Indian Journal of Thoracic and Cardiovascular Surgery最新文献_第6页

Diabetic ketoacidosis: a metabolic emergency post-heart transplantation. 糖尿病酮症酸中毒：心脏移植后的代谢紧急情况。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-04-21 DOI: 10.1007/s12055-026-02211-x

Mugdha Khapre, Swati Garekar, Shivaji Mali, Dhananjay Malankar, Sweta Budyal, Snehal Kulkarni

{"title":"Diabetic ketoacidosis: a metabolic emergency post-heart transplantation.","authors":"Mugdha Khapre, Swati Garekar, Shivaji Mali, Dhananjay Malankar, Sweta Budyal, Snehal Kulkarni","doi":"10.1007/s12055-026-02211-x","DOIUrl":"10.1007/s12055-026-02211-x","url":null,"abstract":"Background: Diabetic ketoacidosis (DKA) is a rare but serious metabolic complication following orthotopic heart transplantation (HT). Immunosuppressive agents, particularly tacrolimus and corticosteroids, contribute to the development of post-transplant diabetes mellitus (PTDM), which can precipitate hyperglycemic emergencies, including DKA. Timely recognition and intervention are crucial to prevent serious adverse outcomes of ketoacidosis.Case study: We report a 21-year-old male with restrictive cardiomyopathy who underwent HT in September 2024. Six months post-transplant, he presented to the emergency department with DKA. In addition to the conventional treatment involving intravenous insulin infusion, isotonic fluid rehydration, and correction of electrolyte imbalances, the immunosuppressive regimen needed major modification. Subsequently, adjusting immunosuppression and maintaining glycemic control remained cornerstones of the patient's therapy.Discussion: Tacrolimus is known to impair pancreatic β-cell function, leading to insulin deficiency and hyperglycemia. It may also unmask underlying type 1 diabetes, leading to insulin dependency, serious risks like DKA, microvascular/macrovascular complications, and consequently reduced allograft survival.Conclusion: Regular blood glucose monitoring, early recognition of metabolic abnormalities, and modification of the immunosuppressive regimen are essential for preventing life-threatening complications.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"923-930"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345187","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}

引用次数: 0

Evaluation of neodymium-doped yttrium aluminum garnet (Nd:YAG) LASER bronchoscopy for airway lesions: a single-center experience. 评价掺钕钇铝石榴石（Nd:YAG）激光支气管镜检查气道病变：单中心经验。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-04-25 DOI: 10.1007/s12055-026-02206-8

Ranjan Sapkota, Prajjwol Luitel, Amit Yadav, Sangita Basnet Sapkota, Sushan Man Shrestha, Aakriti Sharma, Bibhusal Thapa

{"title":"Evaluation of neodymium-doped yttrium aluminum garnet (Nd:YAG) LASER bronchoscopy for airway lesions: a single-center experience.","authors":"Ranjan Sapkota, Prajjwol Luitel, Amit Yadav, Sangita Basnet Sapkota, Sushan Man Shrestha, Aakriti Sharma, Bibhusal Thapa","doi":"10.1007/s12055-026-02206-8","DOIUrl":"10.1007/s12055-026-02206-8","url":null,"abstract":"Neodymium-doped yttrium aluminum garnet (Nd:YAG) LASER bronchoscopy has emerged as an important modality in the management of central airway obstruction, particularly in resource-limited settings. We retrospectively reviewed patients who underwent Nd:YAG LASER bronchoscopy between 2021 and 2024 at a tertiary care referral center in Nepal. Demographic characteristics, lesion profile, procedural details, complications, and outcomes were analyzed. Twenty three patients (86.9% male, median age 34.5 years) underwent 33 LASER sessions during the study period. Shortness of breath on exertion (86.9%) was the most common symptom and median symptom duration before presenting to us was 3 months. Patients were referred from centers across Nepal (73.9% from tertiary and 26.1% from district hospitals). The trachea was the most common site of lesion (48%). Benign lesions (60.9% ) were frequent, with post-intubation tracheal stenosis being the most common diagnosis (21.7%). Use of laryngeal mask airway for airway access increased (75%) while rigid bronchoscopy decreased (75%) over the course of four years. A statistically significant reduction in the Cotton-Myer grade was observed following the intervention (p < 0.001). Sixteen of 19 (84.8%) intubated patients were extubated immediately after the procedure. Minor hypoxia, major hypoxia, and minor bleeding occurred in eight (24%), one (3%), and seven sessions (21%), respectively. No airway fire, major hemorrhage, or 30-day mortality occurred. Nd:YAG LASER bronchoscopy is a safe and effective intervention for diverse airway lesions and demonstrates feasibility in a tertiary care center setting.Graphical abstract: ","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"880-888"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345204","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}

引用次数: 0

Minimally invasive approach for excision of left atrial myxoma-an 8-year single-center experience. 微创入路切除左心房黏液瘤- 8年单中心经验。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-02-23 DOI: 10.1007/s12055-026-02184-x

Gaurav Manglam Pandey, Anil Sharma, Sunil Dixit, Mohit Sharma, Sourabh Mittal, Pritanshi Singh

{"title":"Minimally invasive approach for excision of left atrial myxoma-an 8-year single-center experience.","authors":"Gaurav Manglam Pandey, Anil Sharma, Sunil Dixit, Mohit Sharma, Sourabh Mittal, Pritanshi Singh","doi":"10.1007/s12055-026-02184-x","DOIUrl":"10.1007/s12055-026-02184-x","url":null,"abstract":"With the objective to present a minimally invasive surgical approach for excision of left atrial (LA) myxoma via right anterior thoracotomy (RAT), offering a less traumatic alternative to conventional median sternotomy, patients admitted in the department of Cardiothoracic and Vascular Surgery (CTVS), Sawai Man Singh (SMS) Hospital, from January 2017 to December 2024 with isolated intra-cavitatory LA mass with no other cardiac pathology were included in this prospective study. After informed consent, all participants underwent myxoma excision via the RAT approach. The average clamp time ranged from 18 to 30 minutes and pump time between 30 and 45 minutes. Postoperative drain output averaged 50-75 cc which was notably less than seen in conventional sternotomy. The average cardiac intensive care unit (C-ICU) stay was also shorter. There was no procedure-related morbidity or mortality. Patients reported high satisfaction due to improved scar cosmesis. Thus, we conclude that cardiac myxomas, the most common benign cardiac tumors, typically arise in the left atrium, with a myriad of clinical presentations. Surgical resection by midline sternotomy remains the definitive treatment worldwide. However, we present LA myxoma excision via a RAT approach as a less traumatic alternative. Our technique avoids femoral cannulation (no femoral site complications and extra access ports), uses conventional instruments (cost-effectiveness), and eliminates sternotomy. It achieves similar cardiopulmonary bypass (CPB) time (30-45 minutes) and clamp times (18-30 minutes), lower drain output (50-75 cc), and shorter C-ICU stay and operative time, with excellent cosmetic results (small, cosmetic scar) and high patient satisfaction, without procedure-related complications.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"913-917"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345179","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}

引用次数: 0

Not just another pneumothorax: late diagnosis of Birt-Hogg-Dubé syndrome in a geriatric patient. 不仅仅是另一个气胸：一位老年患者的birt - hogg - dub<s:1>综合征的晚期诊断。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-02-21 DOI: 10.1007/s12055-026-02182-z

Ahmed Magdy Elmezayen, Amar Nandrha, Mike Kay, May April Oo, Tariq Minhas

引用次数: 0

Outcomes of coronary artery bypass grafting: insights from a single centre in South India. 冠状动脉旁路移植术的结果：来自南印度单一中心的见解。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-04-14 DOI: 10.1007/s12055-026-02205-9

Sameer Mohammed, Bineesh Kundoly Radhakrishnan, Remya Sudevan, Varghese Thomas Panicker, Vivek Velayudhan Pillai, Jayakumar Karunakaran

{"title":"Outcomes of coronary artery bypass grafting: insights from a single centre in South India.","authors":"Sameer Mohammed, Bineesh Kundoly Radhakrishnan, Remya Sudevan, Varghese Thomas Panicker, Vivek Velayudhan Pillai, Jayakumar Karunakaran","doi":"10.1007/s12055-026-02205-9","DOIUrl":"10.1007/s12055-026-02205-9","url":null,"abstract":"Purpose: Coronary artery bypass grafting (CABG) has set the benchmark for managing multivessel coronary artery disease (CAD), providing superior mid-term outcomes. However, limited regional data, particularly from South India, exist on mid-term post-CABG outcomes. This study attempts to evaluate survival, major adverse cardiac and cerebrovascular events (MACCE), and freedom from repeat revascularisation over a 5-year follow-up period in patients undergoing CABG at a tertiary referral center.Methods: A retrospective cohort study was conducted on 1634 patients who underwent isolated CABG from January 2003 to December 2007. Data were collected from institutional records, and follow-up information was obtained via outpatient visits, phone calls, and mail. Overall survival and MACCE free survival were assessed using Kaplan-Meier curves. Statistical significance was determined using log-rank tests (p < 0.05).Results: Follow up was done for 5 years, after surgery. 11.32% of patients were lost to follow up at 5 years. The cumulative MACCE rate at 5 years was 5.87%. Overall survival at 5 years was 85.74%. Repeat revascularization was done for 12 patients. Symptom free survival dropped to 75.56% at 5 years (Fig. 1).Conclusions: CABG provides excellent mid-term survival, MACCE-free outcomes and freedom from repeat revascularisation in patients with multivessel CAD, at 5 years follow up. This study contributes valuable insights into CABG outcomes in the Indian population and underscores the importance of regional data for optimizing care strategies.Graphical abstract: Supplementary information: The online version contains supplementary material available at 10.1007/s12055-026-02205-9.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"847-859"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345196","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}

引用次数: 0

Endovascular embolization of a ruptured bronchial artery pseudoaneurysm in an elderly female. 老年女性支气管动脉假性动脉瘤破裂的血管内栓塞治疗。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-02-21 DOI: 10.1007/s12055-025-02165-6

Gaurav Cheraya, Samay Prakash, Siddhi Hegde, Neha Cheraya, Pranav Sharma

{"title":"Endovascular embolization of a ruptured bronchial artery pseudoaneurysm in an elderly female.","authors":"Gaurav Cheraya, Samay Prakash, Siddhi Hegde, Neha Cheraya, Pranav Sharma","doi":"10.1007/s12055-025-02165-6","DOIUrl":"10.1007/s12055-025-02165-6","url":null,"abstract":"Bronchial artery pseudoaneurysm (BAP), pathologically defined as a contained hematoma, is a rare pathology with few reported cases (approximately 60) in the literature. In circumstances where patients are critically ill, prompt diagnosis and treatment are required. A 73-year-old woman with a history of coronary artery disease and interstitial lung disease presented with chest pain and dyspnea. She was hypotensive and anemic on arrival. Computed tomography (CT) angiography revealed a ruptured bronchial artery pseudoaneurysm with a large mediastinal hematoma. Endovascular embolization using N-butyl cyanoacrylate (NBCA) glue and Lipiodol achieved successful occlusion of the pseudoaneurysm. Computed tomographic angiography (CTA) is the investigation of choice to screen for the disease, with digital subtraction angiography (DSA) being the gold standard for confirmation and guiding management. With recent advances in interventional procedures and vascular access techniques, transcatheter embolization has become the first-line management option for managing these cases. In this case report, the pertinent anatomy, work-up, imaging findings, and overview of the interventional procedure technique are discussed.","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 7","pages":"904-907"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345207","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}

引用次数: 0

Pulmonary NUT carcinoma mimicking small cell lung cancer: a diagnostic pitfall in high-grade thoracic tumors. 模拟小细胞肺癌的肺NUT癌：高级别胸部肿瘤的诊断缺陷。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-07-01 Epub Date: 2026-02-21 DOI: 10.1007/s12055-026-02176-x

Sunila Jain, Md Ali Osama, Sabyasachi Bal

引用次数: 0

Large granulomatous fungal mass in the mediastinum with compression symptoms in an infant. 婴儿纵隔有压迫症状的大肉芽肿性真菌肿块。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-06-01 Epub Date: 2026-02-14 DOI: 10.1007/s12055-025-02170-9

Manish Choudhary, Sowmya Ramanan, Veena Vasudev, Baiju Sashi Dharan, Palaniraj Suresh

引用次数: 0

Time to consider TCAR as a potential treatment for CAS for India's elderly. 是时候考虑TCAR作为印度老年人CAS的潜在治疗方法了。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-06-01 Epub Date: 2026-03-21 DOI: 10.1007/s12055-026-02186-9

Mehak Singh, Sukul Khanna

引用次数: 0

Ten top tips for getting your paper rejected quickly: notes from the editorial desk. 让你的论文迅速被拒的十大建议：编辑部的笔记。

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Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI: 10.1007/s12055-026-02223-7

Pradeep Narayan

引用次数: 0