Indian Journal of Thoracic and Cardiovascular Surgery最新文献

{"title":"Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial.","authors":"Pradeep Narayan","doi":"10.1007/s12055-024-01809-3","DOIUrl":"10.1007/s12055-024-01809-3","url":null,"abstract":"<p><p>The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.2%) compared to SAVR (7.1%) in the overall cohort, with even more pronounced differences in patients with bicuspid valves (14.3% for TAVI vs. 3.9% for SAVR). The risk of death or disabling stroke at 1 year was also three times higher with TAVI.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"645-647"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001711","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 histology and immunochemistry study comparing open versus close and open-method endoscopic saphenous vein harvesting.","authors":"Sivakumar Krishnasamy, Raja Amin Raja Mokhtar, Ahmad Farouk Musa, Xian Pei Cheong, Toh Yen Fa","doi":"10.1007/s12055-024-01752-3","DOIUrl":"10.1007/s12055-024-01752-3","url":null,"abstract":"<p><strong>Background: </strong>The introduction of endoscopic saphenous vein harvesting (ESVH) has been reported to reduce wound pain and infection, compared with open saphenous vein harvesting (OSVH) techniques. There are still controversies regarding this technique. The aim of our study is to investigate the endothelial preservation of saphenous vein (SV) grafts harvested by different techniques. Further observations were made for harvesting and closure time, incision length and effect of pressure distension of the veins to the vein endothelium.</p><p><strong>Methods: </strong>Prospective observational study of sixty human saphenous vein grafts was performed to evaluate endothelial preservation by haematoxylin-eosin and Cluster of Differentiation 31 (CD 31) staining. Saphenous vein was harvested endoscopically either by closed CO₂ (carbon dioxide) ESVH, open CO₂ ESVH or OSVH harvesting technique. Demographic data and intra-operative data were collected. Two saphenous vein samples were collected from each patient to compare differences before and after distension of the veins. Both haematoxylin-eosin and immunohistochemistry slides were imaged by a high-resolution slide scanning system.</p><p><strong>Results: </strong>Open CO₂ ESVH group showed the highest number of endothelial detachments. Mean scoring of the immunohistochemistry method using the CD31 antibody was much lower in the open CO₂ ESVH group (33.25% ± 28.71, <i>P</i> < <i>0.0003</i>). This represents a more poorly preserved endothelial cells in the Open CO₂ ESVH than the closed CO₂ ESVH. Closure time and incision lengths were significantly shorter in both ESVH groups compared to the OSVH group. Significant low scores of immunohistochemistry for samples were seen in distended veins (39.0% ± 30.08, <i>p</i> = <i>0.004</i>). The OSVH in random sample B, which represents the conduit that will be used, had a far better endothelium preservation and less endothelial detachment when compared to ESVH.</p><p><strong>Conclusion: </strong>We observed more endothelial detachment in the open CO₂ ESVH group, due to lack of subcutaneous tissue separation, poor visualization and traction stress across the wall of the saphenous vein. The closed CO₂ ESVH group had more endothelial cells preserved, but the OSVH group fared the best with the least number of endothelial cell detachment and a higher score of CD31 antibody.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12055-024-01752-3.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"554-563"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999807","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 traumatic left ventricular pseudoaneurysm: diagnostic challenges and surgical management.","authors":"Rahul Bhushan, Arun Kengalapura Ramesh, Vijay Grover","doi":"10.1007/s12055-024-01729-2","DOIUrl":"10.1007/s12055-024-01729-2","url":null,"abstract":"<p><p>Left ventricular (LV) pseudoaneurysms are uncommon, with traumatic cases being particularly rare. We present a case of a 26-year-old male with a delayed presentation of a traumatic LV pseudoaneurysm, 2 years post-blunt chest trauma. The patient experienced New York Heart Association (NYHA) grade 2 dyspnea, which prompted the investigation. Imaging studies, including X-ray, echocardiogram, and cardiac computed tomography (CT), revealed a large pseudoaneurysm arising from the LV apex, containing intramural thrombus. The surgical intervention involved the closure of the communicating orifice and on-lay pericardial patch placement. This case emphasizes the diagnostic challenges and successful management of traumatic LV pseudoaneurysms. Early detection through imaging and prompt surgical intervention led to a favorable outcome. This report contributes to understanding post-traumatic pseudoaneurysms and underscores the importance of a multidisciplinary approach in their management. Further studies are needed to refine diagnostic and treatment strategies for this rare condition.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"621-625"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999810","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":"Can we de-institutionalise healthcare?","authors":"Om Prakash Yadava","doi":"10.1007/s12055-024-01805-7","DOIUrl":"10.1007/s12055-024-01805-7","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"529-531"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001712","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":"Advanced statistical methods for hazard modeling in cardiothoracic surgery: a comprehensive review of techniques and approaches.","authors":"H Shafeeq Ahmed","doi":"10.1007/s12055-024-01799-2","DOIUrl":"10.1007/s12055-024-01799-2","url":null,"abstract":"<p><p>Hazard modeling in cardiothoracic surgery, crucial for understanding patient outcomes, utilizes survival analysis like the Cox proportional hazards model. Kaplan-Meier curves are employed in survival analysis to represent the probability of survival over time. While Cox assumes proportional hazards, the Fine-Gray model deals with competing risks. Parametric models (e.g., Weibull) specify survival distributions, unlike Cox. Bayesian analysis integrates prior knowledge with data. Machine learning, including decision trees and support vector machines, enhances risk prediction by analyzing extensive datasets. However, it is important to note that whatever new approaches one may adopt will enhance the quality of risk assessment and not the risk assessment as such. Preprocessing is vital for data quality in complex cardiovascular datasets, alongside robust validation methods like cross-validation for model reliability across patient cohorts.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 5","pages":"633-644"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999808","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":"VATS thoracic duct clipping in post-CABG with chylothorax.","authors":"Samir Gupta, Anurag Garg, Santhosh Nanjappa, Tejus Vishwanath Nagireddy, Vipul Sharma","doi":"10.1007/s12055-023-01683-5","DOIUrl":"10.1007/s12055-023-01683-5","url":null,"abstract":"<p><p>Post-coronary artery bypass graft (CABG) surgery, chylothorax is a rare, but a serious, complication. We report a case of 49-year-old female who underwent CABG, and developed pleural effusion on post-operative day 2 which was milky in nature. Chylothorax was confirmed based on the biochemical analysis of the pleural fluid. As the medical line of management failed, video-assisted thoracoscopic surgery (VATS) was done and thoracic duct clipped on the right side. Close to the proximal portion of the left internal thoracic artery, disrupted tributaries of thoracic duct were noted and clipped. Rarity of the case and management is highlighted.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 4","pages":"489-492"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450397","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: Suprasternal approach for insertion of Impella 5.5 into the proximal right subclavian artery.","authors":"Jay A Patel, Zubair A Hashmi","doi":"10.1007/s12055-024-01765-y","DOIUrl":"https://doi.org/10.1007/s12055-024-01765-y","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s12055-024-01699-5.].</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 4","pages":"527"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450395","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":"'Scrubs' versus 'Suits'-a simmering turf war.","authors":"Om Prakash Yadava","doi":"10.1007/s12055-024-01764-z","DOIUrl":"10.1007/s12055-024-01764-z","url":null,"abstract":"","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 4","pages":"405-406"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450396","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":"Posterior reversible encephalopathy syndrome: a rare cause of seizures following non-transplant cardiac surgery.","authors":"Rajesh Kumaar, Lalit Kapoor, Gobinda Pramanick, Pradeep Narayan","doi":"10.1007/s12055-023-01651-z","DOIUrl":"https://doi.org/10.1007/s12055-023-01651-z","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) is rarely reported as a cause for seizures following cardiac surgery. PRES in non-transplant cardiac surgery may reflect under-diagnosis and under-reporting. While the condition is reversible, a delay in diagnosis can lead to irreversible brain injury. We describe a case of PRES that occurred after aortic valve replacement with concomitant coronary artery bypass grafting.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 3","pages":"377-380"},"PeriodicalIF":0.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860082","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":"Choice of valve substitutes.","authors":"Palleti Rajashekar, Anish Gupta, Devagourou Velayoudam","doi":"10.1007/s12055-024-01733-6","DOIUrl":"10.1007/s12055-024-01733-6","url":null,"abstract":"<p><p>Infective endocarditis often necessitates surgical intervention, and the choice of valve substitute remains a topic of controversy and highly debatable due to the wide range of available options and recent technical advancements. This manuscript reviews the different valve substitutes in the context of infective endocarditis, including mechanical and bioprosthetic valves, homografts, xenografts, and tissue-engineered valves. The patient's age, sex, demographic location, intellectual quotient, comorbidities, available options, and the experience of the surgeon should all be taken into consideration while choosing the best valve substitute for that individual. While valve repair and reconstruction are preferred whenever feasible, valve replacement may be the only option in certain cases. The choice between mechanical and bioprosthetic valves should be guided by standard criteria such as age, sex, expected lifespan, associated comorbidities, and anticipated adherence to anticoagulation therapy and accessibility of medical facilities for follow-up. For patients with severe chronic illness or a history of intracranial bleeding or associated hematological disorders, the use of mechanical prostheses may be avoided. Homografts and bioprosthetic valves provide an alternative to mechanical valves, thereby decreasing the necessity for lifelong anticoagulation after surgery and diminishing the likelihood of bleeding complications. The manuscript also discusses specific valve substitutes for different heart valves (aortic, mitral, pulmonary, tricuspid positions) and highlights emerging techniques such as the aortic valve neocuspidization (Ozaki procedure) and tissue-engineered valves. Ultimately, the ideal valve substitute in IE should be evidence based on a comprehensive elucidation of clinical condition of the patient and available options.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"40 Suppl 1","pages":"78-82"},"PeriodicalIF":0.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11139820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199817","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}