Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"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}

{"title":"Persistent neo-aortic root dilatation and aortic valve insufficiency after arterial switch operation following prior pulmonary artery banding.","authors":"Kota Agematsu, Mitsugi Nagashima, Yoshiharu Nishimura","doi":"10.1007/s12055-023-01629-x","DOIUrl":"https://doi.org/10.1007/s12055-023-01629-x","url":null,"abstract":"<p><p>Although there have been great improvements in the short- and medium-term outcomes of the arterial switch operation (ASO) for transposition of the great arteries (TGA), some complications including pulmonary artery stenosis, aortic valve insufficiency, and aortic root dilatation have also been reported. After ASO, the original pulmonary root and valve, which function in the systemic position as the neo-aortic root and valve respectively, are exposed to the systemic blood pressure, resulting in aortic root dilatation and valve insufficiency in some patients. One of the risk factors for these complications is a history of prior pulmonary artery banding (PAB). Complex TGA anatomy, including transposition of the great arteries and ventricular septal defect (TGA-VSD) or double outlet right ventricle and ventricular septal defect (DORV-VSD), is also an independent risk factor for neo-aortic dilatation and aortic valve regurgitation. Aortic valve and root replacement is sometime necessary for the patients with these pathologies long-term after ASO. Here, we present a patient who had persistent aortic sinus dilatation and aortic valve insufficiency since ASO and necessitating aortic root and valve replacement 15 years after ASO preceded by PAB. The patient underwent Bentall operation and his clinical course was favorable. Histological findings after root replacement revealed no remarkable structural difference between neo-aortic wall (originally pulmonary artery) and original aortic wall.</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/PMC10728024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829498","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":"Wire skills for cardiac surgeons-et tu Brute?","authors":"A G Jayakrishnan","doi":"10.1007/s12055-023-01643-z","DOIUrl":"https://doi.org/10.1007/s12055-023-01643-z","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/PMC10728400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829499","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":"Aortic root pseudoaneurysm: a case report and literature review.","authors":"Pravinthiran Manokaran, Sivakumar Krishnasamy, Raja Rizal Azman Bin Raja Aman, Victoria Wen Yeng Teoh, Alexander Loch","doi":"10.1007/s12055-023-01580-x","DOIUrl":"10.1007/s12055-023-01580-x","url":null,"abstract":"<p><p>Pseudoaneurysms of the aortic root are rare. A case of prosthetic aortic valve infection progressing from a confined intramural abscess to a ruptured abscess communicating with the aorta and forming a large pseudoaneurysm is described. Additionally, data from all cases and case series, published between 2000 and 2021, was analyzed. A PUBMED search for the keywords \"aortic root mycotic aneurysm,\" \"aortic root abscess AND infective endocarditis,\" and \"aortic root mycotic aneurysm AND infective endocarditis\" yielded 152 publications (with 157 cases described): Aortic pseudoaneurysm is more common in males (80.9%, <i>n</i> = 127). Mean age is 51 years (4 months-84 years). The most common symptom is fever (68.5%, <i>n</i> = 102). Mean time until diagnosis is 27.2 days. Embolic complications are present in 17.8% (<i>n</i> = 28) at diagnosis. Most cases are due to valvular infections (<i>n</i> = 72 cases, 45.9%). Prior cardiac surgery is documented in 49.0% (<i>n</i> = 77). The mean time interval for developing aortic root abscess following heart surgery is 32.2 months. 22.3% (<i>n</i> = 35) are immunocompromised. Aetiological agents were <i>Staphylococcus</i> sp. (34.1%, <i>n</i> = 47) and <i>Streptococcus</i> sp. (23.2%, <i>n</i> = 32). Mean antimicrobial therapy lasts 58.5 days. Outcome with surgery is superior to medical treatment: overall inpatient mortality 18.5% (<i>n</i> = 27); with surgery 12.2% (<i>n</i> = 15 out of 123 patients), with only medical management 47.8% (<i>n</i> = 11 out of 23 patients). In conclusion, aortic root pseudoaneurysm occurs most commonly in middle-aged male patients. History of prior aortic procedures is commonly present. Correct diagnosis hinges on detailed history, transoesophageal echocardiography, and computed tomography (CT) aorta. Surgery is the preferred therapeutic option.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-023-01580-x.</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/PMC10728390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43281322","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":"Outcomes after surgery for infective endocarditis","authors":"K. Gopal, Rohik Micka Radhakrishnan, R. Jose, Neethu Krishna, P. Varma","doi":"10.1007/s12055-023-01647-9","DOIUrl":"https://doi.org/10.1007/s12055-023-01647-9","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}