Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Resurfacing of awake coronary artery bypass grafting with mid thoracic epidural anesthesia technique.","authors":"Priyanka T Nagarajaiah, Sudhakar Koneru, Thota Venkata Sanjeev Gopal, N Nageswara Rao","doi":"10.1007/s12055-026-02209-5","DOIUrl":"10.1007/s12055-026-02209-5","url":null,"abstract":"<p><p>Awake coronary artery bypass grafting (CABG) is increasingly becoming recognized as a feasible alternative for high-risk cardiac patients, with a potential to reduce perioperative morbidity. In light of this, high thoracic epidural anesthesia (HTEA) has been used for cardiac surgery over the past two decades, providing excellent analgesia and sympathetic blockade. In this case report, a 71-year-old patient with interstitial lung disease (ILD) on home oxygen treatment had successful awake CABG at our institute, using a combined mid-thoracic and lumbar epidural approach. This method offered effective segmental anesthesia and analgesia, ensuring patient comfort and hemodynamic stability throughout the surgery. In comparison to HTEA, the mid-thoracic epidural approach provided better control of anesthesia and analgesia, minimized the risk of high sympathetic blockade, and facilitated early postoperative recovery with minimum opioid usage and early mobilization without any intraoperative or postoperative complications. This case emphasizes the feasibility and potential advantages of combined mid-thoracic and lumbar epidural anesthesia over high thoracic epidural in selected high-risk patients undergoing awake CABG.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1103-1106"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678440","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":"Outcomes of minimally invasive mitral valve repair for non-rheumatic mitral regurgitation: an 8-year retrospective analysis.","authors":"Rajesh M Ramankutty, Jecco Ani Babu, Aiswarya Mohan","doi":"10.1007/s12055-026-02213-9","DOIUrl":"10.1007/s12055-026-02213-9","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive mitral valve repair (MIMVR) offers several advantages over sternotomy, including reduced surgical trauma and faster recovery. However, the quality of repair and long-term functional outcomes have been debated due to the limited access involved. This study evaluates the success of repair, various methods used, functional outcomes, survival rates, and re-intervention rates in patients undergoing MIMVR at Caritas Hospital, Kerala, from 2016 to 2023.</p><p><strong>Methods: </strong>A retrospective cohort study of 114 patients who underwent MIMVR via right mini-thoracotomy was conducted. The techniques included triangular resection, posterior annuloplasty ring, neochords reconstruction, leaflet resection, foldoplasty, and Alfieri stitch. Transoesophageal echocardiography (TOE), intraoperative saline injection test, and on-pump antegrade cardioplegia were used to assess repair integrity. Patients were followed up at 1, 3, and 12 months post-discharge, and annually thereafter. The primary endpoints were survival and recurrent mitral regurgitation (MR), with secondary endpoints being periprocedural complications and freedom from reoperation.</p><p><strong>Results: </strong>The mean follow-up period was 5 years, with an 87% freedom from moderate or severe MR. The perioperative characteristics included a mean age of 52.13 ± 13.11 years, with 72.8% male. The average cardiopulmonary bypass (CPB) and aortic cross-clamp times were 178.78 ± 33.85 and 128.58 ± 27.61 min, respectively. No conversions to sternotomy were required. Postoperative outcomes showed no significant SAM or severe MR, with a stroke incidence of 1.75%. At 1 year, 86.8% of patients were asymptomatic, with 12.3% having moderate or greater MR.</p><p><strong>Conclusion: </strong>MIMVR can achieve high-quality functional outcomes without compromising durability and is associated with low postoperative morbidity. The study supports MIMVR as a viable alternative to conventional approaches, providing favourable safety and results in treating MR. The technique has been particularly effective in patients with degenerative disease, including myxomatous and Barlow's disease, making it a preferred method at our institution.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02213-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1034-1044"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678512","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":"Systemic inflammatory response and complications developing in patients undergoing lobectomy for non-small-cell lung cancer: thoracotomy versus video-assisted thoracoscopic surgery.","authors":"Gizem Kececi Ozgur, Hasan Yavuz, Ahmet Kayahan Tekneci, Kevser Durgun, Tevfik Ilker Akcam, Ayse Gul Ergonul, Kutsal Turhan, Alpaslan Cakan, Ufuk Cagirici","doi":"10.1007/s12055-026-02228-2","DOIUrl":"10.1007/s12055-026-02228-2","url":null,"abstract":"<p><strong>Purpose: </strong>The present study investigates the effect of different surgical approaches on the systemic inflammatory response and the development of complications in patients undergoing lobectomy for non-small-cell lung cancer.</p><p><strong>Methods: </strong>The data of 223 patients who underwent lobectomy for non-small-cell lung cancer via either thoracotomy or video-assisted thoracoscopic surgery (VATS) between 2015 and 2023 were analyzed retrospectively. Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) were used to assess inflammatory response.</p><p><strong>Results: </strong>Of the patients included in the study, 39 (17.5%) were female and 184 (82.5%) were male, and mean age was 63.46 (standard deviation (SD) 10.24) years (min 18-max 84). Of the sample, 59 (26.5%) underwent lobectomy via VATS and 164 (73.5%) via thoracotomy. Delta NLR, delta SII, and delta PIV were all found to be higher in the thoracotomy group than in the VATS group (<i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> = 0.002, respectively). In a univariate analysis examining development of complications, delta NLR and delta SII were significantly higher in the group with complications (<i>p</i> = 0.020, <i>p</i> = 0.026, respectively), while no significant difference was observed in delta PIV (<i>p</i> = 0.066). In multivariable linear regression models adjusted for age, gender, presence of comorbidity, tumor location, tumor size, lymph node involvement, tumor stage, and surgical method, thoracotomy was associated with a greater increase in delta NLR (<i>p</i> = 0.016), as well as approximately 71% and 84% greater increases in delta SII and delta PIV, respectively (<i>p</i> = 0.013 and <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>The present study revealed that patients who underwent lobectomy via VATS for non-small-cell lung cancer had a lower systemic inflammatory response than those undergoing lobectomy via thoracotomy. The increase in inflammatory markers, including NLR, SII, and PIV, was more remarkable in patients undergoing thoracotomy.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1045-1052"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678616","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":"Correction to: Surgery for hypertrophic obstructive cardiomyopathy: the European perspective.","authors":"Eduard Quintana, Polina Danchenko, Kostiantyn Rudenko, Sertaç Cicek, Alex Shipolini, Jerry Braun, Christophe Baufreton, Patrick O Myers, Gloria Färber, Julia Dumfarth, Sara Ranchordás, Gvido Varpins, Peteris Stradins, Lucian Dorobantu, Maciej Kolowca, Ruggero De Paulis, Kamran K Musayev, Ehud Raanani, Shahab Nozohoor, Daniel Pereda, Carlos Alberto Mestres","doi":"10.1007/s12055-026-02248-y","DOIUrl":"https://doi.org/10.1007/s12055-026-02248-y","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s12055-025-02147-8.].</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 9","pages":"1111"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678328","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":"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}