Short-term myocardial infarction (MI) was significantly lower among DAPT patients (<i>p</i> < 0.001); while during the long-term follow-up, MI events were similar (<i>p</i> = 0.77). Dual antiplatelet agents were also compared, suggesting that DAPT with aspirin + clopidogrel and aspirin + ticagrelor regimens lead to similar long-term graft patency (<i>p</i> = 0.09).</p><p><strong>Conclusion: </strong>Postoperative mortality seems to be not affected by the anticoagulant/antiplatelet therapy after CE. DAPT leads to a greater reduction in short-term MI rates; thus, the postoperative use of DAPT seems to offer more benefits compared to ACT therapy. Long-term MI events, however, were comparable. Long-term graft patency analysis of DAPT with aspirin + clopidogrel and aspirin + ticagrelor has not revealed any superiority.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02221-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1053-1065"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678410","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 options in lower extremity arterial occlusion disease.","authors":"Elancheralathan Kalyanaraman, Kanmani Anbarasan, Anurag Bhattacharjee, Ventru Radha Krishna, Vikraman Veerappan Gurusamy, Mukundhan Murali","doi":"10.1007/s12055-025-02106-3","DOIUrl":"10.1007/s12055-025-02106-3","url":null,"abstract":"<p><p>Lower limb bypass surgery remains a key treatment for patients with advanced peripheral arterial disease, particularly those with critical limb ischemia who are not candidates for endovascular procedures. This review highlights essential aspects of the operation, including the selection of inflow and outflow vessels, choice of conduit-especially the saphenous vein-and preferred anastomotic techniques. It also emphasizes the importance of meticulous surgical steps such as vessel exposure, graft tunneling, and intraoperative assessment. With careful planning and technical precision, bypass surgery continues to play a vital role in achieving durable graft patency and limb salvage in complex cases.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"953-973"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446266","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":"Are we reading our journal? Reflections on print, pixels, and the unopened plastic cover.","authors":"Pradeep Narayan","doi":"10.1007/s12055-026-02244-2","DOIUrl":"10.1007/s12055-026-02244-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"933-934"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446043","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 tale of two circuits (in parallel): differential hypoxia in femoral veno-arterial extracorporeal membrane oxygenation.","authors":"Thirugnanasambandan Sunder","doi":"10.1007/s12055-026-02239-z","DOIUrl":"10.1007/s12055-026-02239-z","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"943-945"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446066","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":"Endovascular embolization for treating hemothorax: caveats and considerations.","authors":"Indy Kelderman, Bernd Popko Teunissen, Chris Dickhoff, Martijn Ruben Meijerink, Wietse Pieter Zuidema","doi":"10.1007/s12055-026-02202-y","DOIUrl":"10.1007/s12055-026-02202-y","url":null,"abstract":"<p><p>Thoracic trauma is the third leading cause of death in all age groups. Around a quarter of trauma mortalities is related to thoracic trauma, with a portion of the patients developing a hemothorax requiring surgical intervention. Recently, endovascular embolization has seen a rise in usage as a less invasive alternative to surgical intervention in treating hemothorax. However, larger series and trials comparing efficacy and complication have yet to be completed. In this case series and narrative review of available literature, we described our experience with the endovascular treatment of hemothoraces, and performed a literature review of smaller series on efficacy and re-intervention rates of endovascular embolization compared to surgical intervention. Smaller described cohorts show efficacy rates of up to 93% of endovascular embolization in achieving hemostasis in traumatic hemothorax, with up to 68% needing surgical re-intervention. Based on our experiences and available literature, we propose a clinical algorithm when considering embolization instead of immediate surgical intervention.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02202-y.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"1004-1009"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446158","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":"Atypical cardiac melioidosis masquerading as a right atrial mass: a case report.","authors":"Varsha Malladi, Koustav Biswas, Hemachandren Munuswamy, Ajay Kumar Jha, Deepak Amalnath","doi":"10.1007/s12055-026-02187-8","DOIUrl":"10.1007/s12055-026-02187-8","url":null,"abstract":"<p><p>The incidence of melioidosis, a disease caused by <i>Burkholderia pseudomallei</i>, has been increasing in India over the past decade. Cardiac melioidosis is a rare complication of melioidosis, which typically presents as pericarditis, myocarditis, or endocarditis. We report a very rare and probably the first of its kind presentation of cardiac melioidosis as a right atrial mass. A 24-year-old man presented with fever, cough with expectoration, and right-sided multiple joint pain. <i>Burkholderia pseudomallei</i> was isolated from blood cultures, and culture-specific antibiotic treatment was started accordingly. Echocardiography and computed tomography (CT) images incidentally revealed a right atrial mass extending from the inferior vena cava (IVC) and prolapsing into the right ventricle through the tricuspid valve. The patient was planned for excision of the right atrial mass through median sternotomy. Intraoperatively, the mass was found to be an encapsulated pus-filled sac mimicking a right atrial thrombus. Upon histopathological analysis of the specimen and microbiological culture of the exudate, the final diagnosis of a rare variant of cardiac melioidosis was made. He was successfully operated on and treated with meropenem postoperatively during his hospital stay until blood cultures reported sterile. He was discharged with co-trimoxazole as maintenance therapy on regular follow-up as an outpatient. This clinical case adds cardiac melioidosis as a potential differential diagnosis for intracardiac mass, posing diagnostic challenges-requiring a high index of suspicion, culture confirmation, and appropriate imaging with combined surgical intervention and medical management for accurate diagnosis and effective management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02187-8.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"988-993"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446104","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":"Left atrial appendage morphology, characteristics and its relation with left atrial appendage clot and atrial fibrillation in patients with valvular heart lesions.","authors":"Saurabh Jagtap, Sushrut Potwar, Heli Oza, Abhishek Potnis, Uday Eknathrao Jadhav, Avinash Gonnade","doi":"10.1007/s12055-026-02197-6","DOIUrl":"10.1007/s12055-026-02197-6","url":null,"abstract":"<p><strong>Aim: </strong>To associate the morphology and characteristics, namely, flow velocity, external orifice diameter (EOD), and contractility of the left atrial appendage with the incidence of atrial fibrillation (AF) and left atrial appendage (LAA) clot using transesophageal echocardiogram (TEE) and intraoperative findings during valve surgery.</p><p><strong>Materials and methods: </strong>An observational study of a total of 81 patients during the course of this study with an inclusion criterion of them being in AF and/or having a LAA clot, while 54 patients in the control group being the ones in a sinus rhythm and without a LAA clot.</p><p><strong>Results: </strong>Out of the 81 study patients, 60 patients with AF had a LAA clot, while 21 patients were in AF without a LAA clot. The commonest occurrence of LAA morphology was found to be the chicken wing type (37%). Chicken wing morphology, when compared to non-chicken wing morphology, showed a significantly lower rate of LAA clot and AF (<i>p</i> = 0.0177). Within the 60 patients with LAA clot, windsock (50%) was the commonest morphology.</p><p><strong>Conclusion: </strong>In this comprehensive study, we have found a significant statistical association between the morphology and characteristics of LAA with that of LAA clot and AF. This, therefore, broadens the horizons of application of these findings to patients who are in normal sinus rhythm (NSR) without a clot. Given the marked risk associated with non-chicken wing LAA morphologies, especially the windsock, cactus, and cauliflower types, clinicians should maintain heightened vigilance in patients exhibiting these anatomical patterns, particularly when LAA flow velocity or contractility falls below 25 cm/s and the EOD exceeds 25 mm. Such a combination identifies individuals at distinctly increased risk for future LAA thrombus development and AF, warranting proactive monitoring and potential early intervention.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02197-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"946-952"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446216","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":"Coronary artery bypass grafting in a patient with factor XIII deficiency: case report and review of perioperative management.","authors":"Sowmya Kanthimathinathan, Phani Krishna Machiraju, Louis Felix Sridhar, Prabu Pandurangan, Satya Prasad Namala, Srujan Singanamala","doi":"10.1007/s12055-026-02193-w","DOIUrl":"10.1007/s12055-026-02193-w","url":null,"abstract":"<p><p>Factor XIII (FXIII) is the final enzyme in the coagulation cascade that cross-links the fibrin monomers, thereby enhancing the clot strength. Congenital FXIII deficiency is rare and is inherited in an autosomal recessive manner. FXIII deficiency may lead to bleeding, delayed wound healing, hence increasing the risk for any surgical intervention. Literature on patients undergoing cardiac surgery with FXIII deficiency is rare. Cardiac surgery poses a major risk in this setting, as it involves heparinization while performing the surgery. This increases the risk of bleeding. In this case report, we present a patient undergoing coronary artery bypass grafting (CABG) surgery with FXIII deficiency. In this report, we focus on the perioperative management of FXIII deficiency, intraoperative surgical management, and postoperative surgical care in a patient who underwent CABG surgery with FXIII deficiency as opposed to standard CABG procedure.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"1016-1020"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446165","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":"Diagnostic value of narrow-band imaging in suspected lung cancer: a single-centre observational study.","authors":"Massimiliano Caterino, Cristiano Cesaro, Umberto Masi, Dupuis Diego, Dario Amore, Alfonso Fiorelli, Umberto Caterino","doi":"10.1007/s12055-026-02227-3","DOIUrl":"10.1007/s12055-026-02227-3","url":null,"abstract":"<p><p>Narrow-band imaging (NBI) enhances mucosal and vascular contrast during bronchoscopy and may support the detection of malignant airway lesions, although its specific diagnostic role in routine practice is still being defined. This single-centre retrospective observational study evaluated the relationship between NBI vascular patterns and histological diagnosis in 49 patients undergoing bronchoscopy for suspected lung cancer. Vascular patterns were classified as normal, dotted, abrupt-ending, or tortuous; dotted, abrupt-ending, and tortuous patterns were collectively considered pathological. Malignancy was confirmed in 34 patients (69.4%). Pathological vascular patterns were observed in 28 malignant cases and in three non-malignant cases, whereas normal patterns were present in six malignant and 12 non-malignant cases, corresponding to a sensitivity of 82.4%, specificity of 80.0%, positive predictive value of 90.3%, and negative predictive value of 66.7%. Pathological patterns were significantly associated with malignant histology (<i>p</i> < 0.001). Some numerical differences in the distribution of individual pathological patterns across histological subtypes were considered exploratory only. In conclusion, pathological NBI vascular patterns were significantly associated with malignant disease and demonstrated good diagnostic performance as an adjunct to white-light bronchoscopy. NBI should be regarded as a complementary tool for lesion assessment and biopsy guidance, while histopathological confirmation remains essential.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 8","pages":"977-982"},"PeriodicalIF":0.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446148","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}