Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Early cardiac arrest among cardiac surgeons: a professional crisis requiring systemic introspection.","authors":"Anand Shankar Soundararajan","doi":"10.1007/s12055-026-02196-7","DOIUrl":"https://doi.org/10.1007/s12055-026-02196-7","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"821-823"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972263","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":"Obstructive mechanical mitral valve thrombosis due to chronic subtherapeutic anticoagulation.","authors":"Pramod Tulsidas Gitte, Umesh Khedkar, Milind Kharche, Deepak Borde, Anand Deodhar","doi":"10.1007/s12055-026-02217-5","DOIUrl":"https://doi.org/10.1007/s12055-026-02217-5","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"824-827"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971910","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":"Vacuum versus non-vacuum assisted chest tube drainage in postoperative bullectomy.","authors":"David Zarif Sobhy Labeeb, Ilyas Mohamed Hassan, Mohamed Abul-Dahab Mahmoud, Ali Elsayed Abdelgayed Hetiba, Mohamed Mohamed Abdelraouf Khalil","doi":"10.1007/s12055-026-02198-5","DOIUrl":"https://doi.org/10.1007/s12055-026-02198-5","url":null,"abstract":"<p><strong>Background: </strong>Bullous lung disease (BLD) is frequently associated with spontaneous pneumothorax and may require surgical intervention. The use of vacuum-assisted chest tube drainage after bullectomy is controversial. This study aimed to compare the results of vacuum versus non-vacuum assisted chest tube drainage in patients after bullectomy.</p><p><strong>Methods: </strong>This randomized controlled study included 80 patients who underwent bullectomy between September 2023 and July 2024 at Kasr Al-Ainy Hospitals. Patients were randomly allocated to either vacuum-assisted or non-vacuum chest tube drainage. Postoperative outcomes including chest tube duration, air leak duration, drainage volume, pain scores, length of hospital stay, and complication rates were compared between the two groups.</p><p><strong>Results: </strong>No statistically significant differences were observed between the two groups regarding chest tube duration (7.0 ± 1.5 vs. 6.7 ± 4.03 days), duration of air leak (4.67 ± 1.36 vs. 4.43 ± 3.7 days), or amount of drained fluid (726.7 ± 161.7 mL vs. 669.5 ± 299.1 mL) in the vacuum and non-vacuum groups, respectively. Postoperative pain scores, length of hospital stay, and complication rates (including bleeding, wound infection, empyema, residual cavity, and mortality) were also comparable between groups.</p><p><strong>Conclusion: </strong>By focusing exclusively on bullectomy patients (a group under-represented in prior trials that mainly combined lobectomy and other resections), our study provides procedure-specific evidence showing no clinical advantage of routine suction. These findings help clarify inconsistencies in the literature by demonstrating that the benefit of suction may not extend to bullectomy, where postoperative physiology differs from major lung resections.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"771-777"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972164","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":"Correction to: Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis.","authors":"Peter Dong Won Cho, Amba Viswanathan, Leigham Breckenridge, Katy Strand, Michael Hast, Uday Dasika","doi":"10.1007/s12055-026-02218-4","DOIUrl":"10.1007/s12055-026-02218-4","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s12055-026-02177-w.].</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"783"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972282","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":"Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis.","authors":"Peter Dong Won Cho, Amba Viswanathan, Leigham Breckenridge, Katy Strand, Michael Hast, Uday Dasika","doi":"10.1007/s12055-026-02177-w","DOIUrl":"10.1007/s12055-026-02177-w","url":null,"abstract":"<p><strong>Objective: </strong>Wire fracture during sternal closure following median sternotomy poses significant risks, including sternal dehiscence. This study introduces and evaluates a novel \"twist-to-writhe\" technique aimed at reducing the risk of wire fracture while maintaining adequate sternal closure.</p><p><strong>Methods: </strong>Ten foam sternum models per group were used and bisected to simulate median sternotomy. Each foam sternal model was closed with five sternal wires using either the twist-to-writhe (experimental) technique or the traditional (control) technique. In the twist-to-writhe method, wire ends that were cleaved were left at 10 centimeters (cm) before twisting with a wire twister. In the traditional method, wire ends were cut to 1 cm before twisting. Compressive forces at several sternal points were measured.</p><p><strong>Results: </strong>The average compressive forces across four key sternal points were similar between the twist-to-writhe and traditional methods (167.45 ± 5.96 newton (N) vs. 172.92 ± 7.41 N, <i>p</i> = 0.086). No significant differences in force application were observed at the manubrium, upper mid-sternum, lower mid-sternum, or xiphoid process (<i>p</i> > 0.05 for all comparisons).</p><p><strong>Conclusion: </strong>The twist-to-writhe technique may reduce the incidence of wire fractures without compromising sternal approximation or closure quality. Further clinical validation is needed to confirm these findings.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-026-02177-w.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"778-782"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972242","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":"PCI after SVG failure-native vessel or graft?","authors":"Pradeep Narayan","doi":"10.1007/s12055-026-02199-4","DOIUrl":"https://doi.org/10.1007/s12055-026-02199-4","url":null,"abstract":"<p><p>Saphenous vein graft (SVG) failure following coronary artery bypass grafting may require re-intervention, with current guidelines favoring percutaneous coronary intervention (PCI) of the bypassed native coronary artery over SVG-PCI. The Percutaneous Coronary Intervention of Native Coronary Artery versus Saphenous Vein Graft in Patients with Prior Coronary Artery Bypass Graft Surgery (PROCTOR) trial is the first randomized controlled trial comparing native coronary artery PCI with SVG-PCI. The study shows that at 1 year, SVG-PCI was associated with significantly lower major adverse cardiac events than native vessel PCI. These findings question existing guideline recommendations, although longer-term follow-up is required.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"812-814"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972109","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":"Robotic-assisted coronary artery bypass grafting: comparative analysis of surgical outcomes and learning curve.","authors":"Karana Shekar, Pradeep Narayan, Vikneswaran Gunaseelan, Roshni Vinosha, Mohammed Maaz, Devi Prasad Shetty, Raghu Maruti Govindappa","doi":"10.1007/s12055-025-02123-2","DOIUrl":"https://doi.org/10.1007/s12055-025-02123-2","url":null,"abstract":"<p><strong>Aim: </strong>Data on outcome for robotic coronary artery bypass grafting (CABG) is sparse. The aim of this study was to compare clinical outcomes between conventional and robotic-assisted CABG.</p><p><strong>Methods: </strong>This was a single-center retrospective study comparing conventional and robotic-assisted CABG between January 2024 and October 2024. Baseline patient characteristics, intra-operative details, and post-op outcomes were compared between 2488 conventional and 136 robotic procedures. Propensity matching was done for age, gender, comorbid illness, and operative characteristics. Learning curve was analyzed using a cumulative sum (CUSUM) chart.</p><p><strong>Results: </strong>One hundred and thirty-two propensity-matched pairs were compared. Before matching, the conventional CABG group had a higher frequency of females and diabetes mellitus, and a slightly higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) 2 risk score, while ejection fraction was marginally higher in the robotic surgery group. After matching, the groups were comparable in terms of demographic details, clinical presentation, comorbid illness, and laboratory parameters. The duration of surgery, ventilation duration, and the number of distal anastomoses were higher in the conventional group before matching. After matching, the difference persisted for ventilation duration alone. Patients in the robotic-assisted CABG group had a lower incidence of arrhythmia (5.3% versus (vs.) 18.2%; <i>p</i> < 0.001). There was no difference in other post-op outcomes (renal complications, post-op myocardial infarction, extracorporeal membrane oxygenation (ECMO) requirement, and mortality). CUSUM analysis showed achievement of learning at the 86th patient, proficiency at the 114th patient, and competency by the 136th patient (<i>R</i> ² 0.88).</p><p><strong>Conclusion: </strong>Our study demonstrates that robotic-assisted CABG is a feasible and effective approach in appropriately selected patients. Long-term outcomes, particularly graft patency and completeness of revascularization, require further investigation before definitive conclusions can be drawn regarding its superiority over conventional CABG.</p><p><strong>Clinical significance: </strong>Robotic CABG is a promising alternative to conventional techniques with potential clinical benefits and should form part of the surgical armamentarium.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-02123-2.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"698-711"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972158","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":"Towards seamless myocardial infarction and cardiac rhythm detection: a deep learning approach with automated paper-electrocardiogram digitisation.","authors":"Ravina Pramod Rai, Praveen Ashok Kumar, Mullasari Ajit Sankaradas, Ramarathnam Krishna Kumar","doi":"10.1007/s12055-025-02140-1","DOIUrl":"https://doi.org/10.1007/s12055-025-02140-1","url":null,"abstract":"<p><strong>Purpose: </strong>In India, myocardial infarction (MI) is a significant cause of mortality related to cardiovascular diseases. Timely diagnosis is critical for addressing this issue. While prior studies have concentrated on digital electrocardiogram (ECG) data, the presence of noise and artifacts in paper electrocardiogram is not well addressed in the literature. So, it is important to incorporate a more diverse range of data to understand the intricacies involved in MI diagnosis comprehensively.</p><p><strong>Methods: </strong>This paper proposes an approach for MI and non-MI classification and cardiac rhythm classification using ECG. Modified versions of GoogleNet-Gated Recurrent Unit (GRU) and ResNet50- Bidirectional Long Short-Term Memory (BiLSTM) models were utilized for MI/non-MI and cardiac rhythm classification, respectively. Three different datasets (PTB-XL (dataset 1), ECG images of cardiac patients' data samples (dataset 2), and hospital paper ECG (dataset 3) were used for training the datasets, and final testing was done on digitized hospital paper ECG.</p><p><strong>Results: </strong>The proposed model achieved 88.8% accuracy on the PTB-XL dataset for MI/non-MI classification but showed performance disparity on dataset 3 test data. After a training-retraining process on datasets 2 and 3 and testing on dataset 3 test data, the model showed an accuracy of 92.50% with a balanced performance. For five-class cardiac rhythm classification, the proposed model attained 93.50% accuracy.</p><p><strong>Conclusion: </strong>Retraining models on diverse datasets enhances generalization to real-world scenarios. The study's findings emphasize the importance of incorporating various data sources to improve model robustness and reliability in clinical applications. The developed application facilitates the seamless integration of digitization and classification processes for enhanced diagnostic accuracy.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"715-727"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972194","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 combined vascular anomaly including persistent left superior vena cava, left upper pulmonary vein, and coronary sinus.","authors":"Esra Akcicek, Selin Ardali Duzgun, Tuncay Hazirolan","doi":"10.1007/s12055-026-02207-7","DOIUrl":"https://doi.org/10.1007/s12055-026-02207-7","url":null,"abstract":"<p><p>We report an incidental computed tomography (CT) finding of a persistent left superior vena cava (PLSVC) draining into the left upper pulmonary vein, accompanied by the coronary sinus (CS) connection to both the right atrium and the left upper pulmonary vein. A 57-year-old man underwent coronary CT angiography for bypass graft evaluation. An incidental PLSVC draining into the left upper pulmonary vein was detected. The coronary sinus had normal right atrial drainage but also connected to the left upper pulmonary vein. PLSVC usually drains into the right atrium and rarely into the left upper pulmonary vein. To our best knowledge, the anomaly of the coronary sinus connecting to both the left upper pulmonary vein and right atrium has not been previously reported. Although typically asymptomatic, right-to-left shunting may occur. Recognition of this rare anomaly is crucial before thoracic or electrophysiological procedures.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"815-818"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972196","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 association between gut microbiome and aortic aneurysm: a review article.","authors":"Sidharth Misra, Zainab Yusufali Motiwala, Aditya Puniyani, Shobhit Kumar, Devika Nair, Bratish Poddar, Fatima Nadeem, Mohammed Idhrees","doi":"10.1007/s12055-025-02150-z","DOIUrl":"https://doi.org/10.1007/s12055-025-02150-z","url":null,"abstract":"<p><p>Aortic aneurysm is influenced by traditional risk factors such as atherosclerosis, hypertension, and diabetes. Latest evidence states that the gut microbiome may play a crucial role in its pathogenesis. This review aims to explore the relationship between the gut microbiome and aortic aneurysm. We conducted a comprehensive literature review using PubMed, Embase, and Google Scholar to understand the association between aortic aneurysm and the gut microbiome. Relevant studies were evaluated and critically analyzed to narratively summarize existing knowledge and highlight research gaps. The analysis revealed that gut dysbiosis affects systemic inflammation and immune response. This in turn contributes to the degeneration of the vessel wall and aneurysm development. Bacterial metabolites, such as short-chain fatty acids (SCFAs), were found to influence inflammatory pathways, while microbial translocation exacerbates oxidative stress. Understanding the gut microbiome-aortic aneurysm axis can lead to the development of innovative prevention and therapeutic strategies focused on aortic aneurysm formation.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"42 6","pages":"754-764"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972189","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}