Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"The midterm outcomes of coronary artery bypass grafting for adult anomalous origin of the left coronary artery from the pulmonary artery.","authors":"Gowtham Thakut, Utkarsh Sanghavi, Ishan Gohil, Jignesh Kothari","doi":"10.1007/s12055-024-01739-0","DOIUrl":"10.1007/s12055-024-01739-0","url":null,"abstract":"<p><p>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. It presents as myocardial infarction in children; however, the presentation may vary between asymptomatic to progressive heart failure and also death. As a result, diagnosis in living adults is extremely rare. Different techniques have been mentioned for management of ALCAPA presenting in adults. In our retrospective case study, we present two adults, one male and one female, aged 33 and 49 years, respectively, who underwent transpulmonary direct closure of ALCAPA with left internal thoracic artery anastomosis to the left anterior descending artery and saphenous venous graft to obtuse marginal (OM) major, under standard cardiopulmonary bypass, thus forming a two-coronary system. On 5-year follow-up, both patients were doing well on echocardiography with good biventricular function, and follow-up computed tomography (CT) coronary angiography was carried out showing patent grafts. Therefore, establishment of a two-coronary system in adult ALCAPA can be considered as one of the gold standard treatments. In adult ALCAPA, coronary artery bypass grafting (CABG) is superior to other techniques in terms of alleviation of symptoms, survival, procedural ease, and improvement of left ventricular (LV) function.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 1","pages":"61-65"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828417","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":"Invasive vs conservative management in elderly patients with NSTEMI- insights from the SENIOR-RITA trial.","authors":"Pradeep Narayan","doi":"10.1007/s12055-024-01877-5","DOIUrl":"10.1007/s12055-024-01877-5","url":null,"abstract":"<p><p>The SENIOR-RITA trial randomized 1,518 elderly Non-ST-segment elevation myocardial infarction (NSTEMI) patients to invasive or conservative strategies. The primary composite outcome of cardiovascular death or nonfatal Myocardial Infarction (MI) occurred in 25.6% of the invasive group versus 26.3% in the conservative group (p = 0.53), despite lower nonfatal MI rates with invasive treatment (11.7% vs 15.0%). Procedural complications were low (< 1%), though the invasive group had slightly higher bleeding and Transient Ischemic Attack (TIA) rates. The early 1-year benefit of the invasive approach was not maintained at 5 years, highlighting the need to individualize management in this complex, elderly population. The review discusses the strengths and weaknesses of the SENIOR-RITA (Older Patients with Non-ST-Segment Elevation Myocardial Infarction Randomized Interventional Treatment) trial.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 1","pages":"80-82"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828412","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":"Novel technique of monocuspid reconstruction of pulmonary valve in children requiring transannular patch for right ventricular outflow tract relief during tetralogy of Fallot surgery.","authors":"Raj Benedict, Rhazane Nalluri, Vasudev Vemala","doi":"10.1007/s12055-024-01849-9","DOIUrl":"10.1007/s12055-024-01849-9","url":null,"abstract":"<p><p>Tetralogy of Fallot (TOF) repair involves the placement of a transannular patch (TAP) to relieve right ventricular outflow tract (RVOT) obstruction. TAP results in free pulmonary regurgitation (PR) after surgery. PR is responsible for most of the long-term complications in patients with operated TOF. To overcome this problem of PR we describe a novel method of monocusp reconstruction of the pulmonary valve using autologous pericardium in children requiring TAP. Newly created monocusp pulmonary valves reduce PR, help in faster recovery from surgery, and reduce long-term issues associated with repaired TOF.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01849-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 1","pages":"83-88"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828415","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":"Research designs for cardiothoracic surgeons: part 1 - a primer for evidence-based practice.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-024-01836-0","DOIUrl":"https://doi.org/10.1007/s12055-024-01836-0","url":null,"abstract":"<p><p>Understanding research designs is crucial for cardiothoracic surgeons to enhance their clinical practice and decision-making. This article provides a comprehensive overview of different research study types, including observational and experimental studies, and their relevance to cardiothoracic surgery. Detailed explanations of cohort, case-control, and cross-sectional studies, as well as various types of randomized controlled trials, are presented. Key terms and concepts like bias, validity, and reliability are discussed. Practical case examples from the literature illustrate the application of these research designs, aiding clinicians in selecting the appropriate study design for their research questions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"737-751"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464215","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":"Caps, masks, aprons, and gloves - necessary evils?","authors":"Om Prakash Yadava","doi":"10.1007/s12055-024-01822-6","DOIUrl":"https://doi.org/10.1007/s12055-024-01822-6","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"655-657"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464212","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":"Looking ahead: Incorporation of objective assessment methods, surgical simulation and 3D-printed models to improve technical skills of a cardiac surgeon in training in the Indian context.","authors":"Sudipto Bhattacharya","doi":"10.1007/s12055-024-01789-4","DOIUrl":"https://doi.org/10.1007/s12055-024-01789-4","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"755-756"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464213","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 year outcomes following of carotid endarterectomy in different age groups: Russian multicenter study.","authors":"Anton Kazantsev, Alexander Korotkikh, Roman Leader, Sergey Artyukhov, Lyudmila Roshkovskaya, Vladimir Unguryan, Maxim Chernyavin, Belov Yury","doi":"10.1007/s12055-024-01753-2","DOIUrl":"https://doi.org/10.1007/s12055-024-01753-2","url":null,"abstract":"<p><strong>Introduction: </strong>This is a retrospective analysis of the results of carotid endarterectomy (CEA) in different age groups.</p><p><strong>Methods: </strong>This cohort, comparative, retrospective, open-label study for the period from 2008 to 2020 included 7248 patients with hemodynamically significant stenoses of the internal carotid artery (ICA), who underwent CEA. According to the classification of the World Health Organization, patients were divided into groups depending on age: up to 44 years-young age (<i>n</i> = 84); 45-60 years-middle age (<i>n</i> = 1635); 61-75-elderly age (<i>n</i> = 4817); over 75 years-senile age (<i>n</i> = 712).</p><p><strong>Results: </strong>In terms of the frequency of hospital complications, the group of patients over 75 years of age experienced the largest number of cardiovascular events. One year after surgery, there were no significant differences in the incidence of complications between groups: death (group 1, 1.2%; group 2, 0.5%; group 3, 0.4%; group 4, 1%; <i>p</i> = 0.14), myocardial infarction (group 1, 1.2%; group 2, 0.3%; group 3, 0.14%; group 4, 0.3%; <i>p</i> = 0.12), stroke (group 1, 0%; group 2, 0.3%; group 3, 0.1%; group 4, 0.4%; <i>p</i> = 0.32).</p><p><strong>Conclusion: </strong>The largest number of adverse cardiovascular events after CEA are observed among patients over 75 years of age, which is due to the high frequency of multivessel coronary lesions, atrial fibrillation, and the severity of the comorbidities. One year after surgery, there were no significant differences in the incidence of complications between groups.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 6","pages":"675-683"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464214","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":"Women in cardiothoracic surgery.","authors":"Abha Chandra","doi":"10.1007/s12055-024-01801-x","DOIUrl":"10.1007/s12055-024-01801-x","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"532-535"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999811","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":"An inverted left atrial appendage-when it gives a surprise on the table.","authors":"Ancy Robinson, Thiruvenkitasamy Nareshkumar, Madhava Rao Bathala","doi":"10.1007/s12055-024-01726-5","DOIUrl":"10.1007/s12055-024-01726-5","url":null,"abstract":"<p><p>A newly identified left atrial (LA) mass on a post-repair intraoperative transoesphageal echocardiogram (TEE), following a left ventricle (LV) thrombectomy, will make the surgical team wonder-whether a part of the thrombus has been dislodged into the LA or what else could it be? This report is about a 34-year-old male who underwent LV thrombectomy, for whom the post cardiopulmonary bypass intra-operative TEE showed a new LA mass that turned out to be an inverted left atrial appendage on exploration.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"626-628"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001710","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":"Comparison of a coronary bypass surgery using a combination of both on-pump beating heart and cardioplegic arrest with conventional coronary bypass surgery using cardioplegic arrest on-pump.","authors":"Mehmet Ali Sahin, Erkan Kuralay","doi":"10.1007/s12055-024-01754-1","DOIUrl":"10.1007/s12055-024-01754-1","url":null,"abstract":"<p><strong>Objective: </strong>Antegrade cardioplegia may cause maldistribution in patients with multivessel coronary artery disease. Surgically bypassing large epicardial vessels before the cross-clamp and then administering cardioplegia from both the aortic root and the anastomosed grafts significantly prevent maldistribution and provide better cardiac protection.</p><p><strong>Methods: </strong>This study included 80 patients, all older than 70 years with an ejection fraction between 25 and 35%. Patients were equally divided into two groups. Distal anastomoses to some of large epicardial coronary arteries were performed before the cross-clamp was placed. Grafted veins were attached to multi-perfusion set ports. Then, cross-clamping was performed, and the multi-perfusion set was disconnected from the aortic cannula and attached to the cardioplegia route. Antegrade cardioplegia was administered to both the aortic root and saphenous vein grafts. After all distal anastomoses were completed, the cross-clamp was removed, and the multi-perfusion set was connected to the aortic cannula again. Conventional coronary bypass techniques were used in group 2 patients.</p><p><strong>Results: </strong>Inotropic agents were administered in 12 patients in group 1 and 29 patients in group 2 (<i>p</i> < 0.001). The average troponin I value in coronary sinus blood was 1.05 ± 0.8 ng/mL in group 1 and 3.12 ± 0.7 ng/mL in group 2 (<i>p</i> < 0.001). The average lactate value in coronary sinus blood was 1.15 ± 0.55 mmol/L in group 1 and 3.7 ± 2.4 mmol/L in group 2 (<i>p</i> < 0.001). Six patients died in the early postoperative period in group 2 (<i>p</i> = 0.028).</p><p><strong>Conclusion: </strong>The current technique considerably reduces cross-clamping time and allows better distribution of the cardioplegic solution, preserving myocardium. Reduced coronary sinus lactate and troponin I levels also indicate better myocardial protection.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"547-553"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999809","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}