Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Role of femoral intima-media thickness in risk prediction and assessment of severity of coronary artery disease.","authors":"Atul Kaushik, Surendra Patel, Sourabh Goswami, Pawan Garg, Akhil Dhanesh Goel, Danishwar Meena, Madhusudan Katti, Anupam Das, Rahul Choudhary, Surender Deora, Alok Kumar Sharma","doi":"10.1007/s12055-024-01824-4","DOIUrl":"10.1007/s12055-024-01824-4","url":null,"abstract":"<p><strong>Background/objective: </strong>Atherosclerosis is a systemic multifocal disease which most commonly involves branching points of the large and medium-sized arteries. The carotid intima-media thickness (c-IMT) is an established marker for increased cardiovascular risk and cerebrovascular disease. In this study, we aimed to establish the role of femoral intima-media thickness (FIMT) in predicting cardiovascular risk in angiographically confirmed patients of coronary artery disease (CAD) when compared with apparently healthy patients (having normal coronary angiogram).</p><p><strong>Methods: </strong>A total of 114 consecutive patients presented at our institute with symptoms of CAD who underwent coronary angiogram were included in the study. After the coronary angiogram, patients were divided into three groups, group A having normal coronary angiogram, group B having CAD with a synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score of more than 22, and group C having CAD with a SYNTAX score of 22 or less. The Doppler ultrasound of the bilateral femoral artery in each patient was done 1 day before a coronary angiogram and FIMT was recorded.</p><p><strong>Results: </strong>There was a significant difference (<i>p</i>-value -  < 0.001) found in the mean FIMT in patients with normal coronaries (mean FIMT - 0.49 ± 0.05) and patients having CAD (mean FIMT - 0.73 ± 0.17). The area under the receiver operating characteristic (ROC) curve of mean FIMT in predicting abnormal coronaries was 0.903 (95%CI 0.847-0.958, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The FIMT has a strong correlation with coronary artery disease. With the help of this non-invasive tool, we can diagnose subclinical atherosclerosis and it may contribute to the prevention of CAD and its severe manifestations.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"264-271"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457959","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":"Thoracoscopic management of giant thymolipoma.","authors":"Raghul Maniam, Hariharan Govinddarajan, Vembar Dhanasekarapandian, Raghunath Sambandam Murugan, Sathiyavelu Sekar","doi":"10.1007/s12055-024-01759-w","DOIUrl":"10.1007/s12055-024-01759-w","url":null,"abstract":"<p><p>Thymolipomas are rare benign thymic neoplasms that contribute 2 to 9% of thymic tumors. Surgical excision remains the primary treatment, with video-assisted thoracoscopic surgery (VATS) emerging as a valuable approach. Less than 50 cases of pediatric thymolipomas have been reported, with the youngest case documented at 6 months of age, and fewer than five pediatric cases have been managed using the thoracoscopy approach in the literature. This is India's first report in literature where giant thymolipomas have been excised by the thoracoscopic approach in the pediatric population. Herein, we present two pediatric patients with anterior mediastinal masses, each presenting with distinct clinical features undergoing successful thoracoscopic resections. In case 1, a 9-year-old male child was incidentally diagnosed with giant thymolipoma. Surgical excision was done through the right side by VATS approach and the residual mass through the left by VATS, resulting in an uneventful postoperative course with no recurrence upon 1-year follow-up. In case 2, a 5-year-old female previously diagnosed with giant thymolipoma presented with fatigability. Imaging revealed a massive thymolipoma occupying both hemithoraces. Careful dissection, preservation of vital structures, and successful vascular pedicle management ensured complete excision through a single left thoracic approach, leading to a smooth recovery and absence of mediastinal mass on follow-up X-ray. This case report highlights VATS as a safe and effective management for giant thymolipoma; though it is technically challenging, it is a feasible approach, contributing to improved patient outcomes.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"336-342"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457972","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 comparative study on iliofemoral artery calcification distribution in alternative TAVR approaches.","authors":"Yu Hohri, Kan Zen, Hidetake Kawajiri, Masaki Yashige, Tomotaka Fujimoto, Shunsuke Nakamura, Ryotaro Tani, Satoaki Matoba","doi":"10.1007/s12055-024-01841-3","DOIUrl":"10.1007/s12055-024-01841-3","url":null,"abstract":"<p><strong>Background: </strong>Alternative access approaches are required for transcatheter aortic valve replacement (TAVR) cases wherein the transfemoral approach is restrictive with severe calcification. We aimed to examine the safety of the external iliac artery (EIA) as an alternative access site by evaluating the calcification distributions from the common iliac artery (CIA) to the common femoral arteries (CFA).</p><p><strong>Methods: </strong>We retrospectively enrolled 402 patients who underwent TAVR. Using computed tomography, calcification was visually assessed based on the maximal circumferential involvement, length, and morphology, and its volumes were quantitatively measured using a minimum threshold of 600 Hounsfield units in 804 arteries.</p><p><strong>Results: </strong>The calcification volumes were 0.301 (interquartile range, 0.114-0.624) cc in the CIA, 0.0 (0.0-0.041) cc in the EIA, and 0.047 (0.002-0.158) cc in the CFA (<i>p</i> < 0.01). Maximum calcification of >50% of the arterial circumference was observed in only 7.3% of the EIA, compared to 35.2% and 10.8% of the CIA and CFA, respectively. Almost 55% of the EIA had no calcification, compared with only <5% and 22.7% of the CIA and CFA, respectively. In a subgroup analysis of patients on dialysis, the calcification volume was smallest in the EIA at 0.011 (0.0-0.127) cc (<i>p</i> < 0.01). In all, 33.3% of EIAs had no calcification, while 2.0% of CIAs and 19.6% of CFAs were calcification-free.</p><p><strong>Conclusions: </strong>Calcification rarely presents qualitatively and quantitatively in the EIA, suggesting that it could be an option for TAVR when the transfemoral access is unsuitable.</p><p><strong>Graphical abstract: </strong>We qualitatively and quantitatively evaluated the distribution of calcification in the iliofemoral arteries of patients who underwent TAVR. The calcification was more rarely present in the EIA than in the CIA or CFA.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01841-3.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"272-280"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457873","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 surgical management of capillary hemangioma of the anterior mediastinum with recurrent pleural effusion.","authors":"Mohan Venkatesh Pulle, Anmol Bhan, Sukhram Bishnoi, Belal Bin Asaf, Harsh Vardhan Puri, Sumit Bangeria, Manan Bharatkumar Parikh, Arvind Kumar","doi":"10.1007/s12055-024-01804-8","DOIUrl":"10.1007/s12055-024-01804-8","url":null,"abstract":"<p><p>We report a case of a 73-year-old male, presenting with persistent cough and shortness of breath. He was diagnosed with an anterior mediastinal mass with significant recurrent loculated pleural effusion. The pre-operative biopsy from the mass was inconclusive. The patient underwent video-assisted thoracoscopic decortication on the left side followed by anterolateral thoracotomy for radical mediastinal mass excision, with notable challenges including mass being densely adherent to critical mediastinal structures intra-operatively and atrial fibrillation postoperatively. Final histopathology was suggestive of \"capillary hemangioma.\" This case highlights the complexity of diagnosing and managing such rare mediastinal mass and the importance of a multidisciplinary approach.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"346-349"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457967","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 triangles: an emotional ode to geometry.","authors":"Vidur Bansal, Pratyaksha Rana, Chirag Doshi","doi":"10.1007/s12055-024-01881-9","DOIUrl":"10.1007/s12055-024-01881-9","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"381-384"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457899","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":"\"Parvus sed potens\" coronary collaterals on the right side of the heart.","authors":"Vidur Bansal","doi":"10.1007/s12055-024-01835-1","DOIUrl":"https://doi.org/10.1007/s12055-024-01835-1","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 2","pages":"231-232"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004838","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":"Inferential statistics for cardiothoracic surgeons: Part 3 - drawing valid conclusions from clinical data.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-024-01867-7","DOIUrl":"https://doi.org/10.1007/s12055-024-01867-7","url":null,"abstract":"<p><p>Inferential statistics enable researchers to make predictions about a population based on sample data. This involves hypothesis testing where the null hypothesis assumes no effect, and the alternative hypothesis suggests a significant effect. Testing requires assumptions like normality and independence to be validated using tests like Shapiro-Wilk or Levene's for normality and variance. Significant findings are determined by p-values, with values under 0.05 typically indicating non-random effects. Choosing between parametric and non-parametric tests depends on data normality and variance homogeneity. Tools such as t-tests, analysis of variance (ANOVA), and their non-parametric counterparts like Mann-Whitney or Kruskal-Wallis are used based on these criteria, ensuring appropriate conclusions about clinical effects and interventions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 2","pages":"233-247"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004662","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 bilateral lung transplantation after prolonged ECMO support for aspiration pneumonia in a 79-year-old man.","authors":"Sureshkumaran Kandasami, Komarakshi Rajagopalan Balakrishnan, Suresh Rao Kemundel Genny, Murali Krishna Tanguturu, Senthil Kumar Devarajan, Deepika Ramachandran, Soumitra Sinha Roy, Apar Jindal","doi":"10.1007/s12055-024-01749-y","DOIUrl":"https://doi.org/10.1007/s12055-024-01749-y","url":null,"abstract":"<p><p>Aspiration pneumonia is a serious problem in the elderly due to weakened swallowing reflexes or underlying gastroesophageal reflux disease (GERD). This can lead to acute respiratory distress syndrome (ARDS), which can become life-threatening, sometimes requiring extra corporeal membrane oxygenation (ECMO) support. Lung transplantation is a possible therapeutic option for patients with no signs of lung recovery despite prolonged ECMO support. However, this can be a particularly challenging situation in a geriatric population. We report the case of a 79-year-old male with aspiration pneumonia leading to severe ARDS who underwent successful bilateral lung transplantation after 60 days of ECMO support.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 2","pages":"179-183"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004701","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":"Giant pulmonary vein aneurysm.","authors":"Aprateem Mukherjee, Niraj Nirmal Pandey, Damandeep Singh, Rakesh Yadav, Priya Jagia","doi":"10.1007/s12055-024-01823-5","DOIUrl":"https://doi.org/10.1007/s12055-024-01823-5","url":null,"abstract":"<p><p>We report a case of a 14-year-old girl with complex congenital heart disease where computed tomography (CT) angiography demonstrated a giant aneurysm of the right inferior pulmonary vein, in the absence of any downstream obstruction. The case highlights the developmental aspects of this rare anomaly in addition to the role of CT angiography in anatomical depiction of structures which are difficult to visualize on transthoracic echocardiography.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 2","pages":"223-226"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004661","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":"Computed tomography dataset virtual dissection for sternal re-entry in congenital cardiac surgery.","authors":"Simran Kundan, Saurabh Kumar Gupta, Suresh Gururaja Rao","doi":"10.1007/s12055-024-01879-3","DOIUrl":"10.1007/s12055-024-01879-3","url":null,"abstract":"<p><p>In congenital heart surgery, redo-sternotomies are very common. In most cases, sternal re-entry is achieved without serious complications. However, sometimes elective institution of peripheral cardiopulmonary bypass is needed for safe sternotomy, albeit with a long cardio-pulmonary bypass time. We report our initial experience of three-dimensional reconstruction and virtual dissection of the retrosternal space, using Horos®, an open-source software, which uses the computed tomography (CT) scan dataset from a 64-slice CT pulmonary angiogram. We reconstructed three-dimensional images to help us conceptualize the retrosternal space for safer re-entry, which could be viewed in stereo with depth perception using anaglyph glasses. Once reconstructed, the substernal space could be viewed from multiple angles and this helped us better understand the anatomy for re-entry. The CT scans, though being the age-old imaging modality for assessment of the anatomy, leave room for assessment of the sub-sternal space. Recently, we encountered three patients in whom the sternal re-entry was deemed to be difficult. The CT scan left ambiguity in assessment of the substernal space and all three patients were assessed with 3-dimensional (3D) reconstruction and virtual dissection prior to sternotomy. All three patients underwent a safe redo-sternotomy without institution of cardiopulmonary bypass. Three-dimensional rendering of CT dataset as a novel technique has the potential to help surgeons visualize the retrosternal space in three dimensions and better understand the spatial relation of the heart with the inner table of the sternum.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01879-3.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 2","pages":"248-252"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004516","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}