Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Invasive vs conservative management in elderly patients with NSTEMI- insights from the SENIOR-RITA trial.","authors":"Pradeep Narayan","doi":"10.1007/s12055-024-01877-5","DOIUrl":"10.1007/s12055-024-01877-5","url":null,"abstract":"<p><p>The SENIOR-RITA trial randomized 1,518 elderly Non-ST-segment elevation myocardial infarction (NSTEMI) patients to invasive or conservative strategies. The primary composite outcome of cardiovascular death or nonfatal Myocardial Infarction (MI) occurred in 25.6% of the invasive group versus 26.3% in the conservative group (p = 0.53), despite lower nonfatal MI rates with invasive treatment (11.7% vs 15.0%). Procedural complications were low (< 1%), though the invasive group had slightly higher bleeding and Transient Ischemic Attack (TIA) rates. The early 1-year benefit of the invasive approach was not maintained at 5 years, highlighting the need to individualize management in this complex, elderly population. The review discusses the strengths and weaknesses of the SENIOR-RITA (Older Patients with Non-ST-Segment Elevation Myocardial Infarction Randomized Interventional Treatment) trial.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 1","pages":"80-82"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828412","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":"Research designs for cardiothoracic surgeons: part 1 - a primer for evidence-based practice.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-024-01836-0","DOIUrl":"https://doi.org/10.1007/s12055-024-01836-0","url":null,"abstract":"<p><p>Understanding research designs is crucial for cardiothoracic surgeons to enhance their clinical practice and decision-making. This article provides a comprehensive overview of different research study types, including observational and experimental studies, and their relevance to cardiothoracic surgery. Detailed explanations of cohort, case-control, and cross-sectional studies, as well as various types of randomized controlled trials, are presented. Key terms and concepts like bias, validity, and reliability are discussed. Practical case examples from the literature illustrate the application of these research designs, aiding clinicians in selecting the appropriate study design for their research questions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"737-751"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464215","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":"Caps, masks, aprons, and gloves - necessary evils?","authors":"Om Prakash Yadava","doi":"10.1007/s12055-024-01822-6","DOIUrl":"https://doi.org/10.1007/s12055-024-01822-6","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"655-657"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464212","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":"Looking ahead: Incorporation of objective assessment methods, surgical simulation and 3D-printed models to improve technical skills of a cardiac surgeon in training in the Indian context.","authors":"Sudipto Bhattacharya","doi":"10.1007/s12055-024-01789-4","DOIUrl":"https://doi.org/10.1007/s12055-024-01789-4","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"755-756"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464213","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":"One year outcomes following of carotid endarterectomy in different age groups: Russian multicenter study.","authors":"Anton Kazantsev, Alexander Korotkikh, Roman Leader, Sergey Artyukhov, Lyudmila Roshkovskaya, Vladimir Unguryan, Maxim Chernyavin, Belov Yury","doi":"10.1007/s12055-024-01753-2","DOIUrl":"https://doi.org/10.1007/s12055-024-01753-2","url":null,"abstract":"<p><strong>Introduction: </strong>This is a retrospective analysis of the results of carotid endarterectomy (CEA) in different age groups.</p><p><strong>Methods: </strong>This cohort, comparative, retrospective, open-label study for the period from 2008 to 2020 included 7248 patients with hemodynamically significant stenoses of the internal carotid artery (ICA), who underwent CEA. According to the classification of the World Health Organization, patients were divided into groups depending on age: up to 44 years-young age (<i>n</i> = 84); 45-60 years-middle age (<i>n</i> = 1635); 61-75-elderly age (<i>n</i> = 4817); over 75 years-senile age (<i>n</i> = 712).</p><p><strong>Results: </strong>In terms of the frequency of hospital complications, the group of patients over 75 years of age experienced the largest number of cardiovascular events. One year after surgery, there were no significant differences in the incidence of complications between groups: death (group 1, 1.2%; group 2, 0.5%; group 3, 0.4%; group 4, 1%; <i>p</i> = 0.14), myocardial infarction (group 1, 1.2%; group 2, 0.3%; group 3, 0.14%; group 4, 0.3%; <i>p</i> = 0.12), stroke (group 1, 0%; group 2, 0.3%; group 3, 0.1%; group 4, 0.4%; <i>p</i> = 0.32).</p><p><strong>Conclusion: </strong>The largest number of adverse cardiovascular events after CEA are observed among patients over 75 years of age, which is due to the high frequency of multivessel coronary lesions, atrial fibrillation, and the severity of the comorbidities. One year after surgery, there were no significant differences in the incidence of complications between groups.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"675-683"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464214","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":"Women in cardiothoracic surgery.","authors":"Abha Chandra","doi":"10.1007/s12055-024-01801-x","DOIUrl":"10.1007/s12055-024-01801-x","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"532-535"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999811","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":"An inverted left atrial appendage-when it gives a surprise on the table.","authors":"Ancy Robinson, Thiruvenkitasamy Nareshkumar, Madhava Rao Bathala","doi":"10.1007/s12055-024-01726-5","DOIUrl":"10.1007/s12055-024-01726-5","url":null,"abstract":"<p><p>A newly identified left atrial (LA) mass on a post-repair intraoperative transoesphageal echocardiogram (TEE), following a left ventricle (LV) thrombectomy, will make the surgical team wonder-whether a part of the thrombus has been dislodged into the LA or what else could it be? This report is about a 34-year-old male who underwent LV thrombectomy, for whom the post cardiopulmonary bypass intra-operative TEE showed a new LA mass that turned out to be an inverted left atrial appendage on exploration.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"626-628"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001710","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":"Comparison of a coronary bypass surgery using a combination of both on-pump beating heart and cardioplegic arrest with conventional coronary bypass surgery using cardioplegic arrest on-pump.","authors":"Mehmet Ali Sahin, Erkan Kuralay","doi":"10.1007/s12055-024-01754-1","DOIUrl":"10.1007/s12055-024-01754-1","url":null,"abstract":"<p><strong>Objective: </strong>Antegrade cardioplegia may cause maldistribution in patients with multivessel coronary artery disease. Surgically bypassing large epicardial vessels before the cross-clamp and then administering cardioplegia from both the aortic root and the anastomosed grafts significantly prevent maldistribution and provide better cardiac protection.</p><p><strong>Methods: </strong>This study included 80 patients, all older than 70 years with an ejection fraction between 25 and 35%. Patients were equally divided into two groups. Distal anastomoses to some of large epicardial coronary arteries were performed before the cross-clamp was placed. Grafted veins were attached to multi-perfusion set ports. Then, cross-clamping was performed, and the multi-perfusion set was disconnected from the aortic cannula and attached to the cardioplegia route. Antegrade cardioplegia was administered to both the aortic root and saphenous vein grafts. After all distal anastomoses were completed, the cross-clamp was removed, and the multi-perfusion set was connected to the aortic cannula again. Conventional coronary bypass techniques were used in group 2 patients.</p><p><strong>Results: </strong>Inotropic agents were administered in 12 patients in group 1 and 29 patients in group 2 (<i>p</i> < 0.001). The average troponin I value in coronary sinus blood was 1.05 ± 0.8 ng/mL in group 1 and 3.12 ± 0.7 ng/mL in group 2 (<i>p</i> < 0.001). The average lactate value in coronary sinus blood was 1.15 ± 0.55 mmol/L in group 1 and 3.7 ± 2.4 mmol/L in group 2 (<i>p</i> < 0.001). Six patients died in the early postoperative period in group 2 (<i>p</i> = 0.028).</p><p><strong>Conclusion: </strong>The current technique considerably reduces cross-clamping time and allows better distribution of the cardioplegic solution, preserving myocardium. Reduced coronary sinus lactate and troponin I levels also indicate better myocardial protection.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"547-553"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999809","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":"Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial.","authors":"Pradeep Narayan","doi":"10.1007/s12055-024-01809-3","DOIUrl":"10.1007/s12055-024-01809-3","url":null,"abstract":"<p><p>The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.2%) compared to SAVR (7.1%) in the overall cohort, with even more pronounced differences in patients with bicuspid valves (14.3% for TAVI vs. 3.9% for SAVR). The risk of death or disabling stroke at 1 year was also three times higher with TAVI.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"645-647"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001711","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 histology and immunochemistry study comparing open versus close and open-method endoscopic saphenous vein harvesting.","authors":"Sivakumar Krishnasamy, Raja Amin Raja Mokhtar, Ahmad Farouk Musa, Xian Pei Cheong, Toh Yen Fa","doi":"10.1007/s12055-024-01752-3","DOIUrl":"10.1007/s12055-024-01752-3","url":null,"abstract":"<p><strong>Background: </strong>The introduction of endoscopic saphenous vein harvesting (ESVH) has been reported to reduce wound pain and infection, compared with open saphenous vein harvesting (OSVH) techniques. There are still controversies regarding this technique. The aim of our study is to investigate the endothelial preservation of saphenous vein (SV) grafts harvested by different techniques. Further observations were made for harvesting and closure time, incision length and effect of pressure distension of the veins to the vein endothelium.</p><p><strong>Methods: </strong>Prospective observational study of sixty human saphenous vein grafts was performed to evaluate endothelial preservation by haematoxylin-eosin and Cluster of Differentiation 31 (CD 31) staining. Saphenous vein was harvested endoscopically either by closed CO₂ (carbon dioxide) ESVH, open CO₂ ESVH or OSVH harvesting technique. Demographic data and intra-operative data were collected. Two saphenous vein samples were collected from each patient to compare differences before and after distension of the veins. Both haematoxylin-eosin and immunohistochemistry slides were imaged by a high-resolution slide scanning system.</p><p><strong>Results: </strong>Open CO₂ ESVH group showed the highest number of endothelial detachments. Mean scoring of the immunohistochemistry method using the CD31 antibody was much lower in the open CO₂ ESVH group (33.25% ± 28.71, <i>P</i> < <i>0.0003</i>). This represents a more poorly preserved endothelial cells in the Open CO₂ ESVH than the closed CO₂ ESVH. Closure time and incision lengths were significantly shorter in both ESVH groups compared to the OSVH group. Significant low scores of immunohistochemistry for samples were seen in distended veins (39.0% ± 30.08, <i>p</i> = <i>0.004</i>). The OSVH in random sample B, which represents the conduit that will be used, had a far better endothelium preservation and less endothelial detachment when compared to ESVH.</p><p><strong>Conclusion: </strong>We observed more endothelial detachment in the open CO₂ ESVH group, due to lack of subcutaneous tissue separation, poor visualization and traction stress across the wall of the saphenous vein. The closed CO₂ ESVH group had more endothelial cells preserved, but the OSVH group fared the best with the least number of endothelial cell detachment and a higher score of CD31 antibody.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01752-3.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"554-563"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999807","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}