Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"A novel approach to retrieval of an embolized patent ductus arteriosus device.","authors":"Ridhika Munjal, Neelam Aggarwal, Pankaj Ingole, Sudeep Singh Sidhu","doi":"10.1007/s12055-025-01896-w","DOIUrl":"https://doi.org/10.1007/s12055-025-01896-w","url":null,"abstract":"<p><p>Transcatheter closure (TCC) is considered the treatment of choice for patent ductus arteriosus (PDA) management. Device embolization is a known adverse event associated with TCC. Herein, we are describing a hybrid approach for PDA device retrieval through the proximal descending thoracic aorta (DTA) along with PDA closure through a single thoracotomy incision.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1040-1043"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682511","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":"Cardiac tamponade and massive pleural effusion during pregnancy: a case of mediastinal malignant teratoma.","authors":"Kuky Cahya Hamurajib, Nurulita Ainun Alma, Meydita Fauzia Putri Insani, Diah Rumekti Hadiati","doi":"10.1007/s12055-025-01914-x","DOIUrl":"https://doi.org/10.1007/s12055-025-01914-x","url":null,"abstract":"<p><p>Mediastinal teratomas are germ cell tumors which account for 8-13% of mediastinal masses. Early diagnosis of malignant teratoma is the key point of effective patient management. This report presents a rare case of a mediastinal malignant teratoma in a 38-year-old pregnant woman, complicated by cardiac tamponade and massive pleural effusion. The patient experienced dyspnea on exertion and orthopnea in her 29-week gestation. Thoracic magnetic resonance imaging revealed a tumor in the anterior mediastinal region which compressed the superior vena cava. Biopsy of the mass and analysis of the pericardial fluid showed the presence of malignant cells, and histopathological evaluation verified the diagnosis of malignant teratoma. The patient subsequently underwent neoadjuvant chemotherapy; however, the patient continued to experience persistent shortness of breath and the pregnancy was terminated at 33 weeks of gestation.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1055-1058"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682516","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":"Risk factors associated with surgical reintervention in postoperative cardiac surgery: is there an impact of intraoperative fluid balance?","authors":"Camilo Molineros Barón, Daniel Fernando Rodríguez Camacho, Andrea Duque López, Julián Serrano Giraldo, Williams Cervera Cadena, Oscar Mauricio Muñoz Velandia","doi":"10.1007/s12055-025-01935-6","DOIUrl":"https://doi.org/10.1007/s12055-025-01935-6","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between intraoperative fluid balance and surgical reintervention in patients undergoing cardiac surgery is currently unclear.</p><p><strong>Methods: </strong>Case‒control study nested in a historical cohort. Patients over 18 years of age in the immediate postoperative period of cardiac surgery were included, and unplanned surgical reintervention was evaluated as the primary outcome. Four groups were created according to intraoperative fluid balance. We performed a univariate analysis comparing patients who underwent reintervention (cases) with those who did not (controls), and a multivariate conditional logistic regression model controlling for multiple confusion variables.</p><p><strong>Results: </strong>In total, 304 patients were analyzed (76 cases and 228 controls). The median age was 67 years, and the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was greater in cases than in controls (2.05 (1.21-3.48) vs. 2.5 (1.46-4.63), <i>p</i> = 0.016). A greater proportion of smokers were found in cases (36.8% vs. 15.3%, <i>p</i> < 0.01). No differences were found in fluid balance between groups. Moreover, no differences were found according to the type of procedure performed given the match. The total duration of surgery was longer in reintervened patients (median 4 h (interquartile range (IQR) 3.66-5) vs. 5 h (IQR 4-5.11), <i>p</i> = 0.04). According to multivariate analysis, no association was found between fluid balance and the risk of requiring reintervention (odds ratio (OR) 1.03, confidence interval (CI) 0.86-1.23, <i>p</i> = 0.75). However, reintervention was associated with smoking (OR 4.44; CI 2.09-9.44; <i>p</i> < 0.01) and total duration of the surgical procedure (OR 1.39; CI 1.06-1.82; <i>p</i> < 0.01). The type of programming (urgent surgery) (OR 0.34; CI 0.16-0.74; <i>p</i> < 0.01) and history of acute myocardial infarction in the last 7 days (OR 0.46; CI 0.21-0.99; <i>p</i> = 0.04) were more frequent in patients who did not undergo reintervention.</p><p><strong>Conclusion: </strong>Our findings did not reveal an association between a positive intraoperative fluid balance and the incidence of unplanned reintervention after cardiac surgery.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01935-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"976-985"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682533","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 repair of a middle colic artery aneurysm in a patient with occlusive mesenteric arterial disease.","authors":"Predrag Gajin, Mihailo Neskovic, Slobodan Pesic, Jovan Petrovic, Igor Atanasijevic, Slobodan Tanaskovic, Nenad Ilijevski","doi":"10.1007/s12055-025-01918-7","DOIUrl":"https://doi.org/10.1007/s12055-025-01918-7","url":null,"abstract":"<p><p>Colic artery aneurysms (CAA) are among the rarest visceral artery aneurysms that carry a significant risk of rupture with a high mortality rate. Concomitant occlusive disease of the mesenteric arteries can significantly alter the type of treatment undertaken (open or endovascular). We present the case of a 68-year-old woman with a visceral artery aneurysm that was discovered coincidently during a routine ultrasound examination. The patient reported no abdominal or back pain or any symptoms associated with mesenteric ischemia. Computed tomography angiography showed a near total occlusion of the celiac trunk, segmental complete occlusion of the superior mesenteric artery, and a middle colic artery (MCA) aneurysm measuring 22 mm in diameter. Complete resection of the MCA aneurysm was performed, with subsequent reconstruction by end-to-end anastomosis. There is no clear evidence to support indications for intervention according to aneurysm size in asymptomatic patients with CAA. Endovascular occlusion of the proximal and distal arterial segments is often considered a first-line approach, which was inappropriate in our case. Open surgical reconstruction was mandatory to preserve collateral circulation and avoid bowel ischemia in circumstances of occlusive mesenteric artery disease. We decided not to treat the stenotic lesions of the mesenteric arteries, given the absence of mesenteric ischemia symptoms.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1059-1062"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682537","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":"Lupus aortitis mimicking an aortic intramural hematoma.","authors":"Andreas Sarantopoulos, Ioannis Koukis","doi":"10.1007/s12055-025-01932-9","DOIUrl":"10.1007/s12055-025-01932-9","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder with diverse clinical manifestations. While small vessel vasculitis is a common SLE complication, lupus aortitis is an exceedingly rare entity with limited documentation. Here, we report a novel case of lupus aortitis misleadingly appearing on imaging studies as an aortic intramural hematoma in a 68-year-old male. The patient initially exhibited fatigue, dyspnea, and pericardial effusion. Imaging studies suggested an intramural hematoma of the ascending aorta and the aortic arch, prompting urgent surgical exploration. Intraoperative findings revealed a thickened, fibrotic, and heavily calcified aorta (egg-shell aorta) without hematoma. Subsequent histopathological and immunological analyses confirmed lupus aortitis. This case underscores the diagnostic challenges posed by this rare SLE complication, which can mimic other aortic pathologies. Early recognition and individualized treatment are paramount. Further studies are needed to elucidate its pathophysiology and establish standardized management guidelines.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1067-1071"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682526","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":"Apnoeic oxygenation in tracheal surgeries.","authors":"Shyam Sundar Rengan, Abhishek Mohan, Akhil Kumar, Ashwin Marwaha, Shikha Sharma, Rohit Rathi, Roman Dutta, Sabyasachi Bal","doi":"10.1007/s12055-025-01956-1","DOIUrl":"https://doi.org/10.1007/s12055-025-01956-1","url":null,"abstract":"<p><p>This study evaluates the feasibility, possible utility, and efficacy of apnoeic oxygenation during tracheal resection and anastomosis as an alternative strategy to conventional ventilation techniques used in tracheal surgeries. Eight patients with tracheal stenosis were studied. All had preoperative bronchoscopic balloon dilation to facilitate intubation. During surgery, continuous oxygen at 5 L/min was delivered via an airway exchange catheter positioned above the carina during tracheal anastomosis. Gas exchange parameters were monitored, showing a rise in PaCO₂ and a slight decrease in PaO₂ over 15 min of apnoea, without any desaturation or hypoxic events. Cross-field ventilation was not required in any case. The technique was convenient, simple to implement, and effective in maintaining oxygenation with minimal physiological disruption during tracheal anastomosis.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1007-1012"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682513","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 comparison of two cases of esophageal carcinoma with cirrhosis of the liver.","authors":"Donghui Zhu","doi":"10.1007/s12055-025-01917-8","DOIUrl":"https://doi.org/10.1007/s12055-025-01917-8","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1121-1122"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682536","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":"Birt-Hogg-Dubé syndrome presenting as recurrent secondary spontaneous pneumothorax: VATS.","authors":"Sumit Bangeria, Belal Bin Asaf, Sukhram Bishnoi, Mohan Venkatesh Pulle, Harsh Vardhan Puri, Arvind Kumar","doi":"10.1007/s12055-025-01934-7","DOIUrl":"https://doi.org/10.1007/s12055-025-01934-7","url":null,"abstract":"<p><p>Birt-Hogg-Dubé syndrome is a rare autosomal dominant inherited condition, occurring due to mutations in folliculin gene and is characterized by skin lesions, renal tumors, and pulmonary cysts, which can lead to recurrent pneumothorax. The present report discusses the case of a 35-year-old male presenting with a history of left-sided recurrent pneumothorax, and diagnosed with Birt-Hogg-Dubé syndrome after screening for mutation in folliculin gene. The patient experienced two episodes of spontaneous pneumothorax, both of which were managed by intercostal drainage. However, the third episode was managed using percutaneous needle thoracocentesis, and the patient was subsequently referred for surgical management. Imaging revealed presence of bilateral pulmonary cysts and left-sided pneumothorax. Video-assisted thoracoscopic surgery identified multiple bullae and blebs, which were managed by multiple wedge resections followed by complete parietal pleurectomy to prevent recurrence. Postoperatively, the patient showed complete resolution of pneumothorax and 1 month x-ray showed complete chest expansion. The present case underscores the importance of video-assisted thoracoscopic surgery in management of Birt-Hogg-Dubé syndrome patients presenting with recurrent pneumothorax.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1092-1095"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682514","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":"Endobronchial metastasis of fibrosarcoma successfully managed via rigid bronchoscopy.","authors":"Feride Yaman, Alara Abu Saadeh, Houssam Eddine Youcefi, Seyedehtina Safaei, Ali Kimiaei, Pinar Çağan, Cemal Asim Kutlu","doi":"10.1007/s12055-024-01883-7","DOIUrl":"https://doi.org/10.1007/s12055-024-01883-7","url":null,"abstract":"<p><p>This case report describes a 60-year-old female with a history of high-grade epithelioid myxofibrosarcoma, initially diagnosed in the right gluteal region. After resection, she experienced a recurrence at the same site, treated with radiotherapy. Fifteen months post-diagnosis, she developed pulmonary metastasis, confirmed by positron emission tomography-computed tomography (PET-CT). Surgical resection of the nodules via video-assisted thoracoscopic surgery (VATS) showed clear margins. Three months later, the patient presented with respiratory distress and rapidly deteriorated due to a mass occluding the right main bronchus, leading to complete lung collapse. Emergency bronchoscopy successfully excised the mass, revealing intact bronchial architecture. Following the procedure, she began treatment with larotrectinib, resulting in significant clinical improvement and enhanced lung aeration on follow-up imaging. This case highlights the importance of monitoring for airway obstruction in malignancy patients and the effectiveness of bronchoscopy in managing such complications.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1023-1026"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682519","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":"Modern statistical techniques for cardiothoracic surgeons: Part 8-Bayesian analysis and beyond.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-025-01941-8","DOIUrl":"https://doi.org/10.1007/s12055-025-01941-8","url":null,"abstract":"<p><p>Bayesian analysis is a statistical approach that updates the probability of a hypothesis as new evidence emerges, combining prior knowledge with observed data to produce posterior probabilities. It is particularly useful in adaptive clinical trials and hierarchical modeling, offering flexibility and dynamic decision-making. Machine learning (ML), on the other hand, leverages algorithms to analyze complex patterns in large datasets, providing predictive insights for risk assessment and personalized treatment. Techniques such as deep learning and clustering enhance diagnostic accuracy and treatment optimization. Together, Bayesian methods and ML have the potential to revolutionize cardiothoracic research by integrating prior knowledge with data-driven analytics.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1102-1113"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682527","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}