Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Aortic protrusion of left main coronary artery stent during percutaneous coronary intervention after redo mitral valve replacement: surgical removal and new stent implantation.","authors":"Nöfel Ahmet Binicier, Nail Kahraman, Ahmet Yildirim, Deniz Demir","doi":"10.1007/s12055-025-01957-0","DOIUrl":"10.1007/s12055-025-01957-0","url":null,"abstract":"<p><p>An 83-year-old male patient presented to our hospital with complaints of chest pain, shortness of breath, and leg swelling. His medical history included a biological mitral valve replacement (MVR) for mitral stenosis 9 years ago and percutaneous coronary intervention (PCI) to the circumflex (CX) and diagonal arteries 5 years ago. Echocardiography and coronary angiography (CAG) revealed moderate mitral valve stenosis, left atrial thrombus, and critical stenosis in the left main coronary artery (LMCA) and CX artery. Redo MVR, coronary artery bypass grafting (CABG), tricuspid valve repair, and thrombus excision were planned. However, CABG could not be performed due to extensive pericardial adhesions. After redo MVR, during LMCA stenting, the proximal portion of the stent protruded towards the aorta and hemodynamic instability developed. The protruded stent was surgically removed, and a drug-eluting stent (DES) was successfully implanted into the LMCA.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01957-0.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1189-1192"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952459","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":"Short-term outcomes of chest wall resections.","authors":"Vishnu Santhosh Menon, Amita Sekhar Padhy, Rigved Nittala","doi":"10.1007/s12055-025-01975-y","DOIUrl":"10.1007/s12055-025-01975-y","url":null,"abstract":"<p><strong>Introduction: </strong>Chest wall resections (CWRs) pose a unique challenge for a thoracic surgeon by virtue of the complexities involved in maintaining anatomical integrity and functional dynamics of the region. We aimed at studying the outcomes of CWR from the thoracic surgery unit of a comprehensive cancer care centre located in a tier 2 city in India.</p><p><strong>Methods: </strong>This is a retrospective study of all CWRs from our centre, between 15 January 2019 to 15 January 2025. Patients were identified from a prospectively maintained surgical database and electronic medical records.</p><p><strong>Results: </strong>A total of 12 cases were identified who underwent CWR in the said duration, and the majority were for sarcoma (5/12, 41.6%). Rib resections were needed in 10/12 (83.3%) cases, with the 3rd rib (5/12, 41.6%) being the most commonly resected; and multiple rib resections were needed in 7/12 (58.3%) patients. Mesh repair was used in the majority of patients for reconstruction (10/12, 83.3%). No major perioperative morbidity was observed in any of the patients in the first 30 days of surgery.</p><p><strong>Conclusion: </strong>This study provides preliminary evidence for safe CWR being feasible at a low-volume thoracic surgical unit in India.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1173-1179"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952185","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 hearts in an octogenarian.","authors":"Pratyaksha Rana, Saurabh Deshpande, Dinesh Patel, Vidur Bansal","doi":"10.1007/s12055-025-01972-1","DOIUrl":"10.1007/s12055-025-01972-1","url":null,"abstract":"<p><p>Thoraco-abdominal aortic aneurysm (TAAA) usually arises secondary to systemic hypertension and atherosclerotic disease. Large aneurysms of the descending thoracic aorta can cause pressure symptoms on the adjacent structures with risk of rupture in larger growing aneurysms. Timely identification is crucial to prevent complications. Chest radiograph is often the first-line investigation for chest complaints and can provide first clue to the diagnosis.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1252-1254"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952427","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":"Alternative approach to the management of post-operative chylothorax.","authors":"Anup Holur Srinivasan, Aylliath Gosalakkal Jayakrishnan, Keerthiraj Belle","doi":"10.1007/s12055-025-01952-5","DOIUrl":"10.1007/s12055-025-01952-5","url":null,"abstract":"<p><p>Chylothorax is a rare complication of cardiothoracic surgery which is associated with increased morbidity and mortality. Surgical intervention is necessary in cases refractory to the traditional medical management. However, the increased morbidity and mortality rates of surgical intervention are heralding the growing popularity of percutaneous intervention. We present here a case report of a patient who developed chylothorax, following coronary artery bypass grafting (CABG) who was refractory to medical management. In view of persistent chylothorax, the patient underwent percutaneous intervention and plugging of the chyle leak, which resulted in prompt cessation and resolution of the chylothorax and symptomatic improvement in the patient. Percutaneous intervention such as thoracic duct embolization may be considered a successful alternative to surgical intervention for treatment of chylothorax.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1180-1184"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952477","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":"Case of bilioptysis following hydatid cyst removal.","authors":"Robin B Poovattil, Roman Dutta, Abhishek Mohan, Shyam Rengan, Rohit Kumar Rathi, Sabyasachi Bal","doi":"10.1007/s12055-025-01967-y","DOIUrl":"10.1007/s12055-025-01967-y","url":null,"abstract":"<p><p>Bilioptysis is a rare condition characterized by the presence of bile in the sputum, resulting from an abnormal fistulous connection between the biliary tree and the bronchus (biliobronchial fistula). Biliobronchial fistula is associated with high morbidity and mortality; hence, early diagnosis and timely treatment are crucial. We present a case of a 46-year-old male who presented with complaints of bilioptysis for 1 day. He had a history of a hydatid cyst of the liver, which was surgically treated 2 years ago. The patient subsequently developed recurrent fever and vomiting due to a persistent subdiaphragmatic collection. Multiple attempts to drain the abscess/collection were made using percutaneous drainage and endoscopic retrograde cholangio pancreatography (ERCP) with stenting to relieve intrahepatic biliary obstruction. Despite these interventions, the patient developed intrahepatic biliary radical (IHBRD) dilatation, which led to bile tracking through a diaphragmatic rent likely caused by percutaneous drain insertion, resulting in a fistulous connection with the right anterobasal and basolateral bronchial segments. A contrast computed tomography (CT) scan of the thorax and abdomen showed fistulous tract communication to lung parenchyma. He underwent an operative intervention, during which the fistulous tract was excised under intraoperative bronchoscopy guidance. This was followed by the excision of lung segments with a fistula and the repair of the diaphragmatic rent. ERCP and stenting were also done in the same sitting for source control. The patient was discharged with complete resolution of bilioptysis.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1202-1206"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951924","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":"Recycling is the need of the day.","authors":"Om Prakash Yadava","doi":"10.1007/s12055-025-02063-x","DOIUrl":"10.1007/s12055-025-02063-x","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1123-1124"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952262","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":"Arc of Riolan to the rescue: transcollateral endoleak embolization.","authors":"Aprateem Mukherjee, Damandeep Singh, Sanjeev Kumar, Pradeep Ramakrishnan","doi":"10.1007/s12055-025-01964-1","DOIUrl":"10.1007/s12055-025-01964-1","url":null,"abstract":"<p><p>We present a case of persistent type II endoleak in a patient who underwent endovascular repair for abdominal aortic aneurysm. Computed tomography (CT) angiography identified the source of endoleak and the vascular pathway for endovascular embolization of the endoleak.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01964-1.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1246-1248"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952442","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":"Iatrogenic central arterio-venous fistula-case report.","authors":"Poornima Palanisamy, Chandra Sena Muniswamy, Muralikrishna Nekkanti, Padabeetu Subramanya Seetharama Bhat, Vinay Kothathi Shivaswamy, Davu Narendra Babu","doi":"10.1007/s12055-025-01951-6","DOIUrl":"10.1007/s12055-025-01951-6","url":null,"abstract":"<p><p>Iatrogenic complications provide insight into the limitations of procedures. Complications associated with insertion of permanent dialysis catheter are numerous but central arterio-venous fistulas (cAVF) are a rarity. Our case reports a cAVF between the innominate vessels post insertion of a tunneled hemo-dialysis central venous catheter (HD-CVC) via left internal jugular vein (IJV) in a 43-year-old female. She presented with progressive swelling in the left side of the neck and fullness of the left supra-clavicular fossa and supra-sternal notch with dyspnea upon exertion. High output cardiac failure was noted. Due to the impending rupture status at the catheter insertion site, surgery was expedited. The sternum was split and the communication between the arterial and venous system successfully ligated. Patient was discharged after a week. Literature search culminated in describing this first innominate arterio-venous fistula (AVF) post HD-CVC insertion case and its management.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01951-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1198-1201"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951953","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":"Pleomorphic carcinoma of the lung with paraneoplastic fever as presentation.","authors":"Naveen Kumar Kushwaha, Laleng Mawia Darlong, Sunil Pasricha","doi":"10.1007/s12055-025-01976-x","DOIUrl":"10.1007/s12055-025-01976-x","url":null,"abstract":"<p><p>Pulmonary pleomorphic carcinoma (PPC) is a rare, highly aggressive variant of non-small cell lung cancer (NSCLC), comprising 0.1-0.4% of all pulmonary malignancies. While lung cancers typically present with symptoms like cough and hemoptysis, paraneoplastic syndromes are observed in about 10% of cases. Paraneoplastic fever as an initial manifestation is extremely rare. We present a rare case of PPC with neoplastic fever, emphasizing the importance of paraneoplastic syndromes during the evaluation of lung cancer. Surgical resection successfully alleviates neoplastic fever, highlighting the need to recognize paraneoplastic fever as a diagnostic challenge and consider it as a differential in cases of unexplained fever for prompt intervention.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1207-1211"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952277","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":"Bilateral skeletonized IMAs used as \"in situ\" grafts for different coronary territories: long-term propensity matching study.","authors":"Živojin Jonjev, Ilija Bjeljac, Aleksandar Milosavljević, Mirko Todić, Strahinja Mrvić, Novica Kalinić","doi":"10.1007/s12055-025-01979-8","DOIUrl":"10.1007/s12055-025-01979-8","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral internal mammary arteries (BIMAs) are the most advanced surgical option for coronary artery bypass grafting (CABG). This study compares outcomes between patients receiving skeletonized BIMAs as in situ grafts for different coronary territories and those undergoing CABG with a single internal mammary artery (SIMA).</p><p><strong>Methods: </strong>Between 2013 and 2023, 7543 patients underwent CABG for multivessel coronary artery disease at our institution. BIMA grafting was performed in 1133 patients (15.02%), with in situ BIMA grafting in 283 patients (3.75%). The right internal mammary artery (RIMA) was used for the right coronary artery, and the left internal mammary artery (LIMA) for the left anterior descending artery. Propensity score matching yielded 280 patients in each group for comparison. Primary outcomes were 30-day and 10-year all-cause mortality. Secondary outcomes included length of hospital stay, incidence of postoperative major adverse cardiovascular and cerebrovascular events (MACCE), sternal wound infection, and the need for subsequent revascularization.</p><p><strong>Results: </strong>There was no 30-day postoperative mortality, perioperative MACCE, or deep sternal wound infection in either group. Mean follow-up was 9.78 ± 0.62 years. The 10-year survival rate was significantly higher in the in situ BIMA group (86.07 ± 3.0%) compared to the SIMA group (78.6 ± 4.1%, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Skeletonized BIMA grafting improves long-term survival compared to SIMA grafting, rendering traditionally accepted limitations for BIMA usage irrelevant. These findings support the broader adoption of BIMA grafting in CABG.</p><p><strong>Graphic abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01979-8.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1144-1152"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952445","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}