Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Long-term results of middle lobectomy patients operated for non-small cell lung cancer.","authors":"Bahar Agaoglu Sanli, Yunus Turk, Esra Yamansavci Sirzai, Serkan Yazgan, Ahmet Ucvet","doi":"10.1007/s12055-024-01886-4","DOIUrl":"10.1007/s12055-024-01886-4","url":null,"abstract":"<p><strong>Objectives: </strong>Lobectomy is the most frequently performed surgical treatment for lung cancer; isolated middle lobectomy (IML) is the least frequently performed lobectomy. Until recently, IML performed for Non-Small Cell Lung Cancer (NSCLC) located in the middle lobe of the lung was considered insufficient in oncologic surgery, and upper bilobectomy (Upper lobe + Middle lobe) or lower bilobectomy (Lower lobe + Middle lobe) was performed for isolated middle lobe tumors. Since postoperative morbidity and mortality rates are worse in bilobectomy compared to lobectomy, IMLs have become frequently performed. In this study, patients who underwent IML for NSCLC were compared with upper or lower lobectomies (ULL), and the oncologic results of patients who underwent IML were evaluated.</p><p><strong>Materials and methods: </strong>In this study, 45 patients who underwent IML at our institution between 2012 and 2022 and 45 patients, who underwent right upper or lower lobectomy and were similar in terms of gender and age, were retrospectively analyzed. Oncological outcomes between these two groups were evaluated.</p><p><strong>Results: </strong>The mean age of 45 patients, 34 (75.6%) male and 11 (24.5%) female, who underwent IML was found to be 62.5 ± 8.4 years. According to the type of surgery, 27 (60%) patients underwent thoracotomy and 18 (40%) patients underwent Video-Assisted Thoracoscopic Surgery (VATS). When tumor histopathologies were examined in all lobectomy patients, it was seen that squamous cell carcinoma was statistically significantly more dominant in IML patients than in the other two lobectomy groups (<i>p</i> = 0.014). In addition, it was seen that the tumor size was smaller in IML patients than in the other groups (<i>p</i> = 0.005). When the survival characteristics between these two groups were evaluated, the overall survival time (OS) of patients who underwent IML was 118.0 (59.0-124.0) months, while the overall survival time of patients who underwent ULL was 71.0 (66.0-74.0) months, and no statistically significant difference was found between the groups. No statistically significant difference was observed between the groups in terms of 30-day and 90-day mortality rates and 5-year survival rates.</p><p><strong>Conclusion: </strong>There was no significant difference in survival between patients who underwent IML for NSCLC and those who underwent same-sided ULL. Based on these results, IML can be considered as an oncologically appropriate treatment option for masses confined to the middle lobe without the need for bilobectomy.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01886-4.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"404-410"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718807","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":"New-onset headache after transcatheter atrial septal defect closure: a systematic review.","authors":"H Shafeeq Ahmed, Sneha Reddy Pulkurthi, Akhil Fravis Dias, Maryam Zahid, Varshini Vishwanatham","doi":"10.1007/s12055-025-01906-x","DOIUrl":"10.1007/s12055-025-01906-x","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a complex neurological disorder marked by severe headache and associated with various systemic symptoms. Atrial septal defect (ASD) closure, a common cardiac procedure, has been linked to the onset of new migraine episodes. This systematic review explores the incidence and management of migraine following transcatheter ASD closure.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Scopus, and CINAHL Ultimate, covering studies from inception to August 2024. The review followed PRISMA guidelines and was registered on PROSPERO (CRD42024578609). Data extraction and risk of bias assessment were systematically performed by independent reviewers.</p><p><strong>Results: </strong>A total of 831 studies were identified out of which 13 were included for the final analysis. The studies encompassed diverse populations globally, revealing varying onset times for migraine post-ASD closure, ranging from as early as 1 day to up to a year. Migraine incidence varied significantly, with several studies noting a higher prevalence in females and some cases showing a familial predisposition typically in the maternal side. The typical methods for ASD closure involved transcatheter approaches. Treatment modalities included non-steroidal anti-inflammatory drugs, calcium channel blockers, and anticoagulants, with some cases experiencing spontaneous resolution of symptoms. Modifications to anti-platelet therapy post-procedure, such as the introduction of clopidogrel along with aspirin, showed significant efficacy in treating and preventing migraine.</p><p><strong>Conclusion: </strong>This review highlights a significant correlation between ASD closure and the onset of migraine, underlining the need for further investigation into preventive strategies and management. These findings suggest a complex interaction between structural heart alterations and migraine pathophysiology.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-025-01906-x.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"426-440"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718815","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":"Pulmonary teratoma masquerading as aspergilloma.","authors":"Rahul Kumar Jaiswal, Mohit Kumar Joshi, Ankur Goyal, Aruna Nambirajan, Rajinder Parshad","doi":"10.1007/s12055-024-01818-2","DOIUrl":"10.1007/s12055-024-01818-2","url":null,"abstract":"<p><p>Pulmonary teratomas are extremely rare extragonadal neoplasms. As the clinical features are non-specific, the diagnosis rests on the radiological findings. The characteristic computed tomography (CT) findings of a teratoma in the lung include heterogenous lobulated mass containing soft tissue, fat, fluid, and/or calcification. However, at times these distinctive findings may be absent and the diagnosis is revealed only after surgery. We report a case of intrapulmonary mature teratoma in a patient where the preoperative diagnosis of aspergilloma was considered based on the imaging findings. We discuss some imaging findings that may help differentiate intra-pulmonary teratoma with aspergilloma. We also present a review of all published cases where teratoma mimicked as some other pulmonary lesions.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"447-451"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718818","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":"Minimally invasive cardiac surgery in congenital heart diseases: the new horizon.","authors":"Sayajirao Sargar, Tanushree Kar, Ranjana Lanjewar","doi":"10.1007/s12055-024-01830-6","DOIUrl":"10.1007/s12055-024-01830-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Sternotomy has been the most common approach for the correction of congenital cardiac defects, and questions arise surrounding the safety, feasibility, and cost-effectiveness of implementing minimally invasive techniques in congenital cardiac surgery, despite their global adoption over the past three decades. Nevertheless, the availability of published data from India on this subject remains limited. We aim to describe the techniques and outcomes of minimally invasive cardiac surgery in selected pediatric cases, a subject not previously detailed within the Indian population, and its corresponding surgical setup.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims and objectives: &lt;/strong&gt;To define the safety and efficacy of minimally invasive cardiac surgery (MICS) in the congenital population and provide a preliminary comparison with the open approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From April 2023 to December 2023, we operated on 63 cases of CHDs via a thoracotomy approach. These cases encompassed various conditions, including ostium secundum atrial septal defects (ASDs), partial atrioventricular canal defects, ASD with pulmonary stenosis/right ventricular outflow tract obstruction (ASD + PS/RVOTO), sinus venous ASD (SV ASD), single-ventricle physiology necessitating bidirectional Glenn (BDG), ventricular septal defects (VSDs), and VSD with pulmonary stenosis/right ventricular outflow tract obstruction (VSD + PS/RVOTO). All procedures were performed under general anesthesia using a single-lumen tube. Safety and efficacy parameters were assessed, and a preliminary comparison was drawn with patients undergoing surgery via a conventional sternotomy approach between November 2022 and August 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average age of our patient population was 8.38 ± 4.05 years, with the youngest being two infants who were 6 months old. The mean duration of cardiopulmonary bypass (CPB) was 86.17 ± 35.12 min. The mean cross-clamp time was 52.74 ± 29.88 min. Postoperatively, there was no mortality or arrhythmia within the study cohort. Patients exhibited minimal postoperative pain, and early mobilization was observed as early as postoperative day (POD) 1. However, two cases presented with significant bleeding attributed to coagulopathy. Noteworthy postoperative complications included pneumonia in a patient with a VSD and recurrent fever in another patient, with no identifiable causative organism upon culture. The median duration of the intensive care unit (ICU) stay following surgery was 2 days, while the median postoperative hospitalization duration was 7 days. Echocardiographic assessments conducted before discharge revealed no significant residual lesions or gradients in cases involving valvular pulmonary stenosis (PS) or resection of the right ventricular outflow tract (RVOT) muscle bundle. Follow-up examinations were performed at 2 weeks, 1 month, and 3 months postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Simple congenital c","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"387-394"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718809","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":"Vasopressin as a postoperative management strategy in Fontan procedure: a comparative study.","authors":"Shubhadeep Das, Debasis Das, Nilanjan Dutta, Manish Kumar Sharma, Shivani Gajpal, Susovan Halder, Unmesh Chakraborty, Apu Saha, Bharath Saske, Shubham Gupta","doi":"10.1007/s12055-024-01873-9","DOIUrl":"10.1007/s12055-024-01873-9","url":null,"abstract":"<p><strong>Purpose: </strong>The Fontan procedure is crucial for managing univentricular heart conditions but can lead to prolonged pleural effusions, affecting recovery and hospital stays. This study evaluated the effectiveness of vasopressin in reducing pleural effusion and improving recovery outcomes following Fontan procedure.</p><p><strong>Methods: </strong>This comparative observational study reviewed patient records from October 2021 to September 2023. Two cohorts were included of 23 patients each: patients who received postoperative vasopressin from October 2022 to September 2023 (VP group) and a historical control group from the previous year (NVP group), excluding those who underwent fenestrated Fontan. Vasopressin was administered postoperatively to the VP group to mitigate pleural effusion. Primary outcomes were the volume and duration of chest tube drainage. Secondary outcomes included hospital and intensive care unit (ICU) stay durations and fluid balance metrics.</p><p><strong>Results: </strong>There were no significant differences in the primary or secondary outcomes between the vasopressin group and the control group. The median total drain outputs in the VP and NVP groups were 69.4 ml/kg and 53.9 ml/kg, respectively (<i>p</i> = 0.96). The median duration of chest tube stay was 5.5 days for the VP group and 6 days for the NVP group (<i>p</i> = 0.74). Hospital stay duration (<i>p</i> = 0.74) and ICU stay duration (<i>p</i> = 0.82) showed no significant difference.</p><p><strong>Conclusion: </strong>Vasopressin does not significantly impact chest tube drainage volume or duration, nor does it reduce hospital stays in Fontan patients, suggesting a limited role in managing postoperative pleural effusions. Further research is needed to explore its benefits for specific patient subgroups and acute hemodynamic instabilities postoperatively.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>Below is the link to the electronic supplementary material. 10.1007/s12055-024-01873-9.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"395-403"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718829","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":"Interrupted aortic arch with severe aortic stenosis in an adult bicuspid aortic valve patient.","authors":"Ridhika Munjal, Neelam Aggarwal, Pankaj Ingole, Sudeep Singh Sidhu","doi":"10.1007/s12055-024-01828-0","DOIUrl":"10.1007/s12055-024-01828-0","url":null,"abstract":"<p><p>Interrupted aortic arch (IAA) is a rare congenital anomaly with a high mortality rate if left unoperated in infancy. Very few cases have been reported in adults so far. In this article, we are describing a case of IAA in a 28-year-old male patient. It was associated with bicuspid aortic valve (BAV) leading to severe aortic stenosis (AS). To our knowledge, very few complex cases involving trio of IAA with BAV and AS have been reported so far.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"464-467"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718803","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":"Combined large cell neuroendocrine carcinoma of the lung: case report with brief review.","authors":"Sujata Agrawal, Paramita Paul","doi":"10.1007/s12055-024-01826-2","DOIUrl":"10.1007/s12055-024-01826-2","url":null,"abstract":"<p><p>Large cell neuroendocrine carcinoma (LCNEC) in the lung is an uncommon and highly aggressive type of histological variation, representing only a small percentage of all lung cancer cases. The occurrence of combined LCNEC, distinguished by the coexistence of neuroendocrine and non-neuroendocrine elements within a single tumor, is even more infrequent. A 49-year-old male presented with lytic lesion of the mandible with suspected lung metastasis. Biopsy of the mandibular lesion was reported as ameloblastic fibroma. The biopsy of the lung lesion turned out to be combined LCNEC of the lung. Further positron emission tomography (PET) evaluation showed multiple metastatic deposits in bilateral lungs, mediastinal nodes, liver, bone, adrenal, and kidney. The patient has received seven cycles of paclitaxel and carboplatin with decrease in size of nodes and lesion post 6 months. Herein, we report a case of combined LCNEC with lung adenocarcinoma which is infrequently encountered and has been a subject of research with a brief review of literature.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"468-473"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718788","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":"Epithelioid hemangioendothelioma of the anterior mediastinum.","authors":"Mohan Venkatesh Pulle, Anmol Bhan, Sukhram Bishnoi, Belal Bin Asaf, Harsh Vardhan Puri, Sumit Bangeria, Manan Bharatkumar Parikh, Arvind Kumar","doi":"10.1007/s12055-024-01819-1","DOIUrl":"10.1007/s12055-024-01819-1","url":null,"abstract":"<p><p>Epithelioid hemangioendothelioma (EHE) is a very rare vascular neoplasm in the anterior mediastinum. It is considered an intermediate-grade vascular neoplasm between benign hemangioma and highly aggressive angiosarcoma, with the potential for distant metastasis. The management of this disease is dependent on various factors such as the extent of tumor involvement, presence/absence of metastasis, and the general condition of the patient. Surgery is the treatment of choice with/without adjuvant chemo-radiotherapy in resectable disease. This case report presents the successful surgical management of a large invasive EHE in the anterior mediastinum in a 50-year-old woman.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"456-458"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718793","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":"Qualitative research in cardiac surgery: importance, challenges, and opportunities.","authors":"Eka Narayan, Ramsah Cheah","doi":"10.1007/s12055-025-01923-w","DOIUrl":"10.1007/s12055-025-01923-w","url":null,"abstract":"<p><p>Qualitative research in cardiac surgery remains underutilised despite its crucial role in understanding patient experiences and improving care delivery. Cardiac surgery has traditionally been dominated by quantitative research and despite its clear value, qualitative research remains underutilised in cardiac surgery. This narrative review highlights key qualitative findings in valve replacement procedures, including patient autonomy in decision-making, post-operative challenges, and financial burdens. Mixed-methods research combining quantitative and qualitative approaches offers a comprehensive framework for addressing complex healthcare challenges. We propose strategic areas for future qualitative research and recommend increased integration of qualitative methodologies in cardiac surgical practice.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"498-502"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718819","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":"En-bloc resection of large anterior chest wall chondrosarcoma with myocutaneous flap closure.","authors":"Venkatesa Kumar Anakaputhur Rajan, Siva Kumaran Subbarayan, Arun Kumar Govindarajan, Harikrishnan Subramanian, Chandrasekar Purushothaman, Raghuram Arani Raghavendrarao","doi":"10.1007/s12055-024-01866-8","DOIUrl":"10.1007/s12055-024-01866-8","url":null,"abstract":"<p><p>Primary chondrosarcoma of the chest wall is uncommon but spreads aggressively. The primary treatment is radical excision because it is comparatively resistant to chemotherapy and radiation. When such massive tumors are removed with safety margins, a significant chest wall defect remains, necessitating reconstruction. Reconstruction has involved the use of materials such as titanium plates, polypropylene mesh with methyl methacrylate, sternal steel wires, etc. Chest wall reconstruction with muscle flaps alone after en-bloc resection of chondrosarcoma with extensive mediastinal and thoracic involvement is rarely performed, nowadays. We report a case of massive chondrosarcoma resected en-bloc with a bilateral pectoralis major myocutaneous flap reconstruction.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 4","pages":"490-492"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718790","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}