Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Short-term outcomes of off-pump vs. on-pump coronary artery bypass grafting in left main coronary artery disease: a systematic review and meta-analysis.","authors":"Lucas Nogueira Pansani, Pedro Emanuel de Paula Carvalho, Douglas Gewehr, Maurizio Taramasso, Giullia Burkhardt, Lara Almeidinha, Rafael Ayala, Martin Tobias Robert Grapow","doi":"10.1007/s12055-025-01907-w","DOIUrl":"10.1007/s12055-025-01907-w","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of off-pump relative to on-pump coronary artery bypass grafting (CABG) in patients with left main coronary artery disease (LMCAD) remain unclear.</p><p><strong>Objectives: </strong>Conduct a meta-analysis assessing the outcomes following CABG comparing off-pump CABG vs. on-pump CABG.</p><p><strong>Methods: </strong>MEDLINE, Cochrane, and Embase were examined for randomized controlled trials (RCTs) and observational studies that communicated outcomes after off-pump vs. on-pump CABG in patients with LMCAD. Odds ratios (OR) with 95% confidence intervals (CI) were pooled with a random-effects model. Cochrane recommendations for quality assessment and risk of bias were performed. This study was registered in the PROSPERO platform, ID: CRD42023451467.</p><p><strong>Results: </strong>One RCT and 17 observational studies with 16,848 patients were included, 6735 (40.0%) of whom underwent off-pump CABG. In patients with LMCAD undergoing CABG, off-pump CABG was associated with a lower incidence of all-cause mortality (OR 0.52, 95% CI 0.38-0.71; <i>p</i> < 0.001), acute renal dysfunction (OR 0.40; 95% CI 0.27-0.59; <i>p</i> < 0.001), postoperative use of intra-aortic balloon pump (IABP) (OR 0.38; 95% CI 0.22-0.64; <i>p</i> < 0.01), and wound infection (OR 0.66; 95% CI 0.48-0.9; <i>p</i> = 0.01). There was no difference between the groups for myocardial infarction (OR 0.81; 95% CI 0.59-1.11; <i>p</i> = 0.193), stroke, or transitional ischemic attack (TIA) (OR 0.64; 95% CI 0.38-1.06; <i>p</i> = 0.085). The number of grafts per patient was also lower in the off-pump CABG group (mean deviation (MD) -0.32; 95% CI -0.50 to -0.14; <i>p</i> < 0.001). After a mean follow-up of 38.1 months, no significant difference in all-cause mortality incidence was observed between the two techniques (OR 0.72; 95% CI 0.30-1.74; <i>p</i> = 0.47). This underscores that the reduction in mortality rates was primarily driven by short-term outcomes.</p><p><strong>Conclusion: </strong>In this meta-analysis with 16,848 patients with LMCAD undergoing CABG, off-pump CABG was associated with lower rates of all-cause mortality, acute renal dysfunction, IABP use, and wound infection compared with on-pump CABG.</p><p><strong>Graphical abstract: </strong>On-pump versus off-pump CABG in patients with LMCAD.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01907-w.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"852-862"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325552","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":"The transformative power of mentorship in my journey as a heart transplant surgeon.","authors":"Manoj Durairaj","doi":"10.1007/s12055-025-01955-2","DOIUrl":"https://doi.org/10.1007/s12055-025-01955-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"830-842"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325558","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":"Prevention of bleeding from the pulmonary artery during thoracoscopic lobectomy: can we achieve a rapid and less traumatic vascular control?","authors":"Dario Amore, Dino Casazza, Umberto Caterino, Pasquale Imitazione, Cristiano Cesaro","doi":"10.1007/s12055-025-01960-5","DOIUrl":"10.1007/s12055-025-01960-5","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"970-972"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325549","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":"Investigation of sentinel lymph nodes using SPECT/CT and perioperative gamma assay combined with immunohistochemistry in non-small cell lung cancer patients undergoing lung resection.","authors":"Pinar Çağan, Ali Kimiaei, Seyedehtina Safaei, Fikri Okan Falay, Cemal Asim Kutlu","doi":"10.1007/s12055-025-01924-9","DOIUrl":"10.1007/s12055-025-01924-9","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate mediastinal staging is crucial for treatment planning and prognostication in patients with non-small cell lung cancer (NSCLC). Sentinel lymph node (SLN) detection using single-photon emission computed tomography/computed tomography (SPECT/CT) is a promising technique for improving the precision of mediastinal staging. In this study, we aimed to identify the lymph nodes that the tumor will invade based on the lobe in which it exists by determining the lobar drainage pathways. Additionally, we share our experience with the SLN procedure for NSCLC.</p><p><strong>Methods: </strong>The study included twenty NSCLC patients with N0, N1, or N2 stages, scheduled for surgery and showing no lymph node or distant metastasis on positron emission tomography/computed tomography (PET/CT). Radiopharmaceutical injection around the tumor preoperatively was followed by SPECT/CT visualization. Lymph nodes were counted using a gamma probe post-mediastinal dissection. Evaluation included histopathological analysis of SLNs identified by SPECT/CT and gamma probe, using hematoxylin and eosin and immunohistochemical staining.</p><p><strong>Results: </strong>After postoperative pathological examinations, metastases were found in other mediastinal, hilar, or intrapulmonary lymph nodes without involving the SLN in six patients (30%). Metastasis to the SLN was detected in only two patients (10%). Immunohistochemical staining with cytokeratin revealed SLN metastasis in three patients (15%). The skip metastasis was detected in five patients (25%). Additionally, three patients (15%) experienced pneumothorax post transthoracic radiopharmaceutical injection, which did not require intervention, and one patient (5%) had hemoptysis.</p><p><strong>Conclusion: </strong>We propose that enhancing SLN detection in NSCLC can aid surgeons in selectively sampling lymph nodes that are either invaded or are at risk of invasion without sacrificing the accuracy of mediastinal staging.</p><p><strong>Clinical trial registration: </strong>Not applicable. This manuscript does not report on or involve the use of any clinical trials.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01924-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"874-881"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325548","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":"Energy drinks-the cardiac 'plot twist': <i>…and a lot more to the story!</i>","authors":"Om Prakash Yadava","doi":"10.1007/s12055-025-02012-8","DOIUrl":"10.1007/s12055-025-02012-8","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"823-825"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325544","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 accessory left renal vein draining into the left ovarian.","authors":"Vedat Yaman, Sevtap Arslan","doi":"10.1007/s12055-025-01909-8","DOIUrl":"10.1007/s12055-025-01909-8","url":null,"abstract":"<p><p>We present an extremely rare vascular variation in which the accessory left renal vein (LRV) draining the lower pole of the left kidney drains into the left ovarian vein (LOV). A 35-year-old woman underwent a contrast-enhanced computed tomography (CT) of the abdomen with the clinical symptom of abdominal pain. Unexpectedly, an accessory LRV draining into the LOV was noted. Otherwise, the CT scan was unremarkable. Here we report a case of an accessory LRV draining into the LOV which has not been previously reported in the literature. Recognition and reporting of this anatomic variation is of paramount importance before the surgical or endovascular procedures involving the left kidney, left ovary, and retroperitoneum.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"947-950"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325539","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":"Successful pediatric heart transplantation with bivalirudin use in a cyanotic single ventricle patient with an intracorporeal continuous flow ventricular assist device and heparin-induced thrombocytopenia.","authors":"Sandeep Sainathan, Leonardo Mulinari","doi":"10.1007/s12055-024-01892-6","DOIUrl":"10.1007/s12055-024-01892-6","url":null,"abstract":"<p><p>We describe a case of profound coagulopathy during orthotopic heart transplantation in a cyanotic single ventricle pediatric patient with an intracorporeal continuous flow ventricular assist device performed on bivalirudin for heparin-induced thrombocytopenia. This was successfully managed with central veno-arterial extracorporeal membrane oxygenation and hemofiltration as an adjunct to treat bivalirudin-induced coagulopathy due to lack of a reversal agent for bivalirudin.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"933-936"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325554","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":"Duplication of the umbilical vein along with an extrahepatic, intrathoracic right umbilical vein in the setting of Taussig-Bing anomaly with atrioventricular septal defect.","authors":"Faezeh Soveyzi, Hourieh Soleimani, Elahe Aleebrahim-Dehkordi, Jamal Jandaghi","doi":"10.1007/s12055-024-01885-5","DOIUrl":"10.1007/s12055-024-01885-5","url":null,"abstract":"<p><p>The incidence of persistent right umbilical vein (PRUV) is approximately 2 per 1000 pregnancies, with cases utilizing extrahepatic and intrathoracic routes to connect to the superior vena cava (SVC) being notably rarer. The case in question involved an 18-week fetus presenting with concurrent cardiac anomalies: D-transposition of the great arteries (TGA) classified as Taussig-Bing anomaly and atrioventricular septal defect (AVSD), highlighting the uniqueness of the presentation. A second-trimester ultrasound, including echocardiographic assessment, identified Taussig-Bing anomaly, AVSD, pulmonary stenosis (PS), and a right-sided stomach position with a left-sided umbilical vein exhibiting a PRUV with an anomalous trajectory towards the SVC. These findings indicate a rare association of multiple congenital malformations. The right-sided stomach raised concerns for potential cardiosplenic syndromes, such as heterotaxy. Additionally, two vessels observed posterior to the heart in the four-chamber view raised suspicion for inferior vena cava (IVC) interruption, possibly suggesting an azygos vein formation. However, a thorough assessment of the IVC confirmed normal anatomy, with the posterior vessel identified as the PRUV.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01885-5.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"919-923"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325543","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":"Double bubble trouble: a case of sub-epicardial aneurysms.","authors":"Jecco Ani Babu, Dillip Kumar Mishra, Krishnaswamy Chandrasekaran","doi":"10.1007/s12055-025-01898-8","DOIUrl":"10.1007/s12055-025-01898-8","url":null,"abstract":"<p><p>Here we validate a case of sub-epicardial aneurysms, the precursor for rupture that leads to pseudo-aneurysm (PSA) in a patient with associated coronary artery disease. Sub-epicardial aneurysms are rare and can lead to cardiac tamponade and death. We discuss a rare case of a 42-year-old female with two large sub-epicardial aneurysms and coronary artery disease initially diagnosed as true aneurysm, highlighting the importance of surveillance and the challenges of using echocardiography to diagnose and manage these aneurysms effectively. These PSA are difficult to be differentiated form a true aneurysm with transthoracic echocardiography. Echocardiographic criteria, such as a neck-to-sac diameter ratio of less than 0.5 and a reduction in wall thickness near the aneurysmal neck by more than 50%, were considered valuable in differentiating these aneurysms. Now simultaneous bi-plane and real-time three-dimensional imaging features of trans-esophageal echo will aid echo cardiologists in better identifying the characteristics of the outpouching, to further aid in differentiating pseudo from true aneurysms and even recognize the stage of the sub-epicardial aneurysms. Subjecting the patient to a surgery also depends on the time of occurrence of the myocardial infarction. It is highly advocated that an urgent procedure should be conducted for left ventricle (LV) PSA found within the first 3 months after an infarction, since the onset of rupture is unforeseeable. Although an accurate separation between false and true aneurysms is foremost critical for appropriate management, this differentiation is often challenging clinically and radiologically even with reasonable experience.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"942-946"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325542","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":"Best evidence for coronary revascularization - multisociety endorsement of the 2024 ESC guidelines.","authors":"Adnaldo da Silveira Maia","doi":"10.1007/s12055-025-01971-2","DOIUrl":"10.1007/s12055-025-01971-2","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 7","pages":"826-829"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325540","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}