Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Impact of varying degree of donor-recipient weight mismatch on survival outcomes in pediatric heart transplantation.","authors":"Rohit Ganduboina, John Karamichalis, Xander Jacquemyn, Michel Pompeu Sá, Leonardo Mulinari, Sandeep Sainathan","doi":"10.1007/s12055-026-02195-8","DOIUrl":"10.1007/s12055-026-02195-8","url":null,"abstract":"<p><strong>Objectives: </strong>Body weight is still the most common metric used for donor-recipient matching in Pediatric Heart Transplantation (PHTX) and its impact on long-term outcomes remains unclear from variable definition and conflicting evidence. In this study, the outcomes of varying weight mismatch on PHTX was analysed.</p><p><strong>Methods: </strong>The United Network for Organ Sharing (UNOS) database (1984-2025) was retrospectively analysed. Size mismatch as a percentage donor-recipient weight difference was categorized as Mild (≤ 20%), Moderate (20-30%), Extreme (> 30%), and stratified as undersizing or oversizing. Demographics, clinical characteristics, and post-transplant outcomes were compared. One-year and 15-year mortality were analysed using multivariable logistic and Cox regression, respectively.</p><p><strong>Results: </strong>Oversizing (80%, 9,175/11,583) was more common than undersizing (20%, 2,408/11,583). With increasing oversizing, the recipients were younger, had congenital heart disease (CHD) diagnosis, and elevated pulmonary vascular resistance but with shorter wait-list times. Oversizing had no impact on 30-day, 1-year, or 15-years survival. With increasing undersizing, recipient age was similar, had less restrictive cardiomyopathy diagnosis, and had female donor but with shorter wait-list times. Undersizing had inferior survival till 5-years but not at 15-years. However, on multivariable analysis, undersizing was not predictive of inferior survival anytime as was congenital heart disease diagnosis, Extracorporeal Membrane Oxygenation (ECMO) bridge, elevated pulmonary-vascular resistance, transplantation era, and post-transplant rejection, stroke, and dialysis use.</p><p><strong>Conclusions: </strong>Oversizing is more likely than undersizing in PHTX. While oversizing had no overall survival impact, undersizing had negative mid-term but not long-term survival impact which disappeared when adjusted for underlying cardiac diagnosis, elevated pulmonary vascular resistance, transplantation era and occurrence of post-transplant complications.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02195-8.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"831-843"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345120","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":"Reviewing a paper: simple principles for better peer review.","authors":"Pradeep Narayan","doi":"10.1007/s12055-026-02229-1","DOIUrl":"10.1007/s12055-026-02229-1","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"829-830"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345123","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":"Rigid titanium-polypropylene reconstruction enabling R0 resection in pediatric chest wall Ewing's sarcoma.","authors":"Aghosh Raju, Ratish Radhakrishnan","doi":"10.1007/s12055-026-02178-9","DOIUrl":"10.1007/s12055-026-02178-9","url":null,"abstract":"<p><p>Chest wall Ewing's sarcoma in children presents surgical challenges because radical resection needed for oncological clearance often creates large defects that compromise respiratory mechanics. We report a pediatric case managed with neoadjuvant chemotherapy followed by en bloc resection of the ribs, medial clavicle, and part of the sternum with wedge lung resection, and subsequent reconstruction using titanium plates and polypropylene mesh, achieving microscopically margin-negative (R0) resection and excellent functional recovery.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"897-900"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345154","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":"Minimally invasive repair of interrupted aortic arch with concomitant bicuspid aortic valve disease via video-assisted left thoracotomy.","authors":"Roger Yoel Conde Moncada, Pedro Rojas Sánchez, Christian Yépez Calderón, Wildor Samir Cubas","doi":"10.1007/s12055-026-02175-y","DOIUrl":"10.1007/s12055-026-02175-y","url":null,"abstract":"<p><p>Interrupted aortic arch (IAA) is an exceptionally rare congenital malformation (< 1%), and survival into adulthood relies on the development of a robust collateral arterial network capable of sustaining distal perfusion. Its association with a stenotic bicuspid aortic valve (BAV) is uncommon. While a BAV is a common associated anomaly, its presentation with severe symptomatic stenosis in an adult with IAA is less frequently reported. We report the case of a 50-year-old male with poorly controlled arterial hypertension and heart failure, diagnosed with an IAA and a BAV.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"918-922"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345137","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 balloon, millions of lives: the Fogarty revolution.","authors":"Himanshu Agrawal, Nikhil Gupta","doi":"10.1007/s12055-026-02220-w","DOIUrl":"10.1007/s12055-026-02220-w","url":null,"abstract":"<p><p>Thomas J. Fogarty was a transformative figure in modern surgery whose innovations reshaped the management of vascular disease. Best known for the balloon embolectomy catheter, Fogarty introduced a simple yet revolutionary concept that converted a high-risk open procedure into a rapid, minimally invasive intervention, saving countless limbs and lives worldwide. Beyond a single device, his career exemplified the clinician-inventor model-where bedside observation, engineering ingenuity, and relentless problem-solving converge to advance patient care. This editorial reflects on Fogarty's life, his seminal contributions to vascular and endovascular surgery, and the enduring relevance of his philosophy of innovation in an era increasingly driven by technology, interdisciplinary collaboration, and precision medicine.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"889-891"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345167","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":"Size compatibility in pediatric heart transplantation: impact on outcomes.","authors":"Debasis Das","doi":"10.1007/s12055-026-02216-6","DOIUrl":"10.1007/s12055-026-02216-6","url":null,"abstract":"<p><p>Donor-recipient size mismatch in pediatric heart transplantation remains a clinically important and frequently debated issue, with significant implications for donor utilization and outcomes. In this context, the authors Ganduboina et al. provide a thoughtful analysis of the impact of size mismatch, stratified into graded categories and further delineated into undersizing and oversizing. Oversizing, which is considerably more common in contemporary practice, was not associated with adverse outcomes across short-, mid-, or long-term survival, reinforcing the growing acceptance of liberal size-matching strategies. In contrast, undersizing was associated with reduced mid-term survival; however, this relationship did not persist after adjustment for confounding variables, suggesting that recipient and perioperative factors may play a more dominant role than size mismatch alone. These observations align with evolving clinical practice, where oversized grafts are often preferentially used in higher-risk recipients to provide physiological reserve. At the same time, the study underscores the need to interpret size mismatch within a broader clinical context, rather than as an isolated determinant of outcome. Collectively, these findings support a more flexible, individualized approach to donor selection while highlighting areas for future refinement.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"844-846"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345152","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":"Methodological considerations in estimating the burden of congenital heart disease among Indian children.","authors":"Saptanil Das, Archana Dhyani, Rajnish Kumar, Heena Arora","doi":"10.1007/s12055-026-02222-8","DOIUrl":"10.1007/s12055-026-02222-8","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"931-932"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345159","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":"Burden of congenital heart disease among Indian children: a systematic review and meta analysis.","authors":"Gopireddy Murali Mohan Reddy, Praveen Dontineni, Maruti Haranal, Atul Surendra Prabhu, Shreedhar Joshi, Deepak Prakash Borde, Avelyn Thazhuthadath Kishore, Rakesh Anbazhagan","doi":"10.1007/s12055-026-02181-0","DOIUrl":"10.1007/s12055-026-02181-0","url":null,"abstract":"<p><p>Congenital heart disease (CHD) presents a major health challenge in India. Wide variations exist in the burden of CHD across published studies. Pooling data from published evidence and analyzing factors associated with these variations can provide robust estimates and insights for policymakers and healthcare providers. A systematic literature search was done in PubMed, Embase, Cochrane Library, CINAHL, and Web of Science from inception to August 2023. Two independent reviewers screened studies, extracted data, and evaluated the risk of bias using the Joanna Briggs Institute (JBI) Critical Appraisal tool. This study was registered with International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023469773). A total of 33 studies were included in the systematic review, with 32 studies eligible for meta-analysis. The CHD event rates varied widely across the studies, ranging from 0.67 per 1000 to 40.28 per 1000. The pooled incidence of CHD was 10.10 per 1000 live births (95% confidence interval (CI), 4.52-15.68). These studies predominantly assessed CHD shortly after birth or within a defined time window. The pooled prevalence of CHD among children was 9.61 per 1000 (95% CI, 6.18-13.05). These studies included cross-sectional assessments from school-based, hospital-based, and community-based screening of children in older age groups. Subgroup analyses revealed variations by population group, ranging from 7.44 per 1000 in school-based screenings to 14.00 per 1000 in fetal screening. A time trend analysis revealed 6.65/1000 (95% CI, 1.01 to 12.29) (1980-2000) to 11.47/1000 (95% CI, 5.65 to 17.30) (2016-2022). These findings highlight substantial variation in the burden of CHD reported across the studies, partially attributed to methodological heterogeneity. A nationwide longitudinal database with uniform methodology is essential to the accurate assessment of the burden, changing epidemiological profile, and clinical outcomes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02181-0.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"864-879"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345164","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 transplantation in situs inversus post-TAPVC repair.","authors":"Naresh Kumar Palli Venkata, Madhava Rao Midhe, Vinay Praveen Ayyala, Sharon Richy Talari, Venkata Reddy Navuluri","doi":"10.1007/s12055-026-02183-y","DOIUrl":"10.1007/s12055-026-02183-y","url":null,"abstract":"<p><p>Cardiac transplantation in situs inversus with dextrocardia is rare and surgically complex, owing to the reconstruction of systemic and pulmonary venous pathways. We present a 21-year-old male diagnosed with complex cyanotic congenital heart disease with situs inversus, dextrocardia, mixed total anomalous pulmonary venous connection (TAPVC), and good ventricular function with single ventricle physiology. He underwent left superior vena cava (LSVC) to left pulmonary artery (LPA) bidirectional (BD) Glenn shunt, with mixed TAPVC repair at 3 years of age. At the age of 21 years, he developed severe restrictive myocardial dysfunction and was not suitable for Fontan completion surgery. Hence, he was considered for orthotopic cardiac transplantation. The donor pericardium and donor heart were harvested with the full length of the superior vena cava (SVC) and the innominate vein. The ascending aorta and the aortic arch were harvested to the maximum possible length. After recipient cardiectomy and taking down the Glenn shunt, the recipient's right atrium (RA) was constructed into a composite tunnel by suturing the retained right atrial cuff posteriorly with bovine pericardium anteriorly. The donor inferior vena cava (IVC) was anastomosed to this tunnel. The donor right SVC was anastomosed to the recipient LSVC using the donor aortic homograft as an interposition graft. The native pulmonary artery (PA) confluence was anastomosed to the donor PA using donor pericardium to augment the anterior and lateral parts of the conduit, followed by aortic anastomosis. Post-procedure, the patient performed well with acceptable hemodynamics, and the heart occupied a mesocardial position.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"892-896"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345184","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":"Scalpel wielding sans data!: <i>The missing beat of Indian cardiothoracic surgical landscape</i>.","authors":"Om Prakash Yadava","doi":"10.1007/s12055-026-02230-8","DOIUrl":"10.1007/s12055-026-02230-8","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"860-863"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345135","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}