Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Survival analysis for cardiothoracic surgeons: part 6-interpreting time-to-event data.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-025-01911-0","DOIUrl":"https://doi.org/10.1007/s12055-025-01911-0","url":null,"abstract":"<p><p>Survival analysis is critical in clinical research, especially in cardiothoracic surgery, to assess outcomes and compare interventions. Certain key survival analysis tools, including Kaplan-Meier (KM) curves, log-rank tests, and Cox proportional hazards models, are helpful in providing insights into survival probabilities and risk factors. KM curves help analyze time-to-event data, estimating survival probabilities, while log-rank tests compare survival distributions across groups. Cox proportional hazards models identify covariates influencing survival and calculate hazard ratios, which quantify the relative risk associated with specific variables. Together, these methods enable clinicians to make evidence-based decisions, optimize treatments, and improve patient outcomes.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"629-644"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965201","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":"Aneurysmal left circumflex artery-to-coronary sinus fistula.","authors":"Nataraju Komalamma Girish, Niraj Nirmal Pandey, Satyavir Yadav, Sivasubramanian Ramakrishnan","doi":"10.1007/s12055-025-01913-y","DOIUrl":"https://doi.org/10.1007/s12055-025-01913-y","url":null,"abstract":"<p><p>We report a case of a 19-year-old female patient presenting with recurrent episodes of dyspnoea on exertion and presyncope. Cardiac computed tomography (CT) angiography demonstrated an aneurysmal left circumflex artery-to-coronary sinus fistula which was successfully managed using transcatheter closure of the fistulous communication. The present case highlights a rare variety of coronary artery fistula while underscoring the role of cardiac CT angiography in diagnosis and planning of management in such conditions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"626-628"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020035","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 litany of paradoxes!: <i>Calling for closure-once for all</i>.","authors":"Om Prakash Yadava","doi":"10.1007/s12055-025-01947-2","DOIUrl":"https://doi.org/10.1007/s12055-025-01947-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"519-521"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003590","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":"Robotic mitral valve replacement: a short-term single institution experience.","authors":"Kritikalpa Behera, Ajit Kumar Padhy, Khushwant Popli, Subrata Pramanik, Rimy Prashad, Anubhav Gupta","doi":"10.1007/s12055-024-01852-0","DOIUrl":"https://doi.org/10.1007/s12055-024-01852-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the safety, efficacy, reproducibility and short-term clinical outcomes of robotic mitral valve replacement (MVR).</p><p><strong>Methods: </strong>Between September 2022 and May 2024, 64 robotic cardiac and thoracic surgeries were performed in our institute. Twelve consecutive patients who underwent MVR using da Vinci Xi robotic system were retrospectively analysed. It was performed by right side approach using four instrument ports and one 4-cm working port, under peripheral cardiopulmonary bypass (CPB) with transoesophageal echocardiography (TEE) surveillance.</p><p><strong>Results: </strong>The mean age of patients was 39 ± 9 years (median = 42 years), male-to-female ratio of 1:2, left ventricular ejection fraction (LVEF) = 60 ± 5%. The mean CPB and aortic cross clamp (ACX) time was 273 ± 119 min (174-568 min) and 160 ± 91 min (85-395 min) respectively. All patients received mechanical valve. The ventilation time and length of intensive care unit (ICU) stay was 21 ± 8 h and 3 ± 2 days respectively. The median drain output was 258 ml (Interquartile Range (IQR) = 240-353ml). Two patients (16.67%) were re-explored the same day in view of excessive drain output. Two patients required postoperative opioid analgesics (16.67%). One (8.33%) patient had groin wound infection. There was no mortality. Patients were ambulated from postoperative day 3.91 ± 1.80 days. Duration of hospital stay post-surgery was 9 ± 3 days, and patients were discharged after therapeutic International Normalised Ratio (INR) of 3 was achieved. Postoperative pain score of study group was 3 ± 1 (mild). Patients were satisfied with aesthetically pleasing scar and returned to routine activity within 4 ± 1 weeks. The mean follow-up time was 10.17 ± 5.11 months.</p><p><strong>Conclusion: </strong>Robotic MVR surgery is safe and has excellent short-term outcomes. Patients experienced less pain and faster recovery.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"560-568"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003494","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":"Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) unmasked by coronary artery disease of the left coronary system in a 62-year-old man.","authors":"Ramasubrahmanyam Gutti, Aparna Pilla, Sailaja Vasireddy","doi":"10.1007/s12055-024-01863-x","DOIUrl":"https://doi.org/10.1007/s12055-024-01863-x","url":null,"abstract":"<p><p>This case is an illustration of the complex interplay between congenital coronary anomalies like anomalous right coronary artery from pulmonary artery and acquired cardiovascular conditions like coronary artery disease (CAD) in adults. Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly which is typically diagnosed in childhood or young adulthood. There is limited data on the incidence of ARCAPA in older adults, particularly in association with CAD. Development of symptoms due to onset of significant stenosis in the left coronary artery system (left anterior descending artery and left circumflex artery), led to the discovery of ARCAPA in our case. Surgical correction is considered the treatment of choice in anomalous origin of coronary artery from pulmonary artery, regardless of the age of presentation and symptom status. While several surgical techniques for managing ARCAPA have been described, the goal of surgical intervention should be to restore the dual coronary system in order to optimize outcomes.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"601-604"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002831","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":"Right atrial myxoma excision with pulmonary thrombectomy.","authors":"Ananthanarayanan Chandrasekaran, Karthikaa Mayilsamy, Naveena Muthukumaran, Saigopalakrishnan Manthiramoorthy, Periyanarkunan Ramaiya Murugesan, Ganesan Chinnasamy, Murugan Murugan Sukumar, Pradeep Gnanasekaran, Kevin Patrick Junior, Deepa Krishnan","doi":"10.1007/s12055-024-01844-0","DOIUrl":"https://doi.org/10.1007/s12055-024-01844-0","url":null,"abstract":"<p><p>Myxomas are the most common primary tumors of the heart. Myxomas that are smooth and large usually present with obstructive symptoms whereas the ones that are villous and friable embolize. Due to the risk of mechanical obstruction and embolization, they require immediate surgical intervention. We present a case of a young female with multiple right atrial (RA) myxomas and embolic occlusion of the right pulmonary artery (RPA) managed successfully with surgical excision and pulmonary thrombectomy.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"596-600"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968321","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":"Creation of bicuspid aortic valve for bicuspid annulus using Ozaki's neocuspidization technique, with indigenously developed valve templates.","authors":"Sayyed Ehtesham Hussain Naqvi, Shyam Kumar Singh Thingnam, Jamal Yusuf, Rachna Wadhwa","doi":"10.1007/s12055-024-01843-1","DOIUrl":"https://doi.org/10.1007/s12055-024-01843-1","url":null,"abstract":"<p><p>This study aimed to retrospectively analyze the early outcomes of bicuspid aortic valve (BAV) neocuspidization for Type 0 bicuspid aortic annulus. Bicuspid neo leaflets were created and surgically sutured using Ozaki's neocuspidization technique with indigenously developed valve templates. The study was conducted at the Department of Cardiothoracic and Vascular Surgery, GB Pant Postgraduate Institute of Medical Education and Research, New Delhi, for the patients operated between June 2022 and March 2024. Bicuspid neocuspidization was performed in patients with BAVs who required aortic valve replacement and were not candidates for tricuspid neocuspidization. A total of 8 patients were found to have Type 0 BAVs during the study period. In one of these patients, tricuspid neocuspidization was done, while in the remaining 7 patients, bicuspid neocuspidization was done. In 1 patient of bicuspid neocuspidization, concomitant root replacement was done and was excluded. The outcomes of 6 patients are hereby presented. There was no mortality. The mean postoperative gradient was 14.5 (+ / - 0.9) mm Hg. There was trivial aortic regurgitation in 2 cases of bicuspid neo valves while 4 cases of bicuspid neo valves had no neo aortic valve regurgitation. The average coaptation length of the neo valve was 14.8 (+ / - 0.5) mm.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01843-1.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"552-559"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963408","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":"Repeat sternotomy for congenital heart surgery-impact of inadvertent cardiac injury.","authors":"Sneh Lalwani, Parvathi Unninayar Iyer, Sumir Girotra, Krishna Subramony Iyer","doi":"10.1007/s12055-024-01865-9","DOIUrl":"https://doi.org/10.1007/s12055-024-01865-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of complications resulting from inadvertent cardiac injury occurring during repeat sternotomy (RS) for congenital heart surgery and identify possible predisposing risk factors for this eventuality.</p><p><strong>Methods: </strong>A retrospective observational study was initiated to investigate complications related to RS in congenital heart surgery. Hospital records of patients who underwent RS from January 2016 to December 2020 in the department of Paediatric and Congenital Heart Surgery were reviewed. Preoperative, operative, and post-operative datasets were collected and analysed for incidence of inadvertent cardiac injury and its impact on subsequent clinical course. An attempt was made to identify possible predisposing factors that might contribute to this complication.</p><p><strong>Results: </strong>The study included a total of 261 patients. During RS cardiac injury occurred in 10 patients (3.83%). Postoperatively, organ dysfunction was observed in 49 patients (18.77%), sternal wound infection in 7 patients (2.68%), and pulmonary complications and arrhythmias were both observed in 12 patients each (4.60%). Thirty-day mortality was 1.53% (4/261). Patients who had cardiac injury during sternotomy had significantly higher mortality (20% vs 0.8%, <i>p</i> = 0.007), organ dysfunction (40% vs 9.56%, <i>p</i> = 0.01), sternal wound infection (20% vs 1.99%, <i>p</i> = 0.02), and overall complications (70% vs 19.12%, <i>p</i> = 0.002). Cardio-pulmonary bypass (CPB) time (<i>p</i> = 0.02), aortic cross clamp time (<i>p</i> = 0.04), chest tube drainage (<i>p</i> = 0.04), ventilation time (<i>p</i> = 0.0014), and female gender (<i>p</i> = 0.04) were predictors of organ dysfunction but not mortality. Female gender (<i>p</i> = 0.043) and cardiac injury (<i>p</i> = 0.018) were the predictors of the sternal wound infection. Cardiac injury during sternotomy was the only predictor (<i>p</i> = 0.029) of mortality.</p><p><strong>Conclusion: </strong>Reoperations are a necessity in many forms of congenital heart disease (CHD) surgery. Inadvertent cardiac injury during RS adversely impacted survival in our study. On the other hand, the number of previous sternotomies, duration of surgery, interval from previous sternotomy, and CPB time had no impact on mortality as long as cardiac injury was avoided. Every possible measure must therefore be taken to avoid inadvertent cardiac injury during RS in children with CHD.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01865-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"522-531"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003592","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":"Mechanical circulatory support bridge for restrictive cardiomyopathy with biventricular and pulmonary failure to cardiac transplantation.","authors":"Sandeep Sainathan, Leonardo Mulinari","doi":"10.1007/s12055-024-01847-x","DOIUrl":"https://doi.org/10.1007/s12055-024-01847-x","url":null,"abstract":"<p><p>We describe a simplified technique for mechanical circulatory support using Berlin EXCOR cannulas in a toddler with restrictive cardiomyopathy and biventricular and respiratory failure as a successful bridge to cardiac transplantation.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"578-581"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963303","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":"Intermittent electromechanical dissociation following mitral valve replacement with mechanical valve: a different cause.","authors":"Deepak Gopakumar, Bineesh Kundoly Radhakrishnan, Thomas Koshy, Vivek Velayudhan Pillai","doi":"10.1007/s12055-024-01840-4","DOIUrl":"https://doi.org/10.1007/s12055-024-01840-4","url":null,"abstract":"<p><p>We describe the case of a 62-year-old male patient who developed intermittent electromechanical dissociation following mitral valve replacement with papillary muscle resuspension. Clinical examinations and transoesophageal echocardiography were crucial in diagnosing this potentially fatal extrinsic prosthetic valve dysfunction. The culprit was a torn-through pledgeted suture used for papillary muscle resuspension, wedged between the disc occluder and the valve ring. The resuspension sutures were removed and the patient had an uneventful recovery. This case highlights the importance of advanced evaluation and vigilant monitoring in uncovering unusual causes of prosthetic valve dysfunction.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01840-4.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 5","pages":"574-577"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006051","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}