Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Colonic transposition using mid colon for corrosive oesophageal strictures.","authors":"Vinay H G, Ramesh Reddy G, Ramprashanth M P","doi":"10.1007/s12055-023-01531-6","DOIUrl":"10.1007/s12055-023-01531-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate mid colon as a viable alternative for reconstruction in diffuse corrosive oesophageal stricture compared to other modes.</p><p><strong>Methods: </strong>This is a prospective observational study of surgical management of corrosive oesophageal stricture using the colonic interposition graft. Eight patients were included for a period of 4 years from January 2017 to December 2020 and followed up for a mean period of 32 months (range of 24 to 46 months). The results in these eight patients are discussed.</p><p><strong>Results: </strong>A total of 8 patients underwent retrosternal oesophagocoloplasty and gastrojejunostomy. There was no intraoperative or hospital death. Postoperative complications included one patient each having aspiration pneumonia and anastomotic leak.</p><p><strong>Conclusion: </strong>A successful reconstruction can be done by securing the correct vascular pedicle and a technique of good anastomosis. From our experience, colonic transposition using mid colon as conduit can be considered as a viable alternative in patients with long segment oesophageal stricture.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48301009","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 simple transseptal approach versus the conventional left atrial approach for mitral valve procedures: a retrospective study.","authors":"Mohammed Mahmoud Mostafa, Ahmed ELminshawy, Beshoy Allam, Mahmoud Thabet Ayoub","doi":"10.1007/s12055-023-01565-w","DOIUrl":"10.1007/s12055-023-01565-w","url":null,"abstract":"<p><strong>Background: </strong>Having good exposure to the mitral apparatus during mitral valve replacement is a vital decision every cardiac surgeon must take. This study was conducted to compare the simple transseptal approach and the conventional left atrial approach for mitral valve procedures, to evaluate the safety and efficacy of the simple transseptal approach during open heart mitral valve procedures, as the conventional left atrial approach may not provide optimal exposure, especially in unfavorable anatomical and operative situations.</p><p><strong>Methods: </strong>This is a retrospective study. It has been conducted on 140 patients who were diagnosed with heart diseases that required mitral valve replacement. Surgeries were performed in the Cardiothoracic Surgery Department. Mitral procedure was done through median sternotomy incision under general anesthesia on a cardiopulmonary bypass machine with cold antegrade cardioplegia. Demographic data, preoperative diagnosis, intraoperative findings, hospital stay, complications, and mortality were documented and revised.</p><p><strong>Results: </strong>One hundred and forty patients were enrolled in this study with a median age of 39 years, and no significant differences as regards the baseline demographic data as age, sex, and body mass index (BMI). A total of 68 patients underwent mitral valve replacement through the simple transseptal approach and 72 patients through the conventional left atrial approach. Both studied groups had insignificant differences as regards bypass time, re-operation rate, postoperative complications, hospital stay, and mortality.</p><p><strong>Conclusion: </strong>The simple transseptal approach through the midpoint of the fossa ovalis could be a safe and even favorable alternative to the traditional left atriotomy approach in certain difficult operative situations during mitral valve replacement surgery.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47286121","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":"Surgical outcomes of common arterial trunk repair beyond infancy.","authors":"Chinnaswamy Reddy, Ameya Kaskar, Govardhan Reddy, Niranjan Soundararajan, S Satheesh, Viralam S Kiran, Pujar Venkateshauarya Suresh","doi":"10.1007/s12055-023-01549-w","DOIUrl":"10.1007/s12055-023-01549-w","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to analyze the clinical outcomes of common arterial trunk repair beyond infancy in terms of both early- and long-term outcomes.</p><p><strong>Methods: </strong>Between January 2003 and December 2019, 56 patients underwent repair for common arterial trunk beyond infancy at our institute. Median age was 34.5 months, 51.8% were females, and 48.2% were males.</p><p><strong>Results: </strong>48.2% were type 1, 46.4% were type 2, and 5.4% were type 3. 17.9% patients underwent direct connection technique for right ventricular outflow tract reconstruction; remaining received a conduit. The most common type of truncal valve anatomy was tricuspid (82.1%). Early mortality was 7%. Univariable analysis identified age (<i>p</i> = 0.003), weight (<i>p</i> = 0.04), duration of ventilation (<i>p</i> = 0.036), and pulmonary hypertensive crisis (<i>p</i> ≤ 0.001) as factors affecting early mortality. In our overall cohort of beyond infancy repair for common arterial trunk, at 10 years, the survival, freedom from reintervention for right ventricular outflow tract reconstruction, freedom from ≥ moderate conduit obstruction, freedom from impaired right ventricle function, and freedom from ≥ moderate truncal valve regurgitation were 76.7%, 89.7%, 74%, 88.6%, and 66.3%, respectively.</p><p><strong>Conclusion: </strong>Repair for common arterial trunk in patients presenting beyond 1 year of age is challenging; however, it can be done with satisfactory early and late outcomes in terms of mortality and reintervention.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48689922","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":"Common arterial trunk repair after infancy.","authors":"Tom R Karl","doi":"10.1007/s12055-023-01585-6","DOIUrl":"10.1007/s12055-023-01585-6","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44520077","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":"Del Nido cardioplegia versus blood cardioplegia in coronary artery bypass grafting.","authors":"Lokeswara Rao Sajja, Gopichand Mannam, Devanish Narasimhasanth Kamtam, SatyaBhaskara Raju Dandu, Satyendranath Pathuri, Krishnamurthy Venkata Satya Siva Saikiran, Balakrishna Nagalla, Sriramulu Sompalli, Satyanarayana Ghanta","doi":"10.1007/s12055-023-01584-7","DOIUrl":"10.1007/s12055-023-01584-7","url":null,"abstract":"<p><strong>Purpose: </strong>The del Nido cardioplegia (DC) has been extensively used in congenital heart surgery for over two decades and is becoming popular in adult cardiac surgery. We evaluated the efficacy and safety of DC, compared to conventional blood cardioplegia (BC), in adult patients undergoing isolated coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>This metachronous study included a total of 2330 consecutive patients who underwent isolated CABG. The study population was divided into two groups: BC group, consisting of 1165 patients (May 2012 through December 2015); and DC (del Nido) cardioplegia group consisting of 1165 patients (January 2016 through June 2018). Propensity matching yielded 735 well-matched pairs. The propensity-matched cohorts of BC and DC were compared in terms of myocardial function outcomes and other clinical outcomes to determine the efficacy and safety of both the cardioplegic solutions.</p><p><strong>Results: </strong>There was no difference in 30-day mortality [odds ratio (OR), 0.74; 95% confidence interval (CI), 0.16-3.35, <i>p</i> = 0.70]. There was a significant decrease in the DC group in the postoperative events, including re-exploration rates [OR, 0.25; 95% CI, 0.118-0.568, <i>p</i> < 0.001], myocardial infarction [OR, 0.282; 95% CI, 0.133-0.596, <i>p</i> < 0.001], left ventricular dysfunction [OR, 0.60; 95% CI, 0.396-0.916, <i>p</i> = 0.018], and acute kidney injury (AKI) [OR, 0.255; 95% CI, 0.156-0.418, <i>p</i> < 0.001]. The rate of spontaneous return to sinus rhythm was significantly higher in the DC group [OR, 5.162; 95% CI, 3.701-7.198, <i>p</i> < 0.001]. Cardiopulmonary bypass time (95.2 ± 29.1 min vs. 82.1 ± 28.8 min, <i>p</i> < 0.001) and aortic cross-clamp (ACC) time (57.3 ± 19 min vs. 48.7 ± 19.0 min, <i>p</i> < 0.001) were higher in the DC group, but the absolute difference in ACC time was only 8 min. There was no difference in AKI requiring renal replacement therapy [OR, 0.62; 95% CI, 0.203-1.912, <i>p</i> = 0.40], postoperative cerebrovascular accidents [OR, 0.398; 95% CI, 0.077-2.059, <i>p</i> = 0.073], and postoperative ventricular arrhythmias [OR, 0.80; 95% CI, 0.456-1.916, <i>p</i> = 0.47].</p><p><strong>Conclusion: </strong>This study revealed comparable clinical outcomes and effective myocardial protection with DC, compared to BC in patients undergoing isolated CABG. In addition, DC demonstrated the ease of administration with the feasibility of single-dose administration.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46809618","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 diagnosis and surgical management of pulmonary sequestration in adults: a case series from a single centre in the UK.","authors":"Ashar Asif, Daniel Lilley, Sherene Howard-Walker, Shereen Ajab, Syed Suhail Qadri","doi":"10.1007/s12055-023-01589-2","DOIUrl":"10.1007/s12055-023-01589-2","url":null,"abstract":"<p><p>Pulmonary sequestration (PS) is a rare congenital malformation where extrapulmonary lung tissue receives systemic blood supply from an anomalous branch directly from the thoracic or abdominal aorta. Whilst non-malignant, it can often present with similar symptoms as lung cancer. We present a retrospective review of 8 consecutive adult patients undergoing surgical management for PS within a single centre in the UK. Of our cohort, 62.5% had never smoked. PS in the right lung was seen in 62.5% of cases. Anomalous branches of the pulmonary artery, pulmonary vein or coeliac axis supplied 37.5% of the PS seen in our cohort, and 12.5% did not have a radiologically identifiable blood supply. Techniques varied from thoracotomy (<i>n</i> = 4), video-assisted thoracoscopic surgery (VATS) (<i>n</i> = 3) to robotic resection (<i>n</i> = 1) with no intra-operative or post-operative complications reported within hospital. The mean length of stay was 2 days. The post-operative mortality rate was 12.5%; one patient had died following the robotic resection of the mass of pneumonia in the local district hospital 26 days post-operatively after being discharged. No other complications nor recurrence was recorded over the follow-up period. Where pulmonary masses receive blood supply from anomalous branches of the pulmonary vein and coeliac axis, diagnoses of PS should be considered. The clinical feasibility of discharge in 2 days with no symptom recurrence should undergo further investigation with a larger sample size.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44438296","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":"Standing the test of time: total aortic remodeling 13 years after TEVAR for acute type B aortic dissection.","authors":"Matthias Niklas Hagedorn, Katrin Meisenbacher, Denis Skrypnik, Moritz Sebastian Bischoff, Dittmar Böckler","doi":"10.1007/s12055-023-01586-5","DOIUrl":"10.1007/s12055-023-01586-5","url":null,"abstract":"<p><p>Long-term outcome after thoracic endovascular aortic repair (TEVAR) of acute type B aortic dissection (aTBAD) is still underreported in current literature. This case report shows persistence of aortic remodeling without secondary complication or need of reintervention 13 years after TEVAR. A 45-year-old woman was referred to the emergency room with aTBAD. Due to early diameter progression in combination with therapy-refractory pain and uncontrolled hypertension, TEVAR was performed. Hereafter, the patient showed complete remodeling of the descending thoracic aorta without persistent false lumen perfusion in this segment and with stable true and false lumen diameter in the untreated abdominal segment for a 13-year period. No aortic-related reintervention was needed. With contemporary devices and adapted therapy, TEVAR seems able to treat complex thoracic disease. Long-term follow-up (FU) is mandatory to monitor the efficacy and durability of endovascular treatment in aortic disease.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44613990","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":"Delayed aorto-atrial fistula-a rare complication of tricuspid valve endocarditis.","authors":"Nathaniel Reed, Zachary Brennan, Kaushik Mandal","doi":"10.1007/s12055-023-01570-z","DOIUrl":"10.1007/s12055-023-01570-z","url":null,"abstract":"<p><p>A patient with a history of endocarditis developed a fistula between the aorta and right atrium requiring surgical repair. The patient underwent surgical intervention with closure of the fistula using an autologous pericardial patch and primary repair. This report is significant because a rare surgical pathology is visualized clearly and provides an educational value to aid other clinicians in the recognition and management of this unusual diagnosis.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48793397","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":"Surgery for lung cancer: insight from a state cancer centre in India.","authors":"Mohamed Taher Mithi, Mohit Sharma, Ketul Puj, Jebin Aaron Devarajan, Nilang Joshi, Shashank J Pandya, Shailesh Patel, Vikas Warikoo, Priyank Rathod, Shivam Pandya, Abhijeet Salunke, Keval Patel, Vasudha Garg","doi":"10.1007/s12055-023-01590-9","DOIUrl":"10.1007/s12055-023-01590-9","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer is one of the most common cancers in India. However, less than half receive treatment with a curative intent and very few undergo surgery amongst them. We present our surgical experience with non-small cell lung cancer.</p><p><strong>Methods: </strong>A retrospective analysis of a cohort of 92 non-small cell lung cancer patients operated with curative intent.</p><p><strong>Results: </strong>Less than 2% patients of lung cancer were operated on at our centre. Adenocarcinoma was the most common histological subtype. Right upper lobectomy was the most common surgery performed. Two- and 3-year overall survival was 74.3% and 70.6% respectively. Two- and 3- year disease-free survival was 65.4% and 60.8% respectively.</p><p><strong>Conclusion: </strong>The fraction of patients who are operated for lung cancer is very less. There is a definite missed window of opportunity. We have comparable survival to international data.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45694107","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":"Impact of left atrium plication on chronic heart failure with atrial functional mitral regurgitation.","authors":"Kosuke Nakamae, Takashi Oshitomi, Hideyuki Uesugi, Ichiro Ideta, Kentaro Takaji, Toshiharu Sassa, Hidetaka Murata, Masataka Hirota","doi":"10.1007/s12055-023-01569-6","DOIUrl":"10.1007/s12055-023-01569-6","url":null,"abstract":"<p><strong>Purpose: </strong>We hypothesized that a giant left atrium may oppress  the posterior left ventricle and aggravate diastolic dysfunction and heart failure. We evaluated the effect of left atrial plication (LAP) on atrial functional mitral regurgitation.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent LAP for atrial functional mitral regurgitation at our institution between January 2017 and December 2021. Early outcomes, follow-up echocardiography data, and heart failure indicators were compared.</p><p><strong>Results: </strong>Eighteen patients were divided into two groups: LAP + (n = 9) or LAP- (n = 9). There were no significant differences in patient characteristics and preoperative echocardiographic parameters, except for the preoperative New York Heart Association classification. Operative (505.7 [standard deviation: 100.0] minutes vs. 382.9 [standard deviation: 58.1] minutes, P = .0055) and cardiopulmonary bypass times (335.6 [standard deviation: 50.4] minutes vs. 246.9 [standard deviation: 62.7] minutes, P = .0044) were significantly longer in the LAP + group. No in-hospital mortalities were observed in both groups. The postoperative left atrial volume was significantly reduced in the LAP + group, and mitral regurgitation was controlled at less than mild levels in both groups. At follow-up, the left ventricular end-diastolic volume was reduced significantly in the LAP + group. Brain natriuretic peptide, cardiothoracic ratio, and the New York Heart Association classification were improved in the LAP + group.</p><p><strong>Conclusions: </strong>Additional left atrial plication contributes to the control of atrial functional mitral regurgitation and heart failure at a later stage. A careful long-term follow-up is needed as re-expansion of the left atrium is possible.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-023-01569-6.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45703228","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}