Immediate, early and mid-term outcomes following balloon mitral valvotomy in patients having severe rheumatic mitral stenosis with significant tricuspid regurgitation
ConclusionsSignificant TR identifies a sicker patient population with MS. Even though patients with significant TR have comparable immediate and early outcomes after BMV, they have poor outcomes on mid-term follow-up. Longer follow-up with more patients is needed to assess survival aspect of TR on patients undergoing BMV and also to look at the need for interventions to address the significant TR, apart from the mitral valve interventions. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 27, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemoptysis as a rare presenting symptom of hypertrophic obstructive cardiomyopathy
AbstractA 36-year-old female presented with two episodes of hemoptysis induced by exertion and acute dyspnea. She was diagnosed as a case of hypertrophic obstructive cardiomyopathy (HOCM) with systolic anterior motion (SAM)-induced severe mitral regurgitation (MR). She underwent extended septal myectomy with mitral valve replacement under cardiopulmonary bypass and recovered successfully. This is a unique and rare combination of HOCM with hemoptysis. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 25, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic root translocation: the Bex-Nikaidoh procedure
AbstractPatients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction are managed by various techniques. Traditional techniques include intracardiac baffling with a right ventricle to pulmonary artery conduit (Rastelli procedure) and the “reparation a l’etage ventriculaire” (REV) procedure. However, other techniques such as aortic root translocation (Bex-Nikaidoh procedure), pulmonary root translocation, and double root translocation are equivalent or in fact provide better results than the traditional techniques. In this revi ew we will have ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Single-centre Indian case series using X or cross bar for Nuss procedure in pectus excavatum
We describe the X or cross bar placement and its specific indications based on morphology in a series of five patients from February 2019 until December 2019 with symmetrical focal deformity along the xiphisternum and asymmetric deformity below the xiphoid. The operating time varied from 90 to 120  min. There was no significant postoperative morbidity. They are on follow-up with period ranging from 4 to 15 months from the day of surgery. Early results show the X or cross bar Nuss procedure can be safely performed to achieve a desired long-term morphological correction of symmetric deep foca l xiphisternal defects...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Use of the hybrid room for thoracic surgery procedures: single-stage localization and removal of non-palpable nodules
AbstractWith the widespread availability of lung cancer screening programs, the number of small lung nodules requiring histological characterization has dramatically increased. Because computed tomography –guided fine-needle aspiration may frequently yield false-negative results, excisional biopsy using thoracoscopy is frequently required. Although thoracoscopic procedure has been known to be ideal for nodule resection, the identification of very small, subsolid and deep pulmonary nodules may still be challenging. Precise lesion localization is a key prerequisite to avoid conversion to an unplanned thoracotomy. In th...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Rhabdomyoma association with atrioventricular septal defect in an infant: a rare coincidence
In this study, we report our approach to the tumor during the corrective surgery of the infant, who was diagnosed with an atrioventricular septal defect and patent ductus arteriosus, and rhabdomyoma accompanying these malformations. We treated this asymptomatic rhabdomyoma with everolimus in line with the current literature, without excision. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

First case of cough-induced combined intercostal artery rupture with partial diaphragm tear
We describe a case of vigorous cough-induced left intercostal artery rupture with partial diaphragmatic tear in a 60-year-old obese male with chronic obstructive pulmonary disease. He presented with left hemothorax, a rapidly spreading chest and abdominal wall hematoma, and progression of anemia. Computed tomography (CT) scan revealed a bleeding focus from the left 8th intercostal artery. CT-guided surface marking of the bleeding point was done over the chest wall. The patient underwent open thoracotomy with drainage of clotted hemothorax and ligation of bleeding intercostal artery. Incidentally, a partial diaphragm tear w...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Thrombus straddling patent foramen ovale and massive pulmonary embolism
AbstractA thrombus straddling the foramen ovale is rare; and optimal management is controversial. Most of the literature on this topic is available only in the form of case reports. Here, we present a case of 30-year-old female with recent history of fibular fracture and thrombus in transit through patent foramen ovale and massive pulmonary embolism who was successfully managed with pulmonary embolectomy, extraction of serpentine thrombus straddling patent foramen ovale, and closure of patent foramen ovale. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Veno-arterial extracorporeal membrane oxygenationas a bridge to cytolytic therapy
We describe a case of successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO), as a bridge to cytoreductive therapy, in a patient with large mediastinal mass due to T cell lymphoblastic leukemia, complicated by acute cardiorespiratory compromise from mechanical compression and pulmonary embolism. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Rationale of anticoagulation among patients of COVID-19 undergoing cardiac surgery
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Spontaneous closure of grade IV coronary perforation
AbstractPrevious coronary artery bypass surgery (CABG) is an independent risk factor for coronary perforation (CP) during percutaneous coronary intervention (PCI) because of complexity of the cases. However in patients with prior CABG surgery, cardiac tamponade is rare because of local or regional pericardial adhesions. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Avoiding use of total circulatory arrest in the practice of congenital heart surgery
AbstractDeep hypothermic circulatory arrest (DHCA) technique has been an important armamentarium in the correction of congenital heart diseases. There have been many controversies and concerns associated with DHCA, particularly neurological damage. Selective ante grade cerebral perfusion (SACP) was introduced as an adjunct to DHCA with the objective of limiting the neurologic injury during aortic arch repairs. Over the past two decades, various aspects of cardiopulmonary bypass and DHCA have been studied and modified such as optimisation of flows, anti-inflammatory interventions, haematocrit, and temperature to improve neu...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 20, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Distal tracheal resection and reconstruction through right posterolateral thoracotomy
AbstractMany retrospective series have been reported on the outcomes of tracheal resection for adenoid cystic carcinoma. However, demonstration on techniques of surgery and ventilatory management during the procedure are rare. We, herewith demonstrate a surgical video, wherein a distal tracheal resection was performed through right posterolateral thoracotomy. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 20, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart transplantation in India —are we there yet?
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 20, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac surgery during the times of COVID-19
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 20, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart transplant and mechanical circulatory support —the last frontier?
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 20, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Double-root transfer and the half-turned truncal switch
AbstractTransposition of great arteries (TGA) or double-outlet right ventricle (DORV) with ventricular septal defect (VSD) and pulmonary stenosis (PS) is a complex congenital cardiac malformation, which can be treated by both univentricular and biventricular pathways. Biventricular repair includes Rastelli operation, reparation a l ’etage ventriculaire (REV), pulmonary root translocation, and Nikaidoh procedures. Double-root translocation (DRT) technique and half-turned truncal switch technique (HTTS) are being considered as useful alternatives. In this review, we will see in detail about DRT and HTTS. (Source: India...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Tetralogy of Fallot with congenital diaphragmatic hernia with right lung aplasia —a rare entity
We present a case of 18-month-old child presenting late with cyanosis and respiratory distress. Chest X-ray and computed tomography angiography showed tetralogy of Fallot with small left pulmonary artery with right lung aplasia with congenital diaphragmatic hernia with liver and bowel loops in right chest cavity. The patient was managed with central shunt on cardiopulmonary bypass and was discharged uneventfully. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Pulmonary root translocation and Senning procedure for congenitally corrected transposition of great arteries with pulmonary stenosis: a case report
We report a case of a 4-year-old with CCTGA, VSD, and PS operated by Senning procedure and pulmonary root translocation (PRT) with uneventful postoperative recovery. PRT overcomes problems with the right ventricle to the pulmonary artery conduit and maintains pulmonary valve function and growth capacity. Our initial experience with PRT in CCTGA indicates that it is a feasible surgical alternative for such patients. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Myositis ossificans —a rare tumor of the chest wall
We present the clinical, radiological, and pathological images of a post  traumatic MO of the chest wall, arising from under the medial third of the clavicle and growing into the deeper surface of the pectoralis major muscle. The patient is doing well eight months after the excision of the same. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 10, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

A potential drug in the armamentarium of post-cardiac transplantation immunosuppression: belatacept
AbstractUndeterred by all the advancement in the field of cardiac transplantation, heart transplant rejection remained its mammoth quandary. Management of heart transplant recipients has drastically improved with current regimens of immunosuppressive drugs. The adverse effects of calcineurin inhibitors are lacking with the use of belatacept, which is a costimulation inhibitor that interferes with the interaction between CD28 on T cells and the B7 ligands on antigen-presenting cells. It was originally approved for use in renal transplant recipients but it has shown promising results in heart transplant recipients. (Source: ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 10, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Ventricular pulling sign on computed tomography in mediastinitis —a predictor for right ventricular rupture at surgery
AbstractMediastinitis is an unusual but potentially life-threatening complication of cardiac surgery. Open drainage is one of the standard therapies, but there could sometimes be potential complications. We had a patient who underwent open drainage surgery for postoperative mediastinitis, and right ventricular rupture occurred subsequently to extubation in an operation room. Retrospectively reviewed, computed tomography showed strong adhesions between the right ventricle and the posterior margin of sternum, pulling his right ventricle to the right side of his sternum. We should have noticed the risk of leaving the sternum ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 10, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mediastinal teratoma presenting as a cervical tumor: images
We present these typical images of a mediastinal dermoid in this unusual cervical location. The differential diagnoses to be considered clinically are primary cervical teratomas, thyroid tumors, lymph nodal pathologies, and branchial cyst. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 10, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Conversion of prior univentricular repairs to septated circulation: Case selection, challenges, and outcomes
ConclusionThe possibility of achieving the surgical goal in this unique subset of patients evolves with the progressive experience of the congenital heart surgeon. Case selection is a crucial aspect in achieving the desired outcome, and this ‘borderline’ substrate is often recognized at the time of evaluation for the Fontan completion. A comprehensive preoperative imaging and planning helps in achieving the surgical septation and reconnection to achieve the desired physiological circulation. Though technically challenging, the surge ry has excellent short- and mid-term outcomes as evidenced by our 10-year exper...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 1, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and the appropriateness of revascularization
AbstractThe recently published ISCHEMIA trial which is a prospective randomized multi-centre trial has concluded that there was no evidence that an initial invasive strategy of revascularisation in patients with stable angina reduced the risk of ischaemic cardiovascular events or death from any cause. The trial has confirmed that patients with stable angina do not greatly benefit from revascularisation and optimal medical treatment (OMT) is an acceptable alternative. The trial has also confirmed that in patients with stable angina and end-stage renal impairment, OMT is once again an equally effective initial strategy. Whil...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - July 1, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

History of heart transplantation, the resurgence of DCD heart donations and outcomes following transplantation; the Royal Papworth Experience
AbstractHuman heart transplantation started more than half a century ago. The Royal Papworth Hospital, in Cambridgeshire, United Kingdom, where this procedure has been performed for more than four decades, has pioneered the resurgence of Donor Circulatory Death (DCD) heart transplantation, acknowledging the fact that the first transplant performed by Dr. Christian Barnard was from a DCD donor. The history of this procedure, the work carried out towards establishing a robust and successful DCD heart transplant program and the outcomes of the first fifty DCD heart transplants are described and discussed. (Source: Indian Jour...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 30, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mitral annular calcification: challenges and future perspectives
AbstractMitral annular calcification (MAC) is a chronic degenerative process that implies calcification on the mitral support structure. It usually appears as a bystander to other cardiac pathologies hindering surgical treatment and increasing morbidity and mortality. When addressing the mitral valve, many surgical strategies have been suggested in the past with no clear consensus on what to choose. Moreover, and as transcatheter therapies have gained popularity over the last few decades, transcatheter mitral valve implantation has appeared as another alternative to conventional surgery. In this review, we aim at describin...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 24, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Tale of Two sons - Nobelar and Excelar and the blurring edge between them
AbstractLeft main coronary artery disease (LMCAD) has low incidence but foreshadow a high prognostic risk merely due to the myocardial territory it supplies. Coronary artery bypass grafting (CABG) has been the standard of treatment for LMCAD. Recently, two major trials —NOBEL and EXCEL—with contradicting results have been published. I will not wade into the accusations of malfeasance, but the bottom line is that, superiority of percutaneous coronary interventions (PCI) to CABG is yet to be proved. Heart-team approach has been discussed in every aspect, but in real-world scenario, to what extent, and in what man...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

ABO-incompatible heart transplantation in children —a systematic review of current practice
AbstractPediatric heart transplantation has significantly improved in the survival of children with cardiomyopathy and/or complex congenital heart defects. With the increasing number of children needing transplantation, there is a growing demand for the organ, making it harder to cope with the increasing number of children on the waiting list. One of the advances that helped reduce the waiting list mortality significantly is the ability to transplant children from donors with ABO incompatibility. Modification of perfusion abilities and management of donor organ improves outcome in this select population, making ABO-incompa...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac autotransplantation for repair of left ventricular rupture after mitral valve replacement
We report a case of large posterior mid-ventricular rupture following mitral valve replacement, which was successfully treated by a patch repair and autotransplantation. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Training the next generation of cardiac surgeons: is it time to redesign the case requirements?
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Pseudocoarctation of aorta: a very rare anatomic anomaly
We present the case of a 66-year-old patient with a history of high blood pressure, who was admitted for surgical management of bicuspid aortic valve disease with severe insufficiency and who was incidentally detected to have a PCOA. It was decided to manage the latter conservatively and go ahead with surgical aortic valve replacement, to address the problem that led to his admission to the hospital. The patient had a favorable postoperative course and was discharged in a stable condition with an advice for periodic follow-up as out-patient consultations. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sinus venosus ASD and PAPVC with constrictive pericarditis: a rare association
AbstractThis is a case of a young man who underwent preoperative computed tomography evaluation for sinus venosus type of atrial septal defect, and was found to have associated chronic constrictive pericarditis. Association of these two entities is rare and changes the management approach. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Prevention and management of suture piercel of intra-coronary shunt at off-pump coronary bypass surgery
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 22, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Delayed presentation of superficial femoral artery pseudoaneurysm 45  years following gunshot injury
AbstractThis case report is a description of an uncommon delayed presentation of penetrating trauma of lower limb with history of inciting event being 45  years ago, as there are only 4 such reported cases in the literature. A 65-year-old male presented with progressive enlargement of swelling over the anterior aspect of the right thigh with difficulty in walking due to mechanical effects and paraesthesia in the affected limb. Clinical signs of a la rge lump in the right anteromedial thigh with no pulsations were present. Computerised tomographic angiography revealed the presence of a superficial femoral artery pseudo...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 19, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

3D printing guided closure of submitral aneurysm —an interesting case
We report a case of a 59-year-old gentleman with a posterolateral submitral aneurysm who underwent aneurysm patch repair and mitral valve repair. Good knowledge about the interrelationship between the aneurysmal sac and mitral valve was obtained enabling proper surgical repair. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 19, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgical excellence —an ongoing quest
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 17, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Management of thrombosis of carotid arteries in acute type A aortic dissection in neurologically intact patients: our experience
We report our experience of operative and non-operative management of thrombosis of carotid arteries in type A acute aortic dissection in 3 patients. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

High-output cardiac failure secondary to a post-traumatic iliocaval fistula
We report a case of a 24-year-old man who had an exploratory laparotomy 3  years earlier for a penetrating hypogastric wound. He presented with congestive heart failure that had progressed over the past 4 months. Transthoracic echocardiography and computed tomography (CT) angiography of the aorta demonstrated a wide arteriovenous fistula between the right common iliac a rtery and the iliocaval confluence, resulting in the dilatation of the inferior vena cava and of the right heart chambers. The patient was treated by surgical ligation of the right common iliac artery above and below the fistula in conjunction wit...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

A rare case of total anomalous pulmonary venous connection with intact interatrial septum
We report a rare case of obstructed supracardiac TAPVC with the absence of interatrial communication and with multiple ventricle septal defects (VSDs) in a 3-month-old child. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

The controversy continues. It is a matter of strategy, a matter of delivery, a combination of both? Or Dhoni vs Dev vs Jadeja
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Relevance of Guidelines
AbstractDr. O.P. Yadava, CEO& Chief Cardiac Surgeon, National Heart Institute, New Delhi, India, and Editor-in-Chief, Indian Journal of Thoracic and Cardiovascular Surgery, is in conversation with Dr. Philippe Kolh, Leige, Belgium, on Relevance of Guidelines. Dr. Kolh opined that though most recommendations may not be of level “A” yet, they are relevant and meaningful in optimum delivery of medicare. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 13, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart transplantation in India —looking back as we celebrate 25 years of the transplant law
AbstractIndia ’s heart transplantation programme is the number one programme in South Asia with an average heart transplantation rate of 0.2 per million population (pmp) versus the global average of 1.06 pmp (2016-2018). The deceased donation rate was 0.67 pmp in India in 2018. The law which made it possible has completed 25 years. In the first 5 years, after the law was passed, less than 50 hearts had been transplanted. The foundation for the deceased donation programme was laid through the creation of an ‘Organ Sharing Network’ in the year 2000 by Multi Organ Harvesting Aid Netw...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 11, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

“Repair of common atrioventricular junction in isolation and when associated with other congenital heart defects”
AbstractManagement of atrioventricular septal defects has grown leaps and bounds since the first correction of this malformation. Main reasons considered for the improvement are good understanding of lesion anatomy, precise preoperative diagnosis including imaging, progress in surgical technique, myocardial protection, and post-operative care. In this article we review the anatomy, pathophysiology, clinical features, associations, diagnosis, surgical therapy, complications, and results of atrioventricular septal defects. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 11, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

NOBLE trial —is it time to revise the guidelines?
AbstractThe Nordic –Baltic–British left main revascularization trial (NOBLE) is a prospective, randomized, multicentre, non-inferiority trial comparing percutaneous coronary angioplasty (PCI) with coronary artery bypass grafting (CABG) for revascularization of patients with unprotected left main coronary artery (L MCA) stenosis. The primary outcome was a combined endpoint of all-cause mortality, stroke, non-procedural myocardial infarction and repeat revascularization. CABG was found to be superior to PCI with respect to the 5-year MACCE rates (28% vs. 19%) with a hazard ratio (HR) of 1.58 (95% CI 1.24–2....
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 11, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sutureless hemostasis of a coronary sinus rupture with Hydrofit
We report successful repair of a CSR in a 68-year-old man who underwent total arch replacement for type A acute aortic dissection. CSR was caused by the coronary sinus cannulation for retrograde cardioplegia and was detected during cardiopulmonary bypass weaning. We applied an elastomeric sealant with a bovine pericardium patch on the beating heart. After manual compression for 2  min, complete hemostasis was achieved. A clampless and sutureless hemostasis for repairing coronary sinus rupture is a simple, fast, and effective technique. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 11, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Acute cardio-embolic stroke in a preschooler —a surgical dilemma
We present a rare case of acute cardio-embolic stroke in a 3-year-old child due to left atrial myxoma which was successfully treated. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - June 6, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sepsis and ECMO
AbstractSepsis is being recognized as an important complication of extracorporeal membrane oxygenation (ECMO) and its presence is a poor prognostic marker and increases the overall mortality. The survival rate differs in the various types of cannulation techniques. Adult patients with prolonged duration of ECMO constitute the major risk population. Ventilator-associated pneumonia and bloodstream infections form the main sources of sepsis in these patients. It is important to know the most common etiological agents for sepsis in ECMO, which varies partly with the local epidemiology of the hospitals. A high index of suspicio...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - May 14, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

An unusual case of Aspergillus endocarditis of native aortic valve following ECMO
AbstractFungal endocarditis following Extracorporeal membrane oxygenation (ECMO) is rare and very rarely reported. Though rare it has a high mortality rate. A 49-year-old male patient who had venovenous ECMO presented with aortic valve endocarditis after 40 days. He underwent sutureless bioprosthehtic valve placement and debridement of abscess. Abscess fluid grew aspergillus species and was started on dual antifungal intravenous amphotericin and variconazole. He was discharged after 1 month with oral variconazole. Incidence of aseptic endocarditis (AE) has been on rise due to increase in invasive procedures. Blood culture ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - May 11, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

A systematic review and meta-analysis of the clinical outcomes of TAVI versus SAVR in the octogenarian population
DiscussionThe analysed data on TAVI versus SAVR in the octogenarian population show that TAVI shows similar outcomes with relation to mortality and inpatient admission times, in a population with significantly higher risk profiles than their SAVR counterparts. TAVI has higher occurrences of post-procedural AR. TAVI still does not have robust long-term data to ensure its efficacy and rate of complications, but is showing promising results nonetheless. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - May 6, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research