ASIAN CARDIOVASCULAR & THORACIC ANNALS最新文献

{"title":"Video-assisted thoracic surgery (VATS) in the surgical management of acquired benign broncho-esophageal fistula.","authors":"Sukhram Bishnoi, Mohan Venkatesh Pulle, Harsh Vardhan Puri, Belal Bin Asaf, Sumit Bangeria, Anmol Bhan, Anjali Singh, Arvind Kumar","doi":"10.1177/02184923251343326","DOIUrl":"10.1177/02184923251343326","url":null,"abstract":"<p><p>BackgroundBenign broncho-esophageal fistula (BEF) is a rare condition that often results from infections, trauma, or prior surgical interventions. This study evaluates the outcomes of surgical management of BEF, emphasizing the role of video-assisted thoracoscopic surgery.MethodsA retrospective analysis of 19 patients who underwent surgical management for benign BEF was conducted. Patient demographics, fistula characteristics, surgical approach, perioperative outcomes, and complications were assessed.ResultsThe cohort comprised 14 males (73.7%) and 5 females (26.3%) with a median age of 34 years (range: 19-63 years). The left main bronchus was the most common fistula location (<i>n</i> = 10, 52.6%) followed by right lower lobe (<i>n</i> = 6, 31.6%), left lower lobe (<i>n</i> = 2, 10.5%), and right bronchus intermedius (<i>n</i> = 1, 5.3%). A prior history of antitubercular treatment was noted in 15 patients (79%). Video-assisted thoracic surgery was successfully performed in 17 patients (89.5%), while 2 (10.5%) required conversion to thoracotomy due to dense adhesions. During surgery, division of fistula alone was performed in 14 patients (73.7%). The distal lung destruction necessitated lobectomy in 3 patients (15.78%) and wedge resection in 2 patients (10.52%). The mean operative time was 120 min, with a median hospital stay of 5.5 days. Two patients (10.5%) experienced complications, including a minimal esophageal leak managed with a stent and a case of postoperative pneumonia which resolved with conservative measures. No recurrences were observed during a median follow-up of 48 months.ConclusionsVideo-assisted thoracic surgery is a safe and effective approach for managing benign BEF, offering excellent long-term outcomes with minimal morbidity. Conversion to thoracotomy is required in select cases with dense adhesions.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"135-141"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121005","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}

{"title":"Renal outcomes following oral anticoagulation in non-valvular atrial fibrillation: A multicentre, propensity-matched retrospective analysis in an Asian population.","authors":"Hock Peng Koh, Jivanraj R Nagarajah, Jiaa Yinn Tang, Szu Lynn Tay, Sahimi Mohamed, Li Ling Loh, Chelfi Zhi Fei Chua, Shantini Radhakrishnan, Pradeep Kumar Nair Arumugam","doi":"10.1177/02184923251347471","DOIUrl":"10.1177/02184923251347471","url":null,"abstract":"<p><p>BackgroundDirect oral anticoagulants (DOACs) have been linked to better renal outcomes than warfarin in non-valvular atrial fibrillation (NVAF). We aimed to compare the renal function outcomes in Asian NVAF patients treated with warfarin and DOAC.MethodsThis multicentre retrospective study analysed NVAF patients newly initiated on oral anticoagulant (OAC) from 2013 to 2022 across seven tertiary hospitals. Using propensity-score matching, warfarin and DOAC recipients were matched by incorporating 22 variables potentially affecting renal outcomes. Primary endpoints include clinically significant (≥30%) estimated glomerular filtration rate (eGFR) decline and worsened chronic kidney disease (CKD) stage.ResultsA total of 766 subjects (383 warfarin; 383 DOAC; mean age 70.7 ± 9.6 years) were analysed. Baseline eGFR was 75.0 (59.0-89.0) for warfarin and 76.0 (59.0-88.0) ml/min/1.73 m² for DOAC groups. Following median OAC treatment of 2.8 ± 1.6 years, 14.5% experienced clinically significant eGFR decline and 31.9% had worsened CKD stage. DOAC was associated with a lower risk of clinically significant eGFR decline (OR 0.529, 95% CI 0.343-0.817, <i>p</i> = 0.004) and worsened CKD stage (OR 0.713, 95% CI 0.521-0.975, <i>p</i> = 0.034). In subgroup analysis, rivaroxaban (OR 0.337, 95% CI 0.157-0.724, <i>p</i> = 0.005) and dabigatran (OR 0.516, 95% CI 0.285-0.934, <i>p</i> = 0.029), but not apixaban (OR 0.759, 95% CI 0.432-1.333, <i>p</i> = 0.338), were associated with a lower risk of clinically significant eGFR decline.ConclusionsSignificant renal function decline is common during follow-up of Asian NVAF patients on OAC. Among the DOACs, rivaroxaban and dabigatran, but not apixaban, were associated with a lower risk of renal function decline than warfarin. These findings warrant confirmation in prospective randomised studies.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"124-134"},"PeriodicalIF":0.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200286","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}

{"title":"Superior vena cava syndrome caused by a giant right coronary artery aneurysm.","authors":"Hagen Kahlbau, João João Mendes, Isabel Fragata, José Fragata","doi":"10.1177/02184923251317752","DOIUrl":"10.1177/02184923251317752","url":null,"abstract":"<p><p>We present the case of a 61-year-old male who was admitted with superior vena cava syndrome. Patient's medical history includes a coronary artery bypass surgery 5 years ago. Echocardiography and computed tomography angiography showed a giant right coronary artery aneurysm compressing the superior vena cava. Due to hemodynamic deterioration, emergent cardiac surgery was performed to alleviate the compression, and veno-arterial extracorporal membrane oxygenation (VA ECMO) was necessary during intensive care unit. Hemodynamic improvement over 6 days allowed for successful ECMO weaning and eventually patient's discharge.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"49-51"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190670","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}

{"title":"Failing DeVega tricuspid valve repair due to detachment of annuloplasty sutures: The Bowstring (Guitar string) sign.","authors":"Mohammad Amin Shojaei, Soheila Salari, Saeid Hosseini","doi":"10.1177/02184923251318060","DOIUrl":"10.1177/02184923251318060","url":null,"abstract":"<p><p>The DeVega annuloplasty procedure involves a double-running suture line along the circumference of the tricuspid annulus, encircling the anterior and posterior leaflets. A rare mechanical complication of this technique is the detachment of the suturing from the annulus, which can be referred to as the \"bowstring sign\" or \"guitar string sign.\"</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"87-88"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123023","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}

{"title":"A rare presentation of a mediastinal retiniform type hemangioendothelioma.","authors":"Ubaldo E Rivas, Juan C Rendón, Eric E Vinck, Luis A Correa, Gustavo A Castilla, Bruno Ramírez Castillero","doi":"10.1177/02184923251318388","DOIUrl":"10.1177/02184923251318388","url":null,"abstract":"<p><p>Cardiac tumors, whether primary (mostly benign) or secondary (metastatic), are extremely rare, and very few cases of retiniform hemangioendothelioma have been documented since its initial diagnosis in 1994. We present a 67-year-old male who presented with pericarditis, recurrent pericardial and pleural effusions. On computed axial tomography, an oval lesion located on the superior aspect of the left pulmonary pericardial recess within the transverse sinus, adjacent to the trunk of the pulmonary artery. In the operating room, after dissection and resection of the mass, the histopathological diagnosis of retiniform hemangioendothelioma was confirmed.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"41-44"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383680","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}

{"title":"Multi-societal endorsement of the 2024 European guideline recommendations on coronary revascularization.","authors":"Victor Dayan, Joseph F Sabik, Minoru Ono, Marc Ruel, Song Wan, Lars G Svensson, Leonard N Girardi, Y Joseph Woo, Vinay Badhwar, Marc R Moon, Wilson Szeto, Vinod H Thourani, Rui Almeida, Zhe Zheng, Walter J Gomes, Dawn S Hui, Rosemary F Kelly, Miguel Sousa Uva, Joanna Chikwe, Faisal G Bakaeen","doi":"10.1177/02184923251315320","DOIUrl":"10.1177/02184923251315320","url":null,"abstract":"","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"28-31"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190648","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}

{"title":"Traumatic chylothorax management post-coronary artery bypass grafting - A systematic review.","authors":"Gavin John Carmichael, Duron Prinsloo, Connor Bentley, Rodan Prinsloo, Joshua G Kovoor, Mathew O Jacob, Aashray Gupta","doi":"10.1177/02184923251321541","DOIUrl":"10.1177/02184923251321541","url":null,"abstract":"<p><p>IntroductionCoronary artery bypass graft (CABG) surgery is performed globally around 400,000 times annually. Despite its benefits, CABG can lead to complications, including chylothorax, a rare condition where chyle accumulates in the pleural cavity due to thoracic duct trauma. Currently, there are no international guidelines for traumatic chylothorax management post-CABG. This is the first systematic review to provide a comprehensive overview of the current state of management for chylothorax post-CABG.MethodsThis systematic review was conducted by searching EMBASE, Cochrane, Ovid and PubMed databases on 16 June 2024. The inclusion criteria focused on studies addressing post-CABG chylothorax management and reporting clinical outcomes. Data was extracted from 11 studies focusing on graft type, complications and management strategies.ResultsThis review included 11 case report studies with 14 cases of post-CABG chylothorax. Conservative management was attempted in all cases, with varying components such as total parenteral nutrition, nil by mouth, octreotide and low-fat diets. High-output chylothorax (>1000 mL/day) often necessitated surgical intervention after an average of 12.5 days of conservative management. Surgical approaches included thoracic duct ligation, embolisation and pleurodesis. Surgical ligation was effective in three cases, while thoracic duct embolisation was successful in one case.ConclusionsChylothorax post-CABG is managed initially with conservative strategies, but high-output cases often necessitate surgical intervention. This review highlights the need for standardised guidelines, regarding the timing of surgical escalation and the use of octreotide and somatostatin. Further research should focus on higher-powered studies to validate these findings and establish clinical guidelines for managing chylothorax post-CABG.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"73-86"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484397","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 outcome of late open conversion after endovascular abdominal aortic repair.","authors":"Hironobu Nishiori, Tomohiko Inui, Michiko Watanabe, Hiroki Kohno, Kaoru Matsuura, Hiroki Ikeuchi, Tomoyoshi Kanda, Chihiro Ito, Hiroaki Yamamoto, Yusuke Shibata, Takashi Yamamoto, Maiko Nagahama, Goro Matsumiya","doi":"10.1177/02184923241310916","DOIUrl":"10.1177/02184923241310916","url":null,"abstract":"<p><p>BackgroundEndovascular abdominal aneurysm repair (EVAR) offers a less invasive approach to treating abdominal aortic aneurysms (AAA) compared to open repair. However, EVAR is associated with higher rates of reintervention. This study investigates the early and mid-term outcomes of patients who underwent late open conversion including aneurysmorrhaphy after EVAR at our institution.MethodsWe conducted a retrospective cohort study of 29 patients who underwent late open conversion for AAA dilatation after EVAR between April 2015 and March 2022 at Chiba University Hospital. Surgical strategies included an artificial graft replacement for Type Ia endoleak (EL), Type III EL from stent graft main body, ruptured cases, and aneurysmorrhaphy with branch ligation for Type II EL.ResultsThe average time from EVAR to open conversion was 4.1 ± 2.3 years. There have been no reported cases of in-hospital mortality to date. Aneurysmorrhaphy demonstrated shorter operative times (239 ± 65 min) and lower red blood cell transfusion volumes (2.7 ± 4.2 units) compared to graft replacement. Postoperative complications included spinal cord ischemia in one patient and three patients requiring reintervention due to persistent or new ELs, who underwent angiography. The seven-year all-cause mortality rate was 78.5%. Among cases that underwent aneurysmorrhaphy, postoperative computed tomography scans showed a reduction in the maximum aortic diameter from 65 ± 6 mm preoperatively to 42 ± 10 mm postoperatively and 36 ± 11 mm at follow-up.ConclusionsLate open conversion including aneurysmorrhaphy after EVAR appears to be safe and effective, with no in-hospital mortality and low complication rates. Careful preoperative planning and appropriate surgical techniques are essential for optimizing outcomes.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":"33 1","pages":"21-27"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732120","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}

{"title":"Surgical outcomes of cardiac surgery in patients with antiphospholipid syndrome and systemic lupus erythematosus: A systematic review.","authors":"Rajat Agarwal, Shiv Mudgal, Smarakranjan Rout, Amiy Arnav","doi":"10.1177/02184923251321066","DOIUrl":"10.1177/02184923251321066","url":null,"abstract":"<p><p>BackgroundAntiphospholipid syndrome and systemic lupus erythematosus are autoimmune inflammatory conditions involving multiple organs and sharing various clinical aspects. Owing to the scarcity of data about the surgical outcomes of these autoimmune disorders, we conducted a systematic review to assess the outcomes for patients with these diagnoses undergoing heart surgery and contextualize the findings regarding high-risk cardiac surgeries.MethodsA thorough search of PubMed, Embase and Scopus used Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards to find articles that involved patients who underwent heart surgery and had antiphospholipid syndrome and systemic lupus erythematosus. Inclusion criteria concentrated on a definitive diagnosis, while case reports and studies lacking data on surgical outcomes were excluded. Using the Joanna Briggs Institute's methodologies, quality evaluation categorized studies according to their risk of bias.ResultsFourteen studies with 277 patients and a prevalence of middle-aged females met the inclusion criteria out of 6381 papers. The major preoperative comorbidity in the cohort was a history of thromboembolic events (43%). Thromboembolic complications (6%) and catastrophic antiphospholipid syndrome (2%), even with appropriate anticoagulation, were notable early post-operative outcomes. Six percent of people died within 30 days. Data from follow-up studies showed a 14% death rate and a 23% frequency of thromboembolic events.ConclusionsWith the striking exception of a high frequency of thromboembolic complications and catastrophic antiphospholipid syndrome, surgical results in patients with antiphospholipid syndrome and systemic lupus erythematosus are analogous to those in high-risk cardiac procedures. Improving surgical care for this susceptible population requires an understanding of these hazards.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"62-72"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469326","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}

{"title":"Fetuin-A as a plausible biomarker for cardiac valve calcification in rheumatic heart disease patients from North India.","authors":"Aishwarya Rani, Lakhwinder Singh, Anuradha Chakraborti, Sameer Gupta, Harkant Singh, Devinder Toor","doi":"10.1177/02184923241306482","DOIUrl":"10.1177/02184923241306482","url":null,"abstract":"<p><p>BackgroundRheumatic heart disease (RHD) remains a persistent public health challenge, particularly prevalent in developing and underdeveloped regions despite concerted global eradication efforts. The progressive stage of RHD, marked by valvular calcification, necessitates the imperative need to identify prognostic biomarkers. Fetuin-A, well-known for its role as a negative inhibitor of ectopic calcification, is investigated in our study as a potential biomarker for cardiac valve calcification in RHD patients.MethodsIndividuals with confirmed presence of RHD via echocardiography, who exhibited moderate to severe cardiac valve involvement, were enrolled alongside age and sex-matched healthy controls. Enzyme Linked Immunosorbent Assay was performed to analyse serum concentration of fetuin-A in healthy controls and RHD patients. Cytokine profiling was carried out using Cytometric Bead Array.ResultsSixty confirmed RHD patients along with age and sex-matched case-control were evaluated for their serum fetuin-A and serum cytokines levels. Our findings reveal significantly reduced serum fetuin-A levels in RHD patients (1.96 ± 0.608 ng/ml) compared to healthy controls (2.85 ± 0.55 ng/ml) (<i>p</i> < 0.0001). Cytokine profiling shows nearly two-fold elevations in interleukin (IL)-17A, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), IL-6, IL-10, IL-4 and IL-2 levels among RHD patients versus healthy controls, with IL-6 showing the maximum elevation in serum concentration. Pearson's correlation coefficient (<i>r</i>) values indicate a strong negative correlation between fetuin-A levels in RHD patients and various inflammatory cytokines, including IL-17A (-0.9754), IFN-γ (-0.8142), TNF-α (-0.8281), IL-10 (-0.9183), IL-6 (-0.8479), IL-4 (-0.9182) and IL-2 (-0.9430) (<i>p</i> < 0.05, statistically significant).ConclusionThis study suggests that fetuin-A can be explored as a plausible biomarker for cardiac valve calcification and has an inverse correlation with inflammatory cytokines involved in RHD.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"14-20"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814261","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}