Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Monocusp pulmonary valve reconstruction in Tetralogy of Fallot: early results and evaluation using 2D echocardiography and 3-T cardiac MRI.","authors":"Sneha Daniel, Pranav Gupta, Kalpana Bansal, Arima Nigam, Saket Agarwal, Muhammed Abid Geelani","doi":"10.1007/s12055-025-01944-5","DOIUrl":"10.1007/s12055-025-01944-5","url":null,"abstract":"<p><strong>Background: </strong>Transannular patch (TAP) repair of right ventricular outflow tract (RVOT) in intracardiac repair of Tetralogy of Fallot (TOF) has been plagued by residual anatomic and hemodynamic abnormalities leading to mortality and morbidity. While efforts have been made to mitigate the effects of free pulmonary regurgitation (PR) following TAP repair, no single method demonstrated superior results. In this paper, we tried a novel method of monocusp pulmonary valve reconstruction using a strip of fixed autologous pericardium at the monocusp edge and assessed the early and mid-term results of the repair using two-dimensional (2D) echocardiography and cardiac magnetic resonance imaging (CMR).</p><p><strong>Methods: </strong>Ten consecutive patients who underwent intracardiac repair with TAP and monocusp reconstruction of pulmonary valve were studied. Postoperative 2D echocardiography and CMR were done to compare the diagnostic modalities.</p><p><strong>Results: </strong>Of the ten patients, nine were diagnosed to have only mild and low moderate PR on 2D echocardiography and regurgitant fraction of 10.8 to 28% on CMR during a follow-up period of 1 to 6 months using CMR, and one was diagnosed to have high moderate PR with regurgitant fraction 39.6%. Both the modalities had comparable results in diagnosing postoperative PR.</p><p><strong>Conclusion: </strong>Our method of pulmonary valve reconstruction is reasonable and provides good short-term and mid-term results in preventing postoperative PR. CMR is an excellent non-invasive operator-independent modality for the quantification of PR which provides a reproducible and comprehensive assessment of the repair and can be routinely used for the postoperative assessment of patients undergoing TAP repair of TOF.</p><p><strong>Graphical abstract: </strong>Schematic diagram A. The dotted line represents the incision extending from the right ventricular outflow tract to the main pulmonary artery, B. Visualising the native pulmonary valve anatomy C. the position of the monocusp represented in yellow, and the brown line demonstrating the strip of fixed pericardium D. Cross section of the right ventricular outflow tract- pulmonary artery junction with the position of monocusp with the thickening demonstrating the position of the strip of fixed pericardium.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1165-1172"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952253","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":"Progression or persistence of tricuspid regurgitation after mitral valve replacement in patients with pre-operative moderate tricuspid regurgitation.","authors":"Raj Kumar Joel, Shalom Sylvester Andugala, Spurgen Jesu Krupa, Roy Thankachen, Ravi Shankar, Madhu Andrew Philip, Korah Thomas Kuruvilla, Sathish Kumar Dharmalingam, Nagaraj Veerasamy","doi":"10.1007/s12055-025-01965-0","DOIUrl":"10.1007/s12055-025-01965-0","url":null,"abstract":"<p><strong>Purpose: </strong>There is a paucity of data on factors contributing to post-operative tricuspid regurgitation among patients with pre-operative <i>moderate</i> functional tricuspid regurgitation undergoing mitral valve replacement for rheumatic heart disease, the most common cause of mitral valve disease in the developing world.</p><p><strong>Methods: </strong>Between January 2013 and December 2018, 476 patients underwent mitral valve replacement in our institution, of which 135 fulfilled the exclusion criteria. Of the remaining 341 patients, 142 had moderate functional tricuspid regurgitation. Our primary objective was to estimate the number of patients with of post-operative moderate to severe tricuspid regurgitation. Secondary outcomes were to determine the factors associated with it.</p><p><strong>Results: </strong>Among the 142 patients who had pre-operative moderate functional tricuspid regurgitation (TR), mitral stenosis (46.4%) was the predominant lesion. Concomitant tricuspid annuloplasty (TAP) was done in 41 patients (28.9%). The median duration of follow-up was 35 (11, 79.5) months. Post-operative moderate to severe TR was recorded in 41.5%. Atrial fibrillation was significantly associated with post-operative moderate to severe TR (<i>p</i> = 0.006). Among the patients who did not undergo TAP, post-operative moderate to severe TR (85%, 50/59) compared to post-operative mild TR (61%, 51/83) with a <i>p</i>-value of 0.003.</p><p><strong>Conclusion: </strong>Our data show that concomitant tricuspid annuloplasty during mitral valve replacement can be considered even in patients with pre-operative moderate TR and that pre-operative atrial fibrillation is significantly associated with post-operative TR.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01965-0.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1136-1143"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952233","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":"\"Treat and repair\" strategy for a giant pulmonary artery aneurysm caused by idiopathic pulmonary hypertension and compression of the left main coronary artery.","authors":"Yuchen Cao, Masaaki Koide, Masayuki Goto, Takuya Maeda, Yoshifumi Kunii","doi":"10.1007/s12055-025-01968-x","DOIUrl":"10.1007/s12055-025-01968-x","url":null,"abstract":"<p><p>Compression of the left main coronary artery by a giant pulmonary artery aneurysm is a rare but potentially fatal condition, particularly in patients with pulmonary hypertension. Although percutaneous coronary intervention has been attempted, concerns remain regarding stent durability. Surgical intervention provides a definitive solution but carries high perioperative risks. A 67-year-old woman with idiopathic pulmonary arterial hypertension developed exertional chest tightness and left vocal cord paralysis. Imaging revealed a giant pulmonary artery aneurysm compressing the left main coronary artery, causing severe stenosis. Given the high surgical risk, preoperative medical therapy was initiated, successfully lowering pulmonary artery pressure. The patient then underwent pulmonary artery plication, main pulmonary artery conduit replacement, and left main coronary artery patch angioplasty-a unique combination rarely reported in this setting. Postoperative imaging confirmed an adequately expanded left main coronary artery without external compression. This case highlights a \"treat and repair\" strategy, in which pulmonary hypertension management optimized surgical safety. A multidisciplinary approach is essential, and long-term follow-up is needed to assess the durability of the reconstructed left main coronary artery.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1212-1217"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952432","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":"Buttonhole LASER pulmonary metastasectomy: an innovative parenchyma preserving technique.","authors":"Laleng Mawia Darlong, Naveen Kumar Kushwaha, Neha Garg, Arnab Chakraborty, Prerit Sharma","doi":"10.1007/s12055-025-01988-7","DOIUrl":"10.1007/s12055-025-01988-7","url":null,"abstract":"<p><p>With advances in systemic anticancer therapies, pulmonary metastasectomy is being increasingly employed for local disease control while aiming to preserve lung parenchyma, anatomy, and function with complete (R0) resection. We introduce an innovative neodymium-doped yttrium aluminum garnet (Nd-YAG) light amplification by stimulated emission of radiation (LASER) approach for peripherally located, deep-seated, and fissural lesions, utilizing the lung's natural tongue-like configuration at the edges. This method involves cylindrical excision around the nodule, creating a buttonhole from one surface to the other. This approach minimizes parenchymal loss and maintains anatomical integrity, ensuring adequate lung expansion. We refer to this as the Nd-YAG LASER buttonhole pulmonary metastasectomy. Ten patients who underwent Nd-YAG LASER buttonhole pulmonary metastasectomy for synchronous and metachronous lesions at a tertiary oncology center in India between October 2023 and December 2024 were identified from a prospective database. Data was collected retrospectively from patient records from PARAS software, operative recordings, and clinical imaging systems. Between October 2023 and December 2024, 62 patients underwent Nd-YAG LASER-assisted pulmonary metastasectomy, with 10 patients undergoing buttonhole metastasectomy based on specific criteria. The procedure demonstrated efficacy in managing multiple and bilateral metastases, with 83.3% of bilateral cases completed in a single stage. In this cohort of 10 cases, 43 metastatic lesions were resected, out of which 27 were excised using LASER, including 14 via the buttonhole approach. This technique achieved precise excision with minimal parenchymal loss, maintaining a mean clear margin of 2.78 mm. Postoperative recovery was uneventful, and all patients remained disease-free at follow-up. For deep-seated peripheral lung lesions in the outer third of the lung, especially near the mediastinal pleura, diaphragm, or fissures, Nd-YAG LASER-assisted buttonhole pulmonary metastasectomy serves as a safe and effective alternative to LASER coring, stapled wide wedge resection, or segmentectomy. This technique enhances lung parenchymal preservation while allowing for potential future redo metastasectomies.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01988-7.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 9","pages":"1262-1267"},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952507","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 coronary sinus diversion to left atrium mimicking paravalvular leak: the importance of documentation.","authors":"Ashley Cole, Md Anamul Islam, Joanna Newman, Pankaj Garg, Jorge Francisco Velazco, Amber Malhotra","doi":"10.1007/s12055-025-01926-7","DOIUrl":"https://doi.org/10.1007/s12055-025-01926-7","url":null,"abstract":"<p><p>Managing adult patients with congenital heart disease (CHD) presents unique diagnostic as well as therapeutic challenges due to their altered anatomy, complex physiology, and lack of surgical records. We present a case of pseudo-paravalvular leakage after mitral valve (MV) replacement. The patient was a 46-year-old female who presented with severe mitral regurgitation, pulmonary hypertension, and single-vessel coronary artery disease. Per the patient, she was operated on for ventricular septal defect in her childhood. During surgery, it was discovered that the previous surgery was an atrioventricular septal defect (AVSD) repair, and her coronary sinus had been directed into the left atrium. The patient underwent MV replacement and tricuspid valve repair. Her left atrial coronary sinus mimicked a paravalvular leak after weaning from cardiopulmonary bypass (CPB) requiring re-initiation of CPB and arresting the heart. Mitral annular exploration confirmed no residual paravalvular defect, and the jet was persistent at the site of the coronary sinus after weaning from CPB a second time. The patient made an uneventful recovery except for the need for prolonged ventilation due to pulmonary hypertension and chronic obstructive pulmonary disease (COPD). This case highlights the importance of the availability of congenital heart surgery records and comprehensive preoperative imaging prior to reoperation. Our case is an example of anatomical misconception of paravalvular leakage and emphasizes the importance of diligent preoperative and intraoperative imaging to identify the detailed anatomy to prevent unnecessary procedures in adults operated for congenital heart diseases.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1063-1066"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682523","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":"Pericardial sebaceous cyst masquerading as constrictive pericarditis.","authors":"Karan Kumar Shetty, Abhishek Rajendra Potnis, Sushrut Suhas Potwar, Uday Eknath Jadhav","doi":"10.1007/s12055-025-01919-6","DOIUrl":"https://doi.org/10.1007/s12055-025-01919-6","url":null,"abstract":"<p><p>Sebaceous cysts are common subcutaneous lesions caused by obstruction of sebaceous gland ducts, typically occurring on the skin. Their occurrence in internal organs, particularly the heart, is infrequent. This image presentation explores the unique case of a sebaceous cyst masquerading as constrictive pericarditis.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01919-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1096-1098"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682531","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":"Primary hydatid cyst of the diaphragm: A systematic review.","authors":"Rezheen J Rashid, Soran H Tahir, Ayoob A Mohammed Abid, Deari A Ismaeil, Khanda Abdulateef Anwar, Dilan S Hiwa, Harem K Ahmad, Ali H Hasan, Nasren Sharef Sabr, Fahmi H Kakamad, Sasan M Ahmed, Choman Sabah Omer, Berun A Abdalla","doi":"10.1007/s12055-025-01930-x","DOIUrl":"https://doi.org/10.1007/s12055-025-01930-x","url":null,"abstract":"<p><p>Hydatid cysts of the diaphragm are rare, with limited information available regarding their presentation and management. Typically caused by <i>Echinococcus granulosus</i>, hydatid cysts most commonly affect the liver and lungs, while diaphragmatic involvement is unusual. This study aims to provide insight into this condition by reviewing documented cases in the literature. A comprehensive search was carried out on diaphragmatic hydatid cysts adhered to the following inclusion criteria: (1) the study included a case presentation detailing the patient's condition; (2) diagnostic modalities, surgical findings, or histopathology confirmed the diaphragmatic infection; (3) the cyst(s) originally arising from the diaphragm rather than merely transversing through it from neighboring structures. A total of 20 studies (28 patients) were included in this study. The mean age of patients was 36.4 years. Of the hydatid cysts identified, 13 (46.4%) were located on the right hemidiaphragm, five (17.9%) were located on the left, and four (14.3%) involved both sides of the diaphragm. Regarding size, four cysts (26.7%) measured ≤ 5 cm, two (13.3%) measured > 10 cm, and nine (60.0%) were between these dimensions. Correct preoperative localization of the primary diaphragmatic cyst was achieved in 9 patients (32.1%) and not achieved in 13 patients (46.4%). In conclusion, primary diaphragmatic hydatid cysts are often misdiagnosed as originating from adjacent structures based on imaging findings, with accurate localization typically achieved only during surgery. This condition appears to predominantly affect the right hemidiaphragm. Both thoracotomy and open abdominal approaches have demonstrated favorable outcomes in managing this rare entity.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1013-1022"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682532","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":"Risk factors for intraoperative hypotension during cardiac surgery.","authors":"Jelena Vučković, Milanka Tatić, Sanja Vicković, Ivana Stojanović, Katarina Mitić, Aleksandra Kontić, Lazar Velicki","doi":"10.1007/s12055-025-01961-4","DOIUrl":"https://doi.org/10.1007/s12055-025-01961-4","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative hypotension (IOH), a common adverse effect of general anesthesia, is influenced by multiple preoperative factors and may lead to unfavorable outcomes. This study investigates IOH and identifies risk factors contributing to its occurrence during cardiac surgery.</p><p><strong>Material and methods: </strong>This prospective, single-center study was conducted over one year and included patients undergoing cardiac surgery. Preoperative data, including demographic characteristics, comorbidities, chronic cardiovascular therapy, and their impact on IOH, were recorded. Risk factors for IOH were identified using multivariable binary logistic regression analysis.</p><p><strong>Results: </strong>The IOH group consisted of 182 patients (31.5%), while the control group (without IOH) included 395 patients (68.5%). The total cohort comprised 402 men (69.7%) and 175 women (30.3%), with a mean age of 66.75 ± 9.24 years. The following preoperative factors were identified as significant risk factors for IOH: advanced age (Odds ratio [OR] 1.038, 95% confidence interval [CI] 1.013-1.063; <i>p</i> = 0.002), previous heart failure (OR 5.022, 95% CI 2.478-10.180; <i>p</i> < 0.0005), atrial fibrillation (OR 1.971, 95% CI 1.256-3.093; <i>p</i> = 0.003), chronic kidney disease (OR 2.256, 95% CI 1.064-4.784; <i>p</i> = 0.034), cerebrovascular accident (OR 2.493, 95% CI 1.208-5.144; <i>p</i> = 0.013), and anemia (OR 2.031, 95% CI 1.060-4.008; <i>p</i> = 0.010). Patients classified as ASA IV had a significantly higher risk of IOH compared to those with an ASA III score (OR 3.035, 95% CI 1.256-7.332; <i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>Older age, previous heart failure, atrial fibrillation, chronic kidney disease, cerebrovascular accident, anemia, and a higher ASA score (ASA IV) were identified as significant preoperative risk factors for intraoperative hypotension.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01961-4.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"986-996"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682534","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":"Supracardiac total anomalous pulmonary venous drainage with right-sided vertical vein draining into the proximal superior vena cava.","authors":"Arun Sharma, Dollphy Garg, Pankaj Aggarwal, Manphool Singhal","doi":"10.1007/s12055-025-01912-z","DOIUrl":"https://doi.org/10.1007/s12055-025-01912-z","url":null,"abstract":"<p><p>Total anomalous pulmonary venous drainage (TAPVC) is a rare congenital anomaly with drainage of all the pulmonary veins into the systemic circulation instead of the left atrium. The commonest anomalous pattern of supracardiac TAPVC includes formation of the left-sided vertical vein draining into the left brachiocephalic vein. All the pulmonary veins forming a right-sided vertical vein and draining into proximal superior vena cava (SVC) are a highly uncommon variant, with distinct anatomical course. We present an extremely rare case of an 8-month-old child who presented with a variant pattern of drainage, and was managed successfully.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1051-1054"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682535","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":"E-CPR: coming back to life.","authors":"Shubhadeep Das, Debasis Das, Nilanjan Dutta, Manish Kumar Sharma","doi":"10.1007/s12055-025-01905-y","DOIUrl":"https://doi.org/10.1007/s12055-025-01905-y","url":null,"abstract":"<p><p>Extracorporeal cardiopulmonary resuscitation (E-CPR) employs rapid venoarterial extracorporeal membrane oxygenation (VA-ECMO) during cardiopulmonary resuscitation (CPR) to restore perfusion. This case involves a 3.5-month-old girl with anomalous left coronary artery from the pulmonary artery (ALCAPA), severe left ventricular dysfunction, and moderate mitral regurgitation. After surgical correction, she experienced cardiac arrest post-extubation. Conventional CPR failed, and E-CPR was initiated after 70 min. Hemodynamic stability and end-organ function were maintained during 72 h and 45 min on ECMO. Post-decannulation, she showed significant recovery, normal neurological status, and improved cardiac function. At 6 months post discharge, her left ventricular function was normalized.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 8","pages":"1033-1035"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682517","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}