Pradeep Narayan, Arnaldo Dimagli, Jeremy Chan, Tim Dong, Charles Tan, Tugba Aydin, Daniel Paul Fudulu, Gianni Davide Angelini
{"title":"Outcomes of reoperative aortic valve surgery: data from a national registry over 23 years.","authors":"Pradeep Narayan, Arnaldo Dimagli, Jeremy Chan, Tim Dong, Charles Tan, Tugba Aydin, Daniel Paul Fudulu, Gianni Davide Angelini","doi":"10.1007/s12055-025-01980-1","DOIUrl":"10.1007/s12055-025-01980-1","url":null,"abstract":"<p><strong>Objective: </strong>Over the past two decades, early mortality following re-operative aortic valve surgery has declined significantly; however, it remains higher than that observed after primary isolated valve replacement. We sought to examine temporal trends and identify independent predictors of adverse outcomes in patients undergoing re-operative aortic valve surgery.</p><p><strong>Method: </strong>The study included all patients undergoing re-operative aortic valve replacement (AVR) in the United Kingdom between January-1996 and March-2019 including those with multiple previous operations and those undergoing additional procedures. Data was obtained from the National Institute of Cardiovascular Outcomes Research database. The primary objective was to assess in-hospital mortality trends. Secondary objective was to identify risk factors for in-hospital mortality. Multivariable analysis was carried out to identify independent risk factors for in-hospital mortality.</p><p><strong>Results: </strong>During the study period, 6,109 re-operative aortic valve surgeries were carried out in the United Kingdom. There were 1,973(32%) females, median age was 69(60-76) years with median duration between the initial and the reoperation being 7(2-13) years. Bio-prosthetic valves were more commonly explanted compared to mechanical valves: 4,125(68%) vs. 1,641(27%). Mortality for elective re-operative cases was 4.8% (<i>n</i> = 166). After adjustments, surgery after 2007, age, number of previous operations, urgency of operation, gender, concomitant procedures, pre-operative chronic kidney disease and endocarditis, were important predictors of outcomes. Mortality showed a downward trend during the study period (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>With advances in management strategies, mortality following re-operative AVR continues to decline, but still remains significant. Structural degeneration of bioprosthetic valves continues to be the most common indication for re-operation Emergency re-operations are associated with substantially higher mortality rates; therefore, close follow-up of these patients is essential to facilitate timely elective re-intervention before clinical deterioration.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01980-1.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1125-1135"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952249","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}
Chengwei Li, Jian Wang, Baotong Liu, Lin Jin, Baoyou Zhang
{"title":"Iliac branch endoprosthesis for the treatment of a complex aneurysm.","authors":"Chengwei Li, Jian Wang, Baotong Liu, Lin Jin, Baoyou Zhang","doi":"10.1007/s12055-025-01953-4","DOIUrl":"10.1007/s12055-025-01953-4","url":null,"abstract":"<p><p>Decisions pertaining to the management of an abdominal aortic aneurysm in combination with bilateral internal iliac aneurysms present quandaries during endovascular intervention. This report outlines an endovascular aortic repair method for endovascular aortic repair involving an abdominal aortic aneurysm with bilateral iliac aneurysms. The patient exhibited aneurysmal dilatation of the abdominal aorta, bilateral common iliac arteries, and bilateral internal iliac arteries. There was a short distance from the lowest renal artery to the iliac bifurcation, coupled with tortuous bilateral external iliac arteries. Due to the patient's unique anatomical conditions, we performed an abdominal aortic endovascular repair, along with endovascular repair of the bilateral common iliac arteries, embolization of the right internal iliac artery, and reconstruction of the left internal iliac artery using a GORE iliac branch endoprosthesis. Postoperative computed tomography angiography performed 1 month later revealed complete exclusion of the aortic aneurysm, proper positioning of the stent graft, normal morphology, successful closure of the right internal iliac artery, and clear blood flow in the left iliac artery.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1230-1234"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951947","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 case of the sneaky lymphoma: solved by flow cytometry.","authors":"Renu Singh, Md Ali Osama, Rachana Meena, Shailaja Shukla, Jagdish Chandra","doi":"10.1007/s12055-025-01993-w","DOIUrl":"10.1007/s12055-025-01993-w","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1258-1261"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952259","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}
Sedhupathi Shanmugam, Arun Gopalakrishnan, Ahmed Wayez, Pruthvi Patel, Baiju S Dharan
{"title":"Interventricular septal hematoma following cone repair for Ebstein's anomaly.","authors":"Sedhupathi Shanmugam, Arun Gopalakrishnan, Ahmed Wayez, Pruthvi Patel, Baiju S Dharan","doi":"10.1007/s12055-025-01970-3","DOIUrl":"10.1007/s12055-025-01970-3","url":null,"abstract":"<p><p>Interventricular septal hematoma (IVSH) is a rare complication following pediatric heart surgery involving interventricular septum (IVS). We present the case of an adult who developed IVSH after cone repair for Ebstein's anomaly and the management challenges involved.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01970-3.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1193-1197"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951971","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 ventricular septation and mitral valve repair in an 18-month-old with a single ventricle anatomy.","authors":"Swati Garekar, Shyam Dhake, Sachin Patil, Amit Mhatre, Dinesh Kandevel, Dhananjay Malankar","doi":"10.1007/s12055-025-01954-3","DOIUrl":"10.1007/s12055-025-01954-3","url":null,"abstract":"<p><p>Single ventricle anatomy, with two atrioventricular valves opening into two ventricles but with a large portion of the septum missing, is typically managed via staged single ventricle palliation. We present a case where ventricular septation and mitral valve repair were successfully achieved. A 3-month-old infant presented with cachexia and pneumonia. Echocardiography revealed a large ventricular septal defect (VSD) occupying most of the septum. The right ventricle (RV) was bipartite. Severe mitral regurgitation developed post pulmonary artery (PA) banding. After careful assessment and consideration, at 18 months of age, the patient underwent successful mitral valve repair, ventricular septation, and PA debanding. This case highlights the potential for achieving biventricular repair in select patients with single ventricle anatomy.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1185-1188"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952223","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 management of coronary stent infections: an institutional experience with 18 patients and analysis of long-term outcomes.","authors":"Dhiren Shah, Kishore Gupta, Surabhi Madan, Satya Gupta, Dhaval Naik, Deepa Shah, Chintan Sheth, Niren Bhavsar","doi":"10.1007/s12055-025-01897-9","DOIUrl":"10.1007/s12055-025-01897-9","url":null,"abstract":"<p><p>Coronary stent infection (CSI) is a rare but serious complication following percutaneous coronary intervention, and is associated with significant morbidity and mortality. This report presents a 6-year institutional experience involving 18 patients who underwent surgical management for CSI. The patients, predominantly male (94.12%), ranged from 31 to 80 years old, with the majority presenting with fever, chest pain, and other symptoms, often leading to delayed diagnosis. Infections were primarily caused by <i>Pseudomonas aeruginosa</i>, <i>Staphylococcus aureus</i>, and <i>non-tuberculous mycobacteria</i>, with six cases yielding no pathogen on blood/tissue cultures. Surgical intervention involved stent removal, coronary artery ligation, and revascularization, when feasible. Sixteen patients underwent complete revascularization using on-pump techniques. Despite the complexity of these cases, there was no mortality during the minimum 6-month follow-up, and patients remained in New York Heart Association (NYHA) class I/II. This report underscores the critical importance of early- and late-onset recognition and multidisciplinary approach to managing CSI, emphasizing the need for high clinical suspicion in patients presenting with unexplained fever following stent placement. Strict adherence to sterilization practices in catheterization laboratories is crucial for preventing these infections. Successful outcomes can be achieved with timely surgical intervention and comprehensive perioperative care, highlighting the necessity of coordinated effort among cardiothoracic surgeons, cardiologists, infectious disease specialists, microbiologists, and radiologists.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1153-1164"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952273","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":"Lung epithelioid hemangioendothelioma.","authors":"Wala Ben Kridis, Mahmoud Hakim, Dhouha Sakka, Saadia Makni, Abdesslem Henteti, Khalil Chtourou, Tahia Boudawara, Afef Khanfir","doi":"10.1007/s12055-025-01977-w","DOIUrl":"10.1007/s12055-025-01977-w","url":null,"abstract":"<p><p>Lung epithelioid hemangioendothelioma (LEHE) is a rare tumor of vascular origin with low to intermediate malignancy. Its diagnosis is confirmed by histopathology study. We report a case of a non-smoker man in his fifties who was diagnosed for LEHE with positive staining for erythroblast transformation-specific-related gene (ERG) and cluster of differentiation 31 (CD31). Our case highlights the importance of a histological diagnosis to avoid misdiagnosis.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1249-1251"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952187","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":"Prone position enhances oxygenation and facilitates weaning from percutaneous extracorporeal membrane oxygenation in infants after the bidirectional Glenn procedure.","authors":"Naoki Kaneda, Wataru Sakai, Tomohiro Chaki, Tomohiro Nawa","doi":"10.1007/s12055-025-01989-6","DOIUrl":"10.1007/s12055-025-01989-6","url":null,"abstract":"<p><p>The prone position has been shown to improve oxygenation in patients with acute respiratory distress syndrome (ARDS) and is commonly used in mechanically ventilated patients. However, the short-term efficacy and outcomes of prone positioning in infants requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO) after a bidirectional Glenn procedure have not been reported. A 6-month-old female infant with pulmonary atresia and intact ventricular septum underwent a bidirectional Glenn procedure. On postoperative day 6, the patient was extubated and showed favorable progress. On postoperative day 12, the patient developed ARDS and Glenn failure, leading to the initiation of V-V ECMO through the right subclavian vein (drainage site) and femoral vein (infusion site) for severe hypoxemia. After initial management in the supine and lateral positions failed to improve oxygenation, the prone position was introduced from postoperative day 25 onward, for 8-12 h daily. Oxygenation gradually improved over 12 days, and the prone positioning was discontinued on postoperative day 38. The patient was successfully weaned from V-V ECMO on postoperative day 42, weaned from the mechanical ventilation on day 69, and discharged from the pediatric intensive care unit on day 82 without significant neurological complications. Prone position can be safely implemented in infants undergoing V-V ECMO after a bidirectional Glenn procedure, which might contribute to improving oxygenation and weaning.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1240-1245"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952190","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":"Revisiting the PARTNER 3 trial: are 5-year hemodynamic findings enough to settle the debate in low-risk aortic stenosis?","authors":"Pradeep Narayan","doi":"10.1007/s12055-025-02040-4","DOIUrl":"10.1007/s12055-025-02040-4","url":null,"abstract":"<p><p>This review revisits the 5-year echocardiographic findings from the PARTNER 3 trial, which assessed valve performance in low-surgical-risk patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). While TAVR demonstrated early hemodynamic advantages, including more favourable right ventricular-pulmonary artery coupling and lower valvulo-arterial impedance, these benefits did not consistently translate into superior long-term outcomes. Emerging data from companion publications highlight a potential late mortality in the TAVR group, despite comparable early results. In younger, low-risk patients, long-term survival, not just early hemodynamic metrics, should remain the primary consideration when guiding treatment decisions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1255-1257"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952226","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}