Insulin and glucose infusion could prevent euglycemic diabetic ketoacidosis associated with sodium-glucose cotransporter 2 inhibitors
AbstractPerioperative euglycemic diabetic ketoacidosis (euDKA) is a serious adverse effect of sodium-glucose cotransporter 2 inhibitor (SGLT2i) treatment. We observed perioperative euDKA immediately after discontinuing insulin infusion that was started during surgery in a patient with type 2 diabetes mellitus (T2DM) for whom empagliflozin could not be withdrawn before emergency off-pump coronary artery bypass grafting (OPCAB). Insulin infusion that was started during surgery unexpectedly prevented euDKA until its discontinuation. Therefore, we hypothesized that insulin and glucose infusion initiated at the start of emergen...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 29, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

A rare case of Neuhauser syndrome associated with a Kommerell diverticulum
We describe a case with the association with a computed tomograph y scanner aortic reconstruction and a repair’s operative strategy. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 29, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally invasive extended thymectomy for thymoma associated with pure red cell aplasia
AbstractAnaemia characterised by near absence of red cell precursors in the bone marrow is referred to as “pure red cell aplasia (PRCA).” It has an unusual and intriguing association with thymoma and auto-immunity. Here, we report such a case which was successfully treated with extended thymectomy by minimally invasive approach. A 68-year-old anaemic lady presented to our institute with weakness and exertional dyspnoea for almost a year. She was transfused with blood for the same periodically but remained transfusion dependent. Apart from pallor, her systemic examination was unremarkable. Peripheral smear showe...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 27, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

“Branch-First total arch replacement”: a valuable alternative to frozen elephant trunk in acute type A aortic dissection?
AbstractThe “Branch-First total arch replacement” technique has been used extensively in both elective and acute situations, including in type A aortic dissection. The focus of the Branch-First technique is to reduce the risk of neurological and end-organ dysfunction associated with arch replacement by opti mising neuroprotection, distal organ perfusion and myocardial protection. The Branch-First technique is a valuable alternative to the frozen elephant trunk (FET) technique in type A aortic dissection, providing a stable landing zone for subsequent interventions on the distal aorta should they be req uired. C...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 25, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sutureless valves —are we there yet? Evidence from the PERSIST-AVR trial
AbstractSutur eless valves have emerged as another option for implantation of a biological valve. Several benefits of sutureless valves have been reported in the literature. However, concerns have been raised over increased incidence of para-valvular leak and need for permanent pacemaker implantation. Most of the evidence has been obtained from observational and retrospective single institutional series. The Perceval Sutureless Implant Versus Standard-Aortic Valve Replacement (PERSIST-AVR) trial is the first multicentric randomized control trial to compare sutureless valves with standard bio-prosthesis. Evidence from thi...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 23, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Giant isolated iliac artery aneurysm with ipsilateral hydronephrosis treated with aneurysm resection and extra-anatomic bypass
AbstractIsolated iliac artery aneurysms are rare and very rarely it may lead to hydronephrosis. The majority of uncomplicated iliac artery aneurysms can be managed with endovascular interventions but large complicated iliac artery aneurysms with compression on adjacent structures may require open surgery. We share our experience of a case of a large isolated iliac artery aneurysm with compression of the ureter probably leading to ureteric calculi and hydronephrosis on the ipsilateral side. The patient was managed with aneurysm resection and extra-anatomic bypass. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 23, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac tamponade as a presentation of COVID-19 after cardiac surgery
We present two patients who turned positive for coronavirus disease 2019 (COVID-19) after elective cardiac surgery, developing postoperative pericardial effusion with tamponade. One of the patients who presented with tamponade had no other symptoms of COVID-19 infection. COVID-19 can rarely present with cardiac manifestations including pericardial effusion and tamponade. In the post cardiac surgery setting, this effect of the virus may be accentuated. Hence, a high index of suspicion and prompt management are the keys for a successful outcome. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 23, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Thoracic hydatid cysts: an analysis of surgical management in a tertiary care centre in India
ConclusionSurgery, the treatment of choice for THD, can be done with negligible morbidity and mortality and should be expedited to prevent complications. Risk factors should be identified pre-operatively for better decision-making. Adequate concurrent medical therapy may prevent recurrences. Prolonged follow-up is mandatory to detect late recurrences. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 19, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of staged repair versus single-stage complete repair for pulmonary atresia with ventricular septal defect: A systematic review and meta-analysis
ConclusionSingle-staged early CR of PAVSD significantly reduced total mortality rate as compared with SR. However, there is life-long risk of frequent need for RVOT re-interventions. Future high-quality randomised studies with robust methodological qualities are encouraged to evaluate the optimal timing and technique for repair of PAVSD, by analysing more outcomes in large patient groups and multi-centre studies. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 18, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Chronic lung allograft dysfunction
AbstractLung transplantation remains the only cure for selected patients with advanced irreversible lung diseases. More than 4000 lung transplants are performed worldwide annually. In the last two decades, significant advances have been made in this arena, the most impactful being a modest but improved survival of the recipients. Unfortunately majority of recipients still succumb to chronic lung allograft dysfunction (CLAD), and it remains the most common cause of death after the first year of transplantation. Below is a concise review of the current definition of CLAD, including the various phenotypes, and  a brief d...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 16, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Internal mammary arteries as major blood supply to lower limb in coronary artery disease with peripheral vascular disease
We describe a case of severe peripheral vascular disease in a patient presenting for coronary artery bypass grafting (CABG). There was an occlusion of the abdominal aorta with collaterals from the internal mammary arteries (IMA) and inferior epigastric arteries (IEA) supplying the lower limb. Off-pump CABG was carried out without harvesting the IMA. In presence of concomitant severe peripheral vascular disease, lower limb blood flow should be evaluated with Doppler ultrasound, and in selected cases, computed tomography angiogram should be performed to rule out IMA-IEA collaterals dependent limb perfusion. (Source: Indian J...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 13, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart failure — does ejection fraction hold any relevance?
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 13, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary artery disease in aortic aneurysm and dissection
This article reviewed the data, consensus, and remaining controversy about the diagnosis and management of coexisting coronary artery disease in the patients who require intervention for aortic aneurysm and dissection. It can be summarized as follows: (1) the current guidelines generally recommend the same diagnostic algorithm, including indications of coronary artery angiography, as one for non-surgical patients; (2) they also recommend the same indications of coronary revascularization; and (3) there are minor, but important, remaining issues regarding the details of management and surgical techniques most of which are s...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 8, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Complete internal carotid artery coil after huge carotid body tumor resection
AbstractIn this brief article, we present an 82-year-old female who came to our care due to a carotid body tumor of the right side of the neck. After an uneventful removal of the tumor, we discovered a 360-degree coil in the internal carotid artery which was not observed in the preoperative imaging. After resection, we believe that the free space left by the large tumor and prior mass effect of the tumor on the internal carotid artery have led to carotid coiling. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 8, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Flexible fibre optic bronchoscopy as angioscope to ascertain completeness of pulmonary embolectomy: surgery for pulmonary embolism —how I do it
AbstractRarely pulmonary embolectomy has also been used as a salvage procedure for acute right ventricle (RV) dysfunction following acute pulmonary embolism (APE). Complete surgical removal of thromboembolus in acute pulmonary thromboembolism is an essential pre-requisite for good outcome. Complete clearance of thromboembolic load from pulmonary arterial tree is difficult to assess intraoperatively. We hereby describe the use of flexible fibre optic bronchoscope (FFB) as angioscope to visualise the pulmonary arterial tree intraoperatively. Angioscopy ascertains the complete clearance up to subsegmental level after thromboe...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 6, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Blood culture –negative endocarditis caused by Bartonella henselae: a case report
AbstractBartonella henselae is well known as a causative organism of cat scratch disease. Although this bacterium infrequently involves the heart, the diagnosis is difficult to confirm. A 75-year-old woman who had a pet cat presented with pancytopenia, hepatosplenomegaly, and low-grade fever. Echocardiography depicted sessile nodules on the aortic valve. C-reactive protein concentration was low, and leukocytosis was not seen. Two sets of blood culture turned out negative. However, elevatedB. henselae immunoglobulin G titer led us to the diagnosis of infective endocarditis. Minocycline was administered orally in combination...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 5, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Perioperative right ventricular function and dysfunction in adult cardiac surgery —focused review (part 2—management of right ventricular failure)
AbstractThe single most important factor in improving outcomes in right ventricular (RV) failure is anticipating and recognizing it. Once established, a vicious circle of systemic hypotension, and RV ischemia and dilation, occurs, leading to cardiogenic shock, multi-organ failure, and death. RV dysfunction and failure theoretically can occur in three settings —increase in the pre-load; increase in after load; and decrease in contractility. For patients deemed low risk for the development of RV failure, when it occurs, the correction of underlying cause is the most important and effective treatment strategy. Therapy o...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 4, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Pandemic created clinical eclipse: hemosiderosis versus COVID-19 pneumonia
AbstractIn the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the physician finds difficulty in differentiating the symptoms due to cardiac disease from that of SARS-CoV-2. We would like to present one such mystified situation (hemosiderosis versus SARS-CoV-2 pneumonia) we encountered. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 4, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally invasive surgery in the treatment of triple vessel coronary artery disease with coexisting coronary artery fistula
AbstractCoexistence of triple vessel coronary artery disease with coronary-pulmonary artery fistula is extremely rare. Minimally invasive cardiac surgery in the treatment of such coexisting disease is so far not reported. This case report emphasizes the feasibility of performing complete revascularization of the coronaries with coronary artery fistula ligation through a minimally invasive anterior thoracotomy, obviating full sternotomy. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - November 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Pulmonary endarterectomy
AbstractChronic thromboembolic pulmonary hypertension is an underdiagnosed condition. Patients typically present with the symptoms of right heart failure. Diagnosis is usually done by radionuclide ventilation/perfusion (VQ) scan, high-quality multidetector computed tomography (CT) or pulmonary angiography at expert centers. Pulmonary endarterectomy remains the corner stone in management of chronic thromboembolic pulmonary hypertension. Deep hypothermic circulatory arrest is commonly used for the operation at most centers. In-hospital mortality ranges from 1.7 to 14.2%. Pulmonary hemorrhage, reperfusion lung injury, and rig...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 26, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Successful open surgical repair of large ilio-caval fistula presenting with congestive heart failure
We report a case of 40-year gentleman presenting with symptoms of congestive heart failure and continuous murmur heard over right iliac fossa. His past history was significant for lumbar disc surgery done twice 1  year back. Computed tomography angiogram confirmed a large fistulous communication between right common iliac artery and inferior vena cava. Open surgical repair was performed as the fistula was not well suited for endovascular repair. We successfully managed this case by open surgical ligation of right common iliac artery proximal and distal to fistula and continuity restored with interposition Dacron graft...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 23, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hypertrophic cardiomyopathy with associated ventricular non-compaction —double whammy
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 22, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Total anomalous origin of the coronary arteries from the right pulmonary artery
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 22, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Non-pulmonary  complications after lung transplantation: part II
AbstractLung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. These complications are, therefore, becoming increasingly relevant as patients with LT are living longer. These complications encompass almost all organ systems and are driven by a combination of t...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 12, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Non-pulmonary  complications after lung transplantation: Part I
AbstractLung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. These complications are, therefore, becoming increasingly relevant as patients with LT are living longer. These complications encompass almost all organ systems and are driven by a combination of t...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 8, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Heart transplantation for patients with single ventricle physiology
ConclusionTransplantation in patients with single ventricle and ventricular dysfunction can be offered with a good early and late outcome. There is a need to have multi-institutional and multi-disciplinary collaboration along with work in basic sciences to better understand the effects of failed Fontan physiology with normal ventricular function. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 7, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

On-pump beating heart versus off-pump myocardial revascularization —a propensity-matched comparison
ConclusionsOP-BH CABG is associated with worse clinical outcomes compared to patients undergoing OPCAB. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 6, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Open access —is it the way forward?
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - October 4, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Techniques to avoid hypothermic circulatory arrest in the management of renal tumor with right atrium extension in children
AbstractClear cell sarcoma of the kidney is a rare variety of renal tumor accounting for less than 5% of all pediatric renal tumors. Cardiopulmonary bypass along with hypothermic circulatory arrest is frequently used for management of tumor thrombus extending into supra-hepatic inferior vena cava and right atrium. In this paper, we present a strategy of avoiding circulatory arrest and hypothermia and thereby fast-tracking the recovery in managing a case of clear cell sarcoma of the kidney in a 3.5-year-old child with tumor thrombus extending into the right atrium. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 29, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Double cobra head technique of distal coronary anastomosis
AbstractIn 1967, Dr. Ren é Favaloro introduced the use of reversed greater saphenous vein graft for coronary artery bypass grafting, since then a lot of efforts were made to improve the venous graft patency rate. We introduce a novel double cobra head technique of distal coronary anastomosis for better distal runoff. We ex pect our technique will help in difficult situations such as limited conduit availability and target vessel with bifurcation lesions. Refining our surgical techniques is essential to keep ourselves well equipped to compete with the rapidly evolving stent culture. (Source: Indian Journal of Thoraci...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 28, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Rheumatic mitral valve repair in the developing world: ‘a very different ball game’
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 28, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

A giant ascending aortic aneurysm in a patient with previous aortic valve replacement
AbstractA 64-year male presented with dyspnoea for 2 months. At age of 40 years, he underwent aortic valve replacement. Presently, his echocardiogram reveals a normal functioning prosthetic valve, moderate left ventricular dysfunction and a large ascending aortic aneurysm. A computer tomography aortogram shows a large ascending aortic aneurysm (maximum diameter: 12.2 ×13.5cm, length: 11.9cm). He underwent prosthetic valve-sparing aortic root replacement with hemiarch replacement. To our best of knowledge, this is the largest reported ascending aortic aneurysm among the Asian population. (Source: Indian ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 21, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Roving pen
AbstractCardiac surgeons wish to spare most of their time in the operating rooms with their patients. However, in their busy schedule, sparing few minutes to update  with the important global research is quite essential. These are summaries of few recent articles in cardiac surgery from important journals which might help in better patient care. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 20, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Migration and surgical retrieval of transcatheter aortic valve
We report a case of the migrated transcatheter aortic valve that required surgical intervention for its removal. The case highlights the importance of the availability of a cardiac surgical team and cardiopulmonary bypass machine when the percutaneous technique of retrieval is not feasible. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 20, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Lung transplantation: how we do it
AbstractLung transplantation is considered the gold standard for patients with chronic end-stage pulmonary disease. However, due to the complexity of management and relatively lower median survival as compared to other solid organs, many programs across the world have been slow to adopt the same. In our institution, we started lung transplantation in September 1990. And since then, we performed close to 900 lung transplantations. Here, we describe in detail the operative steps adopted in our institution for a successful lung transplantation. There have been very few variations over the years. We believe that having a stand...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 18, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Caecal bascule following lung transplantation
We describe a case report of caecal bascule following lung transplantation which required right hemicolectomy. It was initially thought to be due to post-operative paralytic ileus which is, not uncommonly, seen following lung transplantation. While most cases of paralytic ileus respond to conservative measures, it is important to maintain a close watch —keeping in mind a high degree of suspicion for possible surgically correctable causes, which can be a lifesaving intervention. The clinical dilemma in subjecting a heavily immunosuppressed patient, soon after lung transplantation (where painless abdominal distention i...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Induction and maintenance immunosuppression in lung transplantation
AbstractImmunosuppression for lung transplant recipients is a critical part of post-transplant care, to prevent acute and chronic rejection. Treatment protocols consist of induction and maintenance immunotherapy. Induction agents provide an immediate state of immunosuppression following transplantation and over time, and their use has become more commonplace. Several agents are available for clinical use, including anti-thymocyte globulin, alemtuzumab, and basiliximab, the latter being most commonly employed. Each induction agent has unique side effects and caveats to their use, of which we must be aware. Maintenance immun...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Management of the brain-dead organ donor
AbstractOrgan transplantation is a life-saving intervention for patients suffering from end-stage organ failure, but it relies on the availability of donor organs. However, even when donors are available, the brain-dead organ donor is a clinically complex patient who presents many management challenges. Donor management with a goal of optimization of organ function is essential to maximizing the number of patients who can be helped by each individual donor. Thoughtful critical care management of the potential organ donor, with a focus on meeting donor management goals, can lead to improved donation outcomes. (Source: India...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Usefulness of transaortic approach for a complex double-outlet right ventricle
We describe the transaortic approach as an alternative procedure to repair a complex case of double-outlet right ventricle (DORV) with subaortic stenosis. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early outcomes of cardiac surgical patients who developed COVID-19 in the peri-operative period —results from an online survey
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 17, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Donor quality assessment and size match in lung transplantation
AbstractCareful donor quality assessment and size match can impact long-term survival in lung transplantation. With this article, we review the conceptual and practical aspects of the preoperative donor lung quality assessment and size matching. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 15, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Methaemoglobinemia with impending rupture of descending thoracic aneurysm
AbstractMethaemoglobinemia was detected incidentally in the operating room before major aortic surgery. It was treated successfully with methylene blue, and successful replacement of the descending thoracic aorta was done the next day under cardiopulmonary bypass and circulatory arrest. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 9, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Giant cystic pulmonary hamartoma —images
AbstractHamartoma is the commonest benign tumor of the lung. They usually present as an asymptomatic solitary solid nodule of varying size, located peripherally in the lung parenchyma and picked up incidentally in a chest X-ray. Rarely, they may be intra-bronchial in location. A giant cystic variant of hamartoma is very rare, with only a few cases reported in literature so far. It may be misdiagnosed as any other cystic disease of the lung and thus get mismanaged. We herewith present the images of a patient with a giant cystic pulmonary hamartoma who presented with respiratory distress. (Source: Indian Journal of Thoracic ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 8, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Training and mentoring of the congenital heart surgeon for India
AbstractCongenital heart surgery is one of the most demanding subspecialities in surgery. To become a competent surgeon, a lot of investment of time, in-depth study, training under a committed mentor, acquisition of the necessary fine surgical skills, and development of a three-dimensional appreciation of corrections are needed to be cultivated. These make it not only a speciality of skills, but also a cerebral speciality. It is commonly felt amongst the residents training in cardiovascular and thoracic surgery that they perform far less operative work to make them even “somewhat” confident of doing procedures ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 7, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Novel technique of achieving hemodynamic stability during systemic to pulmonary artery shunt
AbstractHistorically, the Blalock Taussig (BT) shunt has been an off-pump procedure. For the last two decades, the number of BT shunt operations has come down globally with the adoption of neonatal early corrective surgery. BT shunts are still performed for augmentation of pulmonary arterial (PA) growth or as a part of univentricular palliation. Many infants do not tolerate PA branch clamping while undergoing the graft to PA anastomosis, necessitating institution of cardiopulmonary bypass (CPB). Since the threshold to go on CPB for shunt placement is quite low at most institutions, our technical modification described can ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 7, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Practical considerations for developing a lung transplantation anesthesiology program
AbstractThe advancement in lung transplantation outcomes has been secondary to ongoing improvements within multiple medical specialties. The recent emergence of literature describing the impact of anesthetic management on perioperative outcomes has led to the beginnings of formalized training fellowships within lung transplantation anesthesiology. Practical considerations for the development of a lung transplantation anesthesiology program, both clinical and educational, are herein described. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 3, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Intrapulmonary mature teratoma: an unusual finding
We present the case of a 37-year-old man who presented for evaluation due to persistent and progressive intermittent cough. There was no sputum or hemoptysis. Computed tomography (CT) revealed an irregular, cystic lesion in the upper lobe of his left lung, which raised suspicion for aspergilloma. The patient underwent a left thoracotomy and, after finding a completely collapsed and hypoplastic left lung almost entirely occupied by an irregular mass, a total left pneumonectomy was performed. Pathological review reported an entirely intrapulmonary mature teratoma. Intrapulmonary mature teratomas are extremely rare, although ...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 3, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Virtual reality: a useful simulation tool for planning and training
(Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - September 1, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac transplantation for cardiomyopathy with constrictive pericarditis
We report two distinct cases with cardiomyopat hy requiring cardiac transplantation and the clinical implications of concomitant pericardial constriction. While the first case mimics a natural “cardiac support device,” which addresses ventricular remodeling in heart failure by reducing the wall stress, the second case is a case in point agai nst the use of “biological pericardial membrane—like the bovine pericardium,” as a pericardial substitute. (Source: Indian Journal of Thoracic and Cardiovascular Surgery)
Source: Indian Journal of Thoracic and Cardiovascular Surgery - August 25, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sternectomy for Candida albicans sternal osteomyelitis after left ventricular assist device implantation
AbstractFungal osteomyelitis is an uncommon complication after cardiac surgery and associated with high mortality. A case ofCandida albicans andStaphylococcus epidermidis osteomyelitis with device infection after implantation of a left ventricular assist device in a 60-year-old male patient is presented here. After clinical identification and confirmation with microbiological examinations and fluorodeoxyglucose positron emission tomography (FDG-PET) scan, debridement was performed. Surgical specimens grewC. albicans andS. epidermidis. Fluconazole, daptomycin, and negative pressure wound therapy were initiated, but failed t...
Source: Indian Journal of Thoracic and Cardiovascular Surgery - August 25, 2021 Category: Cardiovascular & Thoracic Surgery Source Type: research